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American Journal of Epidemiology Advance Access originally published online on October 27, 2006
American Journal of Epidemiology 2007 165(2):175-183; doi:10.1093/aje/kwj355
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American Journal of Epidemiology Copyright © 2006 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.

ORIGINAL CONTRIBUTIONS

Work Characteristics and Incidence of Type 2 Diabetes in Women

Candyce H. Kroenke1, Donna Spiegelman2, JoAnn Manson2,3,4, Eva S. Schernhammer3, Graham A. Colditz2,3 and Ichiro Kawachi3,5

1 Robert Wood Johnson Health and Society Scholars Program, University of California, San Francisco and Berkeley, CA
2 Department of Epidemiology, Harvard School of Public Health, Boston, MA
3 Channing Laboratory, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
4 Division of Preventive Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
5 Department of Society, Human Development, and Health, Harvard School of Public Health, Boston, MA

Correspondence to Dr. Candyce H. Kroenke, University of California, 3333 California Street, Suite 465, San Francisco, CA 94118 (e-mail: ckroenke{at}berkeley.edu).

The authors prospectively investigated associations between potentially stressful work characteristics and type 2 diabetes incidence in 62,574 young and middle-aged women, aged 29–46 years at baseline in 1993, from the Nurses' Health Study II; 365 cases of type 2 diabetes accrued over 6 years of follow-up. Cox proportional hazards regression was used to simultaneously evaluate associations of hours per week in paid employment, years of rotating night-shift work, and job strain with incidence of type 2 diabetes. In multivariate-adjusted analyses, women working less than 20 hours per week had a lower risk of diabetes (relative risk = 0.80, 95% confidence interval: 0.50, 1.30), and those working overtime (≥41 hours/week) had an elevated risk of diabetes (relative risk = 1.23, 95% confidence interval: 0.98, 1.55) compared with women working 21–40 hours/week (referent) in paid employment (ptrend = 0.03). In subsequent analysis, the elevated association appeared stronger in unmarried women (pinteraction = 0.02). A positive association between years in rotating night-shift work and diabetes was mediated entirely by body weight. Job strain was unrelated to risk of type 2 diabetes. In conclusion, working overtime predicted a slightly elevated risk of type 2 diabetes in young and middle-aged female nurses.

diabetes mellitus, type 2; nursing staff; stress, psychological; women; work schedule tolerance

Abbreviations: CI, confidence interval; RR, relative risk


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