Shift work, risk factors and cardiovascular disease

Scand J Work Environ Health. 1999 Apr;25(2):85-99. doi: 10.5271/sjweh.410.


The literature on shift work, morbidity and mortality from cardiovascular disease, and changes in traditional risk factors is reviewed. Seventeen studies have dealt with shift work and cardiovascular disease risk. On balance, shift workers were found to have a 40% increase in risk. Causal mechanisms of this risk via known cardiovascular risk factors, in relation to circadian rhythms, disturbed sociotemporal patterns, social support, stress, behavior (smoking, diet, alcohol, exercise), and biochemical changes (cholesterol, triglycerides, etc) are discussed. The risk is probably multifactorial, but the literature has focused on the behavior of shift workers and has neglected other possible causal connections. In most studies methodological problems are present; these problems are related to selection bias, exposure classification, outcome classification, and the appropriateness of comparison groups. Suggestions for the direction of future research on this topic are proposed.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Burnout, Professional / etiology
  • Cardiovascular Diseases / etiology*
  • Cardiovascular Diseases / mortality
  • Cardiovascular Diseases / prevention & control
  • Circadian Rhythm
  • Confounding Factors, Epidemiologic
  • Epidemiologic Factors
  • Health Behavior
  • Humans
  • Morbidity
  • Occupational Diseases / etiology*
  • Occupational Diseases / mortality
  • Occupational Diseases / prevention & control
  • Risk Factors
  • Selection Bias
  • Social Support
  • Work Schedule Tolerance* / physiology
  • Work Schedule Tolerance* / psychology