{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T00:29:42Z","timestamp":1788481782023,"version":"build-2803163510"},"reference-count":47,"publisher":"BMJ","issue":"1","license":[{"start":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T00:00:00Z","timestamp":1768176000000},"content-version":"unspecified","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"name":"National Key Research and Development Program of China","award":["2022YFC3600800"],"award-info":[{"award-number":["2022YFC3600800"]}]},{"name":"National Key Research and Development Program of China, Ministry of Science and Technology of the People's Republic of China","award":["2025YFC2511501"],"award-info":[{"award-number":["2025YFC2511501"]}]},{"name":"National Natural Science Foundation of China - the Key Project of the National Natural Science Foundation of China Regional Innovation and Development Joint Fund","award":["U23A20420"],"award-info":[{"award-number":["U23A20420"]}]},{"name":"Clinical Medicine Plus X - Young Scholars Project, Peking University, the Fundamental Research Funds for the Central Universities","award":["PKU2025PKULCXQ010"],"award-info":[{"award-number":["PKU2025PKULCXQ010"]}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,12,12]]},"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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, &lt;10, &gt;=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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 34\u2009413 workers aged 38\u201354 years, half experienced WEEs or shift work. Over 13.9\u00b11.0 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 &gt;=10\u2009years (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%\u2013100%). 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\u20136.44). The joint impacts of multifaceted WEEs and shift work varied, but few multiplicative\/additive interactions were observed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Co-occurrence of WEEs and shift work is associated with substantial excess risks of long-term work-limiting health conditions and loss of healthy working years. Strengthening control of WEEs and health surveillance for shift workers may be needed to protect working-age health and sustain productive employment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2025-003038","type":"journal-article","created":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T15:30:38Z","timestamp":1768231838000},"page":"e003038","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["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"],"prefix":"10.1136","volume":"4","author":[{"given":"Ziyang","family":"Ren","sequence":"first","affiliation":[{"name":"Institute of Reproductive and Child Health\/National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, People's Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yihao","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yunduo","family":"Liu","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-7393","authenticated-orcid":false,"given":"Chen","family":"Chen","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Binbin","family":"Su","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5844-8973","authenticated-orcid":false,"given":"Jufen","family":"Liu","sequence":"additional","affiliation":[{"name":"Institute of Reproductive and Child Health\/National Health Commission Key Laboratory of Reproductive Health, School of Public Health, Peking University, Beijing, People's Republic of China"},{"name":"Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, People's Republic of China"},{"name":"State Key Laboratory of Female Fertility Promotion, Peking University, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoying","family":"Zheng","sequence":"additional","affiliation":[{"name":"School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, People's Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,1,12]]},"reference":[{"key":"2026011207301722000_4.1.e003038.1","doi-asserted-by":"crossref","first-page":"2133","DOI":"10.1016\/S0140-6736(24)00757-8","article-title":"Global incidence, prevalence, years lived with disability (YLDs), disability-adjusted life-years (DALYs), and healthy life expectancy (HALE) for 371 diseases and injuries in 204 countries and territories and 811 subnational locations, 1990-2021: a systematic analysis for the Global Burden of Disease Study 2021","volume":"403","author":"Ferrari","year":"2024","journal-title":"The Lancet"},{"key":"2026011207301722000_4.1.e003038.2","unstructured":"Commission for Healthier Working Lives . Towards a healthier workforce. The Health Foundation; 2024."},{"key":"2026011207301722000_4.1.e003038.3","unstructured":"Office for Budget Responsibility . Fiscal risks and sustainability. 2023."},{"key":"2026011207301722000_4.1.e003038.4","unstructured":"World Health Organization . Preventing disease through a healthier and safer workplace. 2018. Available: https:\/\/www.who.int\/publications\/i\/item\/9789241513777 [Accessed 13 Sep 2018]."},{"key":"2026011207301722000_4.1.e003038.5","doi-asserted-by":"crossref","first-page":"211","DOI":"10.5271\/sjweh.4082","article-title":"Association of occupational heat exposure and colorectal cancer in the MCC-Spain study","volume":"49","author":"Hinchliffe","year":"2023","journal-title":"Scand J Work Environ Health"},{"key":"2026011207301722000_4.1.e003038.6","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2018-212267"},{"key":"2026011207301722000_4.1.e003038.7","doi-asserted-by":"publisher","DOI":"10.1097\/01.ede.0000142147.49297.9d"},{"key":"2026011207301722000_4.1.e003038.8","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1080\/10773525.2018.1451809","article-title":"Lifetime exposure to self-reported occupational noise and prevalent rheumatoid arthritis in the National Health and Nutrition Examination Survey (2011-2012)","volume":"23","author":"Dzhambov","year":"2017","journal-title":"Int J Occup Environ Health"},{"key":"2026011207301722000_4.1.e003038.9","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.i5210","article-title":"Health consequences of shift work and insufficient sleep","volume":"355","author":"Kecklund","year":"2016","journal-title":"Bmj"},{"key":"2026011207301722000_4.1.e003038.10","doi-asserted-by":"publisher","DOI":"10.1016\/j.apsb.2015.01.003"},{"key":"2026011207301722000_4.1.e003038.11","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2022.829013","article-title":"Circadian Disruption and Occupational Toxicants Exposure Affecting the Immunity of Shift Workers During SARS CoV-2 Pandemic","volume":"10","author":"Mohd Fuad","year":"2022","journal-title":"Front Public Health"},{"key":"2026011207301722000_4.1.e003038.12","doi-asserted-by":"crossref","DOI":"10.1093\/ageing\/afae242","article-title":"Association of night shift work and biological ageing: the mediating role of body mass index","volume":"53","author":"Shen","year":"2024","journal-title":"Age Ageing"},{"key":"2026011207301722000_4.1.e003038.13","doi-asserted-by":"crossref","first-page":"355","DOI":"10.1097\/JOM.0000000000002806","article-title":"The Association Between Shift Work Exposure and Frailty Among Middle-Aged and Older Adults: Results From the Canadian Longitudinal Study on Aging","volume":"65","author":"Khan","year":"2023","journal-title":"J Occup Environ Med"},{"key":"2026011207301722000_4.1.e003038.14","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.595"},{"key":"2026011207301722000_4.1.e003038.15","doi-asserted-by":"crossref","DOI":"10.3390\/ijerph17207495","article-title":"Important Difference between Occupational Hazard Exposure among Shift Workers and Other Workers; Comparing Workplace before and after 1980","volume":"17","author":"Miguet","year":"2020","journal-title":"Int J Environ Res Public Health"},{"key":"2026011207301722000_4.1.e003038.16","doi-asserted-by":"crossref","first-page":"647","DOI":"10.1093\/annweh\/wxae033","article-title":"Effects of the combined exposure to chemicals and unusual working hours","volume":"68","author":"Lie","year":"2024","journal-title":"Ann Work Expo Health"},{"key":"2026011207301722000_4.1.e003038.17","doi-asserted-by":"crossref","first-page":"122036","DOI":"10.1016\/j.envpol.2023.122036","article-title":"Independent, modified, and interacting effects of long-term noise, extremely low-frequency electromagnetic fields, and shift work exposures on liver enzymes","volume":"333","author":"Khosravipour","year":"2023","journal-title":"Environ Pollut"},{"key":"2026011207301722000_4.1.e003038.18","doi-asserted-by":"crossref","first-page":"115837","DOI":"10.1016\/j.ecoenv.2023.115837","article-title":"Association of prolonged occupational co-exposures to electromagnetic fields, noise, and rotating shift work with thyroid hormone levels","volume":"270","author":"Khosravipour","year":"2024","journal-title":"Ecotoxicol Environ Saf"},{"key":"2026011207301722000_4.1.e003038.19","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age","volume":"12","author":"Sudlow","year":"2015","journal-title":"PLoS Med"},{"key":"2026011207301722000_4.1.e003038.20","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1093\/geronb\/gbx042","article-title":"Testing Comparability Between Retrospective Life History Data and Prospective Birth Cohort Study Data","volume":"75","author":"Jivraj","year":"2020","journal-title":"J Gerontol B Psychol Sci Soc Sci"},{"key":"2026011207301722000_4.1.e003038.21","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20629"},{"key":"2026011207301722000_4.1.e003038.22","doi-asserted-by":"crossref","DOI":"10.3389\/fpubh.2020.00415","article-title":"The Association Between Shift Work and Immunological Biomarkers in Nurses","volume":"8","author":"Bjorvatn","year":"2020","journal-title":"Front Public Health"},{"key":"2026011207301722000_4.1.e003038.23","doi-asserted-by":"publisher","DOI":"10.1136\/thoraxjnl-2020-216651"},{"key":"2026011207301722000_4.1.e003038.24","unstructured":"Office for National Statistics . Rising ill-health and economic inactivity because of long-term sickness, UK: 2019 to 2023. 2023."},{"key":"2026011207301722000_4.1.e003038.25","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kws412"},{"key":"2026011207301722000_4.1.e003038.26","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181c1ea43"},{"key":"2026011207301722000_4.1.e003038.27","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e3181ba333c"},{"key":"2026011207301722000_4.1.e003038.28","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39335.541782.AD"},{"key":"2026011207301722000_4.1.e003038.29","doi-asserted-by":"crossref","first-page":"4180","DOI":"10.1093\/eurheartj\/ehab505","article-title":"Long-term night shift work is associated with the risk of atrial fibrillation and coronary heart disease","volume":"42","author":"Wang","year":"2021","journal-title":"Eur Heart J"},{"key":"2026011207301722000_4.1.e003038.30","doi-asserted-by":"publisher","DOI":"10.2337\/dc17-1933"},{"key":"2026011207301722000_4.1.e003038.31","doi-asserted-by":"crossref","first-page":"16","DOI":"10.1186\/s12916-023-03240-8","article-title":"Associations between long-term night shift work and incidence of chronic obstructive pulmonary disease: a prospective cohort study of 277,059 UK Biobank participants","volume":"22","author":"Li","year":"2024","journal-title":"BMC Med"},{"key":"2026011207301722000_4.1.e003038.32","doi-asserted-by":"crossref","first-page":"631","DOI":"10.1093\/qjmed\/hcae068","article-title":"Long-term night shift work, genetic predisposition and risk of incident asthma: a prospective cohort study","volume":"117","author":"Hu","year":"2024","journal-title":"Qjm"},{"key":"2026011207301722000_4.1.e003038.33","doi-asserted-by":"crossref","DOI":"10.1186\/s12889-023-16204-7","article-title":"Association between night shift work and NAFLD: a prospective analysis of 281,280 UK Biobank participants","volume":"23","author":"Huang","year":"2023","journal-title":"BMC Public Health"},{"key":"2026011207301722000_4.1.e003038.34","doi-asserted-by":"crossref","first-page":"735","DOI":"10.1016\/j.jad.2024.03.134","article-title":"Night shift work, genetic risk, and the risk of depression: A prospective cohort study","volume":"354","author":"Chen","year":"2024","journal-title":"J Affect Disord"},{"key":"2026011207301722000_4.1.e003038.35","doi-asserted-by":"publisher","DOI":"10.1097\/ACI.0000000000000247"},{"key":"2026011207301722000_4.1.e003038.36","doi-asserted-by":"crossref","first-page":"4467","DOI":"10.3892\/mmr.2016.5791","article-title":"Occupational exposure to carcinogens: Benzene, pesticides and fibers (Review)","volume":"14","author":"Falzone","year":"2016","journal-title":"Mol Med Rep"},{"key":"2026011207301722000_4.1.e003038.37","doi-asserted-by":"publisher","DOI":"10.1038\/s12276-020-0394-0"},{"key":"2026011207301722000_4.1.e003038.38","doi-asserted-by":"publisher","DOI":"10.1164\/rccm.200606-872OC"},{"key":"2026011207301722000_4.1.e003038.39","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.588962"},{"key":"2026011207301722000_4.1.e003038.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.mrrev.2021.108365"},{"key":"2026011207301722000_4.1.e003038.41","doi-asserted-by":"crossref","first-page":"5619","DOI":"10.1038\/s41598-024-56250-8","article-title":"Noise annoyance and cardiovascular disease risk: results from a 10-year follow-up study","volume":"14","author":"Hahad","year":"2024","journal-title":"Sci Rep"},{"key":"2026011207301722000_4.1.e003038.42","doi-asserted-by":"publisher","DOI":"10.1038\/s41370-024-00642-5"},{"key":"2026011207301722000_4.1.e003038.43","doi-asserted-by":"crossref","DOI":"10.1186\/s12940-020-00641-7","article-title":"Sustainable solutions to mitigate occupational heat strain - an umbrella review of physiological effects and global health perspectives","volume":"19","author":"Morris","year":"2020","journal-title":"Environ Health"},{"key":"2026011207301722000_4.1.e003038.44","doi-asserted-by":"crossref","DOI":"10.3389\/fcvm.2023.1084611","article-title":"A systematic review and meta-analysis of cold exposure and cardiovascular disease outcomes","volume":"10","author":"Fan","year":"2023","journal-title":"Front Cardiovasc Med"},{"key":"2026011207301722000_4.1.e003038.45","doi-asserted-by":"crossref","DOI":"10.1111\/jsr.12710","article-title":"The impact of stress on sleep: Pathogenic sleep reactivity as a vulnerability to insomnia and circadian disorders","volume":"27","author":"Kalmbach","year":"2018","journal-title":"J Sleep Res"},{"key":"2026011207301722000_4.1.e003038.46","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuron.2019.03.013"},{"key":"2026011207301722000_4.1.e003038.47","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v20.i39.14126"}],"container-title":["BMJ Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjph-2025-003038","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T15:30:48Z","timestamp":1768231848000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjpublichealth.bmj.com\/lookup\/doi\/10.1136\/bmjph-2025-003038"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1]]},"references-count":47,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,1,12]]},"published-print":{"date-parts":[[2026,1]]}},"alternative-id":["10.1136\/bmjph-2025-003038"],"URL":"https:\/\/doi.org\/10.1136\/bmjph-2025-003038","relation":{},"ISSN":["2753-4294"],"issn-type":[{"value":"2753-4294","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1]]}}}