Comparing the Health Impacts of Fixed Night and Rotating Shift Work: An Umbrella Review of Meta-Analyses.
Level 3 - non-randomized controlled study
Umbrella review of observational meta-analyses (by design analogy, Oxford CEBM Level 3).
PubMed 40827592 · doi:10.1111/jsr.70172
What was done
An umbrella review of meta-analyses indexed in PubMed, Embase, and Web of Science up to December 2024 was conducted to compare the health impacts of fixed night work versus rotating-shift work. Meta-analytic risk estimates were synthesised, and methodological quality was evaluated using AMSTAR 2.
What was found
Fixed night shifts were associated with higher risks of ischaemic heart disease (pooled RR: 1.44; 95% CI: 1.10–1.89), obesity (pooled OR: 1.43; 95% CI: 1.19–1.71), and miscarriage (pooled OR: 1.23; 95% CI: 1.03–1.47), along with increased blood pressure, Type 2 diabetes, and melatonin disruption (no numeric estimates reported in abstract for these three). Rotating shifts were associated with higher overall cancer risk (pooled OR: 1.14; 95% CI: 1.04–1.24), pre-eclampsia (pooled OR: 1.75; 95% CI: 1.01–3.01), and impaired sleep quality (reduced sleep efficiency, shorter duration, increased disturbance; no numeric estimates reported).
Why it matters
This review distinguishes the risk profiles of shift types, suggesting fixed night work disproportionately drives cardiometabolic harm while rotating schedules are more linked to cancer and sleep disturbance.
Limits
The abstract omits the number of included meta-analyses, primary studies, and participants. The underlying evidence consists of observational studies subject to residual confounding, exposure misclassification, and potential study overlap across meta-analyses. Numerical estimates and confidence intervals were omitted for several reported outcomes.
Cited by
- supports Shift workers who experience chronic sleep-wake disturbances are at a substantially higher risk of developing obesity and type 2 diabetes.