Fangyi Gu1, Jiali Han2, Francine Laden3, An Pan4, Neil E Caporaso1, Meir J Stampfer5, Ichiro Kawachi6, Kathryn M Rexrode7, Walter C Willett8, Susan E Hankinson9, Frank E Speizer10, Eva S Schernhammer11. 1. Division of Cancer Epidemiology & Genetics, Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland. 2. Channing Division of Network Medicine, Harvard School of Public Health, Boston; Clinical Research Program, Department of Dermatology, Harvard School of Public Health, Boston; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana. 3. Department of Environmental Health, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston. 4. Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore. 5. Channing Division of Network Medicine, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston. 6. Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston. 7. Division of Preventive Medicine, Harvard School of Public Health, Boston. 8. Department of Nutrition, Harvard School of Public Health, Boston. 9. Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts. 10. Channing Division of Network Medicine, Harvard School of Public Health, Boston. 11. Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston; Applied Cancer Research-Institution for Translational Research Vienna (ACR-ITR VIEnna), Vienna, Austria. Electronic address: eva.schernhammer@channing.harvard.edu.
Abstract
BACKGROUND: Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. PURPOSE: To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study. METHODS: Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988-2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. RESULTS: All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6-14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). CONCLUSIONS: Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.
BACKGROUND: Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. PURPOSE: To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study. METHODS: Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988-2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. RESULTS: All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6-14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). CONCLUSIONS:Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.
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