Nested case-control study of night shift work and breast cancer risk among women in the Danish military
Nested case-control study of night shift work and breast cancer risk among women in the Danish military
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DOI：
10.1136/oemed-2011-100240
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发表时间：
2012-08-01
影响因子：
4.9
通讯作者：
Lassen, Christina F.
中科院分区：
文献类型：
--
作者：
Hansen, Johnni;Lassen, Christina F.
目的 越来越多但有限的证据表明夜班工作与乳腺癌有关。作者对 1929-1968 年出生的 18 551 名女军人进行了一项全国范围的病例对照研究，以调查夜班工作后患乳腺癌的风险，并探讨休闲时间阳光照射和昼间偏好的作用。 方法 作者记录了 218 例乳腺癌病例（1990-2003 年），并通过发病密度抽样从队列中选择了 899 名年龄匹配的对照。有关轮班工作、阳光照射习惯、昼夜偏好和其他潜在混杂因素的信息是通过结构化调查问卷获得的。 OR 通过多变量条件逻辑回归进行估计。 结果 总体而言，作者观察到，与从未上夜班的女性相比，调整后的 OR 为 1.4（95% CI 0.9 至 2.1）。乳腺癌的 RR 往往随着夜班工作年数的增加 (p=0.03) 和累计轮班次数 (p=0.02) 的增加而增加，每周夜班少于 3 次的风险为中性。累积暴露最高三分位数组的 OR 为 2.3（95% CI 1.2 至 4.6）。夜班工作对乳腺癌风险的最显着影响在具有早晨睡眠时间型偏好和频繁夜班的女性中观察到（OR=3.9，95% CI 1.6 至 9.5）。夜班工人比日班工人更频繁地享受日光浴。 结论 结果表明，频繁的夜班工作会增加患乳腺癌的风险，并且高强度夜班时间越长，患乳腺癌的风险越高。偏好早班、上夜班的女性往往比偏好晚班的女性面临更高的风险。
Objectives Growing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case-control study nested within a cohort of 18 551 female military employees born in 1929-1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference.Methods The authors documented 218 cases of breast cancer (1990-2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression.Results Overall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02), with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers.Conclusions The results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.