Loef Bette, Bosma Esmee, van Kerkhof Linda W M, Proper Karin I, van Baarle Debbie, Dollé Martijn E T
Center for Prevention, Lifestyle and Health; National Institute for Public Health and the Environment; P.O. Box 1, 3720 BA, Bilthoven, The Netherlands.
Scand J Work Environ Health. 2025 Jul 1;51(4):298-311. doi: 10.5271/sjweh.4225. Epub 2025 Apr 6.
A growing body of research on infection susceptibility among night-shift workers has emerged, particularly since the COVID-19 pandemic. However, a comprehensive overview is still lacking. Therefore, this review aimed to synthesize the evidence on the association between night-shift work and susceptibility to infectious diseases.
Embase and PsycINFO were systematically searched for studies published up to September 2024. Studies were included if they comprised a working population, night-shift workers were compared to non-shift workers, and the outcome was an infectious disease. Results were descriptively synthesized for common respiratory infections (flu and common cold), SARS-CoV-2 infection, and other infections. Pooled effect estimates were calculated using random-effects meta-analysis.
In total, 16 articles describing 14 studies among 191 320 workers were included. Based on 4 studies, night-shift work was not associated with a significantly increased risk of common respiratory infections [odds ratio (OR) 1.11, 95% confidence interval (CI) 0.97-1.27, I=65.8%[. However, night-shift workers had a higher risk of SARS-CoV-2 infection than non-shift workers (OR 1.31, 95% CI 1.09-1.58, I=92.2%, N=10 studies). This association was stronger in higher-quality studies and studies conducted in the first year of the COVID-19 pandemic. For other infections, insufficient studies were available to conduct a meta-analysis. The certainty of evidence was graded very low due to a limited number of (prospective cohort) studies and high inconsistency in the available studies.
This systematic review and meta-analysis showed that night-shift work was associated with an increased risk of SARS-CoV-2 infection, but not of common respiratory infections. To address the lack of high-certainty evidence, more studies are needed that apply a prospective design with appropriate adjustment for confounding factors and more extensive information on night-shift work exposure.
尤其是自新冠疫情以来，关于夜班工作者感染易感性的研究越来越多。然而，仍缺乏全面的综述。因此，本综述旨在综合关于夜班工作与传染病易感性之间关联的证据。
系统检索Embase和PsycINFO数据库中截至2024年9月发表的研究。纳入的研究需包含工作人群，将夜班工作者与非夜班工作者进行比较，且结果为传染病。对常见呼吸道感染（流感和普通感冒）、新冠病毒感染及其他感染的结果进行描述性综合分析。使用随机效应荟萃分析计算合并效应估计值。
共纳入16篇文章，描述了191320名工作者中的14项研究。基于4项研究，夜班工作与常见呼吸道感染风险显著增加无关[比值比（OR）1.11，95%置信区间（CI）0.97 - 1.27，I² = 65.8%]。然而，夜班工作者感染新冠病毒的风险高于非夜班工作者（OR 1.31，95% CI 1.09 - 1.58，I² = 92.2%，n = 10项研究）。在高质量研究以及新冠疫情第一年进行的研究中，这种关联更强。对于其他感染，由于研究不足，无法进行荟萃分析。由于（前瞻性队列）研究数量有限且现有研究存在高度不一致性，证据的确定性等级为极低。
本系统综述和荟萃分析表明，夜班工作与新冠病毒感染风险增加有关，但与常见呼吸道感染无关。为解决高确定性证据不足的问题，需要更多采用前瞻性设计、对混杂因素进行适当调整并提供更广泛夜班工作暴露信息的研究。
