A1 Refereed original research article in a scientific journal

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




AuthorsKivimaki M, Nyberg ST, Batty GD, Kawachi I, Jokela M, Alfredsson L, Bjorner JB, Borritz M, Burr H, Dragano N, Fransson EI, Heikkila K, Knutsson A, Koskenvuo M, Kumari M, Madsen IEH, Nielsen ML, Nordin M, Oksanen T, Pejtersen JH, Pentti J, Rugulies R, Salo P, Shipley MJ, Suominen S, Theorell T, Vahtera J, Westerholm P, Westerlund H, Steptoe A, Singh-Manoux A, Hamer M, Ferrie JE, Virtanen M, Tabak AG

PublisherOXFORD UNIV PRESS

Publication year2017

JournalEuropean Heart Journal

Journal name in sourceEUROPEAN HEART JOURNAL

Journal acronymEUR HEART J

Volume38

Issue34

First page 2621

Last page2628

Number of pages8

ISSN0195-668X

eISSN1522-9645

DOIhttps://doi.org/10.1093/eurheartj/ehx324


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 (I-2= 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.



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