Health, lifestyle and care barriers of night shift workers in Japan.

BACKGROUND: Night shift work is increasingly prevalent and has been linked to various health risks. However, nationally representative evidence regarding disease burden, lifestyle behaviours and healthcare access among night shift workers remains scarce. AIMS: To examine the associations between night shift work and chronic disease burden, lifestyle patterns and barriers to care in a large Japanese population. METHODS: We analysed data from the Japan 'COVID-19 and Society' Internet Survey, a nationwide, web-based, self-reported questionnaire conducted in September-October 2023. Among 33 000 respondents, 28 481 provided valid responses and were included in this cross-sectional study. Night shift workers were identified by reported frequency of working between 10.00 p.m. and 5.00 a.m. Multivariable logistic regression models with inverse probability weighting were used to assess associations with health outcomes, adjusting for demographics and socioeconomic status. RESULTS: A total of 6486 respondents (22.8%) were classified as night shift workers. Night shifters were more likely to report several chronic conditions, including diabetes, coronary artery disease, stroke, and chronic respiratory, kidney, liver diseases and cancer. Furthermore, night shift workers were more likely to sleep less and skip breakfast, but less likely to report snacking or physical inactivity. They also faced more healthcare access issues, including missed annual checkups and postponed treatment. CONCLUSIONS: Night shift workers in Japan reported disproportionate chronic disease burdens and care access barriers. Tailored strategies are needed to support this vulnerable workforce.