期刊
AMERICAN JOURNAL OF EPIDEMIOLOGY
卷 176, 期 7, 页码 586-596出版社
OXFORD UNIV PRESS INC
DOI: 10.1093/aje/kws139
关键词
cardiovascular diseases; coronary disease; employment; meta-analysis; myocardial infarction; review; work
资金
- Medical Research Council
- British Heart Foundation
- US National Heart, Lung, and Blood Institute [RO1HL036310]
- US National Institute on Aging [R01AG034454, RO1AG13196]
- Academy of Finland
- Finnish Work Environment Foundation
- European Union NEW OSH ERA
- British Heart Foundation [RG/07/008/23674] Funding Source: researchfish
- Medical Research Council [G0100222, G0902037, G19/35, G8802774] Funding Source: researchfish
- MRC [G0902037] Funding Source: UKRI
The authors aggregated the results of observational studies examining the association between long working hours and coronary heart disease (CHD). Data sources used were MEDLINE (through January 19, 2011) and Web of Science (through March 14, 2011). Two investigators independently extracted results from eligible studies. Heterogeneity between the studies was assessed using the I-2 statistic, and the possibility of publication bias was assessed using the funnel plot and Eggers test for small-study effects. Twelve studies were identified (7 case-control, 4 prospective, and 1 cross-sectional). For a total of 22,518 participants (2,313 CHD cases), the minimally adjusted relative risk of CHD for long working hours was 1.80 (95 confidence interval (CI): 1.42, 2.29), and in the maximally (multivariate-) adjusted analysis the relative risk was 1.59 (95 CI: 1.23, 2.07). The 4 prospective studies produced a relative risk of 1.39 (95 CI: 1.12, 1.72), while the corresponding relative risk in the 7 case-control studies was 2.43 (95 CI: 1.81, 3.26). Little evidence of publication bias but relatively large heterogeneity was observed. Studies varied in size, design, measurement of exposure and outcome, and adjustments. In conclusion, results from prospective observational studies suggest an approximately 40 excess risk of CHD in employees working long hours.
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