Occupational Risk for Coronary Artery Disease in Shift Workers – A Systematic Review
Main Article Content
Keywords
Coronary Artery Disease, Cardiovascular, Shift Work, Night Work, Irregular work schedule.
Abstract
Background: Coronary artery disease (CAD) prevention in shift workers (SWs) poses a significant challenge worldwide, as CAD remains a major cause of mortality and disability. In the past, SWs were found at higher risk of CAD than non-s SWs. Nevertheless, the pathogenic mechanism between shift work and CAD to date is unclear. This systematic review aims to enhance understanding of the risk of CAD occurrence in SWs. Methods: A systematic literature review was conducted from January 2013 to December 2023. MEDLINE/Pubmed databases were used initially, and additional relevant studies were searched from references. Shift work was defined as any schedule outside traditional shifts, including the night shift. Results: Fifteen pertinent papers were categorized into risk assessment or risk management. Findings demonstrated an increased risk of CAD among SWs compared to non-SWs, with an increased CAD risk observed for both shift work and night shift work. Discussion: Duration-response associations indicate that greater shift exposure is linked to higher CAD risk. SWs incur an increased risk of CAD through the atherosclerotic process. As shift work duration increases as the risk of atherosclerosis is higher, workers demonstrate a higher prevalence and severity of coronary artery plaques. Conclusions: The evidence-based results underscore the increased risk of CAD in SWs and are sufficient for proposing guidelines aimed at reducing the risk of CAD in SWs and at managing people with CAD in return to work characterized by disrupted circadian rhythms.
References
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31. Härmä M, Gustavsson P, Kolstad HA. Shift work and cardiovascular disease - do the new studies add to our knowledge? Scand J Work Environ Health. 2018;44(3):225-228.
32. Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7:16.
33. Wells G, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non-randomised Studies in Meta-Analyses. [Last Accessed on 15.022024)]; Available online:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
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38. Ho FK, Celis-Morales C, Gray SR, Demou E, Mackay D, et al. Association and pathways between shift work and cardiovascular disease: a prospective cohort study of 238 661 participants from UK Biobank. Int J Epidemiol. 2022;51(2):579-590.
39. Havakuk O, Zukerman N, Flint N. Shift Work and the Risk of Coronary Artery Disease: A Cardiac Com-puted Tomography Angiography Study. Cardiology. 2018;139(1):11-16.
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41. Hermansson J, Hallqvist J, Karlsson B, et al. Shift work, parental cardiovascular disease and myocardial infarction in males. Occup Med (Lond). 2018;68(2):120-125. Doi: 10.1093/occmed/kqy008
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43. Zhao Y, Lu X, Wan F, Gao L, et al. Disruption of Circadian Rhythms by Shift Work Exacerbates Reperfusion Injury in Myocardial Infarction. J Am Coll Cardiol. 2022;79(21):2097-2115.
44. Kader M, Selander J, Andersson T, et al. Night and shift work characteristics and incident ischemic heart disease and atrial fibrillation among healthcare employees - a prospective cohort study. Scand J Work Environ Health. 2022;48(7):520-529.
45. Vetter C, Devore EE, Wegrzyn LR, et al. Association Between Rotating Night Shift Work and Risk of Cor-onary Heart Disease Among Women. JAMA. 2016;315(16):1726-34.
46. Cheng M, He H, Wang D, et al. Shift work and ischaemic heart disease: meta-analysis and dose-response relationship. Occup Med (Lond). 2019;69(3):182-188.
47. Vestergaard JM, Dalbøge A, Bonde JPE, et al. Night shift work characteristics and risk of incident coro-nary heart disease among health care workers: national cohort study. Int J Epidemiol. 2023:dyad126. Doi: 10.1093/ije/dyad126. Epub ahead of print
48. Mamen A, Øvstebø R, Sirnes PA, et al. High-Intensity Training Reduces CVD Risk Factors among Rotating Shift Workers: An Eight-Week Intervention in Industry. Int J Environ Res Public Health. 2020;17(11):3943.
49. Holtermann A, Schnohr P, Nordestgaard BG, Marott JL. The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults. Eur Heart J. 2021;42(15):1499-1511.
50. Barger LK, Rajaratnam SMW, Cannon CP, et al. Short Sleep Duration, Obstructive Sleep Apnea, Shiftwork, and the Risk of Adverse Cardiovascular Events in Patients After an Acute Coronary Syndrome. J Am Heart Assoc. 2017;6(10):e006959.
51. Solymanzadeh F, Rokhafroz D, Asadizaker M, Dastoorpoor M. Prediction of risk of coronary artery dis-ease based on the Framingham risk score in association with shift work among nurses. Int J Occup Saf Ergon. 2023;29(1):56-61.
52. Carreón T, Hein MJ, Hanley KW, et al. Coronary artery disease and cancer mortality in a cohort of work-ers exposed to vinyl chloride, carbon disulfide, rotating shift work, and o-toluidine at a chemical manu-facturing plant. Am J Ind Med. 2014;57(4):398-411.
53. Wang A, Arah OA, Kauhanen J, Krause N. Shift work and 20-year incidence of acute myocardial infarction: results from the Kuopio Ischemic Heart Disease Risk Factor Study. Occup Environ Med. 2016;73(9):588-94.
2. National Heart, Lung, and Blood Institute (U.S.) https://www.nhlbi.nih.gov/health/coronary-heart-disease [Last Accessed 28.02.2024].
3. Roth GA, Mensah GA, Johnson CO, et al. Global Burden of Cardiovascular Diseases Writing Group. (2020). Global burden of cardiovascular diseases and risk factors, 1990–2019: update from the GBD 2019 study. J Am Coll Cardiol. 76(25), 2982-3021.
4. Bauersachs R, Zeymer U, Brière JB, et al. Burden of coronary artery disease and peripheral artery dis-ease: a literature review. Cardiovasc Ther. 2019;2019:8295054.
5. Ralapanawa U, Sivakanesan R. Epidemiology and the Magnitude of Coronary Artery Disease and Acute Coronary Syndrome: A Narrative Review. J Epidemiol Glob Health. 2021;11(2):169-177.
6. Pelletier-Galarneau M, Vandenbroucke E, Lu M, Li O. Characteristics and key differences between patient populations receiving imaging modalities for coronary artery disease diagnosis in the US. BMC Cardio-vasc Disord. 2023;23(1):251.
7. World Health Organization; Cardiovascular Diseases (CVDs). Year: 2021. https://www.who.int/news-room/fact-sheets/detail/cardiovascular-disea ses-(cvds).
8. Ahmadi M, Lanphear B. The impact of clinical and population strategies on coronary heart disease mor-tality: an assessment of Rose's big idea. BMC Public Health. 2022;22(1):14.
9. Thomas C, Power C. Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort. Eur J Epidemiol. 2010;25(5):305-14. Doi: 10.1007/s10654-010-9438-4. Epub 2010 Mar 18. PMID: 20237824.
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11. Torquati L, Mielke GI, Brown WJ, Kolbe-Alexander T. Shift work and the risk of cardiovascular disease. A systematic review and meta-analysis including dose-response relationship. Scand J Work Environ Health. 2018;44(3):229-238.
12. Fujino Y, Iso H, Tamakoshi A, et al. Japanese Collaborative Cohort Study Group. A prospective cohort study of shift work and risk of ischemic heart disease in Japanese male workers. Am J Epidemiol. 2006;164(2):128-35.
13. Thomas C, Power C. Shift work and risk factors for cardiovascular disease: a study at age 45 years in the 1958 British birth cohort. Eur J Epidemiol. 2010;25(5):305-14.
14. Bøggild H, Knutsson A. Shift work, risk factors and cardiovascular disease. Scand J Work Environ Health. 1999;25(2):85-99.
15. Farha, Rana Abu, Eman Alefishat. "Shift work and the risk of cardiovascular diseases and metabolic syn-drome among Jordanian employees." Oman medical journal 33.3 (2018): 235.
16. Buijs RM, Kreier F. The metabolic syndrome: a brain disease? J Neuroendocrinol. 2006;18(9):715-6.
17. Furlan R, Barbic F, Piazza S, Tinelli M, Seghizzi P, Malliani A. Modifications of cardiac autonomic profile associated with a shift schedule of work. Circulation. 2000;102(16):1912-6.
18. Dutheil F, Baker JS, Mermillod M, et al. Shift work, and particularly permanent night shifts, promote dyslipidaemia: A systematic review and meta-analysis. Atherosclerosis. 2020;313:156-169.
19. Yang X, Di W, Zeng Y, et al. Association between shift work and risk of metabolic syndrome: A systematic review and meta-analysis. Nutr Metab Cardiovasc Dis. 2021;31(10):2792-2799.
20. Dicom AR, Huang X, Hilal S. Association between Shift Work Schedules and Cardiovascular Events in a Multi-Ethnic Cohort. Int J Environ Res Public Health. 2023;20(3):2047.
21. D'Ettorre G, Pellicani V, Greco M, Caroli A, Mazzotta M. Metabolic syndrome in shift healthcare workers. Med Lav. 2019;110(4):285-292.
22. Civelek E, Ozturk Civelek D, Akyel YK, Kaleli Durman D, Okyar A. Circadian Dysfunction in Adipose Tis-sue: Chronotherapy in Metabolic Diseases. Biology (Basel). 2023;12(8):1077. Doi: 10.3390/biology12081077. PMID: 37626963; PMCID: PMC10452180.
23. Vyas MV, Garg AX, Iansavichus AV. Shift work and vascular events: systematic review and me-ta-analysis. BMJ. 2012;345:e4800. Doi: 10.1136/bmj.e4800
24. Pan A, Schernhammer ES, Sun Q, Hu FB. Rotating night shift work and risk of type 2 diabetes: two pro-spective cohort studies in women. PLoS Med. 2011;8(12):e1001141.
25. Rashnuodi P, Afshari D, Shirali GA, et al. Metabolic syndrome and its relationship with shift work in petrochemical workers. Work. 2022;71(4):1175-1182.
26. Kalsbeek A, Kreier F, Fliers E, et al. Minireview: Circadian control of metabolism by the suprachiasmatic nuclei. Endocrinology. 2007;148(12):5635-9.
27. Poetsch MS, Strano A, Guan K. Role of Leptin in Cardiovascular Diseases. Front Endocrinol (Lausanne). 2020;11:354.
28. Li W, Yu K, Jia N, et al. Past Shift Work and Incident Coronary Heart Disease in Retired Workers: A Pro-spective Cohort Study. Am J Epidemiol. 2021;190(9):1821-1829.
29. World Health Organization. International Statistical Classification of Diseases and Related Health Prob-lems, Tenth Revision. Geneva, Switzerland: World Health Organization; 2008. https://icd.who.int/browse10/2008/en#/ I20-I25. [Last Accessed 13.12.2023].
30. Luepker RV, Apple FS, Christenson RH, et al. Case definitions for acute coronary heart disease in epide-miology and clinical research studies: a statement from the AHA Council on Epidemiology and Preven-tion; AHA Statistics Committee; World Heart Federation Council on Epidemiology and Prevention; the European Society of Cardiology Working Group on Epidemiology and Prevention; Centers for Disease Control and Prevention; and the National Heart, Lung, and Blood Institute. Circulation. 2003;108(20):2543-9. Doi: 10.1161/01.CIR.0000100560.46946.EA
31. Härmä M, Gustavsson P, Kolstad HA. Shift work and cardiovascular disease - do the new studies add to our knowledge? Scand J Work Environ Health. 2018;44(3):225-228.
32. Schardt C, Adams MB, Owens T, Keitz S, Fontelo P. Utilization of the PICO framework to improve searching PubMed for clinical questions. BMC Med Inform Decis Mak. 2007;7:16.
33. Wells G, Shea B, O’Connell D, et al. The Newcastle-Ottawa Scale (NOS) for Assessing the Quality of Non-randomised Studies in Meta-Analyses. [Last Accessed on 15.022024)]; Available online:http://www.ohri.ca/programs/clinical_epidemiology/oxford.asp
34. Colaprico C, Grima D, Shaholli D, Imperiale I, La Torre G. Workplace Bullying in Italy: A Systematic Re-view and Meta-Analysis. Med Lav. 2023;114(6):e2023049.
35. Takkouche, Bahi, and Guy Norman. "PRISMA statement." Epidemiology. 22.1 (2011): 128.
36. Jørgensen JT, Karlsen S, Stayner L, Hansen J, Andersen ZJ. Shift work and overall and cause-specific mor-tality in the Danish nurse cohort. Scand J Work Environ Health. 2017;43(2):117-126. Doi: 10.5271/sjweh.3612
37. Eng A, Denison HJ, Corbin M, et al. Long working hours, sedentary work, noise, night shifts and risk of ischaemic heart disease. Heart. 2023;109(5):372-379. Doi: 10.1136/heartjnl-2022-320999
38. Ho FK, Celis-Morales C, Gray SR, Demou E, Mackay D, et al. Association and pathways between shift work and cardiovascular disease: a prospective cohort study of 238 661 participants from UK Biobank. Int J Epidemiol. 2022;51(2):579-590.
39. Havakuk O, Zukerman N, Flint N. Shift Work and the Risk of Coronary Artery Disease: A Cardiac Com-puted Tomography Angiography Study. Cardiology. 2018;139(1):11-16.
40. Kang W, Park WJ, Jang KH, et al. Coronary artery atherosclerosis associated with shift work in chemical plant workers by using coronary CT angiography. Occup Environ Med. 2016;73(8):501-5.
41. Hermansson J, Hallqvist J, Karlsson B, et al. Shift work, parental cardiovascular disease and myocardial infarction in males. Occup Med (Lond). 2018;68(2):120-125. Doi: 10.1093/occmed/kqy008
42. Wang N, Sun Y, Zhang H, et al. Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease. Eur Heart J. 2021;42(40):4180-4188. Doi: 10.1093/eurheartj/ehab505
43. Zhao Y, Lu X, Wan F, Gao L, et al. Disruption of Circadian Rhythms by Shift Work Exacerbates Reperfusion Injury in Myocardial Infarction. J Am Coll Cardiol. 2022;79(21):2097-2115.
44. Kader M, Selander J, Andersson T, et al. Night and shift work characteristics and incident ischemic heart disease and atrial fibrillation among healthcare employees - a prospective cohort study. Scand J Work Environ Health. 2022;48(7):520-529.
45. Vetter C, Devore EE, Wegrzyn LR, et al. Association Between Rotating Night Shift Work and Risk of Cor-onary Heart Disease Among Women. JAMA. 2016;315(16):1726-34.
46. Cheng M, He H, Wang D, et al. Shift work and ischaemic heart disease: meta-analysis and dose-response relationship. Occup Med (Lond). 2019;69(3):182-188.
47. Vestergaard JM, Dalbøge A, Bonde JPE, et al. Night shift work characteristics and risk of incident coro-nary heart disease among health care workers: national cohort study. Int J Epidemiol. 2023:dyad126. Doi: 10.1093/ije/dyad126. Epub ahead of print
48. Mamen A, Øvstebø R, Sirnes PA, et al. High-Intensity Training Reduces CVD Risk Factors among Rotating Shift Workers: An Eight-Week Intervention in Industry. Int J Environ Res Public Health. 2020;17(11):3943.
49. Holtermann A, Schnohr P, Nordestgaard BG, Marott JL. The physical activity paradox in cardiovascular disease and all-cause mortality: the contemporary Copenhagen General Population Study with 104 046 adults. Eur Heart J. 2021;42(15):1499-1511.
50. Barger LK, Rajaratnam SMW, Cannon CP, et al. Short Sleep Duration, Obstructive Sleep Apnea, Shiftwork, and the Risk of Adverse Cardiovascular Events in Patients After an Acute Coronary Syndrome. J Am Heart Assoc. 2017;6(10):e006959.
51. Solymanzadeh F, Rokhafroz D, Asadizaker M, Dastoorpoor M. Prediction of risk of coronary artery dis-ease based on the Framingham risk score in association with shift work among nurses. Int J Occup Saf Ergon. 2023;29(1):56-61.
52. Carreón T, Hein MJ, Hanley KW, et al. Coronary artery disease and cancer mortality in a cohort of work-ers exposed to vinyl chloride, carbon disulfide, rotating shift work, and o-toluidine at a chemical manu-facturing plant. Am J Ind Med. 2014;57(4):398-411.
53. Wang A, Arah OA, Kauhanen J, Krause N. Shift work and 20-year incidence of acute myocardial infarction: results from the Kuopio Ischemic Heart Disease Risk Factor Study. Occup Environ Med. 2016;73(9):588-94.
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Occupational Risk for Coronary Artery Disease in Shift Workers – A Systematic Review. Med Lav [Internet]. 2024 Apr. 24 [cited 2024 May 5];115(2):e2024015. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/15532
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Author Biographies
Gabriele d'Ettorre, ASL Lecce
Dirigente Medico Competente ed Autorizzato alla Radioprotezione della ASL Lecce
Prisco Piscitelli, Department of Experimental Medicine, University of Salento, Lecce, Italy.
Department of Experimental Medicine, University of Salento, Lecce, Italy. Professor
Vincenza Pellicani, Local Health Authority of Lecce, Italy
Local Health Authority of Lecce, Italy
Giancarlo Ceccarelli, Sapienza University of Rome
Azienda Ospedaliero-Universitaria Policlinico Umberto I, Rome, Italy
Department of Public Health and Infectious Diseases, University of Rome Sapienza, Rome, Italy
Gabriella d'Ettorre, Sapienza University of Rome, Italy
Department of Public Health and Infectious Diseases, Sapienza University of Rome, Italy. Professor
How to Cite
1.
Occupational Risk for Coronary Artery Disease in Shift Workers – A Systematic Review. Med Lav [Internet]. 2024 Apr. 24 [cited 2024 May 5];115(2):e2024015. Available from: https://mattioli1885journals.com/index.php/lamedicinadellavoro/article/view/15532
