Association and pathways between shift work and cardiovascular disease: a prospective cohort study of 238 661 participants from UK Biobank

Ho, F. K., Celis-Morales, C. , Gray, S. R. , Demou, E. , Mackay, D. , Welsh, P. , Katikireddi, S. V. , Sattar, N. and Pell, J. P. (2022) Association and pathways between shift work and cardiovascular disease: a prospective cohort study of 238 661 participants from UK Biobank. International Journal of Epidemiology, 51(2), pp. 579-590. (doi: 10.1093/ije/dyab144) (PMID:34414428)

Abstract

Background: This study aimed to study the association between shift work and incident and fatal cardiovascular disease (CVD), and to explore modifying and mediating factors. Methods: This is a population-based, prospective cohort study with a median follow-up of 11 years; 238 661 UK Biobank participants who were in paid employment or self-employed at baseline assessment were included. Results: Shift workers had higher risk of incident [hazard ratio (HR) 1.11, 95% confidence interval (CI) 1.06–1.19] and fatal (HR 1.25, 95% CI 1.08–1.44) CVD compared with non-shift workers, after adjusting for socio-economic and work-related factors. The risk was higher with longer duration of shift work, in women and in jobs with little heavy manual labour. Current smoking, short sleep duration, poor sleep quality, adiposity, higher glycated haemoglobin and higher cystatin C were identified as the main potentially modifiable mediators. Mediators collectively explained 52.3% of the associations between shift work and incident CVDs. Conclusions: Shift workers have higher risk of incident and fatal CVD, partly mediated through modifiable risk factors such as smoking, sleep duration and quality, adiposity and metabolic status. Workplace interventions targeting these mediators have the potential to alleviate shift workers’ CVD risk.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Katikireddi, Professor Vittal and Celis, Dr Carlos and Gray, Professor Stuart and Demou, Dr Evangelia and Ho, Dr Frederick and Welsh, Professor Paul and Pell, Professor Jill and Mackay, Professor Daniel and Sattar, Professor Naveed
• Authors: Ho, F. K., Celis-Morales, C., Gray, S. R., Demou, E., Mackay, D., Welsh, P., Katikireddi, S. V., Sattar, N., and Pell, J. P.
• College/School: College of Medical Veterinary and Life Sciences > School of Cardiovascular & Metabolic Health; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > General Practice and Primary Care; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > MRC/CSO SPHSU; College of Medical Veterinary and Life Sciences > School of Health & Wellbeing > Public Health
• Journal Name: International Journal of Epidemiology
• Publisher: Oxford University Press
• ISSN: 0300-5771
• ISSN (Online): 1464-3685
• Published Online: 20 August 2021
• Copyright Holders: Copyright © 2021 The Authors
• First Published: First published in International Journal of Epidemiology 51(2): 579-590
• Publisher Policy: Reproduced under a Creative Commons License

Project Code	Award No	Project Name	Principal Investigator	Funder's Name	Funder Ref	Lead Dept
172690		Understanding the impacts of welfare policy on health: A novel data linkage study	Srinivasa Katikireddi	Office of the Chief Scientific Adviser (CSO)	SCAF/15/02	SHW - Public Health
72765	1	Measuring and Analysing Socioeconomic Inequalities in Health	Alastair Leyland	Medical Research Council (MRC)	MC_UU_12017/13	HW - MRC/CSO Social and Public Health Sciences Unit
72765	1	Measuring and Analysing Socioeconomic Inequalities in Health	Alastair Leyland	Office of the Chief Scientific Adviser (CSO)	SPHSU13	HW - MRC/CSO Social and Public Health Sciences Unit
310214		Child maltreatment and later life mental health: What are the potential mechanisms and what makes victims more resilient?	Ka-Wing Ho	Wellcome Trust (WELLCOTR)	N/A	SHW - Public Health