Hypotheses for mechanisms linking shiftwork and cancer
Hypotheses for mechanisms linking shiftwork and cancer
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DOI：
10.1016/j.mehy.2011.06.002
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发表时间：
2011-09-01
影响因子：
4.7
通讯作者：
Erren, T. C.
中科院分区：
文献类型：
--
作者：
Fritschi, L.;Glass, D. C.;Erren, T. C.
轮班工作与各种不良健康结果有关。特别是，最近在调查与夜班和其他轮班安排相关的潜在癌症风险方面取得了蓬勃发展。流行病学研究表明，由于缺乏轮班或夜间工作的标准分类等方法学上的挑战，两者之间的关联性普遍较弱。该领域还因轮班工作影响癌症风险的可能机制缺乏明确性而受到阻碍。一种可能的机制是夜间暴露在光线下导致褪黑激素的产生减少。尽管越来越多的证据为这一机制提供了一些支持，但从生物学角度来看，其他几种机制也有意义。此外，夜间光线与褪黑激素水平之间的关联程度相对较弱，这表明多种因素可能在轮班工作和不良健康后果（包括癌症风险）之间发挥作用。在这里，我们提出了四种额外的机制，应考虑对这些潜在途径进行全面调查。它们是： 相移；睡眠中断；生活方式因素（例如饮食质量差、体力活动较少和体重指数较高）；为了设计有效的预防性工作场所策略，必须考虑所有这些机制。在发达国家，大约 20% 的人口从事轮班工作，虽然我们不太可能从当前的工作实践中消除轮班工作，但轮班工作的某些方面是可以修改的，并且我们可以识别个人易感性的方面并进行预防。 (C) 2011 Elsevier Ltd. 保留所有权利。
Shift work has been associated with various adverse health outcomes. In particular, there has been a recent flourish in investigating potential cancer risk associated with working night shifts and other shift schedules. Epidemiologic studies have revealed generally weak associations due to several methodological challenges such as lack of standard classifications of shift or night work. The field also has been hindered by a lack of clarity about the possible mechanisms by which shiftwork could have an effect on cancer risk. One possible mechanism is reduced production of melatonin caused by exposure to light at night. Although there is a growing body of evidence that provides some support for this mechanism, several other mechanisms also make sense from a biological point of view. Further, the relatively weak magnitude of the associations between light at night and melatonin level suggests that multiple factors may be operating along the pathway between shift work and adverse health consequences (including cancer risk). Here we propose four additional mechanisms that should be considered for a comprehensive investigation of these potential pathways. These are: phase shift; sleep disruption; lifestyle factors (such as poor quality diets, less physical activity and higher BMI); and lower vitamin D. Consideration of all these mechanisms is necessary in order to design effective preventative workplace strategies. In developed countries, approximately 20% of the population undertake shiftwork and, while we are unlikely to be able to eliminate shiftwork from current work practices, there are aspects of shiftwork that can be modified and there may be facets of individual susceptibility that we may be able to identify and target for prevention. (C) 2011 Elsevier Ltd. All rights reserved.