《柳叶刀》：工作狂，你拼的是性命

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  顶级医学期刊《柳叶刀》最近发表的一项大规模研究表明，工作时间长会显著提升中风和冠心病的患病风险。由此可见，加班加点地工作的确不利于健康，甚至会危及你的生命。

  为了研究工作时间对心血管疾病的影响，伦敦大学学院的Mika Kivim?ki教授领导研究团队收集了大量的相关数据。他们在25项研究的数据中分析了工作时间与冠心病之间的关系。这些研究涉及欧洲、美国和澳大利亚的六十多万男女，平均时间跨度为8.5年。研究显示，与标准工作时间（每周工作35-40小时）相比，每周工作55小时以上会使冠心病风险提高13%。这一结论已经将年龄、性别、社会经济地位等因素考虑在内。

  研究人员还用17项研究的数据分析了工作时间与中风之间的关系。这些研究涉及五十多万男性和女性，平均时间跨度为7.2年。研究表明，与标准工作时间相比，每周工作55小时以上会使中风的风险提高33%。

  值得注意的是，研究人员发现工作时间越长中风几率就越高。举例来说，与标准工作时间相比，每周工作41-48小时会使中风风险提高10%，每周工作49-54小时会使中风风险提高27%。

  研究人员指出，尽管这其中的具体机制还有待于进一步的研究，不过长时间工作带来的高风险应该和一些不健康的行为（比如运动不足和大量饮酒）以及反复触发压力应答有关。

  “将所有相关研究结合起来进行分析，使我们能够更准确的分析工作时间与心血管疾病之间的关联。人们应当注意的是，长时间工作会显著提升中风和冠心病的风险，”Kivim?ki教授说。

  《柳叶刀》同时还发表了瑞典Ume?大学Dr Urban Janlert的点评文章，Janlert 指出：“工作时间长并不是一件微不足道的小事。在OECD（经济合作与发展组织）成员国中，土耳其每周工作五十小时以上的人最多（43%），荷兰最少（<1%）。在所有OECD成员国中，平均12%的男性雇员和5%的女性雇员每周工作五十小时以上。虽然一些国家对于工作时间是有立法的，但这些法规的实施情况有时并不理想。鉴于工作时间是中风（甚至冠心病）的重要决定因素，我们应当对此给予足够的重视。”

来源：生物通

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Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603 838 individuals

Prof Mika Kivimäki, PhDa, c, , , Markus Jokela, PhDd, Solja T Nyberg, MSce, Archana Singh-Manoux, PhDa, f, Eleonor I Fransson, PhDg, h, i, Prof Lars Alfredsson, PhDg, j, Prof Jakob B Bjorner, MDk, Marianne Borritz, MDl, Hermann Burr, PhDm, Annalisa Casini, PhDn, Els Clays, PhDo, Prof Dirk De Bacquer, PhDo, Prof Nico Dragano, PhDq, Prof Raimund Erbel, MDr, Goedele A Geuskens, PhDs, Mark Hamer, PhDa, Wendela E Hooftman, PhDs, Irene L Houtman, PhDs, Prof Karl-Heinz Jöckelt, Prof France Kittel, PhDn, Prof Anders Knutsson, MDu,

Summary

Background
Long working hours might increase the risk of cardiovascular disease, but prospective evidence is scarce, imprecise, and mostly limited to coronary heart disease. We aimed to assess long working hours as a risk factor for incident coronary heart disease and stroke.

Methods
We identified published studies through a systematic review of PubMed and Embase from inception to Aug 20, 2014. We obtained unpublished data for 20 cohort studies from the Individual-Participant-Data Meta-analysis in Working Populations (IPD-Work) Consortium and open-access data archives. We used cumulative random-effects meta-analysis to combine effect estimates from published and unpublished data.

Findings
We included 25 studies from 24 cohorts in Europe, the USA, and Australia. The meta-analysis of coronary heart disease comprised data for 603 838 men and women who were free from coronary heart disease at baseline; the meta-analysis of stroke comprised data for 528 908 men and women who were free from stroke at baseline. Follow-up for coronary heart disease was 5·1 million person-years (mean 8·5 years), in which 4768 events were recorded, and for stroke was 3·8 million person-years (mean 7·2 years), in which 1722 events were recorded. In cumulative meta-analysis adjusted for age, sex, and socioeconomic status, compared with standard hours (35–40 h per week), working long hours (≥55 h per week) was associated with an increase in risk of incident coronary heart disease (relative risk [RR] 1·13, 95% CI 1·02–1·26; p=0·02) and incident stroke (1·33, 1·11–1·61; p=0·002). The excess risk of stroke remained unchanged in analyses that addressed reverse causation, multivariable adjustments for other risk factors, and different methods of stroke ascertainment (range of RR estimates 1·30–1·42). We recorded a dose–response association for stroke, with RR estimates of 1·10 (95% CI 0·94–1·28; p=0·24) for 41–48 working hours, 1·27 (1·03–1·56; p=0·03) for 49–54 working hours, and 1·33 (1·11–1·61; p=0·002) for 55 working hours or more per week compared with standard working hours (ptrend<0·0001).


http://www.sciencedirect.com/science/article/pii/S0140673615602951