Shift Work and Cardiovascular Disease

Main Article Content

Sawanee Srijaroentham Soontorn Supapong


Shift work is work that takes place on a schedule outside the traditional 8 AM - 6 PM. This is a way of life that is different from day workers. In a study undertaken over 20 years found that shift work was associated with cardiovascular disease but the evidences were not really clear. There are different of definition of shift work and confounding factors in each study. The collected data found that shift work was associated with cardiovascular risk such as obesity, metabolic syndrome and diabetes. And found that rotating night shift work associated with ischemic heart disease the most. While that is associated with stroke is relatively small. However, the studies on the relationship between shift work and stroke were not much. This article is therefore to collect data from many studies. To conclude the definition of shift work, relationship of shift work and cardiovascular disease and associated factors. Aims to define a corresponding of shift work and find some gap of knowledge for further researches.




Article Details

How to Cite
Srijaroentham, S., & Supapong, S. (2018). Shift Work and Cardiovascular Disease. Ramathibodi Medical Journal, 41(3), 100-108.
Review Articles


1. Laslett LJ, Alagona P, Jr., Clark BA 3rd, et al. The worldwide environment of cardiovascular disease: prevalence, diagnosis, therapy, and policy issues: a report from the American College of Cardiology. J Am Coll Cardiol. 2012;60(Suppl 25):S1-S49. doi:10.1016/j.jacc.2012.11.002.

2. Mendis S, Puska P, Norrving B, eds. Global Atlas on Cardiovascular Disease Prevention and Control. Geneva, Switzerland: World Health Organization; 2011.

3. Bureau of Non Communicable Disease, Ministry of Public Health. Annual report 2015. Bangkok, Thailand: The War Veterans Organization of Thailand Under Royal Patronage of His Majesty the King Printing; 2016.

4. Faxon DP, Fuster V, Libby P, et al. Atherosclerotic vascular disease conference: writing group III: pathophysiology. Circulation. 2004;109(21):2617-2625.

5. Patel SA, Winkel M, Ali MK, Narayan KM, Mehta NK. Cardiovascular mortality associated with 5 leading risk factors: national and state preventable fractions estimated from survey data. Ann Intern Med. 2015;163(4):245-253. doi:10.7326/M14-1753.

6. Harris T, Cook EF, Kannel WB, Goldman L. Proportional hazards analysis of risk factors for coronary heart disease in individuals aged 65 or older. The Framingham Heart Study. J Am Geriatr Soc. 1988;36(11):1023-1028.

7. Hermansson J, Gillander Gadin K, Karlsson B, Lindahl B, Stegmayr B, Knutsson A. Ischemic stroke and shift work. Scand J Work Environ Health. 2007;33(6):435-439.

8. Moe B, Mork PJ, Holtermann A, Nilsen TI. Occupational physical activity, metabolic syndrome and risk of death from all causes and cardiovascular disease in the HUNT 2 cohort study. Occup Environ Med. 2013;70(2):86-90. doi:10.1136/oemed-2012-100734. doi:10.1136/oemed-2012-100734.

9. 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):501-505. doi:10.1136/oemed-2015-103118.

10. Hermansson J, Gillander Gadin K, Karlsson B, Reuterwall C, Hallqvist J, Knutsson A. Case fatality of myocardial infarction among shift workers. Int Arch Occup Environ Health. 2015;88(5):599-605. doi:10.1007/s00420-014-0984-z.

11. Knutsson A, Hallquist J, Reuterwall C, Theorell T, Akerstedt T. Shiftwork and myocardial infarction: a case-control study. Occup Environ Med. 1999;56(1):46-50.

12. Jankowiak S, Backe E, Liebers F, et al. Current and cumulative night shift work and subclinical atherosclerosis: results of the Gutenberg Health Study. Int Arch Occup Environ Health. 2016;89(8):1169-1182.

13. Wang A, Arah OA, Kauhanen J, Krause N. Work schedules and 11-year progression of carotid atherosclerosis in middle-aged Finnish men. Am J Ind Med. 2015;58(1):1-13. doi:10.1002/ajim.22388.

14. 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):588-594. doi:10.1136/oemed-2015-103245.

15. Vetter C, Devore EE, Wegrzyn LR, Massa J, Speizer FE, Kawachi I, et al. Association between rotating night shift work and risk of coronary heart disease among women. JAMA. 2016;315(16):1726-34. doi:10.1001/jama.2016.4454.

16. Hublin C, Partinen M, Koskenvuo K, Silventoinen K, Koskenvuo M, Kaprio J. Shift-work and cardiovascular disease: a population-based 22-year follow-up study. Eur J Epidemiol. 2010;25(5):315-323. doi:10.1007/s10654-010-9439-3.

17. Vyas MV, Garg AX, Iansavichus AV, et al. Shift work and vascular events: systematic review and meta-analysis. BMJ. 2012;345:e4800. doi:10.1136/oemed-2015-103245.

18. Gu F, Han J, Laden F, et al. Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts. American journal of preventive medicine. 2015;48(3):241-252. doi:10.1016/j.amepre.2014.10.018.

19. Haupt CM, Alte D, Dorr M, et al. The relation of exposure to shift work with atherosclerosis and myocardial infarction in a general population. Atherosclerosis. 2008;201(1):205-211.doi:10.1016/j.atherosclerosis.2007.12.059.

20. Itani O, Kaneita Y, Murata A, Yokoyama E, Ohida T. Association of onset of obesity with sleep duration and shift work among Japanese adults. Sleep Med. 2011;12(4):341-345. doi:10.1016/j.sleep.2010.09.007.

21. Suwazono Y, Dochi M, Sakata K, Okubo Y. A longitudinal study on the effect of shift work on weight gain in male Japanese workers. Obesity (Silver Spring). 2008;16(8):1887-1893. doi:10.1038/oby.2008.298.

22. Son M, Ye BJ, Kim JI, Kang S, Jung KY. Association between shift work and obesity according to body fat percentage in Korean wage workers: data from the fourth and the fifth Korea National Health and Nutrition Examination Survey (KNHANES 2008-2011). Ann Occup Environ Med. 2015;27:32. doi:10.1186/s40557-015-0082-z.

23. Antunes LC, Levandovski R, Dantas G, Caumo W, Hidalgo MP. Obesity and shift work: chronobiological aspects. Nutr Res Rev. 2010;23(1):155-168. doi:10.1017/S0954422410000016.

24. Atkinson G, Fullick S, Grindey C, Maclaren D. Exercise, energy balance and the shift worker. Sports Med. 2008;38(8):671-685.

25. de Assis MA, Kupek E, Nahas MV, Bellisle F. Food intake and circadian rhythms in shift workers with a high workload. Appetite. 2003;40(2):175-183.

26. Manenschijn L, van Kruysbergen RG, de Jong FH, Koper JW, van Rossum EF. Shift work at young age is associated with elevated long-term cortisol levels and body mass index. J Clin Endocrinol Metab. 2011;96(11):E1862- E1865. doi:10.1210/jc.2011-1551.

27. Yong LC, Li J, Calvert GM. Sleep-related problems in the US working population: prevalence and association with shiftwork status. Occup Environ Med. 2017;74(2):93-104. doi:10.1136/oemed-2016-103638.

28. Knutsson A, Kempe A. Shift work and diabetes--a systematic review. Chronobiol Int. 2014 ;31(10):1146-1151. doi:10.3109/07420528.2014.957308.

29. Pan A, Schernhammer ES, Sun Q, Hu FB. Rotating night shift work and risk of type 2 diabetes: two prospective cohort studies in women. PLoS Med. 2011;8(12):e1001141. doi:10.1371/journal.pmed.1001141.

30. Hansen AB, Stayner L, Hansen J, Andersen ZJ. Night shift work and incidence of diabetes in the Danish Nurse Cohort. Occup Environ Med. 2016;73(4):262-268. doi:10.1136/oemed-2015-103342.

31. Leproult R, Holmbäck U, Van Cauter E. Circadian misalignment augments markers of insulin resistance and inflammation, independently of sleep loss. Diabetes. 2014;63(6):1860-1869.

32. Ohlander J, Keskin MC, Stork J, Radon K. Shift work and hypertension: prevalence and analysis of disease pathways in a German car manufacturing company. Am J Ind Med. 2015;58(5):549-60. doi:10.1002/ajim.22437.

33. Nazri SM, Tengku MA, Winn T. The association of shift work and hypertension among male factory workers in Kota Bharu, Kelantan, Malaysia. Southeast Asian J Trop Med Public Health. 2008;39(1):176-183.

34. Suwazono Y, Dochi M, Sakata K, et al. Shift work is a risk factor for increased blood pressure in Japanese men: a 14-year historical cohort study. Hypertension. 2008;52(3):581-586. doi:10.1161/HYPERTENSIONAHA.108.114553.

35. Pietroiusti A, Neri A, Somma G, et al. Incidence of metabolic syndrome among night-shift healthcare workers. Occup Environ Med. 2010;67(1):54-57. doi:10.1136/oem.2009.046797.

36. Copertaro A, Bracci M, Barbaresi M, Santarelli L. Assessment of cardiovascular risk in shift healthcare workers. Eur J Cardiovasc Prev Rehabil. 2008;15(2):224-229. doi:10.1097/HJR.0b013e3282f364c0.

37. De Bacquer D, Van Risseghem M, Clays E, Kittel F, De Backer G, Braeckman L. Rotating shift work and the metabolic syndrome: a prospective study. Int J Epidemiol. 2009;38(3):848-854. doi:10.1093/ije/dyn360.

38. Asare-Anane H, Abdul-Latif A, Ofori EK, Abdul-Rahman M, Amanquah SD. Shift work and the risk of cardiovascular disease among workers in cocoa processing company, Tema. BMC Res Notes. 2015;8:798. doi:10.1186/s13104-015-1750-3.

39. Marqueze EC, Ulhoa MA, Moreno CR. Effects of irregular-shift work and physical activity on cardiovascular risk factors in truck drivers. Rev Saude Publica. 2013;47(3):497-505.

40. Ramin C, Devore EE, Wang W, Pierre-Paul J, Wegrzyn LR, Schernhammer ES. Night shift work at specific age ranges and chronic disease risk factors. Occup Environ Med. 2015;72(2):100-107. doi:10.1136/oemed-2014-102292.

41. Dochi M, Suwazono Y, Sakata K, et al. Shift work is a risk factor for increased total cholesterol level: a 14-year prospective cohort study in 6886 male workers. Occup Environ Med. 2009;66(9):592-597. doi:10.1136/oem.2008.042176.

42. KivimAki M, Kuisma P, Virtanen M, Elovainio M. Does shift work lead to poorer health habits? a comparison between women who had always done shift work with those who had never done shift work. Work & Stress. 2001;15(1):3-13. doi:10.1080/02678370118685.

43. van Amelsvoort LG, Jansen NW, Kant I. Smoking among Shift Workers: more than a confounding factor. Chronobiol Int. 2006;23(6):1105-1113. doi:10.1080/07420520601089539.

44. Karlsson B, Alfredsson L, Knutsson A, Andersson E, Toren K. Total mortality and cause-specific mortality of Swedish shift- and dayworkers in the pulp and paper industry in 1952-2001. Scand J Work Environ Health. 2005;31(1):30-35. doi:10.5271/sjweh.845.

45. Knutsson A, Akerstedt T, Jonsson BG, Orth-Gomer K. Increased risk of ischaemic heart disease in shift workers. Lancet. 1986;2(8498):89-92. doi:10.1016/S0140-6736(86)91619-3.

46. Fujino Y, Iso H, Tamakoshi A, et al. A prospective cohort study of shift work and risk of ischemic heart disease in Japanese male workers. Am J Epidemiol. 2006;164(2):128-135.

47. Li M, Huang JT, Tan Y, Yang BP, Tang ZY. Shift work and risk of stroke: a meta-analysis. Int J Cardiol. 2016;214:370-373. doi:10.1016/j.ijcard.2016.03.052.

48. Brown DL, Feskanich D, Sanchez BN, Rexrode KM, Schernhammer ES, Lisabeth LD. Rotating night shift work and the risk of ischemic stroke. Am J Epidemiol. 2009;169(11):1370-7. Am J Epidemiol. 2009;169(11):1370-1377. doi:10.1093/aje/kwp056.

Most read articles by the same author(s)