Study Objectives:

Shift work is commonly increasing, and some physiological changes occur as workers sleep less and their circadian rhythms are disrupted. This umbrella review not only summarizes the evidence but also evaluates the validity of the associations of shift work with different health outcomes.

Methods:

We searched the MEDLINE, Web of Science, and Embase databases from their inception to April 25, 2020. This study has been registered at PROSPERO; the registration number is CRD42020188537. For each systematic review and/or meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias.

Results:

Eight eligible systematic reviews and meta-analyses were identified, providing data on 16 associations. We observed highly suggestive evidence for associations between shift work and myocardial infarction (having ever versus having never done shift work) and diabetes mellitus incidence (per five-year increment in shift work). Furthermore, we observed suggestive evidence for an association between shift work and diabetes mellitus incidence (having ever versus having never done shift work). Two health outcomes, including prostate cancer incidence (having ever versus having never done shift work and rotating night shift work versus daytime work), and colorectal cancer incidence (longest versus shortest shift work time) were only supported by weak evidence.

Conclusions:

This umbrella review found that shift work was associated with several health outcomes with different levels of evidence. Associations for myocardial infarction and diabetes mellitus incidence were supported by highly suggestive evidence.

中文翻译：

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轮班工作和健康结果：对流行病学研究的系统评价和荟萃分析的总体审查

学习目标：

轮班工作通常会增加，并且随着工人睡眠减少和他们的昼夜节律被打乱，会发生一些生理变化。本综述不仅总结了证据，还评估了轮班工作与不同健康结果之间关联的有效性。

方法：

我们检索了 MEDLINE、Web of Science 和 Embase 数据库从成立到 2020 年 4 月 25 日。该研究已在 PROSPERO 注册；注册号为 CRD42020188537。对于每个系统评价和/或荟萃分析，我们估计了总结效应大小、95% 置信区间、95% 预测区间、研究间异质性、小研究效应的证据和过度显着性偏倚的证据.

结果：

确定了八项符合条件的系统评价和荟萃分析，提供了 16 个协会的数据。我们观察到关于轮班工作与心肌梗塞（曾经与从未做过轮班工作）和糖尿病发病率（每五年轮班工作增加）之间关联的高度提示性证据。此外，我们观察到有关轮班工作与糖尿病发病率（曾经与从未做过轮班工作）之间关联的提示性证据。两种健康结果，包括前列腺癌发病率（曾经与从未做过轮班工作和轮班夜班工作与白天工作）和结直肠癌发病率（最长与 最短轮班工作时间）仅得到微弱证据的支持。

结论：

该总体审查发现，轮班工作与具有不同证据水平的多种健康结果相关。心肌梗死和糖尿病发病率之间的关联得到了高度提示性的证据的支持。