ORIGINAL RESEARCH article
Front. Public Health
Sec. Occupational Health and Safety
The association between shift work, occupational physical activity and Cardiovascular-kidney-metabolic syndrome: a cohort study in China
- XZ
Xiangran Zhang 1
- WW
Wanyu Wang 1
- HL
Haixia Lu 1
- CH
Changxue Huang 1
- YJ
Yuxin Jin 1
- MX
Manli Xiang 1
- CS
Cainan Sun 1
- DL
Di Li 2
- LC
Li Chen 2
- XW
Xiujuan Wu 2
- HS
Hongzhan Sun 3
- DZ
Dajun Zhang 2
- YL
Yulong Lian 1
1. Nantong University, Nantong, China
2. Karamay Central Hospital of Xinjiang, Karamay, China
3. Karamay Center Disease Control and Prevention, Karamay, China
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Abstract
Background: The relationship between shift work, occupational physical activity (OPA), and CKM syndrome remains unclear. The present study aimed to investigate the independent and joint associations of these two factors with CKM syndrome. Methods: This study conducted a baseline survey in 2013 and a follow-up in 2023, with a total of 690 workers finally enrolled. CKM syndrome was diagnosed according to the American Heart Association (AHA) criteria. Participants were classified into fixed day shifts and shift work, and OPA into light/moderate and heavy/very heavy groups. Poisson regression was adopted to explore the associations of shift work and OPA with CKM syndrome, as well as their joint effects. Result: Compared with fixed day shifts, shift work was associated with CKM syndrome (RR=1.568, 95% CI: 1.328–1.852); two-shift (RR=1.677, 95% CI: 1.391–2.022), three-shift (RR=1.502, 95% CI: 1.223–1.844), four-shift (RR=1.529, 95% CI: 1.235–1.892). The risk of CKM syndrome showed a dose-response relationship with cumulative night shift exposure. Workers with heavy or very heavy OPA had a higher risk of CKM syndrome (RR=1.432, 95% CI: 1.239–1.654) than those with light or moderate OPA. Conclusions: Both shift work and heavy or very heavy OPA increase the risk of CKM syndrome. The risk rises with increasing cumulative night shift exposure. Workers with both shift work and heavy or very heavy OPA have the highest risk. Therefore, early screening for CKM syndrome should be strengthened among shift workers and those with heavy OPA.
Summary
Keywords
ckm syndrome, cohort study, Joint effect, Occupational physical activity, shift work
Received
16 March 2026
Accepted
22 May 2026
Copyright
© 2026 Zhang, Wang, Lu, Huang, Jin, Xiang, Sun, Li, Chen, Wu, Sun, Zhang and Lian. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
*Correspondence: Yulong Lian
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