Un horario laboral prolongado se vincula con un mayor riesgo de ictus

Association Between Reported Long Working Hours and History of Stroke in the CONSTANCES

Abstract

Background and Purpose

Long working hours (LWHs) are a potential risk factor for stroke. The aim of this study was to investigate this association in a large general population cohort.

Methods

We used the French population-based cohort, CONSTANCES (Cohorte des Consultants des Centres d'Examens de Santé), to retrieve information on age, sex, smoking, and working hours from the baseline, self-administered questionnaire. Other cardiovascular risk factors and previous occurrence of stroke were taken from a parallel medical interview. We defined LWH as working time >10 hours daily for at least 50 days per year. Participants with primarily part-time jobs were excluded as were those with stroke before LWH exposure. We used logistic models to estimate the association between LWH and stroke, stratified by age, sex, and occupation. In additional modeling, we excluded subjects whose stroke occurred within 5 years of the first reported work exposure.

Results

Among the 143 592 participants in the analyses, there were 1224 (0.9%) strokes, 42 542 (29.6%) reported LWH, and 14 481 (10.1%) reported LWH for 10 years or more. LWH was associated with an increased risk of stroke: adjusted odds ratio of 1.29 (95% CI, 1.11–1.49). Being exposed to LWH for 10 years or more was more strongly associated with stroke, adjusted odds ratio of 1.45 (95% CI, 1.21–1.74). The association showed no differences between men and women but was stronger in white-collar workers under 50 years of age.

Conclusions

This large analysis reveals a significant association between stroke and exposure to LWH for 10 years or more. The findings are relevant for individual and global prevention.

Stroke is a devastating though largely preventable health condition.1 Long working hours (LWH) may be a risk factor for cardiovascular diseases and stroke.2 In Japan, 60% of compensated Karoshi (death from over-work) cases died of stroke.3 A meta-analysis observed a dose-response relationship between LWH and stroke but did not adjust for other modifiable risk factors of stroke.4 A Danish study found association with LWH only for hemorrhagic stroke.5

Our study investigated the association between LWH and stroke in a large general population study.

References

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2. van der Hulst M. Long workhours and health.Scand J Work Environ Health. 2003; 29:171–188.

3. Ke DS. Overwork, stroke, and karoshi-death from overwork.Acta Neurol Taiwan. 2012; 21:54–59.

4. Kivimäki M, Jokela M, Nyberg ST, Singh-Manoux A, Fransson EI, Alfredsson L, et al.; IPD-Work Consortium. Long working hours and risk of coronary heart disease and stroke: a systematic review and meta-analysis of published and unpublished data for 603,838 individuals.Lancet. 2015; 386:1739–1746. doi: 10.1016/S0140-6736(15)60295-1.

5. Hannerz H, Albertsen K, Burr H, Nielsen ML, Garde AH, Larsen AD, et al.. Long working hours and stroke among employees in the general workforce of Denmark.Scand J Public Health. 2018; 46:368–374.