Shift work, occupation and coronary heart disease over 6 years of follow-up in the Helsinki Heart Study
Shift work, occupation and coronary heart disease over 6 years of follow-up in the Helsinki Heart Study
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DOI：
10.5271/sjweh.218
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发表时间：
1997-08-01
影响因子：
6.3
通讯作者：
Harma, M
中科院分区：
文献类型：
--
作者：
Tenkanen, L;Sjoblom, T;Harma, M
目的探讨倒班工作中冠心病（CHD）发生的危险性及产业工人CHD发生的可能途径，并沿着探讨倒班工作作为CHD危险性职业梯度的重要性。方法采用心理社会问卷、生活方式因素、血压和血脂水平对1806名产业工人进行随访研究。CHD由芬兰官方登记确定。考克斯的比例风险模型与不同的协变量，以评估与轮班works.Results所有的蓝领工人吸烟更多，有较高的收缩压比白领工人的相对风险。在Karasek工作压力量表上，三班倒工人的工作决策自由度得分较低。总胆固醇或高密度脂蛋白胆固醇水平没有差异。当所有轮班工人与所有白天工人进行比较时，CHD的相对危险度为1.5 [95%置信区间（95%CI）1.1-2.1]，仅调整年龄，1.4（95%CI 1.0-1.9），当生活方式因素，育雏压力，血脂也调整。蓝领日工、2班和3班工人的相对危险度为1.3（95% CI 0.8-2.0），1.9（95% CI 1.1-3.4）和1.7结论倒班工作是产业工人冠心病危险性职业梯度的重要组成部分;一些证据被发现的假设，一个直接的压力相关的机制解释了冠心病风险增加的一部分。
Objectives The risk of coronary heart disease (CHD) in shift work and the possible pathways for CHD in industrial workers were studied along with the importance of shift work as an occupational class gradient of CHD risk.Methods Data from a psychosocial questionnaire and on life-style factors, brood pressure, and serum lipid levels were used for a follow-up study of a cohort of 1806 workers. CHD was determined from official Finnish registers. Cox's proportional hazards models were used with different covariates to evaluate the relative risks associated with shift work.Results All the blue-collar workers smoked more and a had higher systolic blood pressure than the white-collar workers. Three-shift workers scored low for job-decision latitude on the Karasek job stress scales. There were no differences in the total cholesterol or high-density lipoprotein cholesterol levels. When all the shift workers were compared with all the day workers, the relative risk of CHD was 1.5 [95% confidence interval (95% CI) 1.1-2.1] when only age was adjusted for and 1.4 (95% CI 1.0-1.9) when life-style factors, brood pressure, and serum lipids were also adjusted for. The blue-collar day workers and 2-shift and 3-shift workers had relative risks of 1.3 (95% CI 0.8-2.0), 1.9 (95% CI 1.1-3.4), and 1.7 (95% CI 1.1-2.7), respectively, when compared with the white-collar day workers.Conclusions shift work is an important part of the occupational gradient in CHD risk among industrial workers; some evidence was found for the hypothesis that a direct stress-related mechanism explains part of the increased CHD risk.