Electronic Thesis and Dissertation Repository

Degree

Master of Science

Program

Epidemiology and Biostatistics

Supervisor

Dr Daniel Hackam

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.

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