Association Between Rotating Night Shift Work and Risk of Coronary Heart Disease Among Women

Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up. To determine whether rotating night shift work is associated with CHD risk. Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurse...

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Vydané v:	JAMA : the journal of the American Medical Association Ročník 315; číslo 16; s. 1726
Hlavní autori:	Vetter, Céline, Devore, Elizabeth E, Wegrzyn, Lani R, Massa, Jennifer, Speizer, Frank E, Kawachi, Ichiro, Rosner, Bernard, Stampfer, Meir J, Schernhammer, Eva S
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	United States 26.04.2016
Predmet:	Adult Coronary Artery Disease - epidemiology Coronary Artery Disease - etiology Female Follow-Up Studies Humans Incidence Middle Aged Nurses - statistics & numerical data Personnel Staffing and Scheduling - statistics & numerical data Proportional Hazards Models Prospective Studies Risk Assessment Surveys and Questionnaires Time Factors United States - epidemiology Work Schedule Tolerance United States
ISSN:	1538-3598, 1538-3598
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Abstract	Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up. To determine whether rotating night shift work is associated with CHD risk. Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535). Lifetime history of rotating night shift work (≥3 night shifts per month in addition to day and evening shifts) at baseline (updated every 2 to 4 years in the NHS2). Incident CHD; ie, nonfatal myocardial infarction, CHD death, angiogram-confirmed angina pectoris, coronary artery bypass graft surgery, stents, and angioplasty. During follow-up, 7303 incident CHD cases occurred in the NHS (mean age at baseline, 54.5 years) and 3519 in the NHS2 (mean age, 34.8 years). In multivariable-adjusted Cox proportional hazards models, increasing years of baseline rotating night shift work was associated with significantly higher CHD risk in both cohorts. In the NHS, the association between duration of shift work and CHD was stronger in the first half of follow-up than in the second half (P=.02 for interaction), suggesting waning risk after cessation of shift work. Longer time since quitting shift work was associated with decreased CHD risk among ever shift workers in the NHS2 (P<.001 for trend). [table: see text] Among women who worked as registered nurses, longer duration of rotating night shift work was associated with a statistically significant but small absolute increase in CHD risk. Further research is needed to explore whether the association is related to specific work hours and individual characteristics.
AbstractList	Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up. To determine whether rotating night shift work is associated with CHD risk. Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535). Lifetime history of rotating night shift work (≥3 night shifts per month in addition to day and evening shifts) at baseline (updated every 2 to 4 years in the NHS2). Incident CHD; ie, nonfatal myocardial infarction, CHD death, angiogram-confirmed angina pectoris, coronary artery bypass graft surgery, stents, and angioplasty. During follow-up, 7303 incident CHD cases occurred in the NHS (mean age at baseline, 54.5 years) and 3519 in the NHS2 (mean age, 34.8 years). In multivariable-adjusted Cox proportional hazards models, increasing years of baseline rotating night shift work was associated with significantly higher CHD risk in both cohorts. In the NHS, the association between duration of shift work and CHD was stronger in the first half of follow-up than in the second half (P=.02 for interaction), suggesting waning risk after cessation of shift work. Longer time since quitting shift work was associated with decreased CHD risk among ever shift workers in the NHS2 (P<.001 for trend). [table: see text] Among women who worked as registered nurses, longer duration of rotating night shift work was associated with a statistically significant but small absolute increase in CHD risk. Further research is needed to explore whether the association is related to specific work hours and individual characteristics. Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up.IMPORTANCEProspective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up.To determine whether rotating night shift work is associated with CHD risk.OBJECTIVETo determine whether rotating night shift work is associated with CHD risk.Prospective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535).DESIGN, SETTING, AND PARTICIPANTSProspective cohort study of 189,158 initially healthy women followed up over 24 years in the Nurses' Health Studies (NHS [1988-2012]: N = 73,623 and NHS2 [1989-2013]: N = 115,535).Lifetime history of rotating night shift work (≥3 night shifts per month in addition to day and evening shifts) at baseline (updated every 2 to 4 years in the NHS2).EXPOSURESLifetime history of rotating night shift work (≥3 night shifts per month in addition to day and evening shifts) at baseline (updated every 2 to 4 years in the NHS2).Incident CHD; ie, nonfatal myocardial infarction, CHD death, angiogram-confirmed angina pectoris, coronary artery bypass graft surgery, stents, and angioplasty.MAIN OUTCOMES AND MEASURESIncident CHD; ie, nonfatal myocardial infarction, CHD death, angiogram-confirmed angina pectoris, coronary artery bypass graft surgery, stents, and angioplasty.During follow-up, 7303 incident CHD cases occurred in the NHS (mean age at baseline, 54.5 years) and 3519 in the NHS2 (mean age, 34.8 years). In multivariable-adjusted Cox proportional hazards models, increasing years of baseline rotating night shift work was associated with significantly higher CHD risk in both cohorts. In the NHS, the association between duration of shift work and CHD was stronger in the first half of follow-up than in the second half (P=.02 for interaction), suggesting waning risk after cessation of shift work. Longer time since quitting shift work was associated with decreased CHD risk among ever shift workers in the NHS2 (P<.001 for trend). [table: see text]RESULTSDuring follow-up, 7303 incident CHD cases occurred in the NHS (mean age at baseline, 54.5 years) and 3519 in the NHS2 (mean age, 34.8 years). In multivariable-adjusted Cox proportional hazards models, increasing years of baseline rotating night shift work was associated with significantly higher CHD risk in both cohorts. In the NHS, the association between duration of shift work and CHD was stronger in the first half of follow-up than in the second half (P=.02 for interaction), suggesting waning risk after cessation of shift work. Longer time since quitting shift work was associated with decreased CHD risk among ever shift workers in the NHS2 (P<.001 for trend). [table: see text]Among women who worked as registered nurses, longer duration of rotating night shift work was associated with a statistically significant but small absolute increase in CHD risk. Further research is needed to explore whether the association is related to specific work hours and individual characteristics.CONCLUSIONS AND RELEVANCEAmong women who worked as registered nurses, longer duration of rotating night shift work was associated with a statistically significant but small absolute increase in CHD risk. Further research is needed to explore whether the association is related to specific work hours and individual characteristics.
Author	Massa, Jennifer Speizer, Frank E Kawachi, Ichiro Rosner, Bernard Vetter, Céline Wegrzyn, Lani R Stampfer, Meir J Devore, Elizabeth E Schernhammer, Eva S
Author_xml	– sequence: 1 givenname: Céline surname: Vetter fullname: Vetter, Céline organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts – sequence: 2 givenname: Elizabeth E surname: Devore fullname: Devore, Elizabeth E organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts – sequence: 3 givenname: Lani R surname: Wegrzyn fullname: Wegrzyn, Lani R organization: Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts – sequence: 4 givenname: Jennifer surname: Massa fullname: Massa, Jennifer organization: Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, Massachusetts – sequence: 5 givenname: Frank E surname: Speizer fullname: Speizer, Frank E organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts4Department of Environmental Health, Harvard T. H. Chan School of Public Health, Boston, Massachusetts – sequence: 6 givenname: Ichiro surname: Kawachi fullname: Kawachi, Ichiro organization: Department of Social and Behavioral Sciences, Harvard T. H. Chan School of Public Health, Boston, Massachusetts – sequence: 7 givenname: Bernard surname: Rosner fullname: Rosner, Bernard organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts6Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, Massachusetts – sequence: 8 givenname: Meir J surname: Stampfer fullname: Stampfer, Meir J organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts2Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts3Department of Nutri – sequence: 9 givenname: Eva S surname: Schernhammer fullname: Schernhammer, Eva S organization: Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts2Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts7Department of Epide
BackLink	https://www.ncbi.nlm.nih.gov/pubmed/27115377$$D View this record in MEDLINE/PubMed
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Snippet	Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up. To determine whether rotating... Prospective studies linking shift work to coronary heart disease (CHD) have been inconsistent and limited by short follow-up.IMPORTANCEProspective studies...
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SubjectTerms	Adult Coronary Artery Disease - epidemiology Coronary Artery Disease - etiology Female Follow-Up Studies Humans Incidence Middle Aged Nurses - statistics & numerical data Personnel Staffing and Scheduling - statistics & numerical data Proportional Hazards Models Prospective Studies Risk Assessment Surveys and Questionnaires Time Factors United States - epidemiology Work Schedule Tolerance
Title	Association Between Rotating Night Shift Work and Risk of Coronary Heart Disease Among Women
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