Original article

Scand J Work Environ Health 2022;48(7):520-529    pdf full text

doi:10.5271/sjweh.4045 | Published online: 20 Jun 2022, Issue date: 01 Sep 2022

Night and shift work characteristics and incident ischemic heart disease and atrial fibrillation among healthcare employees – a prospective cohort study

by Kader M, Selander J, Andersson T, Albin M, Bodin T, Härmä M, Ljungman P, Bigert C

Objective This study aimed to examine the effects of various aspects of night and shift work on the risk of incident ischemic heart disease (IHD) and atrial fibrillation (AF) using detailed and registry-based exposure data.

Methods This prospective cohort study included >30 300 healthcare employees (eg, nurses, nursing assistants) employed for at least one year in Region Stockholm 2008–2016. Information on daily working hours was obtained from a computerized administrative employee register and outcomes from national and regional registers. Using discrete-time proportional hazard models, we analyzed the outcomes as functions of working hour characteristics the preceding year, adjusted for sex, age, country of birth, education, and profession.

Results We observed 223 cases of IHD and 281 cases of AF during follow-up 2009–2016. The risk of IHD was increased among employees who the preceding year had permanent night shifts compared to those with permanent day work [hazard ratio (HR) 1.61, 95% confidence interval (CI) 1.06–2.43] and among employees working night shifts >120 times per year compared to those who never worked night (HR 1.53, 95% CI 1.05–2.21). When restricted to non-night workers, the risk of IHD was increased for employees having frequent quick returns from afternoon shifts. No increased risks were observed for AF.

Conclusions Night work, especially working permanent night shifts and frequent night shifts, is associated with an increased risk of incident IHD but not AF. Moreover, frequent quick returns from afternoon shifts (among non-night workers) increased IHD risk. Organizing work schedules to minimize these exposures may reduce IHD risk.

This article refers to the following texts of the Journal: 2022;48(1):31-40  2018;44(4):403-413  2018;44(3):229-238  2015;41(3):268-279  2010;36(2):96-108  2009;35(3):163-179
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