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Relationship between shift work and the onset of rheumatoid arthritis
Stockholm University, Faculty of Social Sciences, Stress Research Institute. Karolinska Institutet, Sweden.
2017 (English)In: RMD Open, ISSN 2056-5933, Vol. 3, no 2, article id e000475Article in journal (Refereed) Published
Abstract [en]

Background Environmental factors play a prominent role in rheumatoid arthritis (RA) aetiology. Shift work has previously been associated with increased RA risk in females. The aim of this study was to investigate the potential association, including a dose-response association, between permanent night shift work, rotating shift work and day-oriented shift work and risk of developing anticitrullinated peptide antibodies (ACPA)-positive and ACPA-negative RA.

Methods The present report is based on a population-based, case-control study with incident cases of RA (1951 cases and 2225 controls matched by age, gender and residential area). Using logistic regression, occurrence of RA among subjects who have been exposed to different kinds of shift work was compared with that among those who have never been exposed by calculating the OR with a 95% CI.

Results Rotating shift work and day-oriented shift work increased the risk of developing ACPA-positive RA (OR 1.3, 95% CI 1.0 to 1.7 and OR 1.3, 95% CI 1.0 to 1.6), but not ACPA-negative RA. Permanent night shift work appeared to be a protective factor both against ACPA-positive RA (OR 0.7, 95% CI 0.6 to 0.9) and ACPA-negative RA (OR 0.8, 95% CI 0.6 to 1.0). For both subsets of RA, significant trends showed a lower risk of developing RA with increasing duration of permanent night shift work (p value for trend 0.002 vs 0.04).

Conclusions Sleep restriction as a consequence of shift work is associated with several biological effects among which changes in melatonin production may be involved. The present epidemiological findings of a complex relationship between sleep patterns and different forms of RA may be of importance for increasing the understanding of the pathophysiology of RA.

Place, publisher, year, edition, pages
2017. Vol. 3, no 2, article id e000475
Keyword [en]
circadian rhythm, melatonin, rheumatoid arthritis, shift work, sleep restriction
National Category
Occupational Health and Environmental Health Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:su:diva-151125DOI: 10.1136/rmdopen-2017-000475PubMedID: 29225920OAI: oai:DiVA.org:su-151125DiVA, id: diva2:1172169
Available from: 2018-01-09 Created: 2018-01-09 Last updated: 2018-05-18Bibliographically approved

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