Total and cause-specific mortality of U.S. nurses working rotating night shifts.

Total and cause-specific mortality of U.S. nurses working rotating night shifts.
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DOI:
10.1016/j.amepre.2014.10.018
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发表时间:
2015-03
影响因子:
5.5
通讯作者:
Schernhammer ES
Schernhammer ES
中科院分区:
医学2区
文献类型:
--
作者:
Gu F;Han J;Laden F;Pan A;Caporaso NE;Stampfer MJ;Kawachi I;Rexrode KM;Willett WC;Hankinson SE;Speizer FE;Schernhammer ES

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轮流夜班工作会造成昼夜节律紧张,并与几种慢性疾病的风险有关。在护士健康研究的74,862名美国注册护士的前瞻性队列研究中,检查夜班工作与全因心血管疾病(CVD)和癌症死亡率之间的关系。在1988年收集了终生轮流夜班工作(定义为≥3晚/月)信息。在22年(1988-2010)的随访期间,记录了14,181例死亡,包括3,062例CVD和5,413例癌症死亡。考克斯比例风险模型(2013)估计了多变量校正的风险比(HR)和95% CI。与从未上过夜班的女性相比,有≥5年夜班轮换工作的女性的全因死亡率和心血管疾病死亡率显著增加。具体而言,对于6-14岁和≥15岁的轮班工作女性,全因死亡率的HR分别为1.11(95% CI=1.06,1.17)和1.11(95% CI=1.05,1.18),CVD死亡率的HR分别为1.19(95% CI=1.07,1.33)和1.23(95% CI=1.09,1.38)。除了肺癌(HR≥ 15岁=1.25,95% CI=1.04,1.51)外,夜班轮班工作与所有癌症死亡率(HR≥ 15岁=1.08,95% CI =0.89,1.19)或任何其他癌症死亡率之间均无相关性。从事夜班轮换工作≥ 5年的妇女,全因死亡率和心血管疾病死亡率略有增加;从事夜班轮换工作≥15年的妇女,肺癌死亡率略有增加。这些结果增加了先前的证据,表明夜班轮换工作对健康和寿命有潜在的不利影响。
Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. To examine associations between rotating night shift work and all-cause, cardiovascular disease (CVD), and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses’ Health Study. Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988–2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models (2013) estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6–14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.89, 1.19) or any other cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). Women working rotating night shifts for ≥5 five years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.
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