title: Working hours, sleep duration and the risk of acute coronary heart disease: a case-control study of middle-aged men in Taiwan.
abstract: BACKGROUND
  This study aimed to examine whether long working hours and short sleep duration were associated with an increased risk of acute myocardial infarction (AMI) or severe coronary heart diseases (SCHD), independent of established psychosocial work-related factors.
  
  
  METHODS
  A case-control study was conducted. Cases were 322 men, aged <60 years and economically active, who were admitted to hospital with a first diagnosed AMI or SCHD during 2008-2011, of whom 134 were confirmed AMI and the other 188 were angiography-confirmed SCHD. Controls were 644 men who were drawn from a national survey and were matched to the cases on age, education and area of residence. Odds ratios of total CHD and confirmed AMI in relation to average weekly working hours and daily hours of sleep were calculated.
  
  
  RESULTS
  Men with average working hours longer than 60 h/week were found to have significantly increased risks for total CHD (OR=2.2) as compared to those with weekly working hours in 40-48 h, and those with daily hours of sleep fewer than 6 h were found to have increased risks for CHD (OR=3.0) as compared to those with sleeping hours in 6-9 h. Restriction to confirmed AMI yielded a greater risk and these associations remained consistent with adjustment of smoking status, body mass index and psychosocial work factors including job demands, job control, workplace justice, job insecurity and shift work.
  
  
  CONCLUSIONS
  The results support the hypothesis that long working hours and short sleep duration contribute independently to the risk of cardiovascular diseases in men.
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
authors.forename: Yawen
authors.initials: Y
authors.lastname: Cheng
authors.affiliation: Department of Environmental and Occupational Medicine, National Taiwan University Hospital, Taiwan.
authors.forename: Chung-Li
authors.initials: CL
authors.lastname: Du
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taiwan.
authors.forename: Juey-Jen
authors.initials: JJ
authors.lastname: Hwang
authors.affiliation: Institute of Health Policy and Management, College of Public Health, National Taiwan University, Taiwan.
authors.forename: I-Shin
authors.initials: IS
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taiwan.
authors.forename: Ming-Fong
authors.initials: MF
authors.lastname: Chen
authors.affiliation: Department of Internal Medicine, National Taiwan University Hospital, Taiwan.
authors.forename: Ta-Chen
authors.initials: TC
authors.lastname: Su
mesh_terms: D000208:Acute Disease; D000328:Adult; D016022:Case-Control Studies; D003327:Coronary Disease / Q000453:epidemiology* / Q000503:physiopathology* / Q000523:psychology; D006801:Humans; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012890:Sleep / Q000502:physiology; D012894:Sleep Stages / Q000502:physiology*; D013624:Taiwan / Q000453:epidemiology; D013997:Time Factors; D014940:Work Schedule Tolerance / Q000502:physiology* / Q000523:psychology
keywords: Cardiovascular disease; Psychosocial hazards at work; Sleep; Taiwan; Working hours