Shift work is associated with an increased risk of major vascular problems such as myocardial infarction and stroke, according to an analysis.
This is the largest analysis of shift work and vascular risk to date and has implications for public policy and occupational medicine, the researchers said.
Shift work has long been known to disrupt circadian rhythm and is associated with an increased risk of hypertension, high cholesterol and diabetes, but its association with vascular disease has been controversial, researchers noted in background information for the study, which appeared July 26 on the website of the British Medical Journal
A team of international researchers analyzed the results of 34 studies involving more than 2 million individuals to investigate the association between shift work and major vascular events. Shift work was defined as evening shifts, irregular or unspecified shifts, mixed schedules, night shifts and rotating shifts. Control groups in the studies were non-shift workers or the general population. The researchers took into account differences in study design and quality to minimize bias.
Among the 2,011,935 people in the studies, 17,359 had some kind of coronary event, 6,598 had myocardial infarctions and 1,854 had ischemic strokes. These events were more common among shift workers than other people: shift work was associated with an increased risk of MI (23% higher), coronary events (24%) and stroke (5%). These risks remained consistent even after adjusting for factors such as study quality, socioeconomic status and unhealthy behaviors in shift workers.
Night shifts were associated with the steepest increase in risk of coronary events (41%). However, shift work was not associated with increased death rates from any cause.
Although the relative risks were modest, the authors pointed out that the frequency of shift work in the general population means the overall risks are high. For Canada — where some of the study’s authors are based and where 32.8% of workers were on shifts during 2008-9 — 7% of myocardial infarctions, 7.3% of all coronary events and 1.6% of ischemic strokes could be attributed to shift work.
The authors said their findings have several implications. For example, they suggest screening programs could help identify and treat risk factors, such as hypertension and cholesterol levels. Shift workers also could be educated about symptoms that could indicate early heart problems.
Finally, they said more work is needed to identify the most vulnerable groups of shift workers and the effects of modifying shift patterns on overall vascular health.
To read the study, visit http://bit.ly/NZSZdz.
This is the largest analysis of shift work and vascular risk to date and has implications for public policy and occupational medicine, the researchers said.
Shift work has long been known to disrupt circadian rhythm and is associated with an increased risk of hypertension, high cholesterol and diabetes, but its association with vascular disease has been controversial, researchers noted in background information for the study, which appeared July 26 on the website of the British Medical Journal
A team of international researchers analyzed the results of 34 studies involving more than 2 million individuals to investigate the association between shift work and major vascular events. Shift work was defined as evening shifts, irregular or unspecified shifts, mixed schedules, night shifts and rotating shifts. Control groups in the studies were non-shift workers or the general population. The researchers took into account differences in study design and quality to minimize bias.
Among the 2,011,935 people in the studies, 17,359 had some kind of coronary event, 6,598 had myocardial infarctions and 1,854 had ischemic strokes. These events were more common among shift workers than other people: shift work was associated with an increased risk of MI (23% higher), coronary events (24%) and stroke (5%). These risks remained consistent even after adjusting for factors such as study quality, socioeconomic status and unhealthy behaviors in shift workers.
Night shifts were associated with the steepest increase in risk of coronary events (41%). However, shift work was not associated with increased death rates from any cause.
Although the relative risks were modest, the authors pointed out that the frequency of shift work in the general population means the overall risks are high. For Canada — where some of the study’s authors are based and where 32.8% of workers were on shifts during 2008-9 — 7% of myocardial infarctions, 7.3% of all coronary events and 1.6% of ischemic strokes could be attributed to shift work.
The authors said their findings have several implications. For example, they suggest screening programs could help identify and treat risk factors, such as hypertension and cholesterol levels. Shift workers also could be educated about symptoms that could indicate early heart problems.
Finally, they said more work is needed to identify the most vulnerable groups of shift workers and the effects of modifying shift patterns on overall vascular health.
To read the study, visit http://bit.ly/NZSZdz.
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