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

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Summary

Introduction

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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