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Shift work and coronary heart disease.

A Knutsson1

  • 1National Institute for Psychosocial Factors and Health, Karolinska Institutet, Stockholm.

Scandinavian Journal of Social Medicine. Supplementum
|January 1, 1989
PubMed
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Shift work is linked to increased risk of Coronary Heart Disease (CHD). Findings show a dose-response relationship between years of shift work and CHD, suggesting dietary changes and disturbed rhythms as contributing factors.

Area of Science:

  • Occupational Health
  • Cardiovascular Epidemiology
  • Chronobiology

Background:

  • Previous research on shift work's medical effects primarily focused on sleep and gastrointestinal issues, with limited evidence for cardiovascular disease.
  • Existing studies often lacked robust exposure quantification and control for confounding factors, necessitating more rigorous investigation into shift work and Coronary Heart Disease (CHD).

Purpose of the Study:

  • To investigate the association between shift work and the incidence of Coronary Heart Disease (CHD).
  • To identify potential risk factors and disease pathways linking shift work to CHD.

Main Methods:

  • Conducted two longitudinal studies, including one measuring CHD incidence in 504 male shift and day workers over 14 years (1968-1982/83).
  • Performed two cross-sectional studies on male blue-collar workers to assess risk factors like smoking, serum triglycerides, and dietary habits.

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  • Utilized a prospective study of 25 male shift and day workers over six months to analyze dietary changes and their impact on serum lipoproteins (apoB/apoA-1 ratio).

    • Main Results:

    • Shift work was significantly associated with an increased risk of CHD, demonstrating a dose-response relationship with the duration of shift work.
    • Shift workers exhibited higher prevalence of CHD risk factors, including increased smoking rates and elevated serum triglyceride levels, independent of obesity, alcohol, or smoking.
    • Dietary analysis revealed shift workers tended to decrease fiber intake and increase sucrose consumption, correlating with adverse changes in the apoB/apoA-1 ratio, a marker for coronary risk.

    Conclusions:

    • Shift work is a significant risk factor for Coronary Heart Disease (CHD).
    • Proposed pathways include circadian rhythm disruption, behavioral changes (diet), and disturbed sociotemporal rhythms leading to distress.
    • Interventions targeting dietary habits and managing circadian disruption may mitigate CHD risk in shift workers.