title: Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study.
abstract: OBJECTIVE
  To examine the association between overtime work and incident coronary heart disease (CHD) among middle-aged employees.
  
  
  RESULTS
  Six thousand and fourteen British civil servants (4262 men and 1752 women), aged 39-61 years who were free from CHD and worked full time at baseline (1991-1994), were followed until 2002-2004, an average of 11 years. The outcome measure was incident fatal CHD, clinically verified incident non-fatal myocardial infarction (MI), or definite angina (a total of 369 events). Cox proportional hazard models adjusted for sociodemographic characteristics showed that 3-4 h overtime work per day was associated with 1.60-fold (95% CI 1.15-2.23) increased risk of incident CHD compared with employees with no overtime work. Adjustment for all 21 cardiovascular risk factors measured made little difference to these estimates (HR 1.56, 95% CI 1.11-2.19). This association was replicated in multivariate analysis with only fatal cardiovascular disease and incident non-fatal MI as the outcome (HR 1.67, 95% CI 1.02-2.76).
  
  
  CONCLUSIONS
  Overtime work is related to increased risk of incident CHD independently of conventional risk factors. These findings suggest that overtime work adversely affects coronary health.
authors.affiliation: Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland. marianna.virtanen@ttl.fi
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Jane E
authors.initials: JE
authors.lastname: Ferrie
authors.forename: Archana
authors.initials: A
authors.lastname: Singh-Manoux
authors.forename: Martin J
authors.initials: MJ
authors.lastname: Shipley
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
authors.forename: Michael G
authors.initials: MG
authors.lastname: Marmot
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
mesh_terms: D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000453:epidemiology; D002423:Cause of Death; D003327:Coronary Disease / Q000209:etiology* / Q000401:mortality; D005260:Female; D006801:Humans; D008131:London / Q000453:epidemiology; D008297:Male; D009203:Myocardial Infarction / Q000453:epidemiology; D009784:Occupational Diseases / Q000209:etiology* / Q000401:mortality; D011379:Prognosis; D011446:Prospective Studies; D012307:Risk Factors; D014940:Work Schedule Tolerance / Q000502:physiology*
references.citation: Circulation. 2001 Nov 27;104(22):2746-53
references.pmid: 11723030
references.citation: Am J Epidemiol. 2009 Mar 1;169(5):596-605
references.pmid: 19126590
references.citation: Int J Epidemiol. 2005 Apr;34(2):251-6
references.pmid: 15576467
references.citation: Ann Clin Res. 1971 Dec;3(6):300-12
references.pmid: 5156890
references.citation: Am J Epidemiol. 1978 May;107(5):384-402
references.pmid: 665655
references.citation: Ind Health. 1998 Jul;36(3):209-17
references.pmid: 9701898
references.citation: Am J Public Health. 2005 Jan;95(1):98-102
references.pmid: 15623867
references.citation: J Chronic Dis. 1960 Jun;11:615-26
references.pmid: 13805687
references.citation: Heart. 2005 Apr;91(4):419-20
references.pmid: 15772182
references.citation: Am J Med Sci. 1958 Mar;235(3):266-77
references.pmid: 13520712
references.citation: Scand J Work Environ Health. 2006 Dec;32(6):431-42
references.pmid: 17173200
references.citation: Scand J Work Environ Health. 2003 Jun;29(3):171-88
references.pmid: 12828387
references.citation: Int J Epidemiol. 1985 Sep;14(3):378-88
references.pmid: 4055205
references.citation: Sleep. 2006 Feb;29(2):206-16
references.pmid: 16494089
references.citation: Eur Heart J. 2006 Dec;27(23):2763-74
references.pmid: 17082208
references.citation: Sports Med. 2001 Feb;31(2):101-14
references.pmid: 11227978
references.citation: Arch Intern Med. 2007 Mar 26;167(6):573-9
references.pmid: 17389288
references.citation: Psychol Med. 1992 Aug;22(3):739-49
references.pmid: 1410098
references.citation: Hypertension. 2006 Oct;48(4):744-50
references.pmid: 16940208
references.citation: Arterioscler Thromb Vasc Biol. 2008 Jul;28(7):1398-406
references.pmid: 18436803
references.citation: Int J Epidemiol. 2001 Aug;30(4):724-9
references.pmid: 11511592
references.citation: J Cardiovasc Med (Hagerstown). 2008 Aug;9(8):761-8
references.pmid: 18607238
references.citation: Health Rep. 1999 Autumn;11(2):33-48(Eng); 37-55(Fre)
references.pmid: 10618741
references.citation: J Nutr. 2006 Oct;136(10):2588-93
references.pmid: 16988131
references.citation: Sleep. 2007 Dec;30(12):1659-66
references.pmid: 18246975
references.citation: J Epidemiol Community Health. 2003 Sep;57(9):718-23
references.pmid: 12933779
references.citation: J Chronic Dis. 1972 Mar;25(3):139-47
references.pmid: 5029951
references.citation: Arch Intern Med. 2007 Sep 10;167(16):1720-8
references.pmid: 17846390
references.citation: Ergonomics. 2003 Jun 10;46(7):664-80
references.pmid: 12745680
references.citation: J Occup Environ Med. 1996 Oct;38(10):1007-11
references.pmid: 8899576
references.citation: Circulation. 2007 Mar 6;115(9):1067-74
references.pmid: 17339564
references.citation: Cardiol Rev. 2009 Mar-Apr;17(2):83-97
references.pmid: 19367150
references.citation: Circulation. 1994 Jul;90(1):583-612
references.pmid: 8026046
references.citation: Addiction. 2004 Jun;99(6):749-56
references.pmid: 15139873
references.citation: JAMA. 2003 Aug 20;290(7):891-7
references.pmid: 12928465
references.citation: BMJ. 2003 Aug 16;327(7411):364
references.pmid: 12919985
references.citation: Occup Environ Med. 2002 Jul;59(7):447-51
references.pmid: 12107292
references.citation: Soc Sci Med. 1991;32(1):15-27
references.pmid: 2008617
references.citation: BMJ. 1998 Sep 19;317(7161):775-80
references.pmid: 9740562