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工作时长作为日本急性心肌梗死的一个风险因素:病例对照研究。

Working hours as a risk factor for acute myocardial infarction in Japan: case-control study.

作者信息

Sokejima S, Kagamimori S

机构信息

Department of Welfare Promotion and Epidemiology, Faculty of Medicine, Toyama Medical and Pharmaceutical University, 2630 Sugitani, Toyama, 930-0194, Japan.

出版信息

BMJ. 1998 Sep 19;317(7161):775-80. doi: 10.1136/bmj.317.7161.775.

Abstract

OBJECTIVE

To clarify the extent to which working hours affect the risk of acute myocardial infarction, independent of established risk factors and occupational conditions.

DESIGN

Case-control study.

SETTING

University and general hospitals and routine medical examinations at workplaces in Japan.

SUBJECTS

Cases were 195 men aged 30-69 years admitted to hospital with acute myocardial infarction during 1990-3. Controls were 331 men matched at group level for age and occupation who were judged to be free of coronary heart diseases at routine medical examinations in the workplace.

MAIN OUTCOME MEASURES

Odds ratios for myocardial infarction in relation to previous mean daily working hours in a month and changes in mean working hours during previous year.

RESULTS

Compared with men with mean working hours of >7-9 hours, the odds ratio of acute myocardial infarction (adjusted for age and occupation) for men with working hours of >11 hours was 2.44 (95% confidence interval 1.26 to 4.73) and for men with working hours of <=7 hours was 3.07 (1.77 to 5.32). Compared with men who experienced an increase of <=1 hour in mean working hours, the adjusted odds ratio of myocardial infarction for men who experienced an increase of >3 hours was 2.53 (1.34 to 4. 77). No appreciable change was observed when odds ratios were adjusted for established and psychosocial risk factors for myocardial infarction.

CONCLUSION

There was a U shaped relation between the mean working hours and the risk of acute myocardial infarction. There also seemed to be a trend for the risk of infarction to increase with greater increases in mean working hours.

摘要

目的

明确工作时长对急性心肌梗死风险的影响程度,该影响独立于既定风险因素和职业条件。

设计

病例对照研究。

地点

日本的大学医院、综合医院以及工作场所的常规体检。

研究对象

病例为1990 - 1993年间因急性心肌梗死入院的195名30 - 69岁男性。对照为331名在年龄和职业上按组匹配的男性,他们在工作场所的常规体检中被判定无冠心病。

主要观察指标

一个月内既往平均每日工作时长以及上一年平均工作时长变化与心肌梗死的比值比。

结果

与平均工作时长>7 - 9小时的男性相比,工作时长>11小时男性的急性心肌梗死比值比(经年龄和职业调整)为2.44(95%置信区间1.26至4.73),工作时长≤7小时男性的比值比为3.07(1.77至5.32)。与平均工作时长增加≤1小时的男性相比,平均工作时长增加>3小时男性的心肌梗死调整后比值比为2.53(1.34至4.77)。在对心肌梗死的既定风险因素和社会心理风险因素进行调整后,未观察到比值比有明显变化。

结论

平均工作时长与急性心肌梗死风险之间呈U型关系。随着平均工作时长增加幅度增大,梗死风险似乎也有增加趋势。

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