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Shiftwork and Biomarkers of Subclinical Cardiovascular Disease

The BCOPS Study

Holst, Meghan M., MSPH; Wirth, Michael D., MSPH, PhD; Mnatsakanova, Anna, MS; Burch, James B., PhD; Charles, Luenda E., PhD; Tinney-Zara, Cathy, MPH; Fekedulegn, Desta, PhD; Andrew, Michael E., PhD; Hartley, Tara A., PhD; Violanti, John M., PhD

Journal of Occupational and Environmental Medicine: May 2019 - Volume 61 - Issue 5 - p 391–396
doi: 10.1097/JOM.0000000000001541

Objective: To assess the association of shiftwork with biomarkers of subclinical cardiovascular disease and examine the moderating role of body mass index (BMI) in a police cohort.

Methods: A cross-sectional analysis was conducted among officers who were categorized as working the day, evening, or night shift. Comparisons with inflammatory biomarkers were performed among shifts using analysis of variance/covariance and further stratified by BMI to assess potential effect modification.

Results: Associations were observed between day and night shiftworkers for leukocytes, tumor necrosis factor alpha, and homocysteine. After BMI stratification, higher c-reactive protein (CRP) levels were observed among evening shiftworkers with a BMI more than or equal to 30 kg/m2 versus the day shift.

Conclusions: Future studies examining prospective changes in these markers will allow for more comprehensive evaluation of their association with shiftwork.

Department of Epidemiology and Biostatistics, Arnold School of Public Health (Mr Holst, Dr Wirth, Dr Burch); Cancer Prevention and Control Program (Dr Wirth, Dr Burch); College of Nursing (Dr Wirth), University of South Carolina; Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia (Ms Mnatsakanova, Dr Charles, Ms Tinney-Zara, Dr Fekedulegn, Dr Andrew, Dr Hartley); WJB Dorn VA Medical Center (Dr Burch), Columbia, South Carolina; Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University of Buffalo, The State University of New York, Buffalo, New York (Dr Violanti).

Address correspondence to: Michael D. Wirth, MSPH, PhD, Cancer Prevention and Control Program, University of South Carolina, 915 Greene Street, Room 233, Columbia, SC 29208 (

This work was supported by the National Institute for Occupational Safety and Health (NIOSH), NIOSH contract numbers 200-2003-01580, 254-2012-M-53230, and 200-2014-M-60325. The findings and conclusions are those of the authors and do not necessarily represent the official position of the National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention.

Wirth, Holst, Mnatsakanova, Burch, Charles, Tinney-Zara, Fekedulegn, Andrew, Hartley, and Violanti have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM editorial board and planners have no financial interest related to this research.

Copyright © 2019 by the American College of Occupational and Environmental Medicine