Shift work and overall and cause-specific mortality in the Danish nurse cohort
Shift work and overall and cause-specific mortality in the Danish nurse cohort
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DOI：
10.5271/sjweh.3612
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发表时间：
2017-03-01
影响因子：
6.3
通讯作者：
Andersen, Zorana Jovanovic
中科院分区：
文献类型：
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作者：
Jorgensen, Jeanette Therming;Karlsen, Sashia;Andersen, Zorana Jovanovic
目的倒班工作对全因死亡率和特定原因死亡率影响的证据是不一致的。本研究旨在探讨轮班工作是否与全因死亡率和特定原因死亡率的增加有关。方法：我们将1993年或1999年从丹麦护士队列中招募的28731名女护士（年龄0 = 44岁）与丹麦死亡原因登记册联系起来，以确定截至2013年的死亡情况，这些护士报告了轮班工作（夜间、傍晚、轮岗或日间）的信息。我们使用Cox回归模型，以年龄作为基础尺度，检查夜班、晚班和轮班工作（与白班工作相比）与模型中潜在混淆变量调整后的全因和病因特异性死亡率之间的关系。结果纳入本研究的18015名护士中，1616名在研究期间因以下原因死亡：心血管疾病（N=217）、癌症（N=945）、糖尿病（N=20）、阿尔茨海默病或痴呆（N=33）、精神疾病（N=67）。我们发现，夜班[危险比（HR） 1.26, 95%可信区间95% CI) 1.05-1.51]或夜班（HR 1.29, 95% CI 1.11-1.49）与白班相比，全因死亡率显著增加相关。我们发现夜班工作与心血管疾病（HR 1.71, 95% CI 1.09-2.69）和糖尿病（HR 12.0, 95% CI 3.17-45.2，基于8例）有显著关联，但与总体癌症死亡率（HR 1.05, 95% CI 0.81-1.35）或精神疾病死亡率（HR 1.17, 95% CI 0.47-2.92）无关。最后，我们发现夜班（HR 4.28, 95% CI 1.62-11.3）和轮班（HR 5.39, 95% CI 2.35-12.3）与阿尔茨海默病和痴呆症死亡率之间存在强烈关联（基于夜班和轮班工人分别有8人和14人死亡）。结论：上夜班和夜班的女性增加了全因、心血管、糖尿病、阿尔茨海默病和痴呆症的死亡率。
Objectives Evidence of an effect of shift work on all-cause and cause-specific mortality is inconsistent. This study aimed to examine whether shift work is associated with increased all-cause and cause-specific mortality.Methods We linked 28 731 female nurses (age >= 44 years), recruited in 1993 or 1999 from the Danish nurse cohort where they reported information on shift work (night, evening, rotating, or day), to the Danish Register of Causes of Death to identify deaths up to 2013. We used Cox regression models with age as the underlying scale to examine the associations between night, evening, and rotating shift work (compared to day shift work) and all-cause and cause-specific mortality in models adjusted for potentially confounding variables.Results Of 18 015 nurses included in this study, 1616 died during the study time period from the following causes: cardiovascular disease (N=217), cancer (N=945), diabetes (N=20), Alzheimer's disease or dementia (N=33), and psychiatric diseases (N=67). We found that working night [hazard ratio (HR) 1.26, 95% confidence interval 95% CI) 1.05-1.51] or evening (HR 1.29, 95% CI 1.11-1.49) shifts was associated with a significant increase in all-cause mortality when compared to working day shift. We found a significant association of night shift work with cardiovascular disease (HR 1.71, 95% CI 1.09-2.69) and diabetes (HR 12.0, 95% CI 3.17-45.2, based on 8 cases) and none with overall cancer mortality (HR 1.05, 95% CI 0.81-1.35) or mortality from psychiatric diseases (HR 1.17, 95% CI 0.47-2.92). Finally, we found strong association between evening (HR 4.28, 95% CI 1.62-11.3) and rotating (HR 5.39, 95% CI 2.35-12.3) shift work and mortality from Alzheimer's disease and dementia (based on 8 and 14 deaths among evening and rotating shift workers, respectively).Conclusions Women working night and evening shifts have increased all-cause, cardiovascular, diabetes, and Alzheimer's and dementia mortality.