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丹麦护士队列中的夜班工作与帕金森病发病率

Night work and incidence of Parkinson's disease in the Danish Nurse Cohort.

作者信息

Jørgensen Jeanette Therming, Schernhammer Eva, Papantoniou Kyriaki, Hansen Johnni, Westendorp Rudi G J, Stayner Leslie, Simonsen Mette Kildevæld, Andersen Zorana Jovanovic

机构信息

Public Health, University of Copenhagen, Copenhagen, Denmark

Department of Epidemiology, Medical University of Vienna, Wien, Wien, Austria.

出版信息

Occup Environ Med. 2020 Dec 15. doi: 10.1136/oemed-2020-107067.

Abstract

OBJECTIVES

Evidence on the association between night work and Parkinson's disease (PD) is sparse and conflicting, calling for more definitive studies.

METHODS

We included 20 138 female nurses from the Danish Nurse Cohort without PD who at baseline in 1993 and/or 1999 reported their most common current work schedule (day, evening, night, and rotating (a combination of at least two of these)), including information on lifetime cumulative duration (years) of each shift in a 2009 follow-up survey. We obtained information on PD hospital contacts and PD medication until November 2018 via linkage to the Danish National Patient (inpatient from 1977 and outpatient contacts from 1995 onwards) and Prescription Registers starting in 1995. We defined the incidence of PD as the first-ever hospital contact due to PD, or the first-ever redeemed levodopa prescription, whichever came first. We used Cox regression models to calculate HRs and 95% CIs, adjusting for age, smoking status, coffee consumption and use of hormone replacement therapy.

RESULTS

We found no significant difference in PD risk among nurses who reported working evening (HR=0.86; 95% CI=0.55 to 1.34), night (HR=1.26; 95% CI=0.79 to 2.02) or rotating shifts (HR=0.83; 95% CI=0.56 to 1.21) at cohort baseline in 1993 or 1999, when compared with permanent day workers. Similarly, persistency of shift work (working the same work schedule for 6+ years) or duration of shift work was not associated with PD risk.

CONCLUSIONS

Overall, there was little evidence for an association between various shift work schedules including night work and PD in this cohort of middle-aged female nurses.

摘要

目的

关于夜班工作与帕金森病(PD)之间关联的证据稀少且相互矛盾,需要更多确定性研究。

方法

我们纳入了丹麦护士队列中20138名无PD的女性护士,她们在1993年和/或1999年基线时报告了其最常见的当前工作时间表(白班、中班、夜班和轮班(至少包括其中两种的组合)),包括在2009年随访调查中每种班次的终生累积时长(年)信息。我们通过与丹麦国家患者登记处(1977年起的住院患者以及1995年起的门诊患者)和始于1995年的处方登记处建立联系,获取了截至2018年11月的PD住院接触和PD药物治疗信息。我们将PD的发病率定义为首次因PD住院接触,或首次开具左旋多巴处方,以先发生者为准。我们使用Cox回归模型计算风险比(HRs)和95%置信区间(CIs),并对年龄、吸烟状况、咖啡摄入量和激素替代疗法的使用进行了调整。

结果

我们发现,与长期白班工作者相比,在1993年或1999年队列基线时报告从事中班(HR = 0.86;95% CI = 0.55至1.34)、夜班(HR = 1.26;95% CI = 0.79至2.02)或轮班(HR = 0.83;95% CI = 0.56至1.21)工作的护士中,PD风险没有显著差异。同样,持续从事轮班工作(相同工作时间表持续6年以上)或轮班工作时长与PD风险无关。

结论

总体而言,在这一中年女性护士队列中,几乎没有证据表明包括夜班工作在内的各种轮班工作时间表与PD之间存在关联。

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