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Cited by 202Sleep and Work-Related FatigueCircadian rhythm and melatoninWorkplace Health and Well-being

Total and Cause-Specific Mortality of U.S. Nurses Working Rotating Night Shifts

Open access
Gu, Fangyi, Han, Jiali, Laden, Francine, Pan, An, Caporaso, Neil E., Stampfer, Meir J., Kawachi, Ichiro, Rexrode, Kathryn M. +4 more·2015·American Journal of Preventive Medicine
DOI 10.1016/j.amepre.2014.10.018PMC PMC4339532
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Abstract

Background Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases. Purpose To examine associations between rotating night shift work and all-cause, cardiovascular disease (CVD), and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses’ Health Study. Methods Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988–2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models (2013) estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs. Results All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6–14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.89, 1.19) or any other cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51). Conclusions Women working rotating night shifts for ≥5 five years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.

AI snapshot

Written from the paper’s full text.

TL;DR

In the Nurses’ Health Study, working rotating night shifts for more than 5 years was associated with modestly higher all-cause and cardiovascular disease mortality, and ≥15 years was associated with higher lung cancer mortality. No clear association was found for all-cancer mortality overall.

Key findings

  • All-cause mortality was increased for women with 6–14 years (HR=1.11, 95% CI=1.06, 1.17) and ≥15 years (HR=1.11, 95% CI=1.05, 1.18; ptrend<0.001) of rotating night shift work versus never.
  • CVD mortality was increased for 6–14 years (HR=1.19, 95% CI=1.07, 1.33) and ≥15 years (HR=1.23, 95% CI=1.09, 1.38; ptrend<0.001); ischemic heart disease mortality was also increased for ≥15 years (HR=1.31, 95% CI=1.09, 1.59).
  • All-cancer mortality was not associated after multivariable adjustment (HR for ≥15 years=1.08, 95% CI=0.98, 1.19 in the Results), but lung cancer mortality was increased for ≥15 years (HR=1.25, 95% CI=1.04, 1.51).
  • Breast cancer mortality was not increased for ≥15 years (HR=0.99, 95% CI=0.74, 1.33), though a non-significant increase was reported for ≥30 years (HR=1.47, 95% CI=0.94, 2.32).

Methods

  • Prospective cohort study of 74,862 U.S. registered female nurses in the Nurses’ Health Study, with lifetime rotating night shift work (≥3 nights/month) assessed in 1988 and 22 years of follow-up (1988–2010).
  • During follow-up, 14,181 deaths were documented, including 3,062 CVD deaths and 5,413 cancer deaths; cause of death was determined by physician review using medical records and death certificates.
  • Cox proportional hazards models estimated multivariable-adjusted hazard ratios and 95% CIs, with adjustment for age and updated lifestyle, reproductive, smoking, BMI, and SES-related covariates.

Limitations

  • Stated: night shift work information was collected only in 1988 and not updated, potentially causing exposure misclassification; timing of earlier adult exposure was unknown; permanent night shift workers may have been misclassified; multiple comparisons were a concern; and night shift effects were difficult to separate from lack of sleep.
  • Stated: some cancer-site analyses had limited power, especially cancers with <100 deaths, warranting larger studies.
  • Evident: the observational design cannot establish causality, and despite extensive adjustment, residual confounding by unmeasured or imperfectly measured factors remains possible.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1016/j.amepre.2014.10.018

Cites

65 of 65 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 37 cited sources checked · 0 supported · 0 flagged

  • Findingown data

    For all-cause mortality, the multivariable-adjusted HR for women with 6-14 years of rotating night shift work was 1.11 (95% CI=1.06, 1.17).

    “For all-cause mortality, the multivariable-adjusted HRs for women with 1–5, 6–14, or ≥15 years of rotating night shift work were 1.01 (95% CI=0.97, 1.05), 1.11 (95% CI=1.06, 1.17), and 1.11 (95% CI=1.05, 1.18; ptrend<0.001).”
    Quote in the paperSubstantial claim
  • Findingown data

    No significant interaction with BMI was observed for any of the endpoints.

    “No significant interaction with BMI was observed for any of the endpoints (Appendix Table 2).”
    Quote in the paperNot a substantial claim
  • Findingown data

    For colorectal cancer mortality, the age-adjusted HR after ≥15 years of rotating night shift work was 1.42 (95% CI=1.04, 1.94), attenuated to 1.33 (95% CI=0.97, 1.83) after multivariable adjustment.

    “For colorectal cancer, the age-adjusted HR after ≥15 years of rotating night shift work was 1.42 (95% CI=1.04, 1.94), but was attenuated to 1.33 (95% CI=0.97, 1.83) after multivariate adjustment.”
    Quote in the paperSubstantial claim
  • Findingown data

    There were no significant associations among women working rotating night shifts for 6-14 and ≥15 years for cerebrovascular disease or any other CVD.

    “There were no significant associations among women working rotating night shifts for 6–14 and ≥15 years for cerebrovascular disease or any other CVD.”
    Quote in the paperNot a substantial claim
  • Findingown data

    There was no significant association between rotating night shift work and mortality from other cancers.

    “There was no significant association between rotating night shift work and mortality from other cancers.”
    Quote in the paperNot a substantial claim
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 7
  • The quote only partly states this claim. 1

  • May combine two claims.

    Findingown data

    Women working rotating night shifts for >5 years had modest increases in both all-cause and CVD-related mortality, compared to women who never worked rotating night shifts.

    “Women working rotating night shifts for >5 years had modest increases in both all-cause and CVD-related mortality, compared to women who never worked rotating night shifts.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    There was a non-significant increase in kidney cancer mortality among women with 6-14 and ≥15 years of night work; multivariable HRs were 1.72 (95% CI=1.03, 2.86) and 1.39 (95% CI=0.75, 2.57), respectively (ptrend=0.048).

    “There was a non-significant increase in mortality from kidney cancer and myeloma among women with 6–14 and ≥15 years of night work: the multivariable HRs were 1.72 (95% CI=1.03, 2.86) and 1.39 (95% CI=0.75, 2.57) for kidney cancer (ptrend=0.048)”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    There was a non-significant increase in myeloma mortality among women with 6-14 and ≥15 years of night work; multivariable HRs were 1.56 (95% CI=0.93, 2.64) and 1.61 (95% CI=0.90, 2.88), respectively (ptrend=0.08).

    “and 1.56 (95% CI=0.93, 2.64) and 1.61 (95% CI=0.90, 2.88) for myeloma (ptrend=0.08).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Over 22 years and 1.5 million person-years of follow-up, 14,181 deaths were documented, of which 3,062 were attributed to CVD and 5,413 to cancer.

    “Over 22 years and 1.5 million person-years of follow-up, 14,181 deaths were documented, of which 3,062 were attributed to CVD and 5,413 to cancer.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Increased IHD mortality was observed among women who worked rotating night shifts for 6-14 and ≥15 years; HRs were 1.22 (95% CI=1.02, 1.46) and 1.31 (95% CI=1.09, 1.59), respectively (ptrend<0.001).

    “increased IHD mortality was observed among women who worked rotating night shifts for 6–14 and ≥15 years (HR=1.22, 95% CI=1.02, 1.46; 1.31, 1.09, 1.59, respectively; ptrend<0.001).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    After multivariable adjustment, there was no association between rotating night shift work and all-cancer mortality; the HR for ≥15 years was 1.08 (95% CI=0.98, 1.19).

    “Compared to women who never worked rotating night shifts, the age-adjusted HRs were 1.10 (95% CI=1.01, 1.20) and 1.20 (95% CI=1.09, 1.32), but these associations were attenuated after multivariable adjustment, with HRs of 1.04 (95% CI=0.95, 1.13) and 1.08 (95% CI=0.98, 1.19), respectively.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Associations for overall cancer, lung cancer, and colon cancer mortality appeared to vary by smoking status, but there was no statistically significant interaction (pinteraction>0.05).

    “Associations for overall cancer, lung cancer, and colon cancer mortality appeared to vary by smoking status, but there was no statistically significant interaction (pinteraction>0.05).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    The association of rotating night shift work with all-cause mortality appeared stronger among current smokers (HR≥15 years, 1.21 vs 1.11), but remained statistically significant among never smokers (ptrend=0.05).

    “the association of rotating night shift work appeared to be stronger among current smokers for all-cause mortality (HR≥15 years, 1.21 vs 1.11), but remained statistically significant also among never smokers (ptrend=0.05).”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    The WHO in 2007 classified night work as a probable carcinogen.

    “Thus, the WHO in 2007 classified night work as a probable carcinogen.19”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [19] Straif, 2007, Carcinogenicity of shift-work, painting, and fire-fighting, Lancet Oncol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Observational studies consistently suggest positive associations of night shift work with cardiovascular disease and cancer risk.

    “Observational studies consistently suggest positive associations of night shift work and cardiovascular disease (CVD)2 and cancer risk.3-18”
    Quote in the paperSubstantial claim0 of 10 sources checked
    • cites [2] Vyas, 2012, Shift work and vascular events: systematic review and meta-analysis, BMJ source

      Not checked in the free run.

    • cites [3] Hansen, 2001, Increased breast cancer risk among women who work predominantly at night, Epidemiology source

      Not checked in the free run.

    • cites [4] Hansen, 2012, Nested case-control study of night shift work and breast cancer risk among women in the Danish military, Occup Environ Med source

      Not checked in the free run.

    • cites [5] Jia, 2013, Does night work increase the risk of breast cancer? A systematic review and meta-analysis of epidemiological studies, Cancer Epidemiol source

      Not checked in the free run.

    • cites [6] Lie, 2011, Night work and breast cancer risk among Norwegian nurses: assessment by different exposure metrics, Am J Epidemiol source

      Not checked in the free run.

    • cites [7] Lie, 2006, Breast cancer and night work among Norwegian nurses, Cancer Causes Control source

      Not checked in the free run.

    • cites [8] Menegaux, 2013, Night work and breast cancer: a population-based case-control study in France (the CECILE study), Int J Cancer source

      Not checked in the free run.

    • cites [9] O׳Leary, 2006, Shift work, light at night, and breast cancer on Long Island, New York, Am J Epidemiol source

      Not checked in the free run.

    • cites [10] Pesch, 2010, Night work and breast cancer—results from the German GENICA study, Scand J Work Environ Health source

      Not checked in the free run.

    • cites [11] Pronk, 2010, Night shift work and breast cancer risk in a cohort of Chinese women, Am J Epidemiol source

      Not checked in the free run.

  • May combine two claims.

    Interpretationreasoning

    The finding that women with longer durations of rotating night shift work had a higher BMI and tended to gain more weight since age 18 years may be intermediate conditions subsequent to night shift work, and adjustment for them may underestimate associations.

    “The finding that women with longer durations of rotating night shift work had a higher BMI and tended to gain more weight since age 18 years may be intermediate conditions subsequent to night shift work, and adjustment for them in multivariable models may underestimate associations.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The proportional hazards assumption was tested by including interaction terms between duration of night shift work categories and follow-up time.

    “The proportional hazards assumption was tested by including interaction terms between duration of night shift work categories and follow-up time.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Each endpoint was adjusted for age and regularly updated information on alcohol consumption, physical exercise, multivitamin use, menopausal status and postmenopausal hormone use, physical examination in the past 2 years, healthy eating score, smoking status, pack-years, and BMI.

    “Each endpoint was adjusted for age and regularly updated information throughout follow-up on: alcohol consumption, physical exercise, multivitamin use, menopausal status and postmenopausal hormone use, physical examination in the past 2 years, healthy eating score37 (without components of multivitamin and alcohol, which were adjusted individually), smoking status, pack-years, and BMI.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [37] Green, 2008, The meter of metabolism, Cell source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductreasoning

    Night shift work information was not updated after 1988, potentially leading to exposure misclassification.

    “night shift work information was not updated after 1988, potentially leading to exposure misclassification because nurses may have changed their night shift work status during the 22-year follow-up.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductcitation

    Self-reported duration of rotating night shifts cannot be validated, but results are likely accurate because other self-reports were highly accurate in a similar cohort and previous validations of similar questions have shown reasonable reproducibility.

    “Although self-reported duration of rotating night shifts cannot be validated, it is likely that results are accurate, because other self-reports were highly accurate in a similar cohort,62 and previous validations of similar questions (e.g., electric blanket use)63 have shown reasonable reproducibility.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [62]

      Not checked in the free run.

    • cites [63]

      Not checked in the free run.

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    Melatonin exhibits beneficial actions on cardiovascular health by enhancing endothelial function, maintaining metabolic homeostasis, and reducing inflammation.

    “They also exhibit beneficial actions on cardiovascular health by enhancing endothelial function, maintaining metabolic homeostasis,38 and reducing inflammation.39,40”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites [38] K-Laflamme, 1998, de Champlain J. Impaired basal sympathetic tone and alpha1-adrenergic responsiveness in association with the hypotensive effect of melatonin in spontaneously hypertensive rats, Am J Hypertens source

      Not checked in the free run.

    • cites [39] Anwar, 2001, Inhibitory effects of melatonin on vascular reactivity: possible role of vasoactive mediators, Comp Biochem Physiol C Toxicol Pharmacol source

      Not checked in the free run.

    • cites [40] Lucas, 2014, Measuring and using light in the melanopsin age, Trends Neurosci source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    Much of follow-up was accrued at midlife or around retirement, and NHS2 data suggest <5% of nurses continue night shifts after age 45 and <2% start midlife or later.

    “the percentage of nurses working rotating night shifts declines from roughly 40% in their early 20s, to <5% after age 45 years, with only very few women (<2%) starting night shifts midlife or later”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Study design and conductcitation

    Follow-up rates for this cohort remain at approximately 90%, and the overall death follow-up is >98% complete.

    “Follow-up rates for this cohort remain at approximately 90%, and the overall death follow-up is >98% complete.49”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [49] Hublin, 2010, Shift-work and cardiovascular disease: a population-based 22-year follow-up study, Eur J Epidemiol source

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Direct nocturnal light exposure suppresses melatonin production and resets the timing of the circadian clock.

    “Direct nocturnal light exposure suppresses melatonin production41 and resets the timing of the circadian clock.33,42,43”
    Quote in the paperSubstantial claim0 of 4 sources checked
    • cites [41] Honma, 2012, Suprachiasmatic nucleus: cellular clocks and networks, Prog Brain Res source

      Not checked in the free run.

    • cites [33] Lange, 2010, Effects of sleep and circadian rhythm on the human immune system, Ann N Y Acad Sci source

      Not checked in the free run.

    • cites [42] Filipski, 2009, Circadian disruption in experimental cancer processes, Integr Cancer Ther source

      Not checked in the free run.

    • cites [43] Sigurdardottir, 2012, Circadian disruption, sleep loss, and prostate cancer risk: a systematic review of epidemiologic studies, Cancer Epidemiol Biomarkers Prev source

      Not checked in the free run.

  • May combine two claims.

    Study design and conductcitation

    In NHS2, <10% of all nurses worked permanent night shifts; exclusion of these women did not change results of a prior analysis.

    “in the NHS2 cohort, where night shift work history was assessed in much greater detail, <10% of all nurses worked permanent night shifts. A potential concern is that these nurses may not have classified themselves as working rotating night shifts in the current analysis; yet, exclusion of these women did not change results of a prior analysis.13”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites [13] Schernhammer, 2006, Night work and risk of breast cancer, Epidemiology source

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing). The quote only partly states this claim.

    Study design and conductown data

    Additional adjustment for husbands' education as an indicator of SES left results virtually unchanged.

    “Additional adjustment for husbands’ education (less than high school, some high school, high school graduate, college, graduate school) was performed as the best indicator of SES; further adjustment for nurses’ education left the results virtually unchanged and was therefore not retained in the final models.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    The prospective study design eliminates recall bias.

    “Moreover, the prospective study design eliminates recall bias.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    The timing of exposure in earlier adult life is not known.

    “the timing of exposure in earlier adult life is not known (along with the time between exposure and disease diagnosis).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Among women with ≥30 years of rotating night shift work, breast cancer mortality was non-significantly increased by 47% in the current study, somewhat consistent with a previous report in the same cohort describing a significant 36% increase in breast cancer incidence.

    “Among women with ≥30 years of rotating night shift work, breast cancer mortality was non-significantly increased by 47% in the current study, which is somewhat consistent with a previous report in the same cohort14 describing a significant 36% increase in breast cancer incidence.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [14] Schernhammer, 2001, Rotating night shifts and risk of breast cancer in women participating in the nurses׳ health study, J Natl Cancer Inst source

      Not checked in the free run.

  • May combine two claims.

    Interpretationown data

    Current results suggest potentially increased mortality from renal cancer and myeloma among women with >5 years of rotating night shift work.

    “Current results also suggest potentially increased mortality from renal cancer, and myeloma among women with >5 years of rotating night shift work.”
    Quote in the paperSubstantial claim
25 of 25

  • The paper relies on this without support.

    Smoking and obesity are well-established risk factors for CVD and multiple cancers.

    “As smoking and obesity are well-established risk factors for CVD and multiple cancers”

  • The paper relies on this without support.

    No unmeasured confounding remains after adjustment for the listed covariates.

    “To reduce residual confounding, adjustment for pack-years among former and current smokers, and continuous BMI within each BMI stratum, were performed.”

  • The paper relies on this without support.

    Exposure misclassification is non-differential.

    “any remaining non-differential misclassification of the exposure assessment could have biased results, albeit likely toward the null in most situations.”
3 of 3

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Shift work is an independent risk factor for many chronic conditions, including heart disease.

    “Shift work is an independent risk factor for many chronic conditions, including heart disease (133-136), perhaps due to recurring disruptions of the circadian clock itself (e.g., light exposure at unusual circadian phases), or perhaps due to misalignment between the circadian clock and the behaviors (e.g., sleeping and fasting during the day, and being active and eating across the night).”

    From Role of the circadian system in cardiovascular disease (2018) · cites this paper as [135]

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Person-years category is listed as 6-4 years

    Minor

    The person-years breakdown uses a 6-4-year category, whereas the stated shift-work categories use 6-14 years.

  • All-cancer confidence interval differs between abstract and results

    Minor

    The abstract gives 0.89 as the lower 95% confidence limit for the ≥15-year group, while the Results section gives 0.98 for the same hazard ratio.

  • Kidney cancer is listed under a >100-death criterion but later has <100 deaths

    Minor

    The Methods section lists kidney cancer among sites with more than 100 deaths included in the analysis. The Discussion says renal cancer had fewer than 100 deaths.

  • Kidney cancer interval conflicts with "non-significant" description

    Minor

    The kidney cancer hazard ratio for 6-14 years is described as non-significant, but its reported 95% confidence interval, 1.03-2.86, excludes 1.

4 of 4

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Authors
Gu, F., Han, J., Laden, F., Pan, A., Caporaso, N. E., Stampfer, M. J., Kawachi, I., Rexrode, K. M., Willett, W. C., Hankinson, S. E., Speizer, F. E., & Schernhammer, E. S.
Affiliations
  • National Cancer Institute (US)
  • Indiana University Health (US)
  • Harvard University (US)
  • National University of Singapore (SG)
  • Brigham and Women's Hospital (US)
Corresponding author
Schernhammer, Eva S.
ORCID
Venue
American Journal of Preventive Medicine
Publisher
Elsevier BV
Published
2015-03
Volume
48
Issue
3
Pages
241-252
ISSN
0749-3797 (ISSN-L)
DOI
10.1016/j.amepre.2014.10.018
PMC
PMC4339532
OpenAlex
W2128166603
Semantic Scholar
37330ef4ccbec3364e81e47ae5e3cce3cfae7108
Cited by
202
References
65
Citations by year
2026: 13 · 2025: 18 · 2024: 17 · 2023: 24 · 2022: 20 · 2021: 18 · 2020: 15 · 2019: 20 · 2018: 24 · 2017: 16 · 2016: 13 · 2015: 2 · 2013: 1
FWCI
27.61
Type
journal article
Language
en
Open access
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • American Journal of Preventive Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Digital Access to Scholarship at Harvard (DASH) (Harvard University) (submittedVersion, cc-by)
  • National University of Singapore (submittedVersion)
Funders
  • National Cancer Institute (CA50385, CA87969)
  • NIH Heart, Lung and Blood Institute (HL034594)
  • CDC/The National Institute for Occupational Safety and Health (OH009803)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
Keywords
rotating night shift work, nurses, all-cause mortality, cardiovascular mortality, cancer mortality, lung cancer, circadian rhythm disruption, occupational health, Nurses' Health Study
MeSH terms
Adult, Age Factors, Cardiovascular Diseases, Female, Humans, Life Style, Middle Aged, Neoplasms, Nurses, Prospective Studies, Risk Factors, Socioeconomic Factors, Time Factors, United States, Work Schedule Tolerance, Health Behavior, Proportional Hazards Models, Women's Health

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