Rotating Night-Shift Work and Lung Cancer Risk Among Female Nurses in the United States

The risk of lung cancer among night-shift workers is unknown. Over 20 years of follow-up (1988-2008), we documented 1,455 incident lung cancers among 78,612 women in the Nurses' Health Study. To examine the relationship between rotating night-shift work and lung cancer risk, we used multivariat...

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Bibliographic Details
Published in:American journal of epidemiology 2013-11, Vol.178 (9), p.1434-1441
Main Authors: SCHERNHAMMER, Eva S, FESKANICH, Diane, GEYU LIANG, JIALI HAN
Format: Article
Language:English
Subjects:
Adult
Age Factors
Biological and medical sciences
Body Mass Index
Epidemiology
Female
General aspects
Health Behavior
Health participants
Humans
Life Style
Lung cancer
Lung Neoplasms - epidemiology
Lung Neoplasms - pathology
Medical sciences
Middle Aged
Nurses
Nurses - statistics & numerical data
Occupational Diseases - epidemiology
Occupational Diseases - pathology
Occupational Exposure
Occupational Health
Original Contributions
Pneumology
Public health. Hygiene
Public health. Hygiene-occupational medicine
Risk Factors
Shift work
Smoking - epidemiology
Time Factors
Tobacco, tobacco smoking
Toxicology
Tumors of the respiratory system and mediastinum
United States - epidemiology
Womens health
Work Schedule Tolerance
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Summary:The risk of lung cancer among night-shift workers is unknown. Over 20 years of follow-up (1988-2008), we documented 1,455 incident lung cancers among 78,612 women in the Nurses' Health Study. To examine the relationship between rotating night-shift work and lung cancer risk, we used multivariate Cox proportional hazard models adjusted for detailed smoking characteristics and other risk factors. We observed a 28% increased risk of lung cancer among women with 15 or more years spent working rotating night shifts (multivariate relative risk (RR) = 1.28, 95% confidence interval (CI): 1.07, 1.53; Ptrend = 0.03) compared with women who did not work any night shifts. This association was strongest for small-cell lung carcinomas (multivariate RR = 1.56, 95% CI: 0.99, 2.47; Ptrend = 0.03) and was not observed for adenocarcinomas of the lung (multivariate RR = 0.91, 95% CI: 0.67, 1.24; Ptrend = 0.40). Further, the increased risk associated with 15 or more years of rotating night-shift work was limited to current smokers (RR = 1.61, 95% CI: 1.21, 2.13; Ptrend < 0.001), with no association seen in nonsmokers (Pinteraction = 0.03). These results suggest that there are modestly increased risks of lung cancer associated with extended periods of night-shift work among smokers but not among nonsmokers. Though it is possible that this observation was residually confounded by smoking, our findings could also provide evidence of circadian disruption as a "second hit" in the etiology of smoking-related lung tumors.
ISSN:0002-9262
1476-6256
DOI:10.1093/aje/kwt155