Jian Li1, Chantal Brisson2, Els Clays3, Marco M Ferrario4, Ivan D Ivanov5, Paul Landsbergis6, Nancy Leppink7, Frank Pega8, Hynek Pikhart9, Annette Prüss-Üstün10, Reiner Rugulies11, Peter L Schnall12, Gretchen Stevens13, Akizumi Tsutsumi14, Yuka Ujita15, Johannes Siegrist16. 1. Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Faculty of Medicine, University of Düsseldorf, Universitätsstraße 1, Düsseldorf 40225, Germany. Electronic address: jian.li@uni-duesseldorf.de. 2. Centre de Recherche du CHU de Québec, Université Laval, 1050 Chemin Ste-Foy, Quebec City, G1S 4L8, Quebec, Canada. Electronic address: Chantal.Brisson@crchudequebec.ulaval.ca. 3. Department of Public Health, Ghent University, Campus University Hospital, 4K3, De Pintelaan 185, B-9000 Ghent, Belgium. Electronic address: els.clays@UGent.be. 4. Research Centre EPIMED, University of Insubria, Via O Rossi 9, 21100 Varese, Italy. Electronic address: marco.ferrario@uninsubria.it. 5. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Electronic address: ivanovi@who.int. 6. State University of New York-Downstate School of Public Health, 450 Clarkson Ave., Brooklyn, NY 11238, United States of America. Electronic address: paul.landsbergis@downstate.edu. 7. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland. Electronic address: leppink@ilo.org. 8. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Electronic address: pegaf@who.int. 9. Institute of Epidemiology and Health Care, University College London, 1-19 Torrington Place, London WC1E 6BT, United Kingdom. Electronic address: h.pikhart@ucl.ac.uk. 10. Department of Public Health, Environmental and Social Determinants of Health, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Electronic address: pruessa@who.int. 11. National Research Centre for the Working Environment, Lersø Parkallé 105, DK-2100 Copenhagen, Denmark; Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, DK-1014 Copenhagen, Denmark; Department of Psychology, University of Copenhagen, Øster Farimagsgade 2A, DK-1353 Copenhagen, Denmark. Electronic address: rer@nrcwe.dk. 12. Center for Occupational and Environmental Health, University of California-Irvine, 100 Theory Way, Irvine, CA, United States of America. Electronic address: pschnall@workhealth.org. 13. Department of Information, Evidence and Research, World Health Organization, 20 Avenue Appia, 1211 Geneva 27, Switzerland. Electronic address: stevensg@who.int. 14. Department of Public Health, School of Medicine, Kitasato University, 1-15-1 Kitasato, Minami, Sagamihara 252-0374, Japan. Electronic address: akizumi@kitasato-u.ac.jp. 15. Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Route des Morillons 4, 1211 Geneva, Switzerland. Electronic address: ujita@ilo.org. 16. Life Science Centre, University of Düsseldorf, Merowingerplatz 1a, Düsseldorf 40225, Germany. Electronic address: johannes.siegrist@med.uni-duesseldorf.de.
Abstract
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years of ischaemic heart disease from exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on ischaemic heart disease (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. The selection of both, the exposure and the health outcome is justified by substantial scientific evidence on adverse effects of long working hours on ischaemic heart disease risk. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the prevalence of, incidence of or mortality from ischaemic heart disease, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017084243.
BACKGROUND: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing a joint methodology for estimating the national and global work-related burden of disease and injury (WHO/ILO joint methodology), with contributions from a large network of experts. In this paper, we present the protocol for two systematic reviews of parameters for estimating the number of deaths and disability-adjusted life years of ischaemic heart disease from exposure to long working hours, to inform the development of the WHO/ILO joint methodology. OBJECTIVES: We aim to systematically review studies on occupational exposure to long working hours (Systematic Review 1) and systematically review and meta-analyse estimates of the effect of long working hours on ischaemic heart disease (Systematic Review 2), applying the Navigation Guide systematic review methodology as an organizing framework. The selection of both, the exposure and the health outcome is justified by substantial scientific evidence on adverse effects of long working hours on ischaemic heart disease risk. DATA SOURCES: Separately for Systematic Reviews 1 and 2, we will search electronic academic databases for potentially relevant records from published and unpublished studies, Medline, EMBASE, Web of Science, CISDOC and PsychINFO. We will also search electronic grey literature databases, Internet search engines and organizational websites; hand-search reference list of previous systematic reviews and included study records; and consult additional experts. STUDY ELIGIBILITY AND CRITERIA: We will include working-age (≥15 years) workers in the formal and informal economy in any WHO and/or ILO Member State, but exclude children (<15 years) and unpaid domestic workers. For Systematic Review 1, we will include quantitative prevalence studies of relevant levels of exposure to long working hours (i.e. 35-40, 41-48, 49-54 and ≥55 h/week) stratified by country, sex, age and industrial sector or occupation. For Systematic Review 2, we will include randomized controlled trials, cohort studies, case-control studies and other non-randomized intervention studies with an estimate of the relative effect of relevant level(s) of long working hours on the prevalence of, incidence of or mortality from ischaemic heart disease, compared with the theoretical minimum risk exposure level (i.e. 35-40 h/week). STUDY APPRAISAL AND SYNTHESIS METHODS: At least two review authors will independently screen titles and abstracts against the eligibility criteria at a first stage and full texts of potentially eligible records at a second stage, followed by extraction of data from qualifying studies. At least two review authors will assess risk of bias and the quality of evidence, using the most suited tools currently available. For Systematic Review 2, if feasible, we will combine relative risks using meta-analysis. We will report results using the guidelines for accurate and transparent health estimates reporting (GATHER) for Systematic Review 1 and the preferred reporting items for systematic reviews and meta-analyses guidelines (PRISMA) for Systematic Review 2. PROSPERO registration number: CRD42017084243.
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