Total and cause-specific mortality of U.S. nurses working rotating night shifts

Am J Prev Med. 2015 Mar;48(3):241-52. doi: 10.1016/j.amepre.2014.10.018. Epub 2015 Jan 6.

Abstract

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.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Age Factors
  • Cardiovascular Diseases / epidemiology
  • Cardiovascular Diseases / mortality*
  • Female
  • Health Behavior
  • Humans
  • 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*