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Hip osteoarthritis and occupational mechanical exposures: a systematic review and meta-analysis. 髋关节骨关节炎与职业性机械接触:系统回顾与荟萃分析。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-14 DOI: 10.5271/sjweh.4152
Alexander Jahn, Johan Hviid Andersen, Andreas Seidler, David Høyrup Christiansen, Annett Dalbøge

Objectives: The aim was to conduct a systematic review and meta-analysis investigating the association between occupational mechanical exposures and hip osteoarthritis.

Methods: The study was registered in PROSPERO. A systematic literature search was conducted in six databases to identify relevant articles. Two authors independently excluded articles, extracted data, assessed the risk of bias of each included article, and graded the level of evidence. We conducted a meta-analysis using random-effects model and performed a sensitivity analysis stratifying articles based on the risk of bias assessment, study design, and the outcome measurement.

Results: Twenty-four articles were eligible for inclusion. The highest pooled odds ratio (OR) was found for combined mechanical exposures [OR 1.7, 95% confidence interval (CI) 1.4-2.0], non-neutral postures (OR 1.7, 95% CI 1.4-2.1), lifting/carrying loads (OR 1.6, 95% CI 1.3-1.9), and climbing stairs (OR 1.6, 95% CI 1.1-2.2). The range of pooled OR for the remaining mechanical exposures (eg, standing, walking, kneeling, squatting, and sitting) was 0.6-1.6. Grading the quality of evidence, a moderate level of evidence was found for the combined mechanical exposures and for lifting/carrying loads. The remaining exposure categories were graded as having either low or very low levels of evidence.

Conclusions: Considerable heterogeneity was observed across the included studies, and high-quality literature using objective exposure measurements is warranted. Despite various limitations affecting the comparability, occupational mechanical exposures seem to influence the likelihood of developing hip osteoarthritis.

目的旨在对职业性机械接触与髋关节骨关节炎之间的关系进行系统回顾和荟萃分析:研究在 PROSPERO 上注册。在六个数据库中进行了系统的文献检索,以确定相关文章。两位作者独立排除文章、提取数据、评估每篇纳入文章的偏倚风险,并对证据水平进行分级。我们使用随机效应模型进行了荟萃分析,并根据偏倚风险评估、研究设计和结果测量对文章进行了分层,从而进行了敏感性分析:有 24 篇文章符合纳入条件。综合机械暴露(OR 1.7,95% 置信区间(CI)1.4-2.0)、非中立姿势(OR 1.7,95% 置信区间(CI)1.4-2.1)、举重/负重(OR 1.6,95% 置信区间(CI)1.3-1.9)和爬楼梯(OR 1.6,95% 置信区间(CI)1.1-2.2)的集合几率比(OR)最高。其余机械接触(如站立、行走、跪、蹲和坐)的汇总 OR 范围为 0.6-1.6。在对证据质量进行分级时发现,综合机械暴露和举重/搬运负荷的证据质量为中等水平。其余暴露类别的证据等级为低级或极低级:结论:在纳入的研究中观察到了相当大的异质性,因此需要使用客观暴露测量的高质量文献。尽管存在各种影响可比性的局限性,但职业机械接触似乎会影响罹患髋关节骨关节炎的可能性。
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引用次数: 0
Relationship between long working hours and smoking behaviors: Evidence from population-based cohort studies in Korea. 长时间工作与吸烟行为之间的关系:韩国基于人群的队列研究提供的证据。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-18 DOI: 10.5271/sjweh.4147
Seong-Uk Baek, Myeong-Hun Lim, Taeyeon Kim, Yu-Min Lee, Jong-Uk Won, Jin-Ha Yoon

Objectives: Long working hours and overwork are growing public health concerns in the Western-Pacific region. We explored the relationship between working hours and smoking behaviors of Korean workers.

Methods: This study included 284 782 observations (50 508 workers) from four nationwide cohort studies in Korea. Using generalized estimating equations, we estimated the associations of working hours with current smoking status, smoking initiation, and smoking cessation within each cohort. Cohort-specific estimates were combined through random-effect meta-analysis. Effect sizes were presented as odds ratios (OR) and 95 confidence intervals (CI).

Results: The overall smoking prevalence was 26.8% within the cohorts. The adjusted OR (95% CI) of the association between working hours and current smoking were 1.01 (0.94-1.08) for <35 hours/week, 1.04 (1.01-1.09) for 41-48 hours/week, 1.06 (1.01-1.10) for 49-54 hours/week, and 1.07 (1.04-1.10) for ≥55 hours/week compared with 35-40 hours/week. The adjusted OR (95% CI) of the association between working hours and smoking cessation in the follow-up were 0.93 (0.85-1.02) for <35 hours/week, 0.89 (0.83-0.96) for 41-48 hours/week, 0.87 (0.81-0.95) for 48-54 hours/week, and 0.91 (0.85-0.98) for ≥55 hours/week compared with 35-40 hours/week. No clear associations were observed between working hours and smoking initiation.

Conclusion: Long working hours are associated with high current smoking risk and reduced likelihood of smoking cessation among Korean workers. Policy interventions are required to promote smoking cessation and reduce excess overwork for individuals experiencing long working hours.

目的:在西太平洋地区,工作时间过长和工作过度是日益严重的公共健康问题。我们探讨了韩国工人的工作时间与吸烟行为之间的关系:本研究纳入了来自韩国四项全国性队列研究的 284 782 个观察指标(50 508 名工人)。使用广义估计方程,我们估计了每个队列中工作时间与当前吸烟状况、开始吸烟和戒烟的关系。通过随机效应荟萃分析,合并了特定队列的估计值。效应大小以几率比(OR)和 95 置信区间(CI)表示:结果:队列中的总体吸烟率为 26.8%。结论:工作时间长与当前吸烟率之间的调整 OR(95% 置信区间)为 1.01(0.94-1.08):在韩国工人中,工作时间长与当前吸烟风险高和戒烟可能性低有关。需要采取政策干预措施,以促进戒烟并减少工作时间过长者的过度劳累。
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引用次数: 0
Working hours and health - key research topics in the past and future. 工作时间与健康--过去和未来的关键研究课题。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-05-01 Epub Date: 2024-03-18 DOI: 10.5271/sjweh.4157
Mikko Härmä, Göran Kecklund, Philip Tucker

Objective: This paper discusses the past and present highlights of working hours and health research and identifies key research needs for the future.

Method: We analyzed over 220 original articles and reviews on working hours and health in the Scandinavian Journal of Work, Environment & Health published during the last 50 years. Key publications from other journals were also included.

Results: The majority of identified articles focussed on the effects of shift and night work, with fewer studying long and reduced working hours and work time control. We observed a transition from small-scale experimental and intensive field studies to large-scale epidemiological studies utilizing precise exposure assessment, reflecting the recent emergence of register-based datasets and the development of analytic methods and alternative study designs for randomized controlled designs. The cumulative findings provide convincing evidence that shift work and long working hours, which are often associated with night work and insufficient recovery, increase the risk of poor sleep and fatigue, sickness absence, occupational injuries, and several chronic health conditions such as cardiovascular diseases and cancer. The observed risks are strongly modified by individual and work-related factors.

Conclusions: Although the observed health risks of shift work and long working hours are mostly low or moderate, the widespread prevalence of exposure and the hazardousness of the many associated potential outcomes makes such working time arrangements major occupational health risks. Further research is needed to identify exposure-response associations, especially in relation to the chronic health effects, and to elucidate underlying pathways and effective personalized intervention strategies.

目的:本文讨论了工时与健康研究的过去和现在,并确定了未来的主要研究需求:本文讨论了过去和现在工作时间与健康研究的重点,并确定了未来的主要研究需求:我们分析了《斯堪的纳维亚工作、环境与健康期刊》在过去 50 年间发表的 220 多篇有关工作时间与健康的原创文章和评论文章。结果:所发现的大部分文章都集中在工作时间与健康问题上:结果:大部分已确认的文章都侧重于轮班工作和夜班工作的影响,而研究长时间工作、缩短工作时间和工作时间控制的文章较少。我们注意到,从小规模的实验研究和密集的实地研究向利用精确暴露评估的大规模流行病学研究过渡,这反映了最近出现的基于登记册的数据集、分析方法的发展以及随机对照设计的替代研究设计。累积的研究结果提供了令人信服的证据,表明轮班工作和长时间工作通常与夜间工作和恢复不足有关,会增加睡眠质量差和疲劳、病假、工伤以及心血管疾病和癌症等几种慢性疾病的风险。观察到的风险受个人因素和工作相关因素的影响很大:尽管观察到的轮班工作和长时间工作的健康风险大多较低或适中,但普遍存在的接触风险和许多相关潜在结果的危害性使得这种工作时间安排具有重大的职业健康风险。需要进一步开展研究,以确定接触与反应之间的关联,特别是与慢性健康影响有关的关联,并阐明潜在的途径和有效的个性化干预策略。
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引用次数: 0
Climate emergency and decent work. 气候紧急情况与体面工作。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-12 DOI: 10.5271/sjweh.4162
Fernando G. Benavides, G. Delclos
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引用次数: 0
Occupational exposure to organic solvents and the risk of developing testicular germ cell tumors (TESTIS study): Effect of combined exposure assessment on risk estimation. 有机溶剂的职业暴露与睾丸生殖细胞肿瘤的发病风险(TESTIS 研究):综合暴露评估对风险估计的影响。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-10 DOI: 10.5271/sjweh.4161
M. Guth, Corinne Pilorget, Marie Lefevre, Astrid Coste, A. Danjou, B. Dananché, D. Praud, O. Pérol, Myriam Daudin, Marie-Ange Clarotti, Stéphanie Lattes, Céline Bouillon, Adèle Paul, J. Schüz, Louis Bujan, A. Olsson, Béatrice Fervers, B. Charbotel
OBJECTIVESEtiological factors of testicular germ cell tumors (TGCT) remain largely unknown, but a causal role of occupational exposures to solvents has been suggested. Previous studies analyzing these exposures reported discordant results, potentially related to exposure assessment methods. The aim of this study was to investigate the role of occupational exposure to solvents on the risk of developing TGCT among young men.METHODSThis study examined occupational exposures to solvents and TGCT risk based on the lifetime work histories of 454 cases and 670 controls, aged 18-45 years, of the French national TESTIS case-control study. Solvent exposure was estimated using: (i) exposure assignment by job-exposure matrix (JEM) and (ii) JEM combined with self-reported exposure data from specific questionnaires (SQ) and expert assessment (EA). Odds ratios (OR) and 95% confidence intervals (CI) were estimated using conditional logistic regression models.RESULTSBoth approaches (JEM and JEM+SQ+EA) showed a consistent association between TGCT and trichloroethylene exposure (exposed versus not exposed; JEM=OR 1.80 [95% confidence interval (CI) 1.12-2.90] and JEM+SQ+EA= OR 2.59 (95% CI 1.42-4.72). Both approaches also observed positive associations with ketone esters and fuels & petroleum-based solvents.CONCLUSIONThe results suggest that some organic solvents might be involved in the pathogenesis of TGCT among occupationally exposed men. The combined use of JEM+SQ+EA seemed to limit misclassification by considering individual exposure variability and is, therefore, an appealing approach to assess occupational exposures in epidemiological studies.
目的睾丸生殖细胞瘤(TGCT)的致病因素在很大程度上仍然未知,但有人认为职业性接触溶剂可能是其致病因素。以前对这些暴露进行分析的研究报告了不一致的结果,这可能与暴露评估方法有关。本研究旨在调查溶剂职业暴露对年轻男性罹患 TGCT 风险的影响。方法本研究根据法国全国 TESTIS 病例对照研究中 454 例病例和 670 例对照(年龄在 18-45 岁之间)的终生工作史,对溶剂职业暴露和 TGCT 风险进行了调查。溶剂暴露的估算方法包括:(i) 通过工作-暴露矩阵(JEM)进行暴露分配;(ii) 将工作-暴露矩阵与来自特定问卷(SQ)和专家评估(EA)的自我报告暴露数据相结合。结果两种方法(JEM 和 JEM+SQ+EA)均显示 TGCT 与三氯乙烯暴露(暴露与未暴露;JEM=OR 1.80 [95% 置信区间 (CI) 1.12-2.90],JEM+SQ+EA=OR 2.59 (95% CI 1.42-4.72))之间存在一致的关联。结果表明,一些有机溶剂可能与职业暴露男性 TGCT 的发病机制有关。联合使用JEM+SQ+EA似乎可以通过考虑个体暴露变异性来限制误分类,因此是流行病学研究中评估职业暴露的一种有吸引力的方法。
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引用次数: 0
The asbestos-asbestosis exposure-response relationship: a cohort study of the general working population. 石棉--石棉沉滞症暴露--反应关系:对普通劳动人口的队列研究。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-04 DOI: 10.5271/sjweh.4153
I. Iversen, J. Vestergaard, J. Ohlander, Susan Peters, Elisabeth Bendstrup, J. Bonde, Vivi Schlünssen, J. Bønløkke, F. Rasmussen, Z. Stokholm, M. B. Andersen, H. Kromhout, H. Kolstad
OBJECTIVESThe association between asbestos exposure and asbestosis in high-exposed industrial cohorts is well-known, but there is a lack of knowledge about the exposure-response relationship for asbestosis in a general working population setting. We examined the exposure-response relationship between occupational asbestos exposure and asbestosis in asbestos-exposed workers of the Danish general working population.METHODSWe followed all asbestos-exposed workers from 1979 to 2015 and identified incident cases of asbestosis using the Danish National Patient Register. Individual asbestos exposure was estimated with a quantitative job exposure matrix (SYN-JEM) from 1976 onwards and back-extrapolated to age 16 for those exposed in 1976. Exposure-response relations for cumulative exposure and other exposure metrics were analyzed using a discrete time hazard model and adjusted for potential confounders.RESULTSThe range of cumulative exposure in the population was 0.001 to 18 fibers per milliliter-year (f/ml-year). We found increasing incidence rate ratios (IRR) of asbestosis with increasing cumulative asbestos exposure with a fully adjusted IRR per 1 f/ml-years of 1.18 [95% confidence interval (CI) 1.15- -1.22]. The IRR was 1.94 (95% CI 1.53-2.47) in the highest compared to the lowest exposure tertile. We similarly observed increasing risk with increasing cumulative exposure in the inception population.CONCLUSIONSThis study found exposure-response relations between cumulative asbestos exposure and incident asbestosis in the Danish general working population with mainly low-level exposed occupations, but there is some uncertainty regarding the exposure levels.
目的众所周知,在高暴露的工业人群中,石棉暴露与石棉沉滞症之间存在关联,但对于普通劳动人群中石棉沉滞症的暴露-反应关系却缺乏了解。我们研究了丹麦普通劳动人口中暴露于石棉的工人的职业石棉暴露与石棉沉滞症之间的暴露-反应关系。方法 我们从 1979 年到 2015 年对所有暴露于石棉的工人进行了跟踪调查,并通过丹麦全国患者登记册确定了石棉沉滞症的偶发病例。我们使用定量工作暴露矩阵(SYN-JEM)估算了自 1976 年以来的个人石棉暴露量,并将 1976 年暴露于石棉的工人的年龄反推至 16 岁。采用离散时间危害模型分析了累积暴露和其他暴露指标的暴露-反应关系,并对潜在的混杂因素进行了调整。结果人群的累积暴露范围为 0.001 至 18 纤维/毫升-年(f/ml-年)。我们发现石棉沉滞症的发病率比(IRR)随累积石棉暴露量的增加而增加,每 1 纤维/毫升-年的完全调整 IRR 为 1.18 [95% 置信区间 (CI) 1.15--1.22]。与最低暴露三分位数相比,最高暴露三分位数的 IRR 为 1.94(95% 置信区间为 1.53-2.47)。结论:本研究发现,在主要从事低水平暴露职业的丹麦普通劳动人口中,累积石棉暴露与石棉沉滞症发病之间存在暴露-反应关系,但暴露水平存在一定的不确定性。
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引用次数: 0
Associations between precarious employment trajectories and mental health among older workers in Germany: Vertical and horizontal inequalities. 德国老年工人的不稳定就业轨迹与心理健康之间的关系:纵向和横向不平等。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-04 DOI: 10.5271/sjweh.4160
Max Rohrbacher, H. Hasselhorn, Nuria Matilla-Santander
OBJECTIVEThe aim of the study was to investigate the longitudinal association between multi-dimensionally measured precarious employment (PE) trajectories and mental health among older employees in Germany.METHODSCurrent data from the German lidA study was used, including panel cases, who participated in all four survey waves (2011, 2014, 2018, 2022). The study comprised 1636 subjects, aged 46 and 52 years at baseline. Group-based trajectory modelling was used to model PE trajectories based on a score combining multiple items from the dimensions employment insecurity and income inadequacy. The association between PE trajectories (2011-2022) and mental health (2022) was tested using weighted logistic regression.RESULTSWe identified a PE trajectory with upward movement that best described 13.6% of the study sample. Representation in this group was socially unequally distributed with noticeably larger shares of female, lower-educated and lower-skilled workers in PE. Women following this trajectory had increased odds [odds ratio (OR) 1.68-1.82] of reporting poor mental health in 2022 compared to their counterparts in constant non-PE. This was not the case for men (OR 0.37-0.51).CONCLUSIONSOur findings highlight horizontal and vertical inequalities with respect to exposure to and consequences of PE. Future labor market reforms should improve protection of women, who will likely be disadvantaged by accumulating employment-related mental health risks over the course of their lives.
目的本研究旨在调查德国老年雇员的多维度不稳定就业(PE)轨迹与心理健康之间的纵向联系。方法本研究使用了德国lidA研究的当前数据,其中包括参加了所有四次调查(2011年、2014年、2018年和2022年)的面板病例。研究对象共 1636 人,基线年龄分别为 46 岁和 52 岁。研究采用基于群体的轨迹模型,根据就业不稳定和收入不足两个维度多个项目的综合得分来模拟 PE 轨迹。通过加权逻辑回归法检验了 PE 轨迹(2011-2022 年)与心理健康(2022 年)之间的关联。结果我们发现,在研究样本中有 13.6% 的人的 PE 轨迹呈上升趋势。该群体的社会分布不均,女性、低学历和低技能工人在 PE 中的比例明显较高。与常年从事非 PE 工作的女性相比,从事 PE 工作的女性在 2022 年报告心理健康状况不佳的几率[几率比 (OR) 1.68-1.82]更高。结论我们的研究结果凸显了在遭受 PE 及其后果方面的横向和纵向不平等。未来的劳动力市场改革应加强对女性的保护,因为她们很可能会在一生中因积累与就业相关的心理健康风险而处于不利地位。
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引用次数: 0
Impaired kidney function among young healthcare workers with long working hours and night work. 长时间和夜间工作的年轻医护人员肾功能受损。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-03 DOI: 10.5271/sjweh.4159
W. Chen, H. Yang
OBJECTIVESWe aimed to evaluate the association between long working hours, night work, and estimated glomerular filtration rate (eGFR) among young healthcare workers.METHODSWe conducted a retrospective cohort study among healthcare workers in a tertiary medical center in Taiwan from 2002 to 2021. Other than physicians, all hospital employees aged 20-65 years with documented yearly working hours and an annual blood test including creatinine were eligible. We excluded participants with eGFR <60 ml/min/1.73 m2 and proteinuria at enrollment to focus on early renal impairment. Total working hours, night working hours, and eGFR in each year were collected. We assessed the relationship of total working hours and night and non-night working hours with eGFR using the generalized linear mixed model, adjusting for demographic, comorbidities, and laboratory profiles.RESULTSThe study included 10 677 participants with a mean age of 27.2 (standard deviation 7.1) years. The mean follow-up duration was 6.2 years. For every 10-hour increase in total weekly working hours, the eGFR decreased by 0.86 [95% confidence interval (CI) 0.61-1.11] ml/min/1.73 m2. For every 10-hour increase in weekly night working hours, the eGFR decreased by 0.25 (95% CI 0.07-0.42) ml/min/1.73 m2. In stratified analysis, the negative associations between total working hours and eGFR remained in the subgroups of individuals aged <40 years and those without hypertension or diabetes, with a P-value for interaction of <0.05.CONCLUSIONSLonger working hours and night work were associated with lower eGFR among healthcare workers.
目的:我们旨在评估年轻医护人员长时间工作、夜间工作与估计肾小球滤过率(eGFR)之间的关系。方法:我们对台湾一家三级医疗中心的医护人员进行了一项回顾性队列研究(2002-2021 年)。除医生外,所有年龄在 20-65 岁之间、有年度工作时间记录和年度血液检查(包括肌酐)的医院员工均符合条件。我们排除了 eGFR <60 ml/min/1.73 m2 和蛋白尿的参与者,以关注早期肾功能损害。我们收集了每年的总工作时间、夜间工作时间和 eGFR。我们使用广义线性混合模型评估了总工作时间、夜间和非夜间工作时间与 eGFR 的关系,并对人口统计学、合并症和实验室资料进行了调整。平均随访时间为 6.2 年。每周总工时每增加 10 小时,eGFR 就会下降 0.86 [95% 置信区间(CI)0.61-1.11] ml/min/1.73 m2。每周夜间工作时间每增加 10 小时,eGFR 就会下降 0.25(95% 置信区间为 0.07-0.42)毫升/分钟/1.73 平方米。在分层分析中,总工时与 eGFR 之间的负相关在年龄小于 40 岁和无高血压或糖尿病的亚组中依然存在,交互作用的 P 值小于 0.05。
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引用次数: 0
Night shift work and cardiovascular diseases among employees in Germany: five-year follow-up of the Gutenberg Health Study. 德国雇员的夜班工作与心血管疾病:古腾堡健康研究的五年跟踪调查。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-01-23 DOI: 10.5271/sjweh.4139
Sylvia Jankowiak, Karin Rossnagel, Juliane Bauer, Andreas Schulz, Falk Liebers, Ute Latza, Karla Romero Starke, Andreas Seidler, Matthias Nübling, Merle Riechmann-Wolf, Stephan Letzel, Philipp Wild, Natalie Arnold, Manfred Beutel, Norbert Pfeiffer, Karl Lackner, Thomas Münzel, Alicia Schulze, Janice Hegewald

Objective: This study aimed to determine if there is an increased risk of incident cardiovascular diseases (CVD) resulting from cumulative night shift work in the German population-based Gutenberg Health Study (GHS).

Methods: We examined working participants of the GHS at baseline and after five years. Cumulative night shift work in the 10 years before baseline was assessed and categorized as low (1-220 nights ≙ up to 1 year), middle (221-660 nights ≙ 1-3 years), and high (>660 nights ≙ more than 3 years) night shift exposure. Hazard ratios (HR) were estimated for incident "quality-assured CVD events" using Cox proportional hazard models.

Results: At baseline, 1092 of 8167 working participants performed night shift work. During the follow-up, 202 incident cardiovascular events occurred. The crude incidence rates for CVD per 1000 person-years were 6.88 [95% confidence interval (CI) 4.80-9.55] for night shift workers and 5.19 (95% CI 4.44-6.04) for day workers. Cumulative incidence curves showed a higher cumulative incidence in workers exposed to night shift work compared to day workers after five years. The adjusted HR for incident CVD events were 1.26 (95% CI 0.68-2.33), 1.37 (95% CI 0.74-2.53) and 1.19 (95% CI 0.67-2.12) for employees in the low, middle and high night shift categories compared to employees without night shift work, respectively.

Conclusions: The observed tendencies indicate that night shift work might be negatively associated with cardiovascular health. We expect the continued follow-up will clarify the long-term impact of night shift work.

研究目的本研究旨在确定在以德国人口为基础的古腾堡健康研究(GHS)中,累积性夜班工作是否会增加心血管疾病(CVD)的发病风险:方法:我们对参加古腾堡健康研究的在职者进行了基线调查和五年后的调查。我们对基线前 10 年的累计夜班工作进行了评估,并将其分为低夜班(1-220 夜≙ 1 年以内)、中夜班(221-660 夜≙ 1-3 年)和高夜班(>660 夜≙ 3 年以上)。使用 Cox 比例危险模型估算了 "有质量保证的心血管疾病事件 "的危险比(HR):结果:8167 名参加工作的人中,有 1092 人从事夜班工作。在随访期间,共发生了 202 起心血管事件。夜班工人每千人年心血管疾病粗发病率为 6.88 [95% 置信区间 (CI) 4.80-9.55],白班工人为 5.19 (95% CI 4.44-6.04)。累积发病率曲线显示,与日班工人相比,夜班工人五年后的累积发病率更高。与没有夜班工作的员工相比,低、中、高夜班类别的员工发生心血管疾病事件的调整HR分别为1.26(95% CI 0.68-2.33)、1.37(95% CI 0.74-2.53)和1.19(95% CI 0.67-2.12):观察到的趋势表明,夜班工作可能与心血管健康呈负相关。结论:观察到的趋势表明,夜班工作可能会对心血管健康产生负面影响,我们希望持续的跟踪调查能够明确夜班工作的长期影响。
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引用次数: 0
Validity of self-reported night shift work among women with and without breast cancer. 患有和未患有乳腺癌的妇女自我报告夜班工作的有效性。
IF 6.3 2区 医学 Q1 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-08 DOI: 10.5271/sjweh.4142
Jesper Medom Vestergaard, Jesper Nikolai Dietrich Haug, Annett Dalbøge, Jens Peter Ellekilde Bonde, Anne Helene Garde, Johnni Hansen, Åse Marie Hansen, Ann Dyreborg Larsen, Mikko Härmä, Sadie Costello, Henrik Albert Kolstad

Objectives: This study aimed to estimate the validity of self-reported information on ever-night shift work among women with and without breast cancer and illustrate the consequences for breast cancer risk estimates.

Methods: During 2015-2016, 225 women diagnosed with breast cancer and 1800 matched controls without breast cancer employed within the Danish hospital regions during 2007-2016 participated in a questionnaire-based survey. Their reported night shift work status was linked with objective payroll register day-by-day working hour data from the Danish Working Hour Database and the Danish Cancer Registry. For the breast cancer patients and their matched controls, we estimated sensitivity and specificity for ever-working night shifts using the payroll data as the gold standard. We also used quantitative bias analysis to estimate the impact on relative risk estimates for a hypothetical population.

Results: For breast cancer patients, we observed a sensitivity of ever-night shifts of 86.2% and a specificity of never-night shifts of 82.6%. For controls, the sensitivity was 80.6% and the specificity 83.7%. Odds ratio for breast cancer in a hypothetical population decreased from 1.12 [95% confidence interval (CI) 1.03-1.21] to 1.05 (95% CI 0.95-1.16) when corrected by the sensitivity and specificity estimates.

Conclusion: This study shows that female breast cancer patients had slightly better recall of previous night shift work than controls. Additionally, both breast cancer patients and controls recalled previous never-night shift work with low specificity. The net effect of this misclassification is a small over-estimation of the relative breast cancer risk due to night shift work.

研究目的本研究旨在估算患有和未患有乳腺癌的女性自我报告的曾经夜班工作信息的有效性,并说明其对乳腺癌风险估算的影响:在 2015-2016 年期间,225 名确诊患有乳腺癌的女性和 1800 名在 2007-2016 年期间受雇于丹麦医院区域的未患乳腺癌的匹配对照者参与了一项基于问卷的调查。她们报告的夜班工作状况与丹麦工时数据库和丹麦癌症登记处提供的客观薪资登记逐日工时数据相关联。对于乳腺癌患者及其匹配对照,我们以工资单数据为金标准,估算了曾经上夜班的敏感性和特异性。我们还使用定量偏差分析来估计对假设人群相对风险估计值的影响:对于乳腺癌患者,我们观察到曾经上夜班的敏感性为 86.2%,从未上夜班的特异性为 82.6%。对于对照组,敏感性为 80.6%,特异性为 83.7%。根据灵敏度和特异性估计值进行校正后,假设人群中乳腺癌的患病率从 1.12 [95% 置信区间 (CI) 1.03-1.21] 降至 1.05 (95% CI 0.95-1.16):本研究表明,女性乳腺癌患者对以往夜班工作的回忆略好于对照组。此外,乳腺癌患者和对照组对以前从未上过夜班的回忆特异性较低。这种错误分类的净结果是,夜班工作导致的乳腺癌相对风险被略微高估。
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Scandinavian journal of work, environment & health
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