Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep MedicineSep 2, 2021

Health effects of shift work: a summary of studies reviewing large population data

Circadian Biology Weekly Brief ↗PubMed ↗DOI ↗

Updated Mar 19, 2026

Abstract

Highly suggestive evidence indicates that shift work is associated with increased risk of myocardial infarction and diabetes mellitus incidence.

Myocardial infarction risk is associated with having ever engaged in shift work.
Diabetes mellitus incidence is associated with shift work, particularly with increased duration over 5-year increments.
A suggestive association exists between diabetes mellitus incidence and having ever done shift work.
Weak evidence links shift work to prostate cancer and colorectal cancer incidences.
The review analyzed data from eight systematic reviews and meta-analyses across 16 health outcome associations.

Simplified

STUDY OBJECTIVES: Shift work is commonly increasing, and some physiological changes occur as workers sleep less and their circadian rhythms are disrupted. This umbrella review not only summarizes the evidence but also evaluates the validity of the associations of shift work with different health outcomes.

METHODS: We searched the MEDLINE, Web of Science, and Embase databases from their inception to April 25, 2020. For each systematic review and/or meta-analysis, we estimated the summary effect size, the 95% confidence interval, the 95% prediction interval, the between-study heterogeneity, evidence of small-study effects, and evidence of excess-significance bias.

RESULTS: Eight eligible systematic reviews and meta-analyses were identified, providing data on 16 associations. We observed highly suggestive evidence for associations between shift work and myocardial infarction (having ever vs having never done shift work) and diabetes mellitus incidence (per 5-year increment in shift work). Furthermore, we observed suggestive evidence for an association between shift work and diabetes mellitus incidence (having ever vs having never done shift work). Two health outcomes, including prostate cancer incidence (having ever vs having never done shift work and rotating night shift work vs daytime work) and colorectal cancer incidence (longest vs shortest shift work time), were only supported by weak evidence.

CONCLUSIONS: This umbrella review found that shift work was associated with several health outcomes with different levels of evidence. Associations for myocardial infarction and diabetes mellitus incidence were supported by highly suggestive evidence.

SYSTEMATIC REVIEW REGISTRATION: Registry: PROSPERO; Identifier: CRD42020188537.

CITATION: Wu Q-J, Sun H, Wen Z-Y, et al. Shift work and health outcomes: an umbrella review of systematic reviews and meta-analyses of epidemiological studies.2022;18(2):653-662. J Clin Sleep Med.

Funding

Competing interests

The authors read and approved the final manuscript. This work was supported by the National Key R&D Program of China (number 2017YFC0907401 to Yu-Hong Zhao), the LiaoNing Revitalization Talents Program (number XL YC1907102 to Qi-Jun Wu and number XLYC1802095 to Yu-Hong Zhao), and the 345 Talent Project to Qi-Jun Wu. The authors report no conflicts of interest.

PubMed

Health effects of shift work: a summary of studies reviewing large population data

Abstract

Funding

Competing interests

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