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July 30, 2012

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Shift workers more prone to heart problems

Coronary events, including cardiac arrests, heart attacks and strokes, are more common in shift workers than in those who work more traditional work patterns, according to new research.

A team of researchers from Canada and Norway analysed 34 studies involving more than 2 million workers – the largest combined analysis of shift work and vascular risk reported to date – with their findings published in the British Medical Journal (BMJ).

In total, there were 17,359 coronary events, including 6598 heart attacks and 1854 strokes caused by lack of blood to the brain. The researchers calculated that shift work was linked to a 23-per-cent increased risk of heart attack and a 5-per-cent increased risk of stroke.

However, they also stressed that shift work is not linked to increased mortality rates from heart problems and that the relative risks associated with heart problems are “modest”.

Previous studies have shown that shift work is associated with an increased risk of hypertension, metabolic syndrome, dyslipidaemia, and diabetes mellitus. However, the association between shift work and vascular disease is less exact, as conflicting data exists – perhaps, in part, say the researchers, owing to varying methods, populations, and definitions of shift work and vascular or coronary events.

The researchers conclude from this latest study that shift workers should be educated about cardiovascular symptoms in an effort to forestall, or avert the earliest symptoms of disease. They also suggest that modification of shift schedules may bring benefits in the shape of healthier, more productive workers.

Issuing a caveat, the researchers state that the long-term effects of these alterations on vascular outcomes remain unknown, and that more work is needed to identify the most vulnerable subsets of shift workers and the effects of shift-modifying strategies on overall vascular health.

Commenting on the findings, Ellen Mason, a senior cardiac nurse at the British Heart Foundation, said: “Although the associated increased risk to an individual shift worker was relatively small, many Brits don’t work nine to five and so these findings become much more significant.

“Whether you work nights, evenings, or regular office hours, eating healthily, getting active and quitting smoking can make a big difference to your heart health. Anyone over 40 in England should take advantage of a free NHS health check, which will examine blood pressure, cholesterol levels and body mass index.”

Added Mason: “We also need to raise awareness in the workplace about the signs and symptoms of a heart attack, or stroke and urge everybody to call 999 at the first sign of trouble.”

Jane White, research and information services manager at IOSH, welcomed the addition of the latest study to a growing body of research on the effects of shift work on health.

She said those working shifts outside normal daylight hours may experience disruption to their internal body clock and feel fatigued, while other effects can include disturbed appetite and digestion, reliance on sedatives and/or stimulants, as well as social and domestic problems.

“These can affect performance, increase the likelihood of errors and accidents at work, and even have a negative effect on health,” White said.

“Avoiding permanent night shifts, limiting shifts to a maximum of 12 hours and ensuring workers have a minimum of two full nights sleep between day and night shifts are simple, practical solutions that can help people cope with shift work.”

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