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Case fatality of myocardial infarction among shift workers
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.
Mid Sweden University, Faculty of Human Sciences, Department of Health Sciences.ORCID iD: 0000-0003-2148-8044
Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umeå, Umeå, Sweden .
Department of Public Health and Clinical Medicine, Occupational Medicine, University of Umeå, Umeå, Sweden .
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2015 (English)In: International Archives of Occupational and Environmental Health, ISSN 0340-0131, E-ISSN 1432-1246, Vol. 88, no 5, p. 599-605Article in journal (Refereed) Published
Abstract [en]

Purpose: Shift work has been associated with an excess risk of cardiovascular disease (CVD) and more specifically myocardial infarction (MI). The majority of the studies that found a positive association between shift work and CVD have been based on incidence data. The results from studies on cardiovascular-related mortality among shift workers have shown little or no elevated mortality associated with shift work. None of the previous studies have analysed short-term mortality (case fatality) after MI. Therefore, we investigated whether shift work is associated with increased case fatality after MI compared with day workers.Methods: Data on incident cases with first MI were obtained from case–control study conducted in two geographical sites in Sweden (Stockholm Heart Epidemiology Program and Västernorrland Heart Epidemiology Program), including 1,542 cases (1,147 men and 395 women) of MI with complete working time information and 65 years or younger. Case fatality was defined as death within 28 days of onset of MI. Risk estimates were calculated using logistic regression.Results: The crude odds ratios for case fatality among male shift workers were 1.63 [95 % confidence interval (CI) 1.12, 2.38] and 0.56 (95 % CI 0.26, 1.18) for female shift workers compared with day workers. Adjustments for established cardiovascular risk factors such as diabetes type II and socio-economic status did not alter the results.Conclusion: Shift work was associated with increased risk of case fatality among male shift workers after the first MI.

Place, publisher, year, edition, pages
2015. Vol. 88, no 5, p. 599-605
Keywords [en]
Cardiovascular disease, Case–control, Epidemiology, Risk estimation, Shift work
National Category
Health Sciences
Identifiers
URN: urn:nbn:se:miun:diva-17465DOI: 10.1007/s00420-014-0984-zISI: 000354624400007Scopus ID: 2-s2.0-84939876826OAI: oai:DiVA.org:miun-17465DiVA, id: diva2:572527
Available from: 2012-11-28 Created: 2012-11-28 Last updated: 2017-12-07Bibliographically approved
In thesis
1. Shift work and cardiovascular disease
Open this publication in new window or tab >>Shift work and cardiovascular disease
2012 (English)Licentiate thesis, comprehensive summary (Other academic)
Abstract [en]

Shift work is a work schedule being the opposite of normal daytime work, often defined as working time outside normal daytime hours (06:00 to 18:00). In recent years, shift work has been associated with an increased risk of numerous chronic conditions including for example cardiovascular disease, some types of cancer, type II diabetes, and the metabolic syndrome. While some studies on the association between shift work and chronic disease have found results supporting it, others have not. Therefore, more research is needed to clarify potential associations.The aim of this thesis was to further study the proposed association between shift work and cardiovascular disease. This was addressed by performing two studies, one analysing if shift workers had an increased risk of ischemic stroke compared to day workers. The other study analysed whether shift workers had an increased risk of short-term mortality (case fatality) after a myocardial infarction compared to day workers. The studies were performed using logistic regression analysis in two different case-control databasesThe findings from the first study indicated that shift workers did not have an increased risk of ischemic stroke. The findings from the second study showed that male shift workers had an increased risk of death within 28 days after a myocardial infarction; the results did not indicate an increased risk for female shift workers. The results from both studies were adjusted for both behavioural and medical risk factors without affecting the results. The findings from this thesis provide new evidence showing that male shift workers have an increased risk of death 28 days after a myocardial infarction, however more research is needed to clarify and characterise any such potential associations.

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University, 2012. p. 26
Series
Mid Sweden University licentiate thesis, ISSN 1652-8948 ; 89
Keywords
Shift work, epidemiology, cardiovascular disease, stroke, case fatality
National Category
Health Sciences
Identifiers
urn:nbn:se:miun:diva-17466 (URN)978-91-87103-32-2 (ISBN)
Supervisors
Available from: 2012-11-28 Created: 2012-11-28 Last updated: 2012-11-30Bibliographically approved
2. Shift work and cardiovascular disease
Open this publication in new window or tab >>Shift work and cardiovascular disease
2015 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Shift work is often defined as working time outside daytime hours (06:00 to 18:00). In recent years, shift work has been associated with an increased risk of cardiovascular disease (CVD), type II diabetes, and the metabolic syndrome. While some studies support the associations, others do not. Therefore, more research is needed. The aim of this thesis was to further study the association between shift work and CVD. This was addressed by performing four studies, one analysed if shift workers had an increased risk of ischemic stroke, the second study analysed whether shift workers had an increased risk of short-term mortality (case fatality)after a myocardial infarction (MI). The third study analysed if shift work interacts with other risk factors for MI and the fourth study analysed if parental history of CVD interacted with shift work on the risk of MI. The studies were performed using logistic regression analyses and additive interaction analyses in two different case-control databases. Shift workers did not have an increased risk of ischemic stroke. Male shift workers had an increased risk of death within 28 days after a MI. Shift work interacts with some CVD risk factors and interacts with paternal history of CVD and the risk of MI for males. The findings from this thesis provide new evidence showing that shift work is in different ways associated with an increased risk of MI and related mortality, but not with ischemic stroke. However, more research is needed to clarify and characterise these results.

Place, publisher, year, edition, pages
Sundsvall: Mid Sweden University, 2015. p. 77
Series
Mid Sweden University doctoral thesis, ISSN 1652-893X ; 231
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:miun:diva-26219 (URN)978-91-88025-41-8 (ISBN)
Public defence
2015-11-27, Lubbesalen, Sundsvall, 13:15 (Swedish)
Supervisors
Note

Vid tidpunkten för disputationen var följande delarbeten opublicerade: delarbete 3 manuskript, delarbete 4 manuskript

At the time of the doctoral defence the following papers were unpublished: paper 3 manuscript, paper 4 manuscript

Available from: 2015-11-05 Created: 2015-11-05 Last updated: 2015-12-22Bibliographically approved

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Hermansson, JonasGillander Gådin, KatjaKnutsson, Anders

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