Effect of shiftwork on systemic markers of inflammation

Shiftwork is associated with an increased risk of cardiovascular diseases, but the possible role of inflammation in this relationship is not well known. We tested the hypothesis that shiftwork would be associated with higher levels of C-reactive protein (CRP) and increased leukocyte count. We analyzed the cross-sectional associations between work arrangements and low-grade inflammation in 1877 airline-company employees separately for men (n=1037) and women (n=840). The participants were classified into five categories according to their work schedule: day workers who have not worked in shifts (referent group), former shiftworkers, 2-shift workers, 3-shift workers, and in-flight workers. In models adjusted for age and recent infectious diseases, CRP levels were higher among male 3-shift workers (p =.002) and marginally higher in male 2-shift workers (p =.076). In addition, leukocyte count was higher in 2-shift (p =.005) and 3-shift (p =.021) working men. In women, CRP level was higher in 2-shift workers (p =.028), whereas leukocyte count was lower in flight workers (p =.005). Any separate adjustment additionally for smoking, education, alcohol consumption, physical activity, and obesity did not substantially affect the results of 2-and 3-shift work. In the fully adjusted model, only the association between 3-shift work and CRP in men (p =.021) and 2-shift work and leukocyte count in men (p =.020) and leukocyte count in 3-shift-working women (p =.044) were significant. Our results suggest that 2-and 3-shift work is associated with increased systemic inflammation and the relationship is relatively independent of the considered risk factors of cardiovascular disease.