# Increased risk of asthma in female night shift workers

## TL;DR

Female night shift workers have a higher risk of asthma compared to male workers, with postmenopausal women not using hormone replacement therapy being most affected.

## Contribution

The study identifies a stronger association between shift work and asthma in females, particularly postmenopausal women not using HRT.

## Key findings

- Female permanent night shift workers had a 1.50 times higher odds of moderate–severe asthma compared to dayworkers.
- Postmenopausal women not using HRT showed a 1.89 times higher odds of moderate–severe asthma linked to night shift work.
- The association between shift work and asthma in females was not observed in males.

## Abstract

Asthma is more common in females and more common in night shift workers. Since increasing numbers of females are becoming shift workers, it is important to determine if the risk of shift work-associated asthma is higher in females. The objective of the present study was to determine if increasing frequency of shift work is more strongly related to prevalent asthma in females than in males.

We used cross-sectional data from >280 000 UK Biobank participants and logistic regression models adjusted for demographic and lifestyle factors to describe sex differences in prevalent asthma phenotypes related to shift work frequency. To obtain mechanistic insights, we explored associations with chronotype, sex hormones and menopause.

Female permanent night shift workers had higher covariate-adjusted odds of moderate–severe asthma (odds ratio (OR) 1.50, 95% confidence interval (CI) 1.18–1.91) than female dayworkers, but there was no corresponding relationship among males (OR 0.95, 95% CI 0.72–1.26; sex interaction p-value=0.01). Similar relationships were observed for “all asthma” and for “wheeze or whistling in the chest”. Female shift work-related asthma was driven by relationships in postmenopausal women not using hormone replacement therapy (HRT) (adjusted OR 1.89 (95% CI 1.24–2.87) for moderate–severe asthma; sex interaction p-value=0.02 in permanent night shift workers, compared with dayworkers), but these relationships attenuated to the null in postmenopausal women using HRT.

Our finding that increasing shift work frequency is more strongly related to asthma in females than in males could have public health implications. Intervention studies should determine if modifying shift work schedules or using HRT can reduce asthma risk in females.

Increasing shift work frequency is more strongly related to asthma in females than in males
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