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Time of exposure to night work and carotid atherosclerosis: a structural equation modeling approach using baseline data from ELSA-Brasil

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Abstract

Purpose

The study of cardiovascular diseases (CVD) associated with night work is difficult due to the long period required for conditions to manifest and the healthy-worker effect. Analyzing asymptomatic pre-clinical changes in the atherosclerotic process is a way to assess the pathways between exposure to night work and CVD.

Aim

To evaluate the associations between night work and subclinical atherosclerosis measured by carotid intima-media thickness (CIMT) using baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).

Methods

We conducted cross-sectional analyses using baseline data (2008–2010) from 9785 civil servants, aged 35–74 years. The associations between time of exposure to night work and mean CIMT were examined using a structural equation model.

Results

The sample included 4259 men and 5526 women, mean age of 51.6 years. A total of 1778 (18.2%) individuals were exposed to night work (594 current and 1184 former night workers), and the mean years of night work exposed was 11.47 (SD = 9.45) years. On average, mean CIMT was 0.606 (SD = 0.130) mm. Among men, the increase in exposure to night work was significantly associated with an increase in BMI and CIMT. Among women, night work was not associated with increased CIMT. In relation to the indirect associations, results suggest a possible mediation by BMI, diabetes and hypertension on the association between the years of night work and mean CIMT only among men.

Conclusion

Night work was associated with increased CIMT only among men. These findings add to the knowledge of the possible pathways that link night work and carotid atherosclerosis. Additionally, these results contribute to the recognition of work schedules as a public health problem that should be addressed by the medical community and policy makers.

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Funding

The ELSA-Brasil baseline was supported by the Brazilian Ministry of Health (Science and Technology Department) and the Brazilian Ministry of Science and Technology (Financiadora de Estudos e Projetos and CNPq National Research Council) [Grants 01 06 0010.00 RS, 0106 0212.00 BA, 01 06 0300.00 ES, 01 06 0278.00 MG, 01 06 0115.00 SP, 01 06 0071.00 RJ]. ASC was the recipient of scholarships from CNPq-Brasil (150551/2015-0).

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Authors and Affiliations

  1. Department of Collective Health, Federal University of Triângulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil

    Aline Silva-Costa

  2. Sergio Arouca National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil

    Joanna Guimarães, Dora Chor & Maria de Jesus Mendes da Fonseca

  3. Center for Clinical and Epidemiological Research, University of São Paulo (USP), São Paulo, Brazil

    Isabela Bensenor & Itamar Santos

  4. Department of Preventive and Social Medicine, Federal University de Minas Gerais (UFMG), Belo Horizonte, Brazil

    Sandhi Barreto

  5. Laboratory of Health and Environmental Education, Oswaldo Foundation (FIOCRUZ), Rio de Janeiro, Brazil

    Rosane Härter Griep

Authors
  1. Aline Silva-Costa
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  2. Joanna Guimarães
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  3. Dora Chor
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  4. Maria de Jesus Mendes da Fonseca
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  5. Isabela Bensenor
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  6. Itamar Santos
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  7. Sandhi Barreto
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  8. Rosane Härter Griep
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Corresponding author

Correspondence to Rosane Härter Griep.

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All authors declare that they do not have any competing interests.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Silva-Costa, A., Guimarães, J., Chor, D. et al. Time of exposure to night work and carotid atherosclerosis: a structural equation modeling approach using baseline data from ELSA-Brasil. Int Arch Occup Environ Health 91, 591–600 (2018). https://doi.org/10.1007/s00420-018-1305-8

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  • DOI: https://doi.org/10.1007/s00420-018-1305-8

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