Abstract
Background. Shift work, defined as irregular working from 5 pm to 8 am, increases fatigue and disrupts the circadian rhythm, thus triggering coronary artery disease (CAD). The mechanism behind still vague. This study aims to propose a plausible pathophysiology and the shift work dose causing CAD among workers.
Methods. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was applied. Pubmed, Cochrane, and Scopus were used as databases using the keywords “cardiovascular disease”, “coronary artery disease”, and “shift work”.
Results. Total of 104 papers were identified in the literature research, 6 studies were included. There is 7.1% increment risk of CVD events for every additional 5 years of exposure (95% CI 1.05–1.10) due to melatonin disruption and arterial stiffness. Working in shifts for ≥10 years (HR 1.37, 95% CI 1.20-1.58) and 3–8 nights/month (HR 1.35, 95% CI 1.18-1.55) increases the risk of CAD.
Discussion. Melatonin disruption increases cortisol and ghrelin, causing higher cardiac load and formation of atherosclerosis plaque. Physiological stress jacks up inflammatory markers and heightens the Reactive Oxygen Species (ROS), chronically causing myocardial remodeling through calcium overload and delay after myocardial depolarization. Work rotation per 5 years and considering the worker’s chronotype could be beneficial for the body to be in a certain stage, either it is daytime or nighttime, instead of always in the adapting mode. Conducting high-intensity physical activity three times a week could lower the risk of CAD among shift workers.
Conclusion. Shift work can cause CAD due to melatonin disruption and arterial stiffness.
Recommended Citation
Zakina, Oky
(2024)
"Pathophysiology and Dose-Response Relationship of Coronary Artery Disease in Shift Workers: A Literature Review,"
Occupational and Environmental Medicine Journal of Indonesia: Vol. 2:
No.
2, Article 7.
DOI: 10.7454/oemji.v2i2.1058
Available at:
https://scholarhub.ui.ac.id/oemji/vol2/iss2/7
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