title: Medical program for shift workers--impacts on chronic disease and mortality outcomes.
abstract: OBJECTIVE
  In 1983, global chemical company BASF SE implemented a supplemental health protection program to help its employees cope with the stressors associated with shift work. The program included comprehensive medical examinations and health promotion activities targeted at shift workers.
  
  
  METHODS
  To assess the possible long-term health impacts of the program, cohorts of 14,128 male rotating shift and 17,218 male day wage employees were established via electronic job history searches. Health examination and mortality records were linked to job histories and studied over an 11-year period.
  
  
  RESULTS
  Between 1996 and 2006, there were 414 and 463 deaths among rotating shift and day work employees, respectively. Mortality risks were marginally lower among shift working employees when taking age and job level into consideration, and remained so when cigarette smoking, alcohol intake, and existing chronic disease conditions were included as explanatory factors. The incidence of obesity, diabetes, and diseases of the circulatory and digestive system, as diagnosed or reported during health examinations, was higher among shift work employees, possibly as a consequence of enhanced medical surveillance or a direct effect of shift work.
  
  
  CONCLUSIONS
  Incorporation of extensive occupational medical examinations, health seminars, and other intervention programs may help mitigate the long-term health consequences of shift work.
authors.affiliation: Occupational Medicine and Health Protection Department, Ludwigshafen, Germany. christoph.oberlinner@basf.com
authors.forename: Christoph
authors.initials: C
authors.lastname: Oberlinner
authors.forename: M Gerald
authors.initials: MG
authors.lastname: Ott
authors.forename: Michael
authors.initials: M
authors.lastname: Nasterlack
authors.forename: Mei
authors.initials: M
authors.lastname: Yong
authors.forename: Peter
authors.initials: P
authors.lastname: Messerer
authors.forename: Andreas
authors.initials: A
authors.lastname: Zober
authors.forename: Stefan
authors.initials: S
authors.lastname: Lang
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000428:Alcohol Drinking; D002908:Chronic Disease; D002940:Circadian Rhythm / Q000502:physiology*; D016001:Confidence Intervals; D004526:Efficiency; D005858:Germany / Q000453:epidemiology; D006293:Health Promotion; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000209:etiology / Q000401:mortality*; D016273:Occupational Exposure; D016272:Occupational Health; D015397:Program Evaluation; D012306:Risk; D012307:Risk Factors; D013315:Stress, Psychological; D013997:Time Factors; D014940:Work Schedule Tolerance; D017132:Workplace