This review summarises the literature on shift work and its relation to insufficient sleep, chronic diseases, and accidents. It is based on 38 meta-analyses and 24 systematic reviews, with additional narrative reviews and articles used for outlining possible mechanisms by which shift work may cause accidents and adverse health. Evidence shows that the effect of shift work on sleep mainly concerns acute sleep loss in connection with night shifts and early morning shifts. A link also exists between shift work and accidents, type 2 diabetes (relative risk range 1.09-1.40), weight gain, coronary heart disease (relative risk 1.23), stroke (relative risk 1.05), and cancer (relative risk range 1.01-1.32), although the original studies showed mixed results. The relations of shift work to cardiometabolic diseases and accidents mimic those with insufficient sleep. Laboratory studies indicate that cardiometabolic stress and cognitive impairments are increased by shift work, as well as by sleep loss. Given that the health and safety consequences of shift work and insufficient sleep are very similar, they are likely to share common mechanisms. However, additional research is needed to determine whether insufficient sleep is a causal pathway for the adverse health effects associated with shift work.
Background: It has been proposed that night shift work could increase breast cancer incidence. A 2007 World Health Organization review concluded, mainly from animal evidence, that shift work involving circadian disruption is probably carcinogenic to humans. We therefore aimed to generate prospective epidemiological evidence on night shift work and breast cancer incidence.
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Methods: Overall, 522 246 Million Women Study, 22 559 EPIC-Oxford, and 251 045 UK Biobank participants answered questions on shift work and were followed for incident cancer. Cox regression yielded multivariable-adjusted breast cancer incidence rate ratios (RRs) and 95% confidence intervals (CIs) for night shift work vs no night shift work, and likelihood ratio tests for interaction were used to assess heterogeneity. Our meta-analyses combined these and relative risks from the seven previously published prospective studies (1.4 million women in total), using inverse-variance weighted averages of the study-specific log RRs.
Results: In the Million Women Study, EPIC-Oxford, and UK Biobank, respectively, 673, 28, and 67 women who reported night shift work developed breast cancer, and the RRs for any vs no night shift work were 1.00 (95% CI = 0.92 to 1.08), 1.07 (95% CI = 0.71 to 1.62), and 0.78 (95% CI = 0.61 to 1.00). In the Million Women Study, the RR for 20 or more years of night shift work was 1.00 (95% CI = 0.81 to 1.23), with no statistically significant heterogeneity by sleep patterns or breast cancer risk factors. Our meta-analysis of all 10 prospective studies included 4660 breast cancers in women reporting night shift work; compared with other women, the combined relative risks were 0.99 (95% CI = 0.95 to 1.03) for any night shift work, 1.01 (95% CI = 0.93 to 1.10) for 20 or more years of night shift work, and 1.00 (95% CI = 0.87 to 1.14) for 30 or more years.
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The timer on an espresso grinder controls the length of the time interval for which the motor will remain turned on. Many designs allow you to set up more than one preset. The efficiency of grinders can vary greatly. It can take anywhere between 2 and 10 seconds of grinding time to obtain enough coffee for a double espresso. If 5 seconds gives you a little less coffee than your recipe calls for, then the timer should be adjusted to run a few tenths of a second longer for the next dose. As a work shift progresses,
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Shift work is associated with negative health effects. Increased prevalence of several cardiovascular risk factors among shift workers/night workers compared with day workers have been shown resulting in increased risk of cardiovascular events among shift workers and night workers. Previous studies have taken a dichotomous approach to the comparison between day and night workers. The present study uses a continuous approach and provides such a new perspective to the negative effects of night work load as a possible risk factor for undesirable health effects.
Several studies have focused on relative differences in prevalence of cardiovascular risk factors of shift workers/night workers compared to day workers. Shift and night workers have higher prevalence of risk factors such as smoking, dyslipidemia, and weight gain when comparing to day workers [5, 6]. Biggi et al. found that the cluster of independent risk factors collectively termed metabolic syndrome was increased among night workers compared to day workers [7]. Bggild et al. concluded in a metaanalysis that shift work represented a 40 % increase in the risk of cardiovascular disease [8].
As a result of the increasing evidence supporting negative health effects of shift work, newly published studies suggest that countermeasures are needed to reverse this. Different measures for primary prevention have been proposed to counteract the negative effects of shift work: for instance, proper work scheduling, exercise, and dietary guidelines [10, 11]. In addition to longitudinal studies addressing possible causal relationship between shift work and cardiovascular disease, more studies are needed to investigate possible sub-populations among shift workers who have an elevated risk for developing cardiovascular disease.
Most previous studies have taken a dichotomous approach to the comparison of night and day workers in terms of possible cardiovascular risk factors such as weight gain and elevated BMI. The present study instead evaluates the night shift work load effect on BMI, alcohol consumption, smoking habits, caffeine consumption, and exercise habits using the number of night shifts worked the last year as a predictor. Our design may help to investigate further whether workers with a heavy night shift work load might need more frequent health checks or more direct countermeasures due to increased risk of undesirable health effects and habits.
The questionnaire covered demographic factors in terms of sex and age, marital status, and whether the responders had children living at home. Responders were also asked for their working schedule: day only, evening only, day and evening, three shift rotation, night only, or another schedule including night work. The questionnaire also covered how long they had been working this schedule, and how long they had worked as a nurse. The nurses were asked to indicate the number of night shifts they had worked the last year (NNL). Furthermore they were asked to report average work hours per week, and their percentage of a full time equivalent work position (50-75 %, 76-90 % and above 90 %).
Our findings suggest that there is a positive association between night work load and BMI, even when controlling for several relevant confounders. The association was significant both when using BMI as a continuous parameter, and when evaluated as obesity (BMI >30). Ramin et al. found that higher levels of average night shifts per month in American nurses were significantly associated with increased risk of obesity [15]. This is consistent with our finding. Other studies have taken a dichotomous approach and shown a significant difference in BMI or weight gain between night and day workers. For instance, Biggi et al. found that night workers had significantly higher BMI than day workers [7]. Metabolic syndrome is being defined as a cluster of cardiovascular risk factors: obesity, dyslipidemia, hypertension, and impaired glucose tolerance. Bacquer et al. found in a longitudinal study that rotating shift work increased the risk of metabolic syndrome. The risk was graded with respect to the number of years with shift work [16]. Furthermore several studies have looked directly at cardiovascular risk and found that shift workers are at higher risk [8, 17]. There is, however, some controversy regarding increased incidence among shift workers for ischemic heart disease [18]. 0852c4b9a8
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