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Systematic Review and Meta-Analysis on Exposure to Long Working Hours and Risk of Ischaemic Heart Disease – Conclusions Are Supported by the Evidence



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  • Personal Author:
  • Corporate Authors:
    World Health Organization. Working Group of Individual Experts on Long Working Hours on Ischaemic Heart Disease
  • Description:
    We read with interest the commentary by Dr. Kivimäki and colleagues (Kivimäki et al., 2020) on our recently published systematic review and meta-analysis on exposure to long working hours and risk of ischaemic heart disease (Li et al., 2020). Kivimäki et al. appear to agree with the methodology of our systematic review and meta-analysis, and we appreciate that they emphasize that the work "is based on a carefully planned registered protocol and is well-documented and transparent" (Kivimäki et al., 2020). However, Kivimäki et al. are concerned that our conclusions may not be supported by the evidence. We disagree with this opinion and we stand by our judgment and conclusion that there is sufficient evidence for the harmfulness of long working hours (≥55 h/week) with regard to risk of ischaemic heart disease. Based on our pre-specified, peer-reviewed, published protocol (Li et al., 2018), we conducted a rigorous, comprehensive and transparent systematic review and meta-analysis (Li et al., 2020). Initiated and coordinated by the World Health Organization (WHO) and the International Labour Office (ILO) jointly, a Working Group of 21 individual experts working in 10 countries from 4 continents engaged in global scientific discussion and consensus-making, both before publishing the methods in the protocol (Li et al., 2018) and the results in the systematic review (Li et al., 2020). Both publications are peer-reviewed articles in an international academic journal (not WHO/ILO reports). Our Working Group was inclusive, and experts, globally, were invited to participate in the systematic review, including Prof. Kivimäki. In response to the commentary, we highlight and emphasize the methodological and empirical rationale for the results of our systematic review, and we call for a more differentiated understanding and application of systematic review frameworks and methods for hazard identification in global occupational health. Here, a focus on rigorous approaches for assessing the quality across a body of evidence and the strength of evidence is needed, specifically using approaches developed by the Navigation Guide and Grading of Recommendations Assessment, Development and Evaluation (GRADE) Working Group (Morgan et al., 2019, Woodruff and Sutton, 2014). [Description provided by NIOSH]
  • Subjects:
  • Keywords:
  • ISSN:
    0160-4120
  • Document Type:
    Text
  • Funding:
    Grant
  • Genre:
    Journal Article
  • Place as Subject:
  • CIO:
    National Institute for Occupational Safety and Health (NIOSH)
  • Topic:
    Workplace Safety & Health
  • Location:
    North America
  • Volume:
    144
  • NIOSHTIC Number:
    nn:20068290
  • Citation:
    Environ Int 2020 Nov; 144:106118
  • Contact Point Address:
    Jian Li, Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California, Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA 90095, United States
  • Email:
    jianli2019@ucla.edu
  • Federal Fiscal Year:
    2021
  • Performing Organization:
    University of California Los Angeles
  • Peer Reviewed:
    True
  • Start Date:
    20050701
  • Source Full Name:
    Environment International
  • End Date:
    20270630
  • Collection(s):
  • Main Document Checksum:
    urn:sha-512:f775ea4826d71da907a2336f2e9a9b4d127f243a18d77dac40d100423369a47407f1ec9697b3c0fac8af45fe5cdbf5a0fc8c986d17e95c3483bd0e3939632075
  • Download URL:
  • File Type:
    Filetype[PDF - 441.28 KB ]
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