{
  "abstract": "Objective To examine the exposure-response relations between cumulative evening and night shifts and incident myocardial infarction among hospital employed health care workers, including nurses, physicians, and others.Material and Methods This national register-based cohort study includes all newly hired health care workers ever working evening or night shifts with day by day payroll information on evening and night shifts, from 2008/2009 to 2020. In total, we included 137 184 health care workers (mean age 33.3 years at inclusion, 77% women) who were followed from first registered evening or night shift for an average of 6.4 years. First time hospital contacts for myocardial infarction were identified in national health registers. Incidence rates of myocardial infarction by cumulative evening and night shifts were estimated by Poisson regression adjusted for sex, age, calendar year, diabetes, obesity, hypertension, hypercholesterolemia, education, and family history of cardiovascular disease; and for a subset of 13 080 workers, additionally adjusted for self-reported smoking, body mass index, and alcohol consumption.Results During follow-up, 477 workers (49% women) were diagnosed with myocardial infarction. Men and women showed overall incidence rates of 12.5 and 3.4 per 10 000 person years. No increasing incidence rates of myocardial infarction with cumulative number of evening or night shifts were observed.Conclusions This study of health care workers found no exposure-response relation between cumulative evening or night shifts and incident myocardial infarction during up to 13 years after the first recorded evening or night shift.",
  "authors": [
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Jesper Medom Vestergaard"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Annett Dalbøge"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Jens Peter Ellekilde Bonde"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Anne Helene Garde"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Johnni Hansen"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Åse Marie Hansen"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Ann Dyreborg Larsen"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Sadie Costello"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Morten Böttcher"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Morten Fenger-Grøn"
    },
    {
      "affiliations": [
        "Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark. Department of Occupational and Environmental Medicine, Danish Ramazzini Centre, University Research Clinic, Herning, Denmark. Institute of Clinical Medicine, Aarhus University, Denmark. Department of Occupational and Environmental Medicine, Bispebjerg and Frederiksberg Hospital, Denmark. The National Research Centre for the Working Environment, Denmark. Danish Cancer Institute, Denmark. Department of Public Health, University of Copenhagen, Denmark. Environmental Health Science, School of Public Health, University of California, Berkeley. Department of Cardiology, Gødstrup Hospital, NIDO, Herning, Denmark. Medical Diagnostic Center, University Clinic for Innovative Patient Pathways, Regional Hospital Central Jutland, Silkeborg, Denmark"
      ],
      "name": "Henrik Kolstad"
    }
  ],
  "title": "8290478 Working evening and night shifts in the health care sector and incidence of myocardial infarction: a national cohort study in Denmark",
  "uid": "b447cdad-fd06-501b-9b44-868e00a5e4a6"
}