Abstract
ObjectiveShift work has been linked to cardio-metabolic diseases, but insight into different shift work-related aspects and chronotype of shift workers and their relation with metabolic risk factors is limited. This study examined the association between current shift work status, frequency and duration of night shift work, chronotype, and metabolic risk factors in a population of health care workers.MethodsAnthropometrics, questionnaires, and blood samples were collected from 503 shift working and 93 non-shift working health care workers employed in hospitals. Body mass index, waist circumference, cholesterol (total, HDL, LDL), triglycerides, and high-sensitivity C-reactive protein were measured. Associations of current shift work, frequency (non-night shift worker, 1–2, 3–4, ≥5 night shifts/month) and duration of night shift work (non-night shift workers, <10, 10–19, ≥20 years), and shift workers’ chronotype, with metabolic risk factors were studied using linear regression analysis.ResultsCompared to non-shift workers, shift workers’ total cholesterol level was 0.38 mmol/L lower (95%-CI = -0.73 –-0.04) and LDL cholesterol was 0.34 mmol/L lower (95%-CI = -0.60 –-0.08). For all other metabolic risk factors, no differences were found. The association between shift work and LDL cholesterol was especially found among shift workers working night shifts for ≥20 years (B = -0.49 (95%-CI = -0.78 –-0.19)). No differences were found for night shift frequency and chronotype.ConclusionIn this population of health care workers employed in hospitals, no evidence for differences in metabolic risk factors was observed that could underlie a link between shift work and cardio-metabolic diseases. Further research using different aspects of shift work to study the association with metabolic risk factors is recommended.
Highlights
In today’s society, working night shifts and other shifts outside normal working hours is an integral part of the jobs of many workers
Other systematic reviews and meta-analyses suggest that shift work is associated with an increased risk of metabolic syndrome [6], cardiovascular diseases [5, 7], and diabetes mellitus type 2.[2]. As overweight, cardiovascular diseases, and diabetes mellitus type 2 are highly prevalent diseases that are associated with increased mortality and morbidity, insight into the influence of shift work on these health problems is of great public health importance
Reference group: non-shift workers B, regression coefficient; CI, confidence interval; HDL, high-density lipoprotein; HS-CRP, high-sensitivity C-reactive protein; LDL, low-density lipoprotein; ln, natural logarithm. † Adjusted for age, gender, occupation, educational level, general perceived health, smoking, and alcohol intake
Summary
In today’s society, working night shifts and other shifts outside normal working hours is an integral part of the jobs of many workers. Gaining insight into the association between shift work and metabolic risk factors, such as body mass index (BMI) [8], waist circumference [9], cholesterol (total, high-density lipoprotein (HDL), low-density lipoprotein (LDL)) [9, 10], triglycerides [10], and high-sensitivity C-reactive protein (HS-CRP) [11, 12], is useful from a secondary prevention view, because the actual disease may not have been established yet Previous reviews to such metabolic risk factors showed insufficient evidence for a link between shift work and specific metabolic risk factors (e.g. lipid metabolism).[3, 4, 13] Main reasons for this insufficient evidence were inconsistencies between the studies and lack of high quality research
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