Adverse Health Effects of Shift Work

Details

• Personal Author:
  Eliassen H ; Okereke O ; Rosner B ; Schernhammer E
• Description:
  Worker groups studied. Almost 15 million Americans regularly work alternate shifts (1). Considerable uncertainty exists about the potential harm that shift work during pregnancy may impose on a mom's child, yet working night shifts during pregnancy is currently an established reality in the US. We have previously linked work schedules, particularly those involving night shifts, with an increased risk of spontaneous abortion and delivering pre-term in the Nurses' Health Study 2 (NHS2) - risks which remained elevated even after adjusting for exposure to antineoplastic drugs and sterilizing agents. Identifying the effects of shift work on health by targeting the "Developmental Origins of Health and Disease" (DOHaD) concept as it relates to prenatal shift work exposure, to examine how exposure of the embryo and fetus to shift work may affect their health and chronic disease risk later in life, remains central to further research. Approach. Drawing on a worldwide unique resource, which provides critical information on both moms and their offspring, including occupational shift work exposure during pregnancy, existing data from the ongoing NHS2 cohort and Growing Up Today Study (GUTS), i.e. children of the nurses participating in NHS2, and newly collecting urine samples from a subset of GUTS participants, investigated the following 3 major hypotheses: (1) can shift work (prior to conception as well as during pregnancy) induce growth perturbations and altered mental health in the offspring, and how may this influence disease risk across the lifespan? (2) are worsened sleep parameters including lower overnight melatonin production, and higher glucocorticoid signaling in young adulthood associated with such early life exposures? and (3) can we define critical developmental windows (e.g., preconception, embryonic, and fetal periods) during which shift work may influence chronic disease etiology. Data on lifetime shift work history of the NHS2 mothers of all 27,795 children in GUTS, 3,740 children whose mothers additionally provided shift work history during pregnancy, and 621 mom/child pairs where the mom was actually pregnant with the respective GUTS kid during shift work, were available. Key Findings. Over the past decade, our own work, using data from the Nurses' Health Study cohorts has produced landmark findings and generated provocative novel hypotheses related to the health effects of night work and sleep deprivation: We showed that night shift work increases the risk of a number of different cancers; we also linked rotating night shift work, through its profound effects on metabolism and weight (i.e. obesity) with other major chronic diseases, including cardiovascular disease, metabolic syndrome, hypertension, stroke, endometriosis, type 2 diabetes (T2DM). Building on this large body of prior work, in our current project, we were able to show that that children of moms with a history of longer duration of shift work tended to have a higher BMI at age 9-10 than children of moms without any night work. Importantly, adherence to an overall healthy lifestyle before pregnancy was strongly associated with a low risk of offspring obesity in childhood, adolescence, and early adulthood, or for moms who worked night shifts. Additionally, we observed differences in cortisol and sAA patterns suggesting a different stress response (potentially indicative of a more reactive stress system) in offspring of women with night shift work, compared to offspring of women without. Further, we observed a higher risk of depression for offspring of women who worked night shifts before pregnancy and reported being definite morning chronotypes, indicating that maternal chronotype significantly modifies the relationship between maternal night shift work before pregnancy and depression outcomes in their offspring. This is an exciting finding corroborating that the interplay between work hours and internal clock (chronotype) might be of importance for disease outcomes. How the results relate to improvements for worker safety or health. This project's results will not have any direct impact on the NHS cohorts, but the findings may lead to changes in shift work practice that may benefit women who work rotating night shifts in the future. Ultimately, as outlined in detail in our proposal, our research exemplifies the translation of research into practice (r2P) in that it may lead to actual changes in work practice for pregnant women. Ultimately, this is a potentially highly effective prevention practice, which can readily be adopted by any other workplace. [Description provided by NIOSH]
• Subjects:
  Circadian Rhythm Cohort Studies Health Personnel Neoplasms Occupational Health Pregnancy Safety Sleep Sleep Initiation And Maintenance Disorders Surveys And Questionnaires Urogenital System

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• Keywords:
  Cancer Rates Circadian Rhythms Cohort Studies Health Effects Nurses Nursing Questionnaires Reproductive Effects Shift Workers Sleep Deprivation Work Schedules

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• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Massachusetts ; OSHA Region 1
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-26
• NIOSHTIC Number:
  nn:20065378
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-009803, 2021 Nov; :1-26
• Contact Point Address:
  Eva Schernhammer, MD, DrPH, Channing Division of Network Medicine, 181 Longwood Ave, Boston MA 02115
• Email:
  eva.schernhammer@channing.harvard.edu
• CAS Registry Number:
  Melatonin (CAS RN 73-31-4)
• Federal Fiscal Year:
  2022
• NORA Priority Area:
  Healthcare and Social Assistance
• Performing Organization:
  Brigham and Women's Hospital, Inc., Boston, Massachusetts
• Peer Reviewed:
  False
• Start Date:
  20100801
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20190831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:8a070147b3e5d34fefc1164464238b12a4d74282beab8b8c8ac1b371dd48627b2b21126d502e7c37143c55df38185c9f54499605ef705b181c6ab24b89414e5b
• Download URL:
  https://stacks.cdc.gov/view/cdc/219113/cdc_219113_DS1.pdf
• File Type:
  [PDF - 312.37 KB ]