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Joint association of cumulative workplace environmental exposures and shift work with long-term work-limiting health conditions: a prospective cohort study from the UK Biobank

Zi-Yang Ren, Yihao Zhao, Yun-Duo Liu, Chen Chen, Bin-Bin Su, Ju-Fen Liu, Xiaoying Zheng

BMJ public health, 2026

1 citation

Abstract

Abstract Background Workplace environmental exposures (WEEs) and shift work are common occupational hazards, but their joint associations with working-age health and healthy working years are not well characterised. Methods Data were from the UK Biobank. Lifetime WEEs (toxic substances, passive smoking, extreme temperatures, noise) and shift work (day, mixed or night shifts) were derived from complete job histories and classified as cumulative years (never, =10 years). 20 prevalent multisystem long-term work-limiting health conditions before age 70 were ascertained via linked health records. Survival analyses including Cox proportional hazards and accelerated failure time models were conducted. Results Among 34 413 workers aged 38–54 years, half experienced WEEs or shift work. Over 13.9±1.0 years, WEEs and shift work were associated with all 20 conditions, and some associations were more pronounced or only significant in women. Specifically, workers exposed to both exposures for >=10 years (vs both never) had 154% higher risks of new-onset carpal tunnel syndrome, followed by chronic obstructive pulmonary disease, spondylopathy, diabetes and depression (increased risks: 124%–100%). They also lost 8.88 healthy working years due to incident carpal tunnel syndrome, followed by depression, spondylopathy, intervertebral disc diseases and psoriasis (years lost: 7.33–6.44). The joint impacts of multifaceted WEEs and shift work varied, but few multiplicative/additive interactions…

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Evidence Hub reads this as a cohort study, done in people. Its evidence level is 3 of 5 (Moderate · trial / cohort / secondary analysis). Trials without a large randomized design, cohorts and secondary analyses give moderate evidence.

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