Abstract
Objectives Evidence of an effect of shift work on all-cause and cause-specific mortality is inconsistent. This study aims to examine whether shift work is associated with increased all-cause and cause-specific mortality. Methods We linked 28 731 female nurses (age ≥44 years), recruited in 1993 or 1999 from the Danish nurse cohort where they reported information on shift work (night, evening, rotating, or day), to the Danish Register of Causes of Death to identify deaths up to 2013. We used Cox regression models with age as the underlying scale to examine the associations between night, evening, and rotating shift work (compared to day shift work) and all-cause and cause-specific mortality in models adjusted for potentially confounding variables. Results Of 18 015 nurses included in this study, 1616 died during the study time period from the following causes: cardiovascular disease (N=217), cancer (N= 945), diabetes (N=20), Alzheimer's disease or dementia (N=33), and psychiatric diseases (N=67). We found that working night [hazard ratio (HR) 1.26, 95% confidence interval 95% CI) 1.05-1.51] or evening (HR 1.29, 95% CI 1.11-1.49) shifts was associated with a significant increase in all-cause mortality when compared to working day shift. We found a significant association of night shift work with cardiovascular disease (HR 1.71, 95% CI 1.09-2.69) and diabetes (HR 12.0, 95% CI 3.17-45.2, based on 8 cases) and none with overall cancer mortality (HR 1.05, 95% CI 0.81-1.35) or mortality from psychiatric diseases (HR 1.17, 95% CI 0.47-2.92). Finally, we found strong association between evening (HR 4.28, 95% CI 1.62-11.3) and rotating (HR 5.39, 95% CI 2.35-12.3) shift work and mortality from Alzheimer's disease and dementia (based on 8 and 14 deaths among evening and rotating shift workers, respectively). Conclusions Women working night and evening shifts have increased all-cause, cardiovascular, diabetes, and Alzheimer's and dementia mortality.
Highlights
Heat stress is a well-known occupational health concern
While there is a considerable amount of data available for the development of leading and lagging indicators, challenges exist in coordinating data across multiple data stewards and little data is collected in some domains relevant to effective violence prevention
In Indonesia, chronic kidney disease (CKD) is the ninth deadliest disease and the treatment for CKD tops the list of the health care spendings
Summary
Heat stress is a well-known occupational health concern. Objectives o Evaluate the heat exposure for industry workers in West Java, Indonesia o Demonstrate the workersperceptions of the heat situation Methods A pilot study was conducted on two industries in February 2017, winter season in West Java. Heat measures were taken using wet bulb globe temperature (WBGT). Interviews were conducted using HOTHAPS questionnaire with 54 male workers. Result The pilot study showed that workers were exposed to heat above threshold limit value (28°) in 48% of the WBGT measurements. 54% of the workers interviewed were uncomfortable with the ambient temperature. 8% of the workers had abnormal creatinine levels (!1,2 mg/dl) indicating a severe problem with heat exposure. An extended data collection is planned for July to investigate the heat impacts of the summer season, and to include female workers
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