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Cited by 560Sleep and Work-Related FatigueWorkplace Health and Well-beingCircadian rhythm and melatonin

Shift work and cardiovascular disease – pathways from circadian stress to morbidity

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Puttonen, Sampsa, Härmä, Mikko, Hublin, Christer·2010·Scandinavian Journal of Work, Environment & Health
DOI 10.5271/sjweh.2894
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Abstract

In order to establish a causal relation between shift work and cardiovascular disease (CVD), we need to verify the pathways from the former to the latter. This paper aims to review the current knowledge of the mechanisms between shift work and CVD. Shift work can increase the risk of CVD by several interrelated psychosocial, behavioral, and physiological mechanisms. The psychosocial mechanisms relate to difficulties in controlling working hours, decreased work-life balance, and poor recovery following work. The most probable behavioral changes are weight gain and smoking. The plausible physiological and biological mechanisms are related to the activation of the autonomic nervous system, inflammation, changed lipid and glucose metabolism, and related changes in the risk for atherosclerosis, metabolic syndrome, and type II diabetes. The data provide evidence for possible disease mechanisms between shift work and CVD, but compelling evidence on any specific mechanism is missing.

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  • Candidate mechanisms for elevated cardiovascular disease risk due to shift work include disrupted 24-hour rhythms of blood pressure and vascular function, atherosclerosis, proinflammatory states, and altered lipid and glucose metabolism.

    “Candidate mechanisms underlying elevated risk for CVD due to shift work include disrupted 24-hour rhythms of blood pressure [84] and vascular function [85], atherosclerosis [86], proinflammatory states [87], and altered lipid and glucose metabolism [88].”

    From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [88]

  • Shift work-related metabolic dysfunction and its consequences, including obesity, metabolic syndrome, and type II diabetes, potentiate cardiovascular disease development.

    “Shift work-related metabolic dysfunction and the various health consequences thereof, including obesity, metabolic syndrome, and type II diabetes (discussed above), also potentiate the development of CVD [88,89].”

    From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [88]

  • Shift work might increase the risk of diabetes mellitus owing to unfavourable changes to biomarkers, such as cholesterol and other lipids, blood pressure and plasminogen.

    “Second, owing to unfavourable changes to biomarkers, such as cholesterol and other lipids, blood pressure and plasminogen.13 50”

    From Shift work and diabetes mellitus: a meta-analysis of observational studies (2015) · cites this paper as [50]

  • The increased risk of type 2 diabetes associated with rotating night shift work is consistent with previously reported positive associations of rotating shift work with obesity and/or weight gain, metabolic syndrome, and cardiovascular disease.

    “The increased risk of type 2 diabetes associated with rotating night shift work is also consistent with previously reported positive associations of rotating shift work with obesity and/or weight gain [2], metabolic syndrome [3],[4], and cardiovascular disease [16].”

    From Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women (2011) · cites this paper as [16]

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  1. Refers to the following texts of the Journal: 2006;32(6):502-514 1999;25(2):85-99 1989;15(3):165-179 2009;35(3):163-179 2009;35(3):157-161 2006;32(6):413-419 2006;32(6):431-442 2001;27(2):97-105 1999;25(4):376-381 1997;23(4):257-265 2009;35(1):48-55 1998;24 suppl 3:141-145 SJWEH Supplements 2008;(5):14-21 2004;30(2):139-148 2004;30(2):149-156 The following articles refer to this text: 2010;36(2):81-84; 2011;37(1):62-69; 2011;37(1):54-61; 2011;37(4):263-275; 2012;38(1):1-3; 2012;38(4):343-348; 2014;40(3):287-294; 2014;40(6):557-568; 2014;40(6):621-630; 2015;41(1):54-64; 2015;41(1):84-93; 2015;41(3):259-267; 2015;41(3):268-279; 2016;42(6):459-468; 2016;42(6):455-457; 2017;43(2):117-126; 2017;43(2):127-135; 2017;43(3):250-259; 2017;43(6):569-577; 2018;44(3):229-238; 2018;44(3):251-257; 2018;44(3):265-273; 2018;44(4):403-413; 2019;45(5):465-474; 2020;46(5):516-524; 2021;47(3):200-207; 2021;47(8):565-581; 2022;48(1):31-40; 2022;48(7):511-519; 2022;48(7):520-529 References
  2. World Health Organization (WHO). Prevention of cardiovascular disease: guidelines for assessment and management of total cardiovascular risk. �eneva (Switzerland): WHO press; 2007.
  3. Fujino Y, Iso H, Tamakoshi A, Inaba Y, Koizumi A, Kubo T, et al. A prospective cohort study of shift work and risk of ischemic heart disease in Japanese male workers. Am J Epidemiol. 2006;164:128-35.
  4. Furlan R, Barbic F, Piazza S, Tinelli M, Seghizzi P, Malliani A. Modifications of ardiac autonomic profile associated with a shift schedule of work. Circulation. 2000;102:1912-6.

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Authors
Puttonen, S., Härmä, M., & Hublin, C.
Affiliations
Finnish Institute of Occupational Health (FI)
ORCID
Venue
Scandinavian Journal of Work, Environment & Health
Publisher
Scandinavian Journal of Work, Environment and Health
Published
2010-01-20
Volume
36
Issue
2
Pages
96-108
ISSN
  • 0355-3140 (ISSN-L)
  • 1795-990X
DOI
10.5271/sjweh.2894
OpenAlex
W2125679654
Cited by
560
References
135
Citations by year
2026: 20 · 2025: 19 · 2024: 23 · 2023: 28 · 2022: 41 · 2021: 39 · 2020: 41 · 2019: 50 · 2018: 40 · 2017: 35 · 2016: 46 · 2015: 48 · 2014: 37 · 2013: 29 · 2012: 30
FWCI
3.59
Type
journal article
Language
en
Open access
Licence
cc-by
Locations
  • Scandinavian Journal of Work Environment & Health (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
Topics
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Sleep and Work-Related Fatigue
  • Health Sciences › Health Professions › General Health Professions › Workplace Health and Well-being
  • Life Sciences › Neuroscience › Endocrine and Autonomic Systems › Circadian rhythm and melatonin
Keywords
shift work, cardiovascular disease, work-life balance, weight gain, smoking, autonomic nervous system, inflammation, lipid metabolism, glucose metabolism, atherosclerosis, metabolic syndrome, type 2 diabetes, causal pathways
MeSH terms
Adult, Cardiovascular Diseases, Circadian Rhythm, Europe, Female, Humans, Male, Middle Aged, Work Schedule Tolerance

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