Johan Ohlander, M.Sc. and Katja Radon, M.Sc., Ph.D., Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ziemssenstrasse 1, Munich, Germany; and Mekail-Cem Keskin, M.D. and Joachim Stork, M.D., AUDI Gesundheitszentrum Süd, AUDI AG, Ingolstadt, Germany

Hypertension and cardiovascular disease (CVD) may share a similar pathophysiology. Despite shift workers’ CVD excess risk, studies on shift work and hypertension are inconclusive. Blood pressure and shift status for 25,343 auto workers were obtained from medical checkups and company registers. Cross-sectional associations modelling the total effect from shift work (dayshifts, shift work without nights, rotating shift work with nights and nightshifts) on hypertension were assessed. By sequential adjustments, the influence of behavioural, psychosocial and physiological factors on the total effect was examined, with subsequent mediation and moderation analyses. Adjusted for confounders, shift work without nights (vs. day shifts) was significantly associated with hypertension (OR 1.15, 95 per cent CI 1.02-1.30). The total effect was mediated by BMI, physical inactivity and sleep disorders. No moderation of the total effect by behaviours was found. The association between shift work and hypertension seems mainly attributable to behavioural mechanisms.

Am J Ind Med, Volume 58, Issue 5, pages 549-560. Correspondence to: Johan Ohlander, Occupational and Environmental Epidemiology and NetTeaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ziemssenstrasse 1, 80336 Munich, Germany; email: johan.ohlander@med.uni-muenchen.de.