临场实务-职场过负荷

长时间工作导致脑中风及增加冠状动脉心脏病风险

2015发表于THE LANCET的一篇研究，结论如下：
『相较于周工时35-40小时族群，长时间工作(每周工作时数≧55小时，月加班时数约≧60小时)。脑中风相对风险增加33%，冠状动脉心脏病相对风险增加13%。 』

每周工作时数≧55小时，月工时约≧ 55 x 4 + 8 x 2 = 236小时，月加班时数约≧ 236 - 176= 60小时。

『长时间工作导致脑中风增加的风险大于导致冠状动脉心脏病增加的风险。 』
『脑中风的风险和每周工作时数成正比，风险随着每周工时增加而上升。 』

[注：每周工作时数H小时，月工时约：H x 4 + 8 x 2 = (4H+16)小时，月加班时数约(4H+16) – 176 = 4H - 160小时』
『缺乏活动(physical inactivity)、长时间久坐和大量饮酒增加脑中风机率』

www.thelancet.com Vol 386 October 31, 2015
Exposure to long working hours was based on self-report and was measured only once. In two studies, high loss to follow-up could also have contributed to an underestimation of associations, although this bias seemed to be small or absent in the total data.
We had harmonised data for multivariable adjustments for age, sex, SES, smoking, BMI, physical activity, and alcohol consumption, but not for salt intake and blood-based risk factors. Ascertainment of coronary heart disease and stroke varied, ranging from medical records of brain imaging and autopsy to repeated self-report questionnaires outcome misclassification is possible. However, the absence of heterogeneity in the study-specific estimates, and the uniform findings in the analyses stratified by method of ascertainment, suggest that this misclassification is not a major source of bias.

www.thelancet.com Vol 386 October 31, 2015