Shift work and cardiovascular events: systematic review and meta-analysis
Abstract
The prevalence of shift work is increasing in the general population. There is conflicting epidemiologic evidence on the association between shift work and cardiovascular disease. We performed a systematic review and meta-analysis of observational studies that measured shift work-cardiovascular disease associations. We screened 12,350 articles and identified 35 eligible studies. The pooled risk ratios (RR) for myocardial infarction, all coronary events and ischemic stroke were 1.23 (95% confidence interval [CI] 1.15 to 1.31, I2 = 0), 1.24 (95% CI 1.10 to 1.39, I2 = 85%) and 1.05 (95% CI 1.01 to 1.09, I2 = 0), respectively. The population-attributable risks from shift work for myocardial infarction, all coronary events and ischemic stroke in Canada would be 7%, 7.3% and 1.6%, respectively. We found no evidence of publication bias. We report significant yet relatively modest associations for shift work and cardiovascular events. These results have implications for public policy and occupational medicine.