夜间轮班工作对女性生殖健康影响的流行病学研究进展

Epidemiological research progress on effects of night shift work on female reproductive health

国际癌症研究机构(IARC)定义轮班工作是在标准工作时间(一般为上午7:00/8:00至下午5:00/6:00)以外的任何日常工作时间安排。为适应当前社会经济快速发展的需要,轮班工作制度越来越普遍。轮班工作,尤其是夜间轮班工作,对人体健康的影响不容忽视。女性健康不仅关乎自身,对后代甚至整个家庭都会产生影响。目前很多流行病学研究关注到夜间轮班工作对女性生殖健康的影响。本文总结近年来国内外有关夜间轮班工作与女性月经周期、子宫内膜异位症、受孕率、不良妊娠结局和卵巢癌等生殖相关结局关联的流行病学研究证据;并从目前研究较为清楚的褪黑素调节、生物钟基因调控以及性激素调节机制介绍了夜间轮班工作对女性生殖健康影响的生物学机制。本文探讨了轮班工作对女性生殖健康的影响,为确定职业相关危险因素及后续开展相关研究,制定合理的健康促进策略提供参考依据。

The International Agency for Research on Cancer(IARC)defines shift work as any arrangement of daily working hours other than the standard daylight hours(typically 7:00/8:00 am–5:00/6:00 pm).To meet the needs of rapid socioeconomic development,shift work is becoming more and more common.The impact of shift work,especially night shift work,on human health cannot be ignored.Female's health is not only important to the well-being of themselves,but also has a far-reaching impact on their children and even their entire family.Increasing epidemiological studies have focused on the effects of night shift work on female's reproductive health.This article reviewed epidemiological evidence of the associations between night shift work and reproductive outcomes,e.g.menstrual cycle,endometriosis,pregnancy rate,adverse pregnancy outcomes,and ovarian cancer.The potential biological mechanisms connecting night shift work to female reproductive health were also introduced,e.g.melatonin regulation,clock gene regulation,and sex hormone regulation.Through this review,we propose to provide a reference for determining occupational risk factors,conducting subsequent relevant studies,and formulating rational health promotion strategies.