Abstract
As shift work has become prevalent globally, it is important to evaluate the health effects of shift work on employees. Several studies have demonstrated a positive association between shift work and prostate cancer. Therefore, we aimed to further examine the relationship between shift work and elevated prostate-specific antigen (PSA). Our study collected data from 66,817 male participants at baseline and followed up for about 6 years. We categorized shift worker status and shift schedule types. To evaluate the risk of elevated PSA on shift workers, we estimated hazard ratios using the Cox proportional hazards regression analyses. During a median follow-up of 4.1 years, 1030 participants developed elevated PSA. The multivariable-adjusted hazard ratio (HR) of elevated PSA for shift workers compared with daytime workers was 1.37 (1.04–1.80). Among shift workers, rotating shift workers (HR = 1.47, 95% CI 1.06–2.03) showed a significantly increased risk of elevated PSA compared with daytime workers. Our longitudinal study provides evidence for an association between shift work, especially rotating shift work, and elevations of PSA.
Highlights
About 15–20% of workers are engaged in shift work, which has become increasingly prevalent throughout the world over the last several decades [1,2]
Shift work was associated with age, sleep duration, alcohol intake, regular exercise, high education level, high household income, marital status, BMI, and total vitamin D
When we introduced confounders as time-varying covariates, the association between shift work and elevated prostate-specific antigen (PSA) still significantly remained in the time-dependent model
Summary
About 15–20% of workers are engaged in shift work, which has become increasingly prevalent throughout the world over the last several decades [1,2]. European Working Conditions Survey, approximately 21% of European workers are shift workers [4]. In Korea, the Statistics Research Institute of Statistics Korea reported that around 7.1% of workers had a shift work system in 2015 [5]. As shift workers are common in most industrialized countries, it is important to evaluate the health effects of shift work on employees. Studies have demonstrated that shift work affects cardiovascular disease [6], mood disorders [7], gastrointestinal disease [8], and cancer [9]
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