![]() However, studies specifically investigating these type of shift work characteristics and the association with risk factors for disease on the long-term are scarce while these studies can be helpful to make more targeted recommendations for the prevention of health problems 30. Furthermore, recent guidelines also propose to limit the number of consecutive night shifts 30. For example, a higher number of night shifts per month has been found to be positively associated with obesity 31, 32, 33, and people working longer than 20 years in night shift work appear to have a lower level of LDL cholesterol and showed a decrease in overweight and obesity 34, 35. ![]() frequency of night shifts) appear to affect short-term physiological effects and are suggested to also affect long-term health effects 30. Characteristics of night shift work (e.g. Previous studies have indicated that it is important to collect detailed data on the characteristics of the shift work schedule to determine the impact of night shift work on health 29, 30. monocytes or lymphocytes, may be linked with increased inflammation, disease progression and chronic disease risk 26, 27, 28. Higher levels of, and disturbance of the circadian rhythm in specific types of leukocytes levels in blood, e.g. Recently, it was shown that night shift work is also associated with increased immune cell counts 21, 22, 23, 24, 25. ![]() For example, a higher BMI increases the chance of developing type 2 diabetes 15, 16, 17, and a higher waist circumference is a strong indicator for abdominal obesity which predicts cardiovascular disease 18, 19, 20. For metabolic diseases, several predictive markers are well known and have been associated with night shift work 13, 14. It is therefore useful to find risk factors of negative health outcomes on the long term. One challenge of investigating long term health risks of night shift work is that it takes several years to several decades for chronic diseases to develop. The circadian pacemaker controls among others the sleep–wake cycle, the endocrine and metabolic pathways and the immune system, resulting in oscillation in the composition of immune cells 10, 11, 12. The biological clock-which has a cycle of about 24-h-is the circadian pacemaker of the body and is essential for the timing of physiological processes, and is entrained by light daily 9. It is hypothesised that these health risks are a consequence of disturbed circadian rhythms resulting from imposed night shift work 8. Shift work, and in particular night shift work, is associated with increased health risks, such as cardiovascular and metabolic disorders, increased infection susceptibility, autoimmune diseases, and cancer 2, 3, 4, 5, 6, 7. In Europe, 19% of the working population works during the night at least once a month 1. Our current 24-h economy results in frequent occurrence of shift work. Our findings provide evidence for the association between night shift work characteristics and BMI, waist circumference and leukocytes (including, monocytes, lymphocytes, and basophil granulocytes). This association was less pronounced in long-term night shift workers (≥ 20 years). Night shift workers had an increased BMI, waist circumference and immune cell counts compared to non-shift workers. ![]() Linear regression analyses, adjusted for demographic, lifestyle and occupational factors, were used to study associations of night shift work characteristics with metabolic risk factors and immune cell counts. We performed a cross-sectional study using data from 10,201 non-shift workers and 1062 night shift workers of the Lifelines Cohort study. Here we examined the association of metabolic risk factors and immune cell counts, with both night shift work and particular characteristics thereof: frequency, duration and consecutive night shifts. Night shift work is associated with increased health risks.
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