SYSTEMATIC REVIEW article
Front. Public Health
Sec. Occupational Health and Safety
Volume 13 - 2025 | doi: 10.3389/fpubh.2025.1668848
This article is part of the Research TopicStrategies for Workplace Design to Reduce Obesity and Metabolic RisksView all articles
Association between night shift work and cardiovascular disease: A systematic review and dose-response meta-analysis
Provisionally accepted
- 1Chengdu University, Chengdu, China
- 2Sichuan Province Orthopedic Hospital, Chengdu, China
- 3Sun Yat-Sen University, Guangzhou, China
- 4Affiliated Hospital of Chengdu University, Chengdu, China
- 5Sichuan Nursing Vocational College, Chengdu, China
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Background: Shift work, particularly night shift work, has become increasingly prevalent on a global scale and is associated with multiple health issues including type 2 diabetes and cardiovascular diseases (CVD). This study aimed to assess the relationship between night shift work and the incidence and mortality of CVD. Method: Six electronic databases including PubMed, Embase, Cochrane Library, Web of Science, CINAHL, and Scopus were searched from inception until August 10, 2025. Cohort studies eligible for inclusion addressed the association between night shift work and outcomes of CVD. STATA 18.0 software was used for meta-analysis. The dose-response relationship was estimated using generalized least squares regression, and restricted cubic splines were used to analyze potential linear or nonlinear associations. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. Quality assessment and data extraction were performed independently by two researchers. Results: Twenty-three cohort studies were included. Overall, this meta-analysis revealed that night shift work significantly increased the risk of total CVD events (RR = 1.13, 95% CI = 1.10-1.16) and total CVD mortality (RR = 1.27, 95%CI = 1.18-1.36). Dose-response analysis indicated that each 5-year increment in shift work duration was associated with a 7% higher risk of CVD incidence (RR = 1.07, 95% CI: 1.04–1.09) and a 4% increased risk of CVD mortality (RR = 1.05, 95% CI: 1.03–1.06. This is a provisional file, not the final typeset article Subgroup analyses identified elevated risks for incident coronary heart disease (CHD) (RR = 1.22, 95% CI = 1.16-1.28) and ischemic heart disease (IHD) (RR = 1.09, 95% CI = 1.05-1.14), but not stroke (RR = 1.06, 95% CI = 0.95-1.18), and night shift work was associated with an increased risk of mortality due to CHD (RR = 1.22, 95% CI = 1.10-1.36), IHD (RR = 1.39, 95% CI = 1.06-1.84), and stroke (RR = 1.49, 95% CI = 1.04-2.12). Conclusions: These findings indicate that night shift work is significantly associated with increased CVD incidence and mortality risk, highlighting the need for targeted prevention strategies.
Keywords: night shift work1, Cardiovascular disease2, mortality3, Systematic review4, Meta-analysis5
Received: 18 Jul 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Xi, Ma, Tao, Zhang, Liu and Wang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hongyan Wang, Sichuan Nursing Vocational College, Chengdu, China
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