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Workplace
Original research
Night shift work and lymphoma: results from an Italian multicentre case–control study
  1. Pierluigi Cocco1,2,
  2. Sara Piro3,
  3. Federico Meloni1,
  4. Andrea Montagna4,
  5. Michele Pani1,
  6. Ilaria Pilia1,
  7. Marina Padoan5,
  8. Lucia Miligi3,
  9. Corrado Magnani5,
  10. Angela Gambelunghe4,
  11. Giacomo Muzi4,
  12. Giovanni Maria Ferri6,
  13. Luigi Vimercati6,
  14. Roberta Zanotti7,
  15. Aldo Scarpa8,
  16. Mariagrazia Zucca1,
  17. Gian Carlo Latte9,
  18. Emanuele Angelucci10,
  19. Sara De Matteis1,
  20. Monica Puligheddu1
  1. 1 Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
  2. 2 Centre for Occupational and Environmental Health, Division of Population Health, The University of Manchester, Manchester, UK
  3. 3 Environmental and Occupational Epidemiology Branch - Cancer Risk Factors and Lifestyle Epidemiology Unit, ISPRO - Institute for Prevention, Research, and Cancer Network, Florence, Italy
  4. 4 Department of Medicine and Surgery, Occupational Medicine, Respiratory Diseases and Toxicology Section, University of Perugia, Perugia, Italy
  5. 5 Department of Translational Medicine, Unit of Medical Statistics and Cancer Epidemiology, University of Eastern Piedmont Amedeo Avogadro School of Medicine, Novara, Italy
  6. 6 Interdisciplinary Department of Medicine (DIM), Unit of Occupational Medicine, University of Bari, Bari, Italy
  7. 7 Department of Haematology, University of Verona, Verona, Italy
  8. 8 Department of Diagnostics and Public Health, University of Verona, Verona, Italy
  9. 9 Department of Haematology, S. Francesco Hospital, Nuoro, Italy
  10. 10 Department of Haematology, IST - National Institute for Cancer Research, Genova, Italy
  1. Correspondence to Professor Pierluigi Cocco, Department of Medical Sciences and Public Health, University of Cagliari, CAGLIARI, Italy; pcocco{at}unica.it

Abstract

Background Night shift work can disrupt circadian rhythm and cause chronic sleep deprivation, which might increase the risk of lymphoma through immunosuppression and oxidative stress.

Material and methods We investigated the association between night shift work and risk of lymphoma subtypes in 867 incident cases and 774 controls, who participated in a multicentre Italian study between 2011 and 2017. Based on questionnaire information, occupational experts assessed the lifetime probability of night shift work, the total number of night shifts and years of night shift work among study participants. OR and 95% CI for lymphoma and its major subtypes associated with night shift work was calculated with logistic regression, adjusting by age, gender, education, study area, marital status and family history of haemolymphatic cancer.

Results Ever working night shifts was associated with an increase in the risk of chronic lymphocytic leukaemia (CLL) (OR 1.9, 95% CI 1.14 to 3.32), which was highest after a 15–34 years latency. However, there was not a linear increase in risk by probability of exposure, years of night shift work, nor lifetime number of night shifts whether under rotating or permanent work schedules. Risk of lymphoma overall, B cell lymphoma (BCL), its major subtypes other than CLL, and other less prevalent BCL subtypes combined did not show an association.

Conclusions We found conflicting evidence of an association between night shift work and the risk of CLL. We did not observe an association with other lymphoma subtypes.

  • hematology
  • sleep
  • retrospective studies
  • shift work schedule
  • occupational health

Data availability statement

Data are available on reasonable request. Data are preserved in the digital archives of the Department of Medical Sciences and Public Health of the Cagliari University in aggregated form, and they are publicly available as such. Please contact PC (pcocco@unica.it) for any requests.

https://doi.org/10.1136/oemed-2021-107845

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    Data availability statement

    Data are available on reasonable request. Data are preserved in the digital archives of the Department of Medical Sciences and Public Health of the Cagliari University in aggregated form, and they are publicly available as such. Please contact PC (pcocco@unica.it) for any requests.

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    Footnotes

    • Twitter @pierluic1

    • Contributors PC is the author responsible for the overall content as the guarantor, conceived the study, supervised and revised the epidemiological analysis, revised the draft manuscript, wrote the final version, and provided overall supervision; FM, AM, IP and MiP conducted the epidemiological analysis and drafted the manuscript; MaP, AG, GMF, SP, RZ, GCL and MZ conducted the study in the field; CM, LM, GM, GMF, LV, RZ, AS and SDM were responsible for data management and revised the manuscript; PC, SP and LM coordinated the exposure assessment; EA and MoP revised the manuscript and provided overall supervision. All authors participated in the interpretation of the results, provided critical feedback and approved the final version.

    • Funding This study was funded within the following programmes: (1) the Italian Ministry for Education, University and Research (PRIN 2007 Prot. 2007WEJLZB and PRIN 2009 Prot. 20092ZELR2); (7) the Italian Association for Cancer Research (IG 2011/11855).

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.