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      Global, regional, and national burdens of ischemic heart disease and stroke attributable to exposure to long working hours for 194 countries, 2000–2016: A systematic analysis from the WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury

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          Highlights

          • We present the first WHO/ILO Joint Estimates of the Work-related Burden of Disease and Injury.

          • Globally in 2016, 488 million people were exposed to long working hours (≥55 hours/week).

          • This exposure had 745,194 attributable deaths and 23.3 million DALYs from ischemic heart disease and stroke.

          • These are 4.9% of all deaths and 6.9% of all DALYs from these causes.

          • The Western Pacific, South-East Asia, men, and older people carried higher burdens.

          Abstract

          Background

          World Health Organization (WHO) and International Labour Organization (ILO) systematic reviews reported sufficient evidence for higher risks of ischemic heart disease and stroke amongst people working long hours (≥55 hours/week), compared with people working standard hours (35–40 hours/week). This article presents WHO/ILO Joint Estimates of global, regional, and national exposure to long working hours, for 194 countries, and the attributable burdens of ischemic heart disease and stroke, for 183 countries, by sex and age, for 2000, 2010, and 2016.

          Methods and Findings

          We calculated population-attributable fractions from estimates of the population exposed to long working hours and relative risks of exposure on the diseases from the systematic reviews. The exposed population was modelled using data from 2324 cross-sectional surveys and 1742 quarterly survey datasets. Attributable disease burdens were estimated by applying the population-attributable fractions to WHO’s Global Health Estimates of total disease burdens.

          Results

          In 2016, 488 million people (95% uncertainty range: 472–503 million), or 8.9% (8.6–9.1) of the global population, were exposed to working long hours (≥55 hours/week). An estimated 745,194 deaths (705,786–784,601) and 23.3 million disability-adjusted life years (22.2–24.4) from ischemic heart disease and stroke combined were attributable to this exposure. The population-attributable fractions for deaths were 3.7% (3.4–4.0) for ischemic heart disease and 6.9% for stroke (6.4–7.5); for disability-adjusted life years they were 5.3% (4.9–5.6) for ischemic heart disease and 9.3% (8.7–9.9) for stroke.

          Conclusions

          WHO and ILO estimate exposure to long working hours (≥55 hours/week) is common and causes large attributable burdens of ischemic heart disease and stroke. Protecting and promoting occupational and workers’ safety and health requires interventions to reduce hazardous long working hours.

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          Most cited references54

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              Guidelines for Accurate and Transparent Health Estimates Reporting: the GATHER statement

              Measurements of health indicators are rarely available for every population and period of interest, and available data may not be comparable. The Guidelines for Accurate and Transparent Health Estimates Reporting (GATHER) define best reporting practices for studies that calculate health estimates for multiple populations (in time or space) using multiple information sources. Health estimates that fall within the scope of GATHER include all quantitative population-level estimates (including global, regional, national, or subnational estimates) of health indicators, including indicators of health status, incidence and prevalence of diseases, injuries, and disability and functioning; and indicators of health determinants, including health behaviours and health exposures. GATHER comprises a checklist of 18 items that are essential for best reporting practice. A more detailed explanation and elaboration document, describing the interpretation and rationale of each reporting item along with examples of good reporting, is available on the GATHER website.
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                Author and article information

                Contributors
                Journal
                Environ Int
                Environ Int
                Environment International
                Elsevier Science
                0160-4120
                1873-6750
                1 September 2021
                September 2021
                : 154
                : 106595
                Affiliations
                [a ]Department of Environment, Climate Change and Health, World Health Organization, Geneva, Switzerland
                [b ]Labour Administration, Labour Inspection and Occupational Safety and Health Branch, International Labour Organization, Geneva, Switzerland
                [c ]UNIV Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail) – UMR_S 1085, Angers, France
                [d ]AP-HP (Paris Hospital), Occupational Health Unit, Poincaré University Hospital, Garches, France
                [e ]Versailles St-Quentin Univ-Paris Saclay Univ (UVSQ), UMS 011, UMR-S 1168, France
                [f ]Inserm, U1168 UMS 011, Villejuif, France
                [g ]Sydney School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
                [h ]Department of Environmental Health, School of Public Health, University of Sao Paulo, Sao Paulo, SP, Brazil
                [i ]Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
                [j ]Eurostat, European Commission, Luxembourg, Luxembourg
                [k ]Department of Environmental Health Sciences, Fielding School of Public Health, School of Nursing, University of California Los Angeles, Los Angeles, CA, USA
                [l ]Stress Research Institute at Department of Psychology, Stockholm University, Stockholm, Sweden
                [m ]National Research Centre for the Working Environment, Copenhagen, Denmark
                [n ]Department of Public Health, University of Copenhagen, Copenhagen, Denmark
                [o ]Department of Psychology, University of Copenhagen, Copenhagen, Denmark
                [p ]Program on Reproductive Health and the Environment, University of California San Francisco, San Francisco, CA, USA
                Author notes
                [* ]Corresponding author at: Department of Environment, Climate Change and Health, World Health Organization, Avenue Appia 20, 1211 Geneva 27, Switzerland (F. Pega). pegaf@ 123456who.int
                Article
                S0160-4120(21)00220-8 106595
                10.1016/j.envint.2021.106595
                8204267
                34011457
                c7a06f2c-e2b2-476e-aa69-936122804cbd
                © 2021 World Health Organization, International Labour Organization

                This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/3.0/).

                History
                : 15 December 2020
                : 16 April 2021
                : 20 April 2021
                Categories
                Article

                burden of disease,working hours,ischemic heart disease,stroke

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