Night-shift work and breast cancer--a systematic review and meta-analysis.
Sharea Ijaz,Jos Verbeek,Andreas Seidler,Marja-Liisa Lindbohm,Anneli Ojajärvi,Nicola Orsini,Giovanni Costa,Kaisa Neuvonen +7 more
TLDR
There is insufficient evidence for a link between night-shift work and breast cancer, based on the low quality of exposure data and the difference in effect by study design.Abstract:
Objective The aim of this review was to synthesize the evidence on the potential relationship between nightshift work and breast cancer.
Methods We searched multiple databases for studies comparing women in shift work to those with no-shift work reporting incidence of breast cancer. We calculated incremental risk ratios (RR) per five years of night-shift work and per 300 night shift increases in exposure and combined these in a random effects dose–response meta-analysis. We assessed study quality in ten domains of bias.
Results We identified 16 studies: 12 case–control and 4 cohort studies. There was a 9% risk increase per five years of night-shift work exposure in case–control studies [RR 1.09, 95% confidence interval (95% CI) 1.02–1.20; I 2 =37%, 9 studies], but not in cohort studies (RR 1.01, 95% CI 0.97–1.05; I 2 =53%, 3 studies). Heterogeneity was significant overall (I 2 =55%, 12 studies). Results for 300 night shifts were similar (RR 1.04, 95% CI 1.00–1.10; I 2 =58%, 8 studies). Sensitivity analysis using exposure transformations such as cubic splines, a fixed-effect model, or including only better quality studies did not change the results. None of the 16 studies had a low risk of bias, and 6 studies had a moderate risk.
Conclusions Based on the low quality of exposure data and the difference in effect by study design, our findings indicate insufficient evidence for a link between night-shift work and breast cancer. Objective prospective exposure measurement is needed in future studies.read more
Citations
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Health consequences of shift work and insufficient sleep
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Association between light at night, melatonin secretion, sleep deprivation, and the internal clock: Health impacts and mechanisms of circadian disruption.
TL;DR: Countermeasures to the effects of ALAN, such as melatonin, bright light, or psychotropic drugs, have been proposed as a means to combat circadian clock disruption and improve adaptation to shift and night work.
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Circadian misalignment and health
TL;DR: The role of circadian misalignment as a risk factor for disease in the general population and in clinical populations, including circadian rhythm sleep disorders and psychiatric disorders is described.
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GRADE: Assessing the quality of evidence in environmental and occupational health.
Rebecca L. Morgan,Kristina A. Thayer,Lisa Bero,Nigel Bruce,Yngve Falck-Ytter,Davina Ghersi,Gordon H. Guyatt,Carlijn R. Hooijmans,Miranda W. Langendam,Daniele Mandrioli,Reem A. Mustafa,Eva Rehfuess,Andrew A. Rooney,Beverley Shea,Ellen K. Silbergeld,Patrice Sutton,Mary S. Wolfe,Tracey J. Woodruff,Jos Verbeek,Alison C. Holloway,Nancy Santesso,Holger J. Schünemann +21 more
TL;DR: An overview of the Grading of Recommendations Assessment, Development and Evaluation framework is provided, its applicability to environmental health is discussed, and priority areas for method assessment and development are identified.
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Night shift work at specific age ranges and chronic disease risk factors
Cody Ramin,Elizabeth E. Devore,Weike Wang,Jeffrey Pierre-Paul,Lani R. Wegrzyn,Eva S. Schernhammer +5 more
TL;DR: The results indicate that nightshift work may contribute to an adverse chronic disease risk profile, and that risk factors may vary depending on the age at which night shift work was performed.
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