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Shift work and cardiovascular disease – pathways from circadian stress to morbidity
Open accessAbstract
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 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]
In the citing paper
“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]
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“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]
In the citing paper
“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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Assessment of cardiovascular risk in shift healthcare workers
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Self-citationIntervention in shift scheduling and changes in biomarkers of heart disease in hospital wards
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Research works printed but not linked: 4
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Cited by
Sorted by citations
Health consequences of shift work and insufficient sleep
Kecklund, G., & Axelsson, J. (2016) · BMJ · doi:10.1136/bmj.i5210 · Cited by 1,195
Wilkinson, M. J., Manoogian, E. N. C., Zadourian, A., Lo, H., Fakhouri, S., Shoghi, A., Wang, X., Fleischer, J. G., Navlakha, S., Panda, S., et al. (2020) · Cell Metabolism · doi:10.1016/j.cmet.2019.11.004 · Cited by 927
Shift work and vascular events: systematic review and meta-analysis
Vyas, M. V., Garg, A. X., Iansavichus, A. V., Costella, J., Donner, A., Laugsand, L. E., Janszky, I., Mrkobrada, M., Parraga, G., & Hackam, D. G. (2012) · BMJ · doi:10.1136/bmj.e4800 · Cited by 840
Rotating Night Shift Work and Risk of Type 2 Diabetes: Two Prospective Cohort Studies in Women
Pan, A., Schernhammer, E. S., Sun, Q., & Hu, F. B. (2011) · PLoS Medicine · doi:10.1371/journal.pmed.1001141 · Cited by 805
“, cholesterol and other lipids, plasminogen, blood pressure, and cardiac activity) might also impact the association [16,27].”
BackgroundResultNegative Impacts of Shiftwork and Long Work Hours
Caruso, C. C. (2014) · Rehabilitation Nursing · doi:10.1002/rnj.107 · Cited by 639
Metadata
- Authors
- Puttonen, S., Härmä, M., & Hublin, C.
- Affiliations
- Finnish Institute of Occupational Health (FI)
- Venue
- Scandinavian Journal of Work, Environment & Health
- Published
- 2010-01-20
- Volume
- 36
- Issue
- 2
- Pages
- 96-108
- ISSN
- 0355-3140 (ISSN-L)
- 1795-990X
- 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
- hybrid
- doi.org
- 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 › Medicine › Public Health, Environmental and Occupational Health › 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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