Shift work and the risk of diabetes mellitus among Japanese male factory workers.
OBJECTIVE
This study investigated whether shift work is a risk factor for the development of diabetes mellitus.


METHODS
The workers, 2860 men in a sash and zipper factory in the Toyama prefecture of Japan, were followed for 8 years, and the incidence rate of diabetes mellitus was determined. The cohort contained fixed daytime blue-collar workers, shift blue-collar workers, and white-collar workers. The workers were considered to have diabetes mellitus if, in their annual health examination, they had a glycated hemoglobin level of > or = 6.1 or if the diagnosis had been made by a hospital physician. The relative risks were estimated by Cox's proportional hazards regression model.


RESULTS
Among the 2860 workers, there were 87 cases of new-onset diabetes mellitus, resulting in an incidence rate of 4.41 per 1000 person-years. The age-adjusted incidence was highest for the two-shift workers and lowest for the white-collar workers. The relative risk of diabetes mellitus for the two-shift workers and the three-shift workers compared with the fixed daytime workers was 1.73 and 1.33, respectively, after adjustment for all the confounding factors, but these values were not statistically significant. When the white-collar workers were used as a reference group, a significantly increased risk of diabetes mellitus was found for the two-shift workers (relative risk was 2.01 after adjustment for all confounding factors), but not for the three-shift workers or the fixed daytime blue-collar workers.


CONCLUSIONS
The study suggests that shift work is a risk factor for the onset of diabetes mellitus and that there is a different risk associated with different shift schedules.
Morikawa
Yuko
Y
Department of Public Health, Kanazawa Medical University, 1-1 Daigaku, Uchinada-machi, Kahoku-gun, Ishikawa, Japan 920-0293. ymjr@kanazawa-med.ac.jp
Nakagawa
Hideaki
H
Miura
Katsuyuki
K
Soyama
Yoshiyuki
Y
Ishizaki
Masao
M
Kido
Teruhiko
T
Naruse
Yuchi
Y
Suwazono
Yasushi
Y
Nogawa
Koji
K
D000328:Adult; D003920:Diabetes Mellitus / Q000453:epidemiology*; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D016016:Proportional Hazards Models; D012307:Risk Factors; D014940:Work Schedule Tolerance