Night Work and Mortality: Prospective Study Among Finnish Employees Over the Time Span 1984 to 2008

Abstract

There is considerable evidence showing that night work is associated with increased morbidity, but only a few studies have focused on its relation to mortality. This study investigates the relationship between the type of working-time arrangement (weekly night work/daytime work) and total and cause-specific mortality among men and women. The data consist of a representative working conditions survey of Finnish employees conducted in 1984 (2286 men/2216 women), which has been combined with register-based follow-up data from Statistics Finland covering the years 1985–2008. In the 1984 survey, the employees were asked if they worked during the night (23:00–06:00 h) and if so, how often. In this study, the authors compare employees who worked at night (121 men/89 women) to daytime employees who did not do night work (1325 men/1560 women). The relative risk of death was examined by Cox proportional hazards analyses adjusted for background (age, level of education, family situation, and county), health (longstanding illness, pain symptoms, smoking status, and psychological symptoms), and work-related factors (weekly working hours, physical and psychological demands, demands of learning at work, and perceived job insecurity). Female employees working at night had a 2.25-fold higher risk of mortality than female dayworkers (95% confidence interval [CI] 1.20–4.20) after adjustment for background and health- and work-related factors. In addition to total mortality, night work was also associated with tumor mortality. Female night workers had a 2.82-fold higher risk of tumor mortality than female dayworkers (95% CI 1.20–6.65) in the adjusted model. Among men, no such significant association was observed. The present study indicated that female night workers had a higher risk of both total and tumor mortality compared to female daytime employees. Additional research on the potential factors and mechanisms behind the association between night work and mortality is required. (Author correspondence: jouko.natti@uta.fi)