A 12-year prospective study of circulatory disease among Danish shift workers

Finn Tüchsen ^1*, Harald Hannerz ¹ and Hermann Burr ¹

¹ National Institute of Occupational Health, Denmark

^* To whom correspondence should be addressed. E-mail: ft{at}ami.dk.

Accepted 24 March 2006

Abstract

Objectives: Previous studies of the risk of heart disease after shift work reached different estimates and review authors disagree about the validity of some of the studies. A cross sectional study showed that shift workers had a higher prevalence of nearly every unfavourable work environment factor investigated. Conflicts at work and low decision latitude were more frequent among shift workers, and all-day walking or standing work and part-time jobs were more often found among female shift workers. The aim of the present study was to estimate the risk of circulatory disease in a prospective follow-up of a representative sample of gainfully employed Danes considering known or suspected confounding factors.

Methods: A cohort of 5517 people who were gainfully employed in 1990 were followed up for all hospital treatments due to circulatory diseases (international classification of diseases version 8=390-458 and version 10=I00-I99) from 1991 to 2002 inclusive. A log linear Poisson regression model was applied to control confounding factors and calculate the relative risk for 927 men and women working nights, evenings or other non-day shifts compared to 4579 day-workers.

Results: Non-day workers compared to day-workers had a relative risk (RR) for all circulatory diseases of 1.31 (95% confidence interval (95% CI): 1.06-1.63). Without control for BMI and smoking the relative risk estimate was 133 (95% CI: 1.07-1.65). For a subgroup of workers with at least 3 years seniority the RR was 1.40 (95% CI: 1.09-1.81). The population based etiologic fraction of shift work was estimated to 5%.

Conclusion: This study adds to a growing body of evidence suggesting that shift work carry an excess risk of circulatory diseases.

Keywords: Follow-up study, Heart diseases, Hospitalisation, Night work, Non-day work

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