Overtime work and incident coronary heart disease: the Whitehall II prospective cohort study.
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.
Virtanen
Marianna
M
Finnish Institute of Occupational Health, Centre of Expertise for Work Organizations, Topeliuksenkatu 41 aA, FIN-00250 Helsinki, Finland. marianna.virtanen@ttl.fi
Ferrie
Jane E
JE
Singh-Manoux
Archana
A
Shipley
Martin J
MJ
Vahtera
Jussi
J
Marmot
Michael G
MG
Kivimäki
Mika
M
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*
Circulation. 2001 Nov 27;104(22):2746-53
11723030
Am J Epidemiol. 2009 Mar 1;169(5):596-605
19126590
Int J Epidemiol. 2005 Apr;34(2):251-6
15576467
Ann Clin Res. 1971 Dec;3(6):300-12
5156890
Am J Epidemiol. 1978 May;107(5):384-402
665655
Ind Health. 1998 Jul;36(3):209-17
9701898
Am J Public Health. 2005 Jan;95(1):98-102
15623867
J Chronic Dis. 1960 Jun;11:615-26
13805687
Heart. 2005 Apr;91(4):419-20
15772182
Am J Med Sci. 1958 Mar;235(3):266-77
13520712
Scand J Work Environ Health. 2006 Dec;32(6):431-42
17173200
Scand J Work Environ Health. 2003 Jun;29(3):171-88
12828387
Int J Epidemiol. 1985 Sep;14(3):378-88
4055205
Sleep. 2006 Feb;29(2):206-16
16494089
Eur Heart J. 2006 Dec;27(23):2763-74
17082208
Sports Med. 2001 Feb;31(2):101-14
11227978
Arch Intern Med. 2007 Mar 26;167(6):573-9
17389288
Psychol Med. 1992 Aug;22(3):739-49
1410098
Hypertension. 2006 Oct;48(4):744-50
16940208
Arterioscler Thromb Vasc Biol. 2008 Jul;28(7):1398-406
18436803
Int J Epidemiol. 2001 Aug;30(4):724-9
11511592
J Cardiovasc Med (Hagerstown). 2008 Aug;9(8):761-8
18607238
Health Rep. 1999 Autumn;11(2):33-48(Eng); 37-55(Fre)
10618741
J Nutr. 2006 Oct;136(10):2588-93
16988131
Sleep. 2007 Dec;30(12):1659-66
18246975
J Epidemiol Community Health. 2003 Sep;57(9):718-23
12933779
J Chronic Dis. 1972 Mar;25(3):139-47
5029951
Arch Intern Med. 2007 Sep 10;167(16):1720-8
17846390
Ergonomics. 2003 Jun 10;46(7):664-80
12745680
J Occup Environ Med. 1996 Oct;38(10):1007-11
8899576
Circulation. 2007 Mar 6;115(9):1067-74
17339564
Cardiol Rev. 2009 Mar-Apr;17(2):83-97
19367150
Circulation. 1994 Jul;90(1):583-612
8026046
Addiction. 2004 Jun;99(6):749-56
15139873
JAMA. 2003 Aug 20;290(7):891-7
12928465
BMJ. 2003 Aug 16;327(7411):364
12919985
Occup Environ Med. 2002 Jul;59(7):447-51
12107292
Soc Sci Med. 1991;32(1):15-27
2008617
BMJ. 1998 Sep 19;317(7161):775-80
9740562