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Extended work hours increase risk for cancer among U.S. women
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Women in the United States who worked at least 60 hours per week during the span of 3 decades demonstrated increased risk for cancer and other chronic health problems, according to researchers at The Ohio State University.
These women were at threefold greater risk for malignancies other than skin cancer, as well as arthritis and diabetes.
Allard E. Dembe , ScD, professor in the division of health services management and policy at The Ohio State University College of Public Health, and Xiaoxi Yao, PhD, MPH, MS, of the department of health science research at Mayo Clinic in Rochester, Minnesota, assessed whether extended work hours affected the long-term health of nearly 7,500 participants included in The National Longitudinal Survey of Youth.
Participants reported average work hours each week during the 32-year study period. Researchers evaluated associations between work hours and development of eight chronic diseases, including nonskin cancers, diabetes, cardiovascular disease, arthritis and chronic lung disease. They also evaluated data based on sex.
More than half (56%) of study participants reported working an average of 41 to 50 hours per week, 13% reported working 51 to 60 hours weekly, and 3% reported working more than 60 hours per week.
Researchers identified a significant association between extended work hours and development of cancer, cardiovascular disease, diabetes and arthritis, particularly among women.
Dembe spoke with HemOnc Today about the study results and their potential implications.
Question: Can you describe what you found in terms of cancer incidence?
A: We looked at eight different disease outcomes, including malignancies other than skin cancers. These diseases were the most interesting to us, and we had data on them from the National Longitudinal Survey of Youth. Our overall findings truly shocked us. We did not go into this thinking we would find what we found. Among men and women, we observed consistent results in terms of cancer risk. People who worked 30 to 40 hours per week served as the baseline. For those who worked 41 to 50 hours per week, the risk for cancer was increased by about 50%. For those who worked 51 to 60 hours per week, the OR went up to 2.03. Among those who worked 60 or more hours per week, the OR increased to 2.83. We saw a lot of consistency and some pretty high ORs. This stood out and surprised me. This type of dose–response relationship adds credibility to what is happening. We did not see this association for some of the other areas we studied, such as chronic lung disease, asthma, heart disease or hypertension.
Q: The association between more hours worked and cancer risk was stronger among women. Can you explain why?
A: I can speculate. As researchers, we crank all of these numbers ... but we never truly know all of the mechanisms or underlying reasons. All we know is the statistical association. The most popular suggestion I have heard for why men do not appear to be affected by long work hours in the same way as women is the sociological gender effect of working life. The data used in this study date to 1979 and were collected through 2010. This covers many decades, during which many things happened to women with respect to the workforce. As women became very active in the workforce and started taking on more responsibilities, it became more customary for women to work 40 to 60 hours per week. Men have done this for years, but women carry the burden of other responsibilities that men may not be as likely to perform, particularly around issues regarding child rearing and pregnancy. When a woman is working 50 to 70 hours per week and then has the responsibilities of taking care of the home, going through pregnancy or raising children, this creates a heavier burden that could manifest itself with respect to over-work and stress conditions.
Q: What are the potential implications of the findings?
A: As people work to build their careers, they are not thinking about the types of chronic conditions they will have later in life. Maybe during this time they should also emphasize building good health patterns. There is a bodily response to the stress involved with long work hours and trying to raise children. A person can only do so much. What gives way is taking care of oneself over long periods of time. Employers want employees to work hard and to do well in their careers, but up to what limits? For the most part in the United States, there are no regulations to cap working hours. Employers often set up programs to promote workers’ health, but it is less common to think about chronic conditions later in life. Early screening could identify onset of disease symptoms before it is too late. There also needs to be more work–life balance.
Q: What additional research needs to be conducted?
A: The way to do a study like this is to follow the cohort for a long time and assess the data each year. Even though we used the data from the National Longitudinal Survey of Youth, our methods were not longitudinal because we did not really follow individuals and we did not have the data available on specific work hours at a specific time in a person’s life relative to what happens in the years following. From a technical research standpoint, it would be great to get this longitudinal data, but this is very difficult. A lot of money is required to take on something like that. – by Jennifer Southall
Reference:
Dembe AE and Yao X. J Occup Environ Med. 2016; doi:10.1097/JOM.0000000000000810.
For more information:
Allard E. Dembe , ScD, can be reached at The Ohio State University College of Public Health, 283 Cunz Hall, 1841 Neil Ave., Columbus, OH 43210; email: adembe@cph.osu.edu.
Disclosure: The study was funded by the CDC, as well as the National Institute of Occupational Safety and Health. Dembe reports no relevant financial disclosures.