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Case fatality of myocardial infarction among shift workers

  • Jonas Hermansson
  • Katja Gillander Gådin
  • Berndt Karlsson
  • Christina Reuterwall
  • Johan Hallqvist
  • Anders Knutsson
Original Article

Abstract

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.

Keywords

Cardiovascular disease Case–control Shift work Risk estimation Epidemiology 

Notes

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Andersen LB, Schnohr P, Schroll M, Hein HO (2000) All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work. Arch Intern Med 160:1621–1628CrossRefGoogle Scholar
  2. Bøggild H, Knutsson A (1999) Shift work, risk factors and cardiovascular disease. Scand J Work Environ Health 25:85–99CrossRefGoogle Scholar
  3. Costa G (2003) Shift work and occupational medicine: an overview. Occup Med 53:83–88CrossRefGoogle Scholar
  4. Ellingsen T, Bener A, Gehani AA (2007) Study of shift work and risk of coronary events. J R Soc Promot Health 127:265–267CrossRefGoogle Scholar
  5. Emeny RT, Zierer A, Lacruz ME et al (2013) Job strain-associated inflammatory burden and long-term risk of coronary events: findings from the MONICA/KORA Augsburg case-cohort study. Psychosom Med 75:317–325. doi: 10.1097/PSY.0b013e3182860d63 CrossRefGoogle Scholar
  6. Frost P, Kolstad HA, Bonde JP (2009) Shift work and the risk of ischemic heart disease—a systematic review of the epidemiologic evidence. Scand J Work Environ Health 35:163–179CrossRefGoogle Scholar
  7. Fujino Y, Iso H, Tamakoshi A et al (2006) A prospective cohort study of shift work and risk of ischemic heart disease in Japanese male workers. Am J Epidemiol 164:128–135. doi: 10.1093/aje/kwj185 CrossRefGoogle Scholar
  8. Greenland S (1989) Modeling and variable selection in epidemiologic analysis. Am J Public Health 79:340–349CrossRefGoogle Scholar
  9. Härenstam A, Theorell T, Orth-Gomer K, Palm U, Unden A (1987) Shift work, decision latitude and ventricular ectopic activity: a study of 24-hour electrocardiograms in Swedish prison personnel. Work Stress 1:341–350CrossRefGoogle Scholar
  10. Haupt CM, Alte D, Dörr M et al (2008) The relation of exposure to shift work with atherosclerosis and myocardial infarction in a general population. Atherosclerosis 201:205–211. doi: 10.1016/j.atherosclerosis.2007.12.059 CrossRefGoogle Scholar
  11. Karlsson B, Alfredsson L, Knutsson A, Andersson E, Toren K (2005) 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 31:30–35CrossRefGoogle Scholar
  12. Knutsson A (1989) Shift work and coronary heart disease. Scand J Soc Med Suppl 44:1–36Google Scholar
  13. Knutsson A, Hallquist J, Reuterwall C, Theorell T, Akerstedt T (1999) Shiftwork and myocardial infarction: a case-control study. Occup Environ Med 56:46–50CrossRefGoogle Scholar
  14. Kolstad HA (2008) Nightshift work and risk of breast cancer and other cancers—a critical review of the epidemiologic evidence. Scand J Work Environ Health 34:5–22CrossRefGoogle Scholar
  15. Kuper H, Marmot M (2003) Job strain, job demands, decision latitude, and risk of coronary heart disease within the Whitehall II study. J Epidemiol Community Health 57:147–153CrossRefGoogle Scholar
  16. Mannsverk J, Wilsgaard T, Nøjstad I et al (2012) Age and gender differences in incidence and case fatality trends for myocardial infarction: a 30-year follow-up. The Tromso Study. Eur J Prev Cardiol 19:927–934. doi: 10.1177/1741826711421081 CrossRefGoogle Scholar
  17. Meloni M, Setzu D, Del Rio A, Campagna M, Cocco P (2013) QTc interval and electrocardiographic changes by type of shift work. Am J Ind Med 56:1174–1179. doi: 10.1002/ajim.22207 CrossRefGoogle Scholar
  18. Puttonen S, Kivimäki M, Elovainio M et al (2009) Shift work in young adults and carotid artery intima-media thickness: the Cardiovascular Risk in Young Finns study. Atherosclerosis 205:608–613. doi: 10.1016/j.atherosclerosis.2009.01.016 CrossRefGoogle Scholar
  19. Reuterwall C, Hallqvist J, Ahlbom A et al (1999) Higher relative, but lower absolute risks of myocardial infarction in women than in men: analysis of some major risk factors in the SHEEP study. The SHEEP Study Group. J Intern Med 246:161–174CrossRefGoogle Scholar
  20. Rosengren A, Spetz CL, Koster M, Hammar N, Alfredsson L, Rosen M (2001) Sex differences in survival after myocardial infarction in Sweden; data from the Swedish National Acute Myocardial Infarction Register. Eur Heart J 22:314–322. doi: 10.1053/euhj.2000.2368 CrossRefGoogle Scholar
  21. Rosvall M, Gerward S, Engstrom G, Hedblad B (2008) Income and short-term case fatality after myocardial infarction in the whole middle-aged population of Malmo, Sweden. Eur J Pub Health 18:533–538. doi: 10.1093/eurpub/ckn059 CrossRefGoogle Scholar
  22. Rothman K, Greenland S, Lash T (2008) Modern epidemiology. Lippincott Williams & Wilkins, New YorkGoogle Scholar
  23. Salomaa V, Miettinen H, Niemelä M et al (2001) Relation of socioeconomic position to the case fatality, prognosis and treatment of myocardial infarction events; the FINMONICA MI Register Study. J Epidemiol Community Health 55:475–482CrossRefGoogle Scholar
  24. Statistics Sweden (2012) Men and women in Sweden. Facts and figures 2012. In: Sweden S (ed). Stockholm. http://www.scb.se/sv_/Hitta-statistik/Publiceringskalender/Visa-detaljerad-information/?publobjid=17389+
  25. Taylor PJ, Pocock SJ, Sergean R (1972) Shift and dayworkers’ absence: relationship with some terms and conditons of service. Br J Ind Med 29:338–340Google Scholar
  26. Tenkanen L, Sjoblom T, Kalimo R, Alikoski T, Harma M (1997) Shift work, occupation and coronary heart disease over 6 years of follow-up in the Helsinki Heart Study. Scand J Work Environ Health 23:257–265CrossRefGoogle Scholar
  27. Theorell T, Perski A, Åkerstedt T et al (1988) Changes in job strain in relation to changes in physiological state. A longitudinal study. Scand J Work Environ Health 14:189–196CrossRefGoogle Scholar
  28. Vyas MV, Garg AX, Iansavichus AV et al (2012) Shift work and vascular events: systematic review and meta-analysis. BMJ 345:e4800. doi: 10.1136/bmj.e4800 CrossRefGoogle Scholar
  29. Wang XS, Armstrong ME, Cairns BJ, Key TJ, Travis RC (2011) Shift work and chronic disease: the epidemiological evidence. Occup Med 61:78–89. doi: 10.1093/occmed/kqr001 CrossRefGoogle Scholar
  30. Wannamethee G, Whincup PH, Shaper AG, Walker M, MacFarlane PW (1995) Factors determining case fatality in myocardial infarction “who dies in a heart attack”? Br Heart J 74:324–331CrossRefGoogle Scholar
  31. Yang D, Dzayee DA, Beiki O, de Faire U, Alfredsson L, Moradi T (2012) Incidence and case fatality after day 28 of first time myocardial infarction in Sweden 1987–2008. Eur J Prev Cardiol 19:1304–1315. doi: 10.1177/1741826711425340 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2014

Authors and Affiliations

  • Jonas Hermansson
    • 1
  • Katja Gillander Gådin
    • 1
  • Berndt Karlsson
    • 2
  • Christina Reuterwall
    • 2
  • Johan Hallqvist
    • 3
  • Anders Knutsson
    • 1
  1. 1.Department of Health SciencesMid Sweden UniversitySundsvallSweden
  2. 2.Department of Public Health and Clinical Medicine, Occupational MedicineUniversity of UmeåUmeåSweden
  3. 3.Department of Public Health and Caring Sciences, Preventive MedicineUppsala UniversityUppsalaSweden

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