Shift work and cardiovascular risk factors : prevention among airline employees

Katriina Viitasalo

Forskningsoutput: AvhandlingDoktorsavhandling


Epidemiologic evidence supports an association between shift work and increased risk of cardiovascular disease. Circadian misalignment, shortened and disturbed sleep, and alterations of lifestyle aspects are the main factors related to shift workers health problems. Shift work is carried out by 17% of workers across the EU. In a globally operating airline, irregular working hours and time-zone flights are challenging to workers coping strategies and their health, especially as they age. The main purpose of this study was to evaluate the feasibility and effectiveness of screening and prevention of cardiovascular risk factors and type 2 diabetes among the workers of a Finnish airline. Two kinds of interventions were tested; changes in shift systems and lifestyle counselling. We found that metabolic syndrome, a clustering of risk factors for cardiovascular disease, was more prevalent among former male shift workers than workers who had never worked shifts. In shift rotation, a faster speed together with a change from the backward to forward direction alleviated daytime sleepiness and older workers had less sleep complaints in a quickly forward rotating shift system than their younger colleagues. In addition, lower systolic blood pressure and a declining trend for heart rate in a flexible shift system indicated a decrease in psychophysiological stress. Health check-ups effectively identified employees with increased risk of type 2 diabetes and cardiovascular diseases. The FINDRISC questionnaire proved to be a practicable first-step screening method. Low intensity lifestyle intervention was feasible in an occupational health care setting. However, only modest health benefits were observed among the men with increased risk. The study revealed that a number of factors are associated with participation in the lifestyle interventions. Employees with higher baseline FINDRISC score and clinical and lifestyle risk factors were eager to take part in lifestyle counselling by a dietician or a diabetes nurse. Also problems in sleep and mood increased attendance in the interventions. From research to practice: former shift workers increased risk for metabolic syndrome should be recognized in occupational health care and taken into account in preventive work. In the design of new shift systems, a faster speed, together with the forward rotation of the shift system enhances older workers well-being and coping strategies for shift work. In addition, combining individual elements with company-based working-time flexibility may have favourable effects on shift workers cardiovascular health. Low intensity lifestyle interventions targeted at risk individuals may be profitable. It is important to identify the work and individual related characteristics affecting intervention project attendance to develop more effective methods for the preventive work of occupational health care.
Tryckta ISBN978-951-51-2268-1
Elektroniska ISBN978-951-51-2269-8
StatusPublicerad - 2016
MoE-publikationstypG5 Doktorsavhandling (artikel)


  • 3142 Folkhälsovetenskap, miljö och arbetshälsa
  • 3121 Inre medicin

Citera det här

Viitasalo, K. (2016). Shift work and cardiovascular risk factors : prevention among airline employees. Helsinki : University of Helsinki.