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首页> 外文期刊>Occupational and environmental medicine >The effect of shift work on ischaemic heart disease.
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The effect of shift work on ischaemic heart disease.

机译：轮班工作对缺血性心脏病的影响。

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We would like to clarify some of the issues raised by Professor Kntitsson (Occtip EnvironMed 2008;65:152) in his recent commentary concerning our article "Shift work, confounding and death from ischaemic heart disease". Firstly, it is not true that previously "a similar study was carried out at the same factory". As we state in our article, the subjects of the present study were from a different cohort from that investigated by McNamee et al in 1996. The cohorts of the two studies had the same employer but correspond to two different factory sites approximately 100 miles apart. Thus, the recent study provides new evidence which is independent of the 1996 publication.We agree with Professor Knutsson that one should not adjust for intermediate variables that might lie on the causal chain between shift work and outcome. In our article we noted that such adjustments would be "inappropriate" and we adjusted only for pre-employment "metabolic" variables (typically measured about 1 month before taking up employment at the company). It is true that both day and shift workers in our cohort may have had some prior experience of shift work with a different employer. Thus Professor Knutsson appears to argue that our adjustment for pre-entry metabolic measures might still constitute a form of over-adjustment."While we cannot rule this out, it is important to note that the adjustment had almost minimal impact, changing the relative risk for shift work from 1.09 to 1.10; thus an unadjusted analysis would have given virtually the same results throughout the article. Furthermore, in unreported analyses, there was no evidence of interaction between shift work and the baseline variables.
机译：我们想澄清一下Kntitsson教授（Occtip EnvironMed 2008; 65：152）在他最近关于我们的文章“轮班工作，缺血性心脏病的混杂和死亡”的评论中提出的一些问题。首先，以前“在同一家工厂进行过类似的研究”并不正确。正如我们在文章中指出的那样，本研究的主题来自与McNamee等人在1996年调查的主题不同的队列。这两项研究的队列拥有相同的雇主，但分别对应于相距约100英里的两个不同的工厂。因此，最近的研究提供了独立于1996年出版物的新证据。我们同意纳特森教授的观点，即不应调整可能位于轮班工作与结果之间因果链上的中间变量。在我们的文章中，我们注意到这种调整将是“不适当的”，并且我们仅针对就业前的“代谢”变量进行了调整（通常在进入公司工作之前约1个月进行测量）。的确，我们这个队列中的日间和轮班工人可能都曾经有过与另一位雇主轮班的经验。因此，克努特森教授似乎认为，我们对进入前代谢测量的调整可能仍构成过度调整的形式。“虽然我们不能排除这一点，但重要的是要注意，该调整几乎没有什么影响，改变了相对风险从1.09到1.10的轮班工作;因此，未经调整的分析将在整篇文章中给出几乎相同的结果;此外，在未报告的分析中，没有证据表明轮班工作与基准变量之间存在相互作用。

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