Minimizing Cancer Risk in Shift Workers

最大限度地降低轮班工人的癌症风险

• 批准号: 8124956
• 负责人: EVA S SCHERNHAMMER
• 金额: $ 29.9万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8124956
• 关键词: Minimizing; Cancer; Risk; Shift; Workers

DESCRIPTION (provided by applicant): Almost 15 million Americans regularly work alternate shifts, including evening, night, and rotating shifts. Shift work is integral to the modern work force, which spans all age and ethnic groups. Observational studies have consistently associated rotating shift work with increases in cancer risk, prompting the WHO in December 2007 to classify night shift work a probable carcinogen - the main operating mechanism being assumed circadian disruption by means of melatonin suppression. Based on results from the Nurses' Health Study II (NHS2), in March 2009, Denmark as the first country worldwide began paying monetary compensation to women who developed breast cancer after 20 or more years of night shift work. Because no definitive strategy currently exists to reduce the cancer risk associated with shift work-induced circadian disruption, determining what aspects of shift schedules are most detrimental to health is the next frontier in shift work and disease prevention. To date, no study has examined how specific aspects of shift schedules including length, frequency of rotation, and hours worked per week interact and relate to cancer risk. Moreover, whether there is an age range at which people are particularly vulnerable to the effects of circadian disruption also remains unclear. Future research would benefit from a clear and complete description of work schedules and their effects on human cancer risk. In 2009, we have added a battery of shift work questions to the main NHS2 questionnaire. We newly assess specific aspects of the nurses' work schedule including types of shift schedules and changes throughout their professional career. In addition, other factors of potential relevance to circadian disruption were assessed, including morningness-eveningness and sleep duration during each of the various life time periods. To evaluate the hypothesis that certain aspects of shift work schedules are more strongly associated with breast cancer risk than others, we will use both a cohort and cross-sectional study approach. We estimate 1,108 newly diagnosed cases of breast cancer between 2009 and 2013. We will use these cases, as well as prevalent cases to enhance the power of subanalyses, for an estimated total of 4,295 women with a diagnosis of breast cancer through 2013. Because mechanisms that link shift work to breast cancer risk are similar for other cancers, the findings from this proposal are likely to affect not only the risk of breast cancer but that of other cancers and men as well. We expect that the impact of our results will extend well beyond the specific aims we currently propose. Ultimately, as time progresses and nurses become older, this data and the newly added battery of shift work questions will lay the foundation for a comprehensive and unique study of shift work on the health needs of older workers. PUBLIC HEALTH RELEVANCE: In December 2007, the WHO classified night shift work as probably inducing cancer - the main operating mechanism being assumed the suppression of melatonin and consequences thereof. Because no definitive strategy currently exists to reduce the cancer risk associated with shift work- induced changes in the body that could lead to cancer risk, determining what specific aspects of the nurses' work schedule including types of shift schedules and changes throughout their professional career are most detrimental to cancer risk is the next frontier in shift work and disease prevention.

描述（由申请人提供）：近 1500 万美国人定期轮班工作，包括晚班、夜班和轮班。轮班工作是现代劳动力不可或缺的一部分，涵盖所有年龄和种族群体。观察性研究始终将轮班工作与癌症风险增加联系起来，促使世界卫生组织于 2007 年 12 月将夜班工作归类为可能的致癌物——其主要运作机制被认为是通过抑制褪黑激素而扰乱昼夜节律。根据护士健康研究 II (NHS2) 的结果，2009 年 3 月，丹麦成为全球第一个开始向从事夜班工作 20 年或以上患乳腺癌的女性提供货币补偿的国家。由于目前尚无明确的策略来降低与轮班工作引起的昼夜节律紊乱相关的癌症风险，因此确定轮班时间表的哪些方面对健康最有害是轮班工作和疾病预防的下一个前沿领域。迄今为止，还没有研究探讨轮班安排的具体方面（包括长度、轮换频率和每周工作时间）如何相互作用以及与癌症风险的关系。此外，是否存在一个年龄范围的人特别容易受到昼夜节律紊乱的影响也仍不清楚。未来的研究将受益于对工作安排及其对人类癌症风险影响的清晰完整的描述。 2009 年，我们在 NHS2 主要调查问卷中添加了一系列轮班工作问题。我们新评估了护士工作安排的具体方面，包括轮班安排的类型和整个职业生涯的变化。此外，还评估了与昼夜节律紊乱潜在相关的其他因素，包括不同生命时间段的早晚和睡眠持续时间。为了评估轮班工作安排的某些方面比其他方面与乳腺癌风险更密切相关的假设，我们将使用队列和横断面研究方法。我们估计 2009 年至 2013 年间新诊断出 1,108 例乳腺癌病例。我们将使用这些病例以及流行病例来增强对 2013 年估计总共 4,295 名被诊断为乳腺癌的女性进行亚分析的能力。由于将轮班工作与乳腺癌风险联系起来的机制与其他癌症相似，因此该提案的结果可能不仅会影响乳腺癌的风险，还会影响其他癌症和男性的风险，如下所示： 出色地。我们预计我们的结果的影响将远远超出我们目前提出的具体目标。最终，随着时间的推移和护士年龄的增长，这些数据和新增加的一系列轮班工作问题将为对轮班工作对老年工人的健康需求进行全面而独特的研究奠定基础。 公共健康相关性：2007 年 12 月，世界卫生组织将夜班工作列为可能诱发癌症的一类——其主要作用机制被认为是抑制褪黑激素及其后果。由于目前尚无明确的策略来降低与轮班工作引起的可能导致癌症风险的身体变化相关的癌症风险，因此确定护士工作时间表的哪些具体方面（包括轮班时间表的类型和整个职业生涯的变化）对癌症风险最有害是轮班工作和疾病预防的下一个前沿领域。