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      Prevalence and Recent Trends in Exposure to Night Shiftwork in Canada

      1 , 2 , 3 , 4 , 1 , 5 , 6
      Annals of Work Exposures and Health
      Oxford University Press (OUP)

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          Abstract

          Objectives

          Night shiftwork has been linked to various health outcomes. Knowing where and to what extent workers are exposed to this type of shiftwork can help prioritize areas for intervention and further study. This study describes recent estimates of exposure to night shiftwork in Canada for 2011, and temporal trends from 1997 to 2010.

          Methods

          Estimates by occupation, industry, province, and sex were calculated using data from the Survey of Labour and Income Dynamics (SLID) from 1996 to 2011. Workers who reported rotating or regular night shifts were classified as exposed to shiftwork involving nights, while those reporting other types of shiftwork, outside of regular daytime and evening shifts, were classified as possibly exposed. Results, with 97.5% confidence intervals (CIs), were summarized for three exposure categories: exposed workers, possibly exposed workers, and evening shift workers. Trends in 3-year rolling averages were described.

          Results

          In 2011, approximately 1.8 million Canadians (97.5% CI, 1.7–1.8 million), or 12% of the working population (97.5% CI, 11–12%), were exposed to night shiftwork; 45% were female. An additional 2.6 million were possibly exposed (97.5% CI, 2.5–2.7 million workers), and 745 000 worked evening shifts (97.5% CI, 701 000–792 000). This amounts to 17% (97.5% CI, 17–18%) and 4.9% (97.5% CI, 4.6–5.2%) of the labour force, respectively. Industries with the highest prevalence were accommodation and food services (20%; 97.5% CI, 18–22%), forestry, fishing, mining, oil, and gas (19%; 97.5% CI, 16–23%), and healthcare and social assistance (18%; 97.5% CI, 17–19%). By occupation, the highest prevalence of exposure was in occupations in protective services (37%; 97.5% CI, 32–42%), professional occupations in health (35%; 97.5% CI, 32–39%), and machine operators and assemblers in manufacturing (24%; 97.5% CI, 22–28%). The overall number of exposure workers increased by 29% from 1997 to 2010, but the overall proportion remained relatively the same (11% and 12%, respectively). The proportion of female workers exposed increased by 2%.

          Conclusions

          These estimates characterize exposure to night shiftwork in Canada. Continued collection of shiftwork data, with greater detail on scheduling, workplace and personal factors, is needed for high-quality surveillance and investigations of shiftwork and health.

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          Most cited references21

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          Global, Regional, and National Cancer Incidence, Mortality, Years of Life Lost, Years Lived With Disability, and Disability-Adjusted Life-years for 32 Cancer Groups, 1990 to 2015

          IMPORTANCE Cancer is the second leading cause of death worldwide. Current estimates on the burden of cancer are needed for cancer control planning. OBJECTIVE To estimate mortality, incidence, years lived with disability (YLDs), years of life lost (YLLs), and disability-adjusted life-years (DALYs) for 32 cancers in 195 countries and territories from 1990 to 2015. EVIDENCE REVIEW Cancer mortality was estimated using vital registration system data, cancer registry incidence data (transformed to mortality estimates using separately estimated mortality to incidence [MI] ratios), and verbal autopsy data. Cancer incidence was calculated by dividing mortality estimates through the modeled MI ratios. To calculate cancer prevalence, MI ratios were used to model survival. To calculate YLDs, prevalence estimates were multiplied by disability weights. The YLLs were estimated by multiplying age-specific cancer deaths by the reference life expectancy. DALYs were estimated as the sum of YLDs and YLLs. A sociodemographic index (SDI) was created for each location based on income per capita, educational attainment, and fertility. Countries were categorized by SDI quintiles to summarize results. FINDINGS In 2015, there were 17.5 million cancer cases worldwide and 8.7 million deaths. Between 2005 and 2015, cancer cases increased by 33%, with population aging contributing 16%, population growth 13%, and changes in age-specific rates contributing 4%. For men, the most common cancer globally was prostate cancer (1.6 million cases). Tracheal, bronchus, and lung cancer was the leading cause of cancer deaths and DALYs in men (1.2 million deaths and 25.9 million DALYs). For women, the most common cancer was breast cancer (2.4 million cases). Breast cancer was also the leading cause of cancer deaths and DALYs for women (523 000 deaths and 15.1 million DALYs). Overall, cancer caused 208.3 million DALYs worldwide in 2015 for both sexes combined. Between 2005 and 2015, age-standardized incidence rates for all cancers combined increased in 174 of 195 countries or territories. Age-standardized death rates (ASDRs) for all cancers combined decreased within that timeframe in 140 of 195 countries or territories. Countries with an increase in the ASDR due to all cancers were largely located on the African continent. Of all cancers, deaths between 2005 and 2015 decreased significantly for Hodgkin lymphoma (−6.1% [95% uncertainty interval (UI), −10.6% to −1.3%]). The number of deaths also decreased for esophageal cancer, stomach cancer, and chronic myeloid leukemia, although these results were not statistically significant. CONCLUSION AND RELEVANCE As part of the epidemiological transition, cancer incidence is expected to increase in the future, further straining limited health care resources. Appropriate allocation of resources for cancer prevention, early diagnosis, and curative and palliative care requires detailed knowledge of the local burden of cancer. The GBD 2015 study results demonstrate that progress is possible in the war against cancer. However, the major findings also highlight an unmet need for cancer prevention efforts, including tobacco control, vaccination, and the promotion of physical activity and a healthy diet.
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            Interval Estimation for a Binomial Proportion

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              Is Open Access

              Shift work and vascular events: systematic review and meta-analysis

              Objective To synthesise the association of shift work with major vascular events as reported in the literature. Data sources Systematic searches of major bibliographic databases, contact with experts in the field, and review of reference lists of primary articles, review papers, and guidelines. Study selection Observational studies that reported risk ratios for vascular morbidity, vascular mortality, or all cause mortality in relation to shift work were included; control groups could be non-shift (“day”) workers or the general population. Data extraction Study quality was assessed with the Downs and Black scale for observational studies. The three primary outcomes were myocardial infarction, ischaemic stroke, and any coronary event. Heterogeneity was measured with the I2 statistic and computed random effects models. Results 34 studies in 2 011 935 people were identified. Shift work was associated with myocardial infarction (risk ratio 1.23, 95% confidence interval 1.15 to 1.31; I2=0) and ischaemic stroke (1.05, 1.01 to 1.09; I2=0). Coronary events were also increased (risk ratio 1.24, 1.10 to 1.39), albeit with significant heterogeneity across studies (I2=85%). Pooled risk ratios were significant for both unadjusted analyses and analyses adjusted for risk factors. All shift work schedules with the exception of evening shifts were associated with a statistically higher risk of coronary events. Shift work was not associated with increased rates of mortality (whether vascular cause specific or overall). Presence or absence of adjustment for smoking and socioeconomic status was not a source of heterogeneity in the primary studies. 6598 myocardial infarctions, 17 359 coronary events, and 1854 ischaemic strokes occurred. On the basis of the Canadian prevalence of shift work of 32.8%, the population attributable risks related to shift work were 7.0% for myocardial infarction, 7.3% for all coronary events, and 1.6% for ischaemic stroke. Conclusions Shift work is associated with vascular events, which may have implications for public policy and occupational medicine.
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                Author and article information

                Contributors
                Journal
                Annals of Work Exposures and Health
                Oxford University Press (OUP)
                2398-7308
                2398-7316
                April 2020
                March 10 2020
                February 05 2020
                April 2020
                March 10 2020
                February 05 2020
                : 64
                : 3
                : 270-281
                Affiliations
                [1 ]CAREX Canada, Faculty of Health Sciences, Simon Fraser University, Vancouver, BC, Canada
                [2 ]Occupational Cancer Research Centre, Toronto, ON, Canada
                [3 ]nternational Agency for Research on Cancer, Lyon, France
                [4 ]Veterans Affairs Canada, Daniel J MacDonald Building, Charlottetown, PE, Canada
                [5 ]Cancer Epidemiology and Prevention Research, CancerControl Alberta, Alberta Health Services, Calgary, AB, Canada
                [6 ]Department of Oncology, Cumming School of Medicine, University of Calgary, Health Sciences Centre - Foothills Campus, Calgary, AB, Canada
                Article
                10.1093/annweh/wxaa001
                32020159
                7659607a-4312-4399-8237-157ef0e748b8
                © 2020

                https://academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model

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