Hanif Ayesha, Okafor Donatus K, Katyal Gitika, Kaur Gursharan, Ashraf Hafsa, Bodapati Adiprasad, Nath Tuheen Sankar
Internal Medicine, Fatima Jinnah Medical University, Lahore, PAK.
Internal Medicine, California Institute of Behavioral Neurosciences & Psychology, Fairfield, USA.
Cureus. 2024 Oct 7;16(10):e71003. doi: 10.7759/cureus.71003. eCollection 2024 Oct.
Shift work has long been studied as a contributing risk factor for cardiovascular disease. This study aims to provide a comprehensive summary of data regarding shiftwork and its impact on the cardiovascular system from the last decade. It explores the association of shift schedules with multiple aspects of cardiovascular disease and the physiological processes that lead up to it. It also identifies gaps in current knowledge regarding the topic. Two hundred and sixty-eight articles were gathered from PubMed, Google Scholar, and Science Direct using relevant medical subject headings (MeSH) strategy and advanced search using keywords including 'Shift work,' 'Night shift,' 'Occupational health,' 'Circadian rhythm,' 'Cardiovascular disease,' 'Cardiovascular health.' The search was conducted in April and completed in May 2023. Systemic reviews, meta-analysis, cohort and cross-sectional studies from the last 10 years were included, and assessment of multiple systematic reviews (AMSTAR), Newcastle Ottawa, and Joanna Briggs Institute (JBI) tools were used, respectively, for quality assessment. A total of 14 articles were included in our review, including five systematic reviews and meta-analyses, six prospective cohort studies, and three cross-sectional studies. Each study reported a significant association between shift work with some aspect of cardiovascular disease. An increase in the risk of myocardial infarction, coronary heart disease, hypertension, atherosclerosis, and metabolic syndrome is reported. Circadian disruption, unhealthy diet, and emotional and physiological stress contribute to these effects. Oxidative damage and inflammatory biomarkers appear to play a role in this process, but more research is warranted for a deeper understanding of these changes. Despite an abundance of evidence pointing towards the short-term and long-term harm to shift workers' cardiovascular health, there is limited research regarding the policies that are needed to better monitor cardiovascular damage in employees. The focus needs to shift toward prevention-based policies and their efficacy in workplace settings.
长期以来，轮班工作一直被视为心血管疾病的一个促成风险因素。本研究旨在全面总结过去十年中有关轮班工作及其对心血管系统影响的数据。它探讨了轮班安排与心血管疾病多个方面的关联以及导致心血管疾病的生理过程。它还指出了当前关于该主题的知识空白。使用相关医学主题词（MeSH）策略，并通过包括“轮班工作”、“夜班”、“职业健康”、“昼夜节律”、“心血管疾病”、“心血管健康”等关键词进行高级搜索，从PubMed、谷歌学术和科学Direct收集了268篇文章。搜索于2023年4月进行，5月完成。纳入了过去10年的系统评价、荟萃分析、队列研究和横断面研究，并分别使用多系统评价评估（AMSTAR）、纽卡斯尔渥太华和乔安娜·布里格斯研究所（JBI）工具进行质量评估。我们的综述共纳入14篇文章，包括5篇系统评价和荟萃分析、6篇前瞻性队列研究和3篇横断面研究。每项研究都报告了轮班工作与心血管疾病某些方面之间存在显著关联。据报道，心肌梗死、冠心病、高血压、动脉粥样硬化和代谢综合征的风险增加。昼夜节律紊乱、不健康饮食以及情绪和生理压力导致了这些影响。氧化损伤和炎症生物标志物似乎在这一过程中起作用，但需要更多研究以更深入地了解这些变化。尽管有大量证据表明轮班工作对工人心血管健康有短期和长期危害，但关于更好地监测员工心血管损伤所需政策的研究有限。重点需要转向基于预防的政策及其在工作场所环境中的效果。
