Differences between fixed day shift workers and rotating shift workers in gastrointestinal problems: a systematic review and meta-analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational studies
PubMed 33408309 · doi:10.2486/indhealth.2020-0153
What was done
Authors searched PubMed, CINAHL, and the Cochrane Library for studies published between January 1, 1985, and June 30, 2020, comparing gastrointestinal health between fixed day shift workers (shifts starting between 7:00 and 9:00 AM) and rotating shift workers (shifts starting at any other time). A meta-analysis of 16 included studies was conducted using Comprehensive Meta-Analysis software, evaluating overall gastrointestinal issues and four specific conditions: irritable bowel syndrome, constipation, indigestion, and peptic ulcers.
What was found
Rotating shift workers had significantly higher odds of gastrointestinal problems overall compared to fixed day shift workers (odds ratio [OR] = 1.56, 95% confidence interval [CI]: 1.24–1.95). In subgroup analyses, significant differences were identified for indigestion (OR = 1.72, 95% CI: 1.28–2.30) and peptic ulcers (OR = 1.66, 95% CI: 1.19–2.30). Differences were not statistically significant for irritable bowel syndrome or constipation.
Why it matters
This review quantifies the elevated gastrointestinal burden associated with rotating work schedules, highlighting upper gastrointestinal disorders (indigestion and peptic ulcers) as the primary drivers of this risk.
Limits
The abstract does not disclose the total participant count, study designs of included papers (e.g., cross-sectional vs. cohort), or geographic diversity. Classifying any schedule not starting between 7:00–9:00 AM as a 'rotating shift' may conflate permanent night workers with truly rotating workers. Potential confounders such as diet, smoking, alcohol, medication use, and baseline stress were not reported in the abstract.
Cited by
- supports Shift work is associated with adverse health outcomes including gastrointestinal dysfunction, increased cancer risk, and reduced longevity.