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. 2022 Feb 1;18(2):653-662.
doi: 10.5664/jcsm.9642.

Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies

Qi-Jun Wu  1   2 , Hui Sun  1   2 , Zhao-Yan Wen  1   2 , Meng Zhang  1   2 , Han-Yuan Wang  1   2 , Xin-Hui He  1   2 , Yu-Ting Jiang  1   2 , Yu-Hong Zhao  1   2
Affiliations

Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies

Qi-Jun Wu et al. J Clin Sleep Med. .

Abstract

Study objectives: Shift work is commonly increasing, and some physiological changes occur as workers sleep less and their circadian rhythms are disrupted. This umbrella review not only summarizes the evidence but also evaluates the validity of the associations of shift work with different health outcomes.

Methods: We searched the MEDLINE, Web of Science, and Embase databases from their inception to April 25, 2020. For each systematic review and/or meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias.

Results: Eight eligible systematic reviews and meta-analyses were identified, providing data on 16 associations. We observed highly suggestive evidence for associations between shift work and myocardial infarction (having ever vs having never done shift work) and diabetes mellitus incidence (per 5-year increment in shift work). Furthermore, we observed suggestive evidence for an association between shift work and diabetes mellitus incidence (having ever vs having never done shift work). Two health outcomes, including prostate cancer incidence (having ever vs having never done shift work and rotating night shift work vs daytime work) and colorectal cancer incidence (longest vs shortest shift work time), were only supported by weak evidence.

Conclusions: This umbrella review found that shift work was associated with several health outcomes with different levels of evidence. Associations for myocardial infarction and diabetes mellitus incidence were supported by highly suggestive evidence.

Systematic review registration: Registry: PROSPERO; Identifier: CRD42020188537.

Citation: Wu Q-J, Sun H, Wen Z-Y, et al. Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies. J Clin Sleep Med. 2022;18(2):653-662.

Keywords: evidence; health outcome; shift work; umbrella review.

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Conflict of interest statement

The authors read and approved the final manuscript. This work was supported by the National Key R&D Program of China (number 2017YFC0907401 to Yu-Hong Zhao), the LiaoNing Revitalization Talents Program (number XL YC1907102 to Qi-Jun Wu and number XLYC1802095 to Yu-Hong Zhao), and the 345 Talent Project to Qi-Jun Wu. The authors report no conflicts of interest.

Figures

Figure 1
Figure 1. Flow chart of selection of studies for inclusion in umbrella review on shift work and health outcomes.
See this image and copyright information in PMC

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