title: Total and cause-specific mortality of U.S. nurses working rotating night shifts.
abstract: BACKGROUND
  Rotating night shift work imposes circadian strain and is linked to the risk of several chronic diseases.
  
  
  OBJECTIVE
  To examine associations between rotating night shift work and all-cause; cardiovascular disease (CVD); and cancer mortality in a prospective cohort study of 74,862 registered U.S. nurses from the Nurses' Health Study.
  
  
  METHODS
  Lifetime rotating night shift work (defined as ≥3 nights/month) information was collected in 1988. During 22 years (1988-2010) of follow-up, 14,181 deaths were documented, including 3,062 CVD and 5,413 cancer deaths. Cox proportional hazards models estimated multivariable-adjusted hazard ratios (HRs) and 95% CIs.
  
  
  RESULTS
  All-cause and CVD mortality were significantly increased among women with ≥5 years of rotating night shift work, compared to women who never worked night shifts. Specifically, for women with 6-14 and ≥15 years of rotating night shift work, the HRs were 1.11 (95% CI=1.06, 1.17) and 1.11 (95% CI=1.05, 1.18) for all-cause mortality and 1.19 (95% CI=1.07, 1.33) and 1.23 (95% CI=1.09, 1.38) for CVD mortality. There was no significant association between rotating night shift work and all-cancer mortality (HR≥15years=1.08, 95% CI=0.98, 1.19) or mortality of any individual cancer, with the exception of lung cancer (HR≥15years=1.25, 95% CI=1.04, 1.51).
  
  
  CONCLUSIONS
  Women working rotating night shifts for ≥5 years have a modest increase in all-cause and CVD mortality; those working ≥15 years of rotating night shift work have a modest increase in lung cancer mortality. These results add to prior evidence of a potentially detrimental effect of rotating night shift work on health and longevity.
authors.affiliation: Division of Cancer Epidemiology & Genetics, Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland.
authors.forename: Fangyi
authors.initials: F
authors.lastname: Gu
authors.affiliation: Channing Division of Network Medicine, Harvard School of Public Health, Boston; Clinical Research Program, Department of Dermatology, Harvard School of Public Health, Boston; Department of Epidemiology, Richard M. Fairbanks School of Public Health, Simon Cancer Center, Indiana University, Indianapolis, Indiana.
authors.forename: Jiali
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Environmental Health, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston.
authors.forename: Francine
authors.initials: F
authors.lastname: Laden
authors.affiliation: Saw Swee Hock School of Public Health and Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore.
authors.forename: An
authors.initials: A
authors.lastname: Pan
authors.affiliation: Division of Cancer Epidemiology & Genetics, Genetic Epidemiology Branch, National Cancer Institute, Bethesda, Maryland.
authors.forename: Neil E
authors.initials: NE
authors.lastname: Caporaso
authors.affiliation: Channing Division of Network Medicine, Harvard School of Public Health, Boston; Department of Epidemiology, Harvard School of Public Health, Boston.
authors.forename: Meir J
authors.initials: MJ
authors.lastname: Stampfer
authors.affiliation: Department of Social and Behavioral Sciences, Harvard School of Public Health, Boston.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Kawachi
authors.affiliation: Division of Preventive Medicine, Harvard School of Public Health, Boston.
authors.forename: Kathryn M
authors.initials: KM
authors.lastname: Rexrode
authors.affiliation: Department of Nutrition, Harvard School of Public Health, Boston.
authors.forename: Walter C
authors.initials: WC
authors.lastname: Willett
authors.affiliation: Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Biostatistics and Epidemiology, University of Massachusetts, Amherst, Massachusetts.
authors.forename: Susan E
authors.initials: SE
authors.lastname: Hankinson
authors.affiliation: Channing Division of Network Medicine, Harvard School of Public Health, Boston.
authors.forename: Frank E
authors.initials: FE
authors.lastname: Speizer
authors.affiliation: Channing Division of Network Medicine, Harvard School of Public Health, Boston; Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Harvard School of Public Health, Boston; Applied Cancer Research-Institution for Translational Research Vienna (ACR-ITR VIEnna), Vienna, Austria. Electronic address: eva.schernhammer@channing.harvard.edu.
authors.forename: Eva S
authors.initials: ES
authors.lastname: Schernhammer
mesh_terms: D000328:Adult; D000367:Age Factors; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000401:mortality*; D005260:Female; D015438:Health Behavior; D006801:Humans; D008019:Life Style; D008875:Middle Aged; D009369:Neoplasms / Q000453:epidemiology / Q000401:mortality*; D009726:Nurses / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D016387:Women's Health; D014940:Work Schedule Tolerance