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dc.contributor.authorRahim, Ahmaden
dc.date.accessioned2018-09-14T19:22:55Z
dc.date.available2018-09-14T19:22:55Z
dc.identifier.urihttp://hdl.handle.net/1974/24837
dc.description.abstractBackground: The epidemiological evidence supporting an association between shift work, and cardiovascular diseases and hypertension is growing. However, few population-based studies have explored the relationship between shift work and hypertension risk and the potential mechanism(s) linking them. Objectives: 1) To determine the association between shift work status and rates of hypertension in a cohort of Ontario working adults during a 12-year follow-up period; 2) To determine whether sleep quality mediates this relationship. Methods: The cohort included Ontario adult respondents of the 2000-01 Canadian Community Health Survey (CCHS), which was linked to health administrative databases within the Institute for Clinical Evaluative Sciences (ICES). Baseline shift work status, sleep quality, and covariate measures were obtained from the CCHS; time of hypertension diagnosis was ascertained from the ICES databases. The inception cohort included individuals who reported working with no pre-existing hypertension. Follow-up was 12 years. We conducted a mediation analysis using the natural effects models that use marginal structural modeling to directly parameterize the natural direct and indirect effects of shift work on the rates of hypertension in a Cox proportional hazard model. Results: Shift workers reported lower frequency of refreshing sleep, more trouble sleeping, and poorer sleep quality overall. Night shift work was not associated with increased hypertension rates in either men (HR=1.15, 95% CI:0. 93-1.43) or women (HR=1.23, 95% CI: 0.96-1.57) during 12 years of follow-up, but the hazard ratios were in the hypothesized direction. Other shift work (including evening shifts, split shifts, irregular schedules, on-call, or other schedules) was associated with increased hypertension rates in men (HR=1.29, 95% CI: 1.03-1.62) during 12 years of follow-up, but this association was not mediated through sleep quality (HR=1.00, 95% CI: 0.99-1.01). Similar results were found among women (HR=1.30, 95% CI: 0.97-1.74) during 12 years of follow-up. Conclusions: Irregular working hours appear to increase hypertension rates. Shift work does disrupt sleep, but sleep quality does not appear to be a mediator between shift work and increased hypertension rates.en
dc.language.isoengen
dc.relation.ispartofseriesCanadian thesesen
dc.rightsQueen's University's Thesis/Dissertation Non-Exclusive License for Deposit to QSpace and Library and Archives Canadaen
dc.rightsProQuest PhD and Master's Theses International Dissemination Agreementen
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dc.rightsCopying and Preserving Your Thesisen
dc.rightsThis publication is made available by the authority of the copyright owner solely for the purpose of private study and research and may not be copied or reproduced except as permitted by the copyright laws without written authority from the copyright owner.en
dc.subjectShift worken
dc.subjectsleep qualityen
dc.subjectHypertensionen
dc.subjectCardiovascualr diseasesen
dc.titleShift work, sleep quality, and hypertension among working adults in Ontarioen
dc.typethesisen
dc.description.degreeM.Sc.en
dc.contributor.supervisorTranmer, Joanen
dc.contributor.supervisorMcIsaac, Michaelen
dc.contributor.departmentPublic Health Sciencesen
dc.embargo.termsWe would also like to have the on-line publication of this thesis restricted, until we have successfully published a paper.en
dc.embargo.liftdate2023-09-13T00:36:25Z
dc.degree.grantorQueen's University at Kingstonen


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