Shift work and hypertension: Prevalence and analysis of disease pathways in a German car manufacturing company

Ohlander, Johan; Keskin, Mekail-Cem; Stork, Joachim; Radon, Katja

doi:10.1002/ajim.22437

Cited by 39 publications

(24 citation statements)

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“…In the present study, healthcare workers with rotational night shift duties did not have significantly higher obesity, hypertension or fasting dyslipidaemia compared with non-shift workers. This finding is different from several earlier studies, which have reported metabolic syndrome in shift workers (Antunes et al, 2010;De Bacquer et al, 2009;Ghiasvand et al, 2006;Morgan, Hampton, Gibbs, & Arendt, 2003;Ohlander, Keskin, Stork, & Radon, 2015;Pan et al, 2011). This difference might be attributable to the short duration of exposure to night shifts and younger age of the subjects in our study.…”

Section: Discussioncontrasting

confidence: 99%

Association of postprandial triglyceride responses with insulin resistance among rotational night shift healthcare workers

Kiranmala

Aslam

Mishra

et al. 2019

Experimental Physiology

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New Findings What is the central question of this study?Does long‐term rotational night shift work among healthcare workers alter postprandial triglyceride metabolism, and are the postprandial triglyceride responses associated with insulin resistance? What is the main finding and its importance?Rotational night shift duties in healthcare workers might have a negative impact on postprandial triglyceride responses and insulin sensitivity. This is the first study in which postprandial triglyceride responses among shift workers exposed to long‐term night shifts have been studied. Abstract Studies on the postprandial period demonstrate that in experimental conditions, abrupt or acute changes in sleep timing and work are followed by significantly altered postprandial glucose, insulin secretion and lipid tolerance. Whether shift work results in altered postprandial triglyceride (PPTG) metabolism in the long term is not known. In the present study, we aimed to ascertain the association between PPTG and shift work in relationship to cardiometabolic risks and to compare the PPTG response among healthcare workers with and without night shift duties. Twenty healthcare workers with rotational night shifts (group 2) and 20 age‐ and sex‐matched healthcare workers who had not done night shift duty in the past 1 year or ever (group 1) were recruited. Only subjects with normal glucose tolerance were recruited. A standardized fat challenge test was done in all study subjects. The postprandial triglyceride area under the curve (PPTG AUC) showed overall (n = 40) a significant positive correlation with fasting insulin and homeostatic model assessment of insulin resistance (HOMA‐IR) (r = 0.40, P = 0.01 and r = 0.37, P = 0.01, respectively) and in group 2 (r = 0.49, P = 0.02 and r = 0.44, P = 0.042, respectively). The PPTG peak also showed a significant positive correlation with fasting insulin and HOMA‐IR in group 2 (r = 0.52, P = 0.01 and r = 0.47, P = 0.03, respectively). No significant correlation was found in group 1. The PPTG AUC and PPTG peak were, however, comparable between both groups. The findings of this pilot study suggest that rotational night shift duties in healthcare workers might have a negative impact on metabolic parameters, including postprandial triglyceride responses and insulin sensitivity.

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Section: Discussioncontrasting

confidence: 99%

Association of postprandial triglyceride responses with insulin resistance among rotational night shift healthcare workers

Kiranmala

Aslam

Mishra

et al. 2019

Experimental Physiology

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“…However, BMI (and other adiposity measures) attenuated the association between number of 24-h shifts and BP to some extent, particularly in the firefighters who reported 17–21 shifts in the past month in the current study. It is similar to the study by Ohlander et al (2015) in German autoworkers where the impact of shift work without nights (vs. day shifts) on hypertension was significantly mediated by BMI and physical inactivity. However, the significant associations of 14 and 16 shifts in the past month with DBP, after adjustment for BMI, points to another possible mechanism by which many additional 24-h shifts may increase DBP in professional firefighters: frequent circadian misalignment.…”

Section: Discussionsupporting

confidence: 88%

“…The working condition variables, if significant in the univariate analyses, were examined in relation to SBP and DBP using the following multivariate models: after adjustment for the other psychosocial working conditions and sociodemographic variables (Model 1) and additionally after adjustment for health-related behaviors, sleep, mental health variables, and BMI (Model 2). The second adjustment procedure was to see any mediation effects of health-related behaviors, sleep, mental health variables, and BMI on the associations between psychosocial working conditions and BP (Ohlander et al 2015). The final multivariate models for Model 1 and Model 2 were determined with the four indicators ( R square, sum of squares for error, estimated error variance, and Mallows’s C p ) about the explanatory power and parsimoniousness of the competing multivariate models (Kleinbaum et al 1998, pp 390–392).…”

Section: Methodsmentioning

confidence: 99%

“…Furthermore, despite some evidence for shift work or overtime work as a risk factor for clinically assessed high blood pressure or hypertension in non-firefighter working populations (Hayashi et al 1996; Kubo et al 2013; Nakamura et al 2012; Ohlander et al 2015; Ohira et al 2000; Sakata et al 2003; Souza et al 2015; Su et al 2008; Suwazono et al 2008), none of the studies examined the impact of the unique shift schedules of most US professional firefighters who work a 24-h shift work schedule, including frequent additional/overtime 24-h shifts (Choi et al 2014b). Also, most of the studies have considered only shift work or overtime as the occupational risk factor in analyses.…”

Section: Introductionmentioning

confidence: 99%

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Twenty-four-hour work shifts, increased job demands, and elevated blood pressure in professional firefighters

Choi

Schnall

Dobson

2016

Int Arch Occup Environ Health

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Purpose To investigate whether working conditions (number of 24-h shifts, number of calls, sedentary work, job strain, effort–reward imbalance, and physical demands) are associated with elevated blood pressure and hypertension among professional firefighters. Methods A total of 330 (321 males and 9 females) firefighters were chosen for this study among the Southern California firefighters who participated in a work and obesity project. Working conditions were measured with a firefighter-specific occupational health questionnaire. Blood pressure was clinically assessed, and hypertension was defined according to the contemporary standard classification. Results About 11 % of the firefighters had hypertension. Fifty percent of the hypertensive firefighters (mostly mild hypertensive) had uncontrolled high blood pressure. Hypertension was more prevalent in male, older, and high-rank firefighters and firefighter who reported low numbers of daily calls. In male firefighters who were normotensive or hypertensive without taking anti-hypertensive medication, additional 24-h shifts in the past month increased the risk of elevated diastolic blood pressure (DBP) than those who reported a standard work schedule (eight to eleven 24-h shifts). Particularly, firefighters who reported sixteen 24-h shifts had 5.0 mmHg higher DBP (p < 0.01). Body mass index attenuated the association between number of shifts and blood pressure to some extent. Firefighters who reported “increased job demands over the past years” had 3.0 mmHg (p = 0.06) higher systolic blood pressure. Other working conditions were not associated with elevated blood pressure and hypertension. Conclusions Many additional 24-h shifts and increased job demands were risk factors for elevated blood pressure in male firefighters. Optimal collective and individual workload and improved hypertension management are warranted for enhancing the cardiovascular health of firefighters.

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“…Shift work has been identified as a cause of many health problems due to disruption of circadian rhythm 910). Prolonged interruption of the circadian rhythm may lead to an array of disorders, including insomnia, impaired glucose tolerance, obesity, and high blood pressure, which are important determinants of cardiovascular disease 1112).…”

Section: Introductionmentioning

confidence: 99%

Shift Work Is Associated with Metabolic Syndrome in Young Female Korean Workers

Kim

et al. 2017

Korean J Fam Med

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BackgroundShift work is associated with health problems, including metabolic syndrome. This study investigated the association between shift work and metabolic syndrome in young workers.MethodsA total of 3,317 subjects aged 20–40 years enrolled in the 2011–2012 Korean National Health and Nutrition Examination Survey were divided into shift and day workers. We conducted a cross-sectional study and calculated odds ratios using multivariate logistic regression analysis in order to examine the association between shift work and metabolic syndrome.ResultsThe prevalence of metabolic syndrome was 14.3% and 7.1% among male and female shift workers, respectively. After adjusting for confounding factors, shift work was associated with metabolic syndrome in female workers (odds ratio, 2.53; 95% confidence interval, 1.12 to 5.70).ConclusionShift work was associated with metabolic syndrome in young women. Timely efforts are necessary to manage metabolic syndrome in the workplace.

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Shift work and hypertension: Prevalence and analysis of disease pathways in a German car manufacturing company

Abstract: The association between shift work and hypertension seems mainly attributable to behavioral mechanisms.

Cited by 39 publications

References 38 publications

Association of postprandial triglyceride responses with insulin resistance among rotational night shift healthcare workers

Association of postprandial triglyceride responses with insulin resistance among rotational night shift healthcare workers

Twenty-four-hour work shifts, increased job demands, and elevated blood pressure in professional firefighters

Shift Work Is Associated with Metabolic Syndrome in Young Female Korean Workers

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