title: Separate and Joint Associations of Shift Work and Sleep Quality with Lipids.
abstract: BACKGROUND
  Shift work and/or sleep quality may affect health. We investigated whether shift work and sleep quality, separately and jointly, were associated with abnormal levels of triglycerides, total cholesterol (TC), and low-and high-density lipoprotein cholesterol in 360 police officers (27.5% women).
  
  
  METHODS
  Triglycerides, TC, and high-density lipoprotein were analyzed on the Abbott Architect; low-density lipoprotein was calculated. Shift work was assessed using City of Buffalo payroll work history records. Sleep quality (good, ≤ 5; intermediate, 6-8; poor, ≥ 9) was assessed using the Pittsburgh Sleep Quality Index questionnaire. A shift work + sleep quality variable was created: day plus good sleep; day plus poor sleep; afternoon/night plus good; and poor sleep quality. Mean values of lipid biomarkers were compared across categories of the exposures using analysis of variance/analysis of covariance.
  
  
  RESULTS
  Shift work was not significantly associated with lipids. However, as sleep quality worsened, mean levels of triglycerides and TC gradually increased but only among female officers (age- and race-adjusted p = 0.013 and 0.030, respectively). Age significantly modified the association between sleep quality and TC. Among officers ≥ 40 years old, those reporting poor sleep quality had a significantly higher mean level of TC (202.9 ± 3.7 mg/dL) compared with those reporting good sleep quality (190.6 ± 4.0 mg/dL) (gender- and race-adjusted p = 0.010). Female officers who worked the day shift and also reported good sleep quality had the lowest mean level of TC compared with women in the other three categories (p = 0.014).
  
  
  CONCLUSIONS
  Sleep quality and its combined influence with shift work may play a role in the alteration of some lipid measures.
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Luenda E
authors.initials: LE
authors.lastname: Charles
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Ja K
authors.initials: JK
authors.lastname: Gu
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Cathy A
authors.initials: CA
authors.lastname: Tinney-Zara
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Desta
authors.initials: D
authors.lastname: Fekedulegn
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Claudia C
authors.initials: CC
authors.lastname: Ma
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Penelope
authors.initials: P
authors.lastname: Baughman
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Tara A
authors.initials: TA
authors.lastname: Hartley
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Michael E
authors.initials: ME
authors.lastname: Andrew
authors.affiliation: Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, State University of New York at Buffalo, Buffalo, NY, USA.
authors.forename: John M
authors.initials: JM
authors.lastname: Violanti
authors.affiliation: Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, WV, USA.
authors.forename: Cecil M
authors.initials: CM
authors.lastname: Burchfiel
keywords: lipids; police officers; sleep quality; work schedules