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Eur Heart J. 2017 Sep 7;38(34):2621-2628. doi: 10.1093/eurheartj/ehx324.

Long working hours as a risk factor for atrial fibrillation: a multi-cohort study.

Author information

1
Department of Epidemiology and Public Health, University College London, WC1E 6BT London, UK.
2
Clinicum, Faculty of Medicine, University of Helsinki, Tukholmankatu 8 B, 00290 Helsinki, Finland.
3
Finnish Institute of Occupational Health, Topeliuksenkatu 41 B, 00250 Helsinki, Finland.
4
Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, 7 George Square, EH8 9JZ, Edinburgh, UK.
5
Department of Social & Behavioral Sciences, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Kresge Building 7th Floor, Boston, Massachusetts 02115, USA.
6
Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Haartmaninkatu 3, 00014 Helsinki, Finland.
7
Centre for Occupational and Environmental Medicine, Stockholm County Council, Solnavägen 4, 113 65 Stockholm, Sweden.
8
Institute of Environmental Medicine, Nobels väg 13, Karolinska Institutet, 171 77 Stockholm, Sweden.
9
National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen ø, Denmark.
10
Bispebjerg University Hospital Copenhagen, Department of Occupational and Environmental Medicine, Bispebjerg Bakke 23_20F, DK-2400 Copenhagen NV, Denmark.
11
Federal Institute for Occupational Safety and Health (BAuA), Nöldnerstraße 40/42, 10317 Berlin, Germany.
12
Institute of Medical Sociology, Medical Faculty, University of Düsseldorf, Universitätsstraße 1, D-40225 Düsseldorf, Germany.
13
School of Health and Welfare, Jönköping University, Barnarpsgatan 39, 551 11 Jönköping, Sweden.
14
Stress Research Institute, Stockholm University, Frescati Hagväg 16 A, 114 19 Stockholm, Sweden.
15
Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, UK 15-17 Tavistock Place, WC1H 9SH London, UK.
16
Clinical Effectiveness Unit, The Royal College of Surgeons, 35-43 Lincoln's Inn Fields, WC2A 3PE London, UK.
17
Department of Health Sciences, Mid Sweden University, Holmgatan 10, 851 70 Sundsvall, Sweden.
18
Institute for Social and Economic Research, University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, Essex, UK.
19
AS3 Employment, AS3 Companies, Hasselager Centervej 35, DK-8260 VIBY J, Denmark.
20
Department of Psychology, Umeå University, SE-901 87 Umeå, Sweden.
21
Danish National Centre for Social Research, Herluf Trolles Gade 11, 1052 Copenhagen K, Denmark.
22
Department of Public Health and Department of Psychology, University of Copenhagen, Nørregade 10, PO Box 2177, 1017 Copenhagen K, Denmark.
23
Department of Psychology, University of Turku, Assistentinkatu 7, 20014 Turku, Finland.
24
University of Skövde, Högskolevägen 28, 541 45 Skövde, Sweden.
25
Department of Public Health, University of Turku, Joukahaisenkatu 3-5 A, 20520 Turku, Finland.
26
Turku University Hospital, Kiinamyllynkatu 4-8, 20521 Turku, Finland.
27
Department of Medical Sciences, Uppsala University, Akademiska sjukhuset, 75185 Uppsala, Sweden.
28
Inserm U1018, Centre for Research in Epidemiology and Population Health, Hôpital Paul-Brousse 16 avenue Paul Vaillant-Couturier, Bâtiment 15/16, 94807 Villejuif Cedex, France.
29
School of Sport, Exercise and Health Sciences, National Centre Sport & Exercise Medicine, Loughborough University, Epinal Way, Loughborough LE11 3TU, UK.
30
School of Social and Community Medicine, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK.
31
1st Department of Medicine, Semmelweis University Faculty of Medicine, Budapest, Üllöi út 26, 1085 Budapest, Hungary.

Abstract

Aims:

Studies suggest that people who work long hours are at increased risk of stroke, but the association of long working hours with atrial fibrillation, the most common cardiac arrhythmia and a risk factor for stroke, is unknown. We examined the risk of atrial fibrillation in individuals working long hours (≥55 per week) and those working standard 35-40 h/week.

Methods and results:

In this prospective multi-cohort study from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium, the study population was 85 494 working men and women (mean age 43.4 years) with no recorded atrial fibrillation. Working hours were assessed at study baseline (1991-2004). Mean follow-up for incident atrial fibrillation was 10 years and cases were defined using data on electrocardiograms, hospital records, drug reimbursement registers, and death certificates. We identified 1061 new cases of atrial fibrillation (10-year cumulative incidence 12.4 per 1000). After adjustment for age, sex and socioeconomic status, individuals working long hours had a 1.4-fold increased risk of atrial fibrillation compared with those working standard hours (hazard ratio = 1.42, 95% CI = 1.13-1.80, P = 0.003). There was no significant heterogeneity between the cohort-specific effect estimates (I2 = 0%, P = 0.66) and the finding remained after excluding participants with coronary heart disease or stroke at baseline or during the follow-up (N = 2006, hazard ratio = 1.36, 95% CI = 1.05-1.76, P = 0.0180). Adjustment for potential confounding factors, such as obesity, risky alcohol use and high blood pressure, had little impact on this association.

Conclusion:

Individuals who worked long hours were more likely to develop atrial fibrillation than those working standard hours.

KEYWORDS:

Atrial fibrillation ; Cohort study; Life stress ; Risk factors

PMID:
28911189
PMCID:
PMC5837794
DOI:
10.1093/eurheartj/ehx324
[Indexed for MEDLINE]
Free PMC Article

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