title: Assessment of cardiovascular risk in shift healthcare workers.
abstract: BACKGROUND
  Shift work has been associated with an increased risk of cardiovascular disease (CVD); in particular, night work affects the circadian rhythm.
  
  
  METHODS
  The study examines the effectiveness of three screening methods and plasma hyperhomocysteinemia, an independent risk factor, in assessing the risk of CVD in 147 healthcare providers doing daytime or rotational shift work. The methods applied were: (i) the method proposed by the European Cardiovascular Indicators Surveillance Set (EUROCISS); (ii) the metabolic syndrome (MS) criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) and (iii) the MS criteria of the International Diabetes Federation (IDF).
  
  
  RESULTS
  EUROCISS was unable to distinguish between the CVD risk of daytime and rotational shift workers. Both the ATPIII and the IDF detected MS, which is strongly associated with CVD, but only the IDF evidenced a significantly greater prevalence of MS (P<0.05) among shift workers. Hyperhomocysteinemia was unable to discriminate the CVD risk between daytime and shift workers, as it was influenced by multiple confounding factors.
  
  
  CONCLUSIONS
  The increased risk of CVD associated with shift work is related to the greater incidence of MS among these workers. In our study a high prevalence of MS was detected only with the IDF. The method is useful for CVD prevention and the promotion of health during any medical examination of shift workers.
authors.affiliation: Healthcare Workers Service, Regional Health Administration, Loreto Hospital, Via S.Francesco 1 - 60025 Loreto, Italy. copertaroa@asurzona7.marche.it
authors.forename: Alfredo
authors.initials: A
authors.lastname: Copertaro
authors.forename: Massimo
authors.initials: M
authors.lastname: Bracci
authors.forename: Mariella
authors.initials: M
authors.lastname: Barbaresi
authors.forename: Lory
authors.initials: L
authors.lastname: Santarelli
mesh_terms: D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D002940:Circadian Rhythm; D005260:Female; D006282:Health Personnel; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000097:blood / Q000150:complications* / Q000453:epidemiology; D015994:Incidence; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000453:epidemiology; D008875:Middle Aged; D009784:Occupational Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology*; D015995:Prevalence; D018570:Risk Assessment; D012307:Risk Factors; D014940:Work Schedule Tolerance
chemical_list: D006710:Homocysteine