Nested case–control study of night shift work and breast cancer risk among women in the Danish military

• Published in: Occupational and environmental medicine (London, England) Vol. 69; no. 8; pp. 551 - 556
• Main Authors: Hansen, Johnni, Lassen, Christina F
• Format: Journal Article
• Language: English
• Published: London BMJ Publishing Group Ltd 01.08.2012; BMJ Publishing Group; BMJ Publishing Group LTD
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Breast; Breast cancer; Breast Neoplasms - etiology; Breastfeeding; Cancer; Carcinogens; Case studies; Case-Control Studies; Circadian Rhythm; Denmark - epidemiology; Epidemiology; Exposure; Female; Gynecology. Andrology. Obstetrics; Health risks; Hormones; Humans; hygiene/occupational hygiene; Logistic Models; Mammary gland diseases; Medical sciences; Melatonin; Middle Aged; Military; Military Personnel; Morning; Night shifts; Night tables; Night work; Occupations; Odds Ratio; Questionnaires; retrospective exposure assessment; Risk; Risk Factors; Shift work; Sun; Sunlight; Tobacco smoking; Tumors; women; Womens health; Work; Work Schedule Tolerance; Working women; Workplace; Denmark; Europe; Human; Breast disease; Night work; Breast cancer; Case control study; Malignant tumor; Occupational exposure; Epidemiology; Shift work; Mammary gland diseases; Risk factor; Female; Mammary gland; Woman; Occupational medicine; Cancer; Military
• ISSN: 1351-0711; 1470-7926
• DOI: 10.1136/oemed-2011-100240

ObjectivesGrowing but limited evidence suggests that night shift work is associated with breast cancer. The authors conducted a nationwide case–control study nested within a cohort of 18 551 female military employees born in 1929–1968 to investigate the risk for breast cancer after night shift work and to explore the role of leisure time sun exposure and diurnal preference.MethodsThe authors documented 218 cases of breast cancer (1990–2003) and selected 899 age-matched controls from the cohort by incidence density sampling. Information on shift work, sun exposure habits, diurnal preference and other potential confounders was obtained from a structured questionnaire. ORs were estimated by multivariate conditional logistic regression.ResultsOverall, the authors observed an adjusted OR of 1.4 (95% CI 0.9 to 2.1) among women with ever compared with never night shifts. The RR for breast cancer tended to increase with increasing number of years of night shift work (p=0.03) and with cumulative number of shifts (p=0.02),with a neutral risk for fewer than three night shifts per week. The OR for the group with the highest tertile of cumulative exposure was 2.3 (95% CI 1.2 to 4.6). The most pronounced effect of night shift work on breast cancer risk was observed in women with morning chronotype preference and intense night shifts (OR=3.9, 95% CI 1.6 to 9.5). Night shift workers tended to sunbathe more frequently than day workers.ConclusionsThe results indicate that frequent night shift work increases the risk for breast cancer and suggest a higher risk with longer duration of intense night shifts. Women with morning preference who worked on night shifts tended to have a higher risk than those with evening preference.