Minimizing Cancer Risk in Shift Workers

最大限度地降低轮班工人的癌症风险

• 批准号: 8124956
• 负责人: EVA S SCHERNHAMMER
• 金额: $ 29.9万
• 依托单位: BRIGHAM AND WOMEN'S HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-08-01 至 2015-07-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8124956
• 关键词: Minimizing; Cancer; Risk; Shift; Workers

DESCRIPTION (provided by applicant): Almost 15 million Americans regularly work alternate shifts, including evening, night, and rotating shifts. Shift work is integral to the modern work force, which spans all age and ethnic groups. Observational studies have consistently associated rotating shift work with increases in cancer risk, prompting the WHO in December 2007 to classify night shift work a probable carcinogen - the main operating mechanism being assumed circadian disruption by means of melatonin suppression. Based on results from the Nurses' Health Study II (NHS2), in March 2009, Denmark as the first country worldwide began paying monetary compensation to women who developed breast cancer after 20 or more years of night shift work. Because no definitive strategy currently exists to reduce the cancer risk associated with shift work-induced circadian disruption, determining what aspects of shift schedules are most detrimental to health is the next frontier in shift work and disease prevention. To date, no study has examined how specific aspects of shift schedules including length, frequency of rotation, and hours worked per week interact and relate to cancer risk. Moreover, whether there is an age range at which people are particularly vulnerable to the effects of circadian disruption also remains unclear. Future research would benefit from a clear and complete description of work schedules and their effects on human cancer risk. In 2009, we have added a battery of shift work questions to the main NHS2 questionnaire. We newly assess specific aspects of the nurses' work schedule including types of shift schedules and changes throughout their professional career. In addition, other factors of potential relevance to circadian disruption were assessed, including morningness-eveningness and sleep duration during each of the various life time periods. To evaluate the hypothesis that certain aspects of shift work schedules are more strongly associated with breast cancer risk than others, we will use both a cohort and cross-sectional study approach. We estimate 1,108 newly diagnosed cases of breast cancer between 2009 and 2013. We will use these cases, as well as prevalent cases to enhance the power of subanalyses, for an estimated total of 4,295 women with a diagnosis of breast cancer through 2013. Because mechanisms that link shift work to breast cancer risk are similar for other cancers, the findings from this proposal are likely to affect not only the risk of breast cancer but that of other cancers and men as well. We expect that the impact of our results will extend well beyond the specific aims we currently propose. Ultimately, as time progresses and nurses become older, this data and the newly added battery of shift work questions will lay the foundation for a comprehensive and unique study of shift work on the health needs of older workers. PUBLIC HEALTH RELEVANCE: In December 2007, the WHO classified night shift work as probably inducing cancer - the main operating mechanism being assumed the suppression of melatonin and consequences thereof. Because no definitive strategy currently exists to reduce the cancer risk associated with shift work- induced changes in the body that could lead to cancer risk, determining what specific aspects of the nurses' work schedule including types of shift schedules and changes throughout their professional career are most detrimental to cancer risk is the next frontier in shift work and disease prevention.

描述（由申请人提供）：将近1500万美国人定期进行替代轮班，包括晚上，夜间和轮换班次。轮班工作是现代劳动力不可或缺的，该劳动力跨越了所有年龄段和种族。观察性研究一直将旋转转移工作与癌症风险的增加相关联，促使WHO在2007年12月将夜班工作分类为可能的致癌，这是通过抑制褪黑激素抑制作用的主要工作机制。根据2009年3月的护士健康研究II（NHS2）的结果，丹麦是全球第一个国家开始为在20年或更长时间的夜班工作后患上乳腺癌的妇女支付货币补偿。因为目前尚无确切的策略来减少与班次工作引起的昼夜节律中断相关的癌症风险，因此确定转移时间表的哪些方面对健康有害最有害，这是转移工作和疾病预防疾病的下一个领域。迄今为止，尚无研究检查如何在包括长度，旋转频率和每周工作的时间相互作用的转移时间表的特定方面，并且与癌症风险有关。此外，是否有一个年龄段，人们特别容易受到昼夜节律造成的影响的年龄范围也不清楚。未来的研究将受益于对工作时间表的清晰，完整的描述及其对人类癌症风险的影响。在2009年，我们为主要NHS2问卷添加了一系列轮班工作问题。我们新评估护士工作时间表的特定方面，包括整个职业生涯的轮班时间表和变化的类型。此外，评估了与昼夜节律中断的其他潜在相关因素，包括在各个生活期间的每一个中的早晨夜间和睡眠持续时间。为了评估以下假设，即轮班工作时间表的某些方面与乳腺癌风险相比，与其他乳腺癌风险更强烈，我们将同时使用同类和横断面研究方法。我们在2009年至2013年之间估计了1,108例新诊断的乳腺癌病例。我们将使用这些病例以及普遍的病例来增强亚分析的力量，估计总共有4295名在2013年诊断为乳腺癌的女性。 出色地。我们预计我们的结果的影响将远远超出我们目前建议的特定目标。最终，随着时间的进步和护士的年龄，这些数据和新添加的轮班工作问题将为全面而独特的研究对老年工人的健康需求进行全面和独特的研究奠定基础。 公共卫生相关性：2007年12月，该世卫组织将夜班工作归类为可能引起癌症 - 主要运营机制被认为是抑制褪黑激素及其后果的主要工作机制。因为目前尚无确切的策略来减少与转移工作引起的身体变化相关的癌症风险，这可能导致癌症风险，从而确定护士工作时间表的哪些特定方面，包括转移计划的类型和整个职业生涯中最有害的癌症风险是转变工作和疾病预防疾病的下一个领域。