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Shift work and cardiovascular disease
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Shift work is often defined as working time outside daytime hours (06:00 to 18:00). In recent years, shift work has been associated with an increased risk of cardiovascular disease (CVD), type II diabetes, and the metabolic syndrome. While some studies support the associations, others do not. Therefore, more research is needed. The aim of this thesis was to further study the association between shift work and CVD. This was addressed by performing four studies, one analysed if shift workers had an increased risk of ischemic stroke, the second study analysed whether shift workers had an increased risk of short-term mortality (case fatality)after a myocardial infarction (MI). The third study analysed if shift work interacts with other risk factors for MI and the fourth study analysed if parental history of CVD interacted with shift work on the risk of MI. The studies were performed using logistic regression analyses and additive interaction analyses in two different case-control databases. Shift workers did not have an increased risk of ischemic stroke. Male shift workers had an increased risk of death within 28 days after a MI. Shift work interacts with some CVD risk factors and interacts with paternal history of CVD and the risk of MI for males. The findings from this thesis provide new evidence showing that shift work is in different ways associated with an increased risk of MI and related mortality, but not with ischemic stroke. However, more research is needed to clarify and characterise these results.

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University , 2015. , 77 p.
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 231
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
URN: urn:nbn:se:miun:diva-26219ISBN: 978-91-88025-41-8 (print)OAI: oai:DiVA.org:miun-26219DiVA: diva2:867223
Public defence
2015-11-27, Lubbesalen, Sundsvall, 13:15 (Swedish)
Supervisors
Note

Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 3 manuskript, delarbete 4 manuskript

At the time of the doctoral defence the following papers were unpublished: paper 3 manuscript, paper 4 manuscript

Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2015-12-22Bibliographically approved
List of papers
1. Ischemic stroke and shift work
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2007 (English)In: Scandinavian Journal of Work, Environment and Health, ISSN 0355-3140, E-ISSN 1795-990X, Vol. 33, no 6, 435-439 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: This study analyzed the potential association between shift work and ischemic stroke. METHODS: The analysis was carried out using a nested case-control study consisting of 138 shift workers and 469 day workers from the register of the Northern Sweden Monitoring of Trends and Determinants in Cardiovascular Diseases (MONICA) study and the Vasterbotten Intervention Programme. Logistic regression analysis was used to analyze the risk estimate for day workers in a comparison with shift workers and the risk of ischemic stroke. RESULTS: The crude odds ratio for shift workers' risk of experiencing an ischemic stroke was 1.0 (95% confidence interval 0.6-1.8) for both the men and the women. The risk estimates were consistent despite the introduction of several recognized risk factors for ischemic stroke in the logistic regression models. CONCLUSIONS: In the present study, none of the findings indicated a higher risk of shift workers undergoing an ischemic stroke than day workers.

Keyword
Ischemic stroke, shift work
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-4088 (URN)000253834000004 ()18327511 (PubMedID)2-s2.0-40749141220 (Scopus ID)4646 (Local ID)4646 (Archive number)4646 (OAI)
Available from: 2008-12-09 Created: 2008-12-09 Last updated: 2017-10-20Bibliographically approved
2. Case fatality of myocardial infarction among shift workers
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2015 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, 599-605 p.Article in journal (Refereed) Published
Abstract [en]

Purpose: Shift work has been associated with an excess risk of cardiovascular disease (CVD) and more specifically myocardial infarction (MI). The majority of the studies that found a positive association between shift work and CVD have been based on incidence data. The results from studies on cardiovascular-related mortality among shift workers have shown little or no elevated mortality associated with shift work. None of the previous studies have analysed short-term mortality (case fatality) after MI. Therefore, we investigated whether shift work is associated with increased case fatality after MI compared with day workers.Methods: Data on incident cases with first MI were obtained from case–control study conducted in two geographical sites in Sweden (Stockholm Heart Epidemiology Program and Västernorrland Heart Epidemiology Program), including 1,542 cases (1,147 men and 395 women) of MI with complete working time information and 65 years or younger. Case fatality was defined as death within 28 days of onset of MI. Risk estimates were calculated using logistic regression.Results: The crude odds ratios for case fatality among male shift workers were 1.63 [95 % confidence interval (CI) 1.12, 2.38] and 0.56 (95 % CI 0.26, 1.18) for female shift workers compared with day workers. Adjustments for established cardiovascular risk factors such as diabetes type II and socio-economic status did not alter the results.Conclusion: Shift work was associated with increased risk of case fatality among male shift workers after the first MI.

Keyword
Cardiovascular disease, Case–control, Epidemiology, Risk estimation, Shift work
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-17465 (URN)10.1007/s00420-014-0984-z (DOI)000354624400007 ()2-s2.0-84939876826 (Scopus ID)
Available from: 2012-11-28 Created: 2012-11-28 Last updated: 2017-12-07Bibliographically approved
3. Interaction between shift work and coronary risk factors on risk of myocardial infarction
Open this publication in new window or tab >>Interaction between shift work and coronary risk factors on risk of myocardial infarction
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(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-26217 (URN)
Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2015-11-05Bibliographically approved
4. Interaction between parental history of myocardial infarction or sudden cardiac death and shift work on the incidence of myocardial infarction among males
Open this publication in new window or tab >>Interaction between parental history of myocardial infarction or sudden cardiac death and shift work on the incidence of myocardial infarction among males
(English)Manuscript (preprint) (Other academic)
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-26218 (URN)
Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2015-11-05Bibliographically approved

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