Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts

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...

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Published in:American journal of preventive medicine 2015-03, Vol.48 (3), p.241-252
Main Authors: Gu, Fangyi, MD, ScD, Han, Jiali, PhD, Laden, Francine, ScD, Pan, An, PhD, Caporaso, Neil E., MD, Stampfer, Meir J., MD, DrPH, Kawachi, Ichiro, MD, PhD, Rexrode, Kathryn M., MD, MPH, Willett, Walter C., MD, DrPH, Hankinson, Susan E., ScD, Speizer, Frank E., MD, Schernhammer, Eva S., MD, DrPH
Format: Article
Language:English
Subjects:
Adult
Age Factors
Cardiovascular Diseases - epidemiology
Cardiovascular Diseases - mortality
Female
Health Behavior
Humans
Internal Medicine
Life Style
Middle Aged
Neoplasms - epidemiology
Neoplasms - mortality
Nurses - statistics & numerical data
Proportional Hazards Models
Prospective Studies
Risk Factors
Socioeconomic Factors
Time Factors
United States - epidemiology
Women's Health
Work Schedule Tolerance
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Summary: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.
ISSN:0749-3797
1873-2607
DOI:10.1016/j.amepre.2014.10.018