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首页> 外文期刊>Occupational and environmental medicine >Shift work, confounding and death from ischaemic heart disease.
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Shift work, confounding and death from ischaemic heart disease.

机译：轮班工作，混杂性心脏病以及因缺血性心脏病导致的死亡。

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OBJECTIVE: To investigate the relation between shift work and death from ischaemic heart disease (IHD) and evidence for confounding by social class and healthy shift worker effects. METHODS: A case-referent study nested within an industrial cohort was used. Cases (n = 635) were cohort members who died of ischaemic heart disease (ICD 410-414) during 1950-98 aged 75 or under. Referents were matched on age and year of starting work at the site and were alive at time of case's death. Shift work status was determined from historical personnel records and pre-employment weight, height, blood pressure and smoking from medical records. Social class at first employment was inferred from job titles. To overcome potential bias due to a healthy shift worker hire effect, odds ratios were calculated from survivors 10 years after hire. To control for any healthy shift worker survivor effect, they were adjusted for duration of employment and time since termination of employment. Conditional logistic regression analysis was used to estimate ORs. RESULTS: 55% of subjects had worked as shift workers. Shift workers were more likely than day workers to belong to social class IV or V. The OR for shift workers compared with day workers, after adjustment for pre-employment risk factors, duration of employment and restricted to those who survived 10 years after hire was 1.11 (90% CI 0.90 to 1.37). This reduced to 1.04 (90% CI 0.83 to 1.30) after inclusion of social class. No dose-response relation was found. CONCLUSION: No excess risk of death from IHD for shift workers was found. The potential for confounding by social class in this relatively homogeneous cohort underlines the need to consider such confounding in more heterogeneous populations.
机译：目的：探讨轮班工作与缺血性心脏病（IHD）死亡之间的关系，以及社会阶层和健康的轮班工人影响混淆的证据。方法：采用病例对照研究，嵌套在一个工业队列中。病例（n = 635）是在1950-98年期间死于缺血性心脏病（ICD 410-414）的年龄在75岁以下的队列成员。根据现场开始工作的年龄和年份对他们进行匹配，并且在病例死亡时还活着。轮班工作状态是根据历史人事记录以及就业前的体重，身高，血压和吸烟情况来确定的。首次就业时的社会阶层是根据职称推断的。为了克服由于健康的轮班员工雇用效应而造成的潜在偏见，应从雇用10年后的幸存者中计算出优势比。为了控制任何健康的轮班工人幸存者效应，对他们的就业时间和终止雇用后的时间进行了调整。条件对数回归分析用于估计OR。结果：55％的受试者曾担任轮班工人。与轮班工人相比，轮班工人更可能属于IV级或V级社会。在调整了职前风险因素，就业时间之后，轮班工人与轮班工人的OR为1.11（90％CI 0.90至1.37）。纳入社会阶层后，这一比例降至1.04（90％CI为0.83至1.30）。没有发现剂量反应关系。结论：未发现轮班工人死于IHD的额外危险。在这个相对同质的人群中，社会阶层产生混淆的可能性强调了需要在更加异类的人群中考虑这种混淆。

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