American journal of epidemiologyMay 19, 2006

Shift work and risk of heart disease in Japanese male workers

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Updated Apr 2, 2026

Abstract

Among 17,649 Japanese male workers, rotating-shift work is associated with a 2.32-fold increased risk of death from ischemic heart disease compared to day work.

A total of 1,363 deaths were recorded during 233,869 person-years of follow-up, with 86 attributed to ischemic heart disease.
Rotating-shift workers face a significantly higher risk of ischemic heart disease-related death compared to those who work day shifts.
Fixed-night work does not show a significant association with ischemic heart disease mortality.
Individuals with coronary risk factors may be more susceptible to the negative effects of rotating-shift work on heart disease risk.

Simplified

This study prospectively examined the association between shift work and the risk of ischemic heart disease among Japanese male workers. A baseline survey, which involved 110,792 inhabitants (age range: 40-79 years) from 45 areas throughout Japan, was conducted between 1988 and 1990. The causes of death were identified from death certificates. The analysis was restricted to 17,649 men (age range: 40-59 years) who were employed at the time of the baseline survey. All subjects were asked to indicate the most regular shift work that they had undertaken previously: day work, rotating-shift work, or fixed-night work. The Cox proportional hazards model was used to estimate the risks of shift work for ischemic heart disease. During the 233,869 person-years of follow-up, a total of 1,363 deaths were recorded, 86 of which were due to ischemic heart disease. Compared with the day workers, the rotating-shift workers had a significantly higher risk of death due to ischemic heart disease (relative risk = 2.32, 95% confidence interval: 1.37, 3.95; p = 0.002), whereas fixed-night work was not associated with ischemic heart disease (relative risk = 1.23, 95% confidence interval: 0.49, 3.10; p = 0.658). In addition, subjects with coronary risk factors, such as hypertension, overweight, habitual alcohol consumption, and smoking, were highly susceptible to the effect of rotating-shift work on the risk of death due to ischemic heart disease.

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Shift work and risk of heart disease in Japanese male workers

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