Cardiovascular mortality in a Swedish cohort of female industrial workers exposed to noise and shift work
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ORIGINAL ARTICLE
Cardiovascular mortality in a Swedish cohort of female industrial workers exposed to noise and shift work Helena P. Eriksson1,2 · Mia Söderberg2 · Richard L. Neitzel3 · Kjell Torén1,2 · Eva Andersson1,2 Received: 17 December 2019 / Accepted: 28 August 2020 © The Author(s) 2020
Abstract Purpose The aim was to study mortality due to cardiovascular disease as well as total mortality, among female industrial workers, and the association to occupational noise and shift work. Methods Women from cohorts of soft tissue paper mills (N = 3013) and pulp and paper mills (N = 1483) were merged into one cohort. Job exposure matrices were developed and used for classification of shift work and noise exposure. Every year was classified as shift work excluding nights or shift work including nights. Noise was classified into seven 5 dB(A) bins from 10 years was 1.41 (95% CI 1.02–1.89) and for those exposed to night shifts > 10 years, 1.33 (95% CI 0.91–1.89). Shift workers without nights ≤ 65 years, with noise exposure ≥ 90 dB(A), had SMR 2.41 (95% CI 1.20–4.31) from myocardial infarction. There was no increased mortality from cerebrovascular disease. Conclusions Female paper mill workers had an increased mortality from acute myocardial infarction, especially before retirement age, when exposed to noise ≥ 90 dB(A) and with long-time employment. Exposure to shift work and noise usually occurred concurrently. Keywords Cerebrovascular disease · JEM · Myocardial infarction · Night work · Noise · Paper mills
Background Shift work is a commonly occurring form of work. In Sweden, one of five employees works on a shift schedule according to an investigation by Statistics Sweden in 2018 (Statistics Sweden 2018). There are different definitions, but shift work is commonly defined as all work that is not scheduled during the daytime, (e.g., outside the hours between 7–8 am * Helena P. Eriksson [email protected] 1
Department of Occupational and Environmental Medicine, Sahlgrenska University Hospital, Göteborg, Sweden
2
Occupational and Environmental Medicine, School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, BOX 414, 405 30 Göteborg, Sweden
3
Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
and 5–6 pm) (IARC 2010). Shift work can disturb the diurnal rhythm, sleep and social life, which can influence wellbeing and health (Boivin and Boudreau 2014). Studies have indicated that shift work can increase the risk of coronary heart disease. A systematic review and meta-analysis from 2012 concluded that shift work is associated with increased risk for myocardial infarction with a relative risk of 1.23 (95% confidence interval, CI 1.15–1.31) (Vyas et al. 2012). Most shift work studies on women have investigated nurses (Vetter et al. 2016). There are few studies of industrially employed female shift workers and health risks, especially regarding cardiovascular disease. Women within the industrial sect
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