A Prospective Cohort Study of Shift Work and Risk of Ischemic Heart Disease in Japanese Male Workers

TLDR

The study prospectively examined whether shift work increases the risk of ischemic heart disease in Japanese male workers. The authors followed 17,649 employed men aged 40–59 from a nationwide baseline survey, classified them by day, rotating‑shift, or fixed‑night work, and used a Cox proportional hazards model to estimate ischemic heart disease risk. During 233,869 person‑years, rotating‑shift workers had a 2.32‑fold higher risk of ischemic heart disease death compared to day workers, while fixed‑night work showed no significant association; the effect was amplified among individuals with hypertension, overweight, alcohol use, or smoking.

Abstract

This study prospectively examined the association between shift work and the risk of ischemic heart disease among Japanese male workers. A baseline survey, which involved 110,792 inhabitants (age range: 40–79 years) from 45 areas throughout Japan, was conducted between 1988 and 1990. The causes of death were identified from death certificates. The analysis was restricted to 17,649 men (age range: 40–59 years) who were employed at the time of the baseline survey. All subjects were asked to indicate the most regular shift work that they had undertaken previously: day work, rotating-shift work, or fixed-night work. The Cox proportional hazards model was used to estimate the risks of shift work for ischemic heart disease. During the 233,869 person-years of follow-up, a total of 1,363 deaths were recorded, 86 of which were due to ischemic heart disease. Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (relative risk = 2.32, 95% confidence interval: 1.37, 3.95; p = 0.002), whereas fixed-night work was not associated with ischemic heart disease (relative risk = 1.23, 95% confidence interval: 0.49, 3.10; p = 0.658). In addition, subjects with coronary risk factors, such as hypertension, overweight, habitual alcohol consumption, and smoking, were highly susceptible to the effect of rotating-shift work on the risk of death due to ischemic heart disease.