Assessment of cardiovascular risk in shift healthcare workers

BACKGROUND: Shift work has been associated with an increased risk of cardiovascular disease (CVD); in particular, night work affects the circadian rhythm. DESIGN AND METHODS: The study examines the effectiveness of three screening methods and plasma hyperhomocysteinemia, an independent risk factor, in assessing the risk of CVD in 147 healthcare providers doing daytime or rotational shift work. The methods applied were: (i) the method proposed by the European Cardiovascular Indicators Surveillance Set (EUROCISS); (ii) the metabolic syndrome (MS) criteria of the Third Report of the National Cholesterol Education Program Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATPIII) and (iii) the MS criteria of the International Diabetes Federation (IDF). RESULTS: EUROCISS was unable to distinguish between the CVD risk of daytime and rotational shift workers. Both the ATPIII and the IDF detected MS, which is strongly associated with CVD, but only the IDF evidenced a significantly greater prevalence of MS (P<0.05) among shift workers. Hyperhomocysteinemia was unable to discriminate the CVD risk between daytime and shift workers, as it was influenced by multiple confounding factors. CONCLUSIONS: The increased risk of CVD associated with shift work is related to the greater incidence of MS among these workers. In our study a high prevalence of MS was detected only with the IDF. The method is useful for CVD prevention and the promotion of health during any medical examination of shift workers.