Night-shift work is associated with increased susceptibility to SARS-CoV-2 infection

ABSTRACT

Night-shift workers experience disturbances of their circadian rhythm and sleep, which may make them more susceptible to infectious diseases. Therefore, we studied whether night-shift workers are at higher risk of testing positive for SARS-CoV-2 infection than day workers. In this prospective study, data were used from 20 questionnaire rounds of the Dutch Lifelines COVID-19 cohort that was initiated in March 2020. In the different questionnaire rounds, 2285 night-shift workers and 23,766 day workers reported whether they had tested positive for SARS-CoV-2. Cox proportional hazards regression models adjusted for demographic, work, and health covariates were used to compare SARS-CoV-2 incidence between night-shift and day workers. From March 2020-January 2021, 3.4% of night-shift workers and 2.2% of day workers reported to have tested positive for SARS-CoV-2 (p < .001). After adjustment for covariates, night-shift workers had a 37% higher risk of testing positive for SARS-CoV-2 (hazard ratio: 1.37, 95% confidence interval: 1.05–1.77). In this study, we show that night-shift workers were more likely to test positive for SARS-CoV-2 than day workers, which adds to the growing evidence that night-shift work may influence the complex processes involved in infection susceptibility. Further mechanistic insight is needed to understand the relation between night-shift work and (SARS-CoV-2) infection susceptibility.

KEYWORDS:

• COVID-19
• infection susceptibility
• longitudinal study
• night-shift work
• occupational health
• SARS-CoV-2

Acknowledgements

The authors wish to acknowledge the services of the Lifelines Cohort study, the contributing research centers delivering data to Lifelines, and all the study participants. The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University, and the provinces in the north of the Netherlands (Drenthe, Friesland, Groningen).

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

The data analyzed in this study were obtained from Lifelines (https://www.lifelines.nl/researcher). Requests to access these data should be directed to Lifelines Research Office ([email protected]).

Additional information

Funding

This work was supported by the Dutch Ministry of Social Affairs and Employment (Ministerie van Sociale Zaken en Werkgelegenheid KV11.16). The funding bodies had no role in the study design, the collection, analysis, and interpretation of data, the writing of the manuscript, and the decision to submit the manuscript for publication.