Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants

Cillekens, Bart; Huysmans, Maaike A.; Holtermann, Andreas; Mechelen, Willem van; Straker, Leon; Krause, Niklas; Beek, Allard J. van der; Coenen, Pieter

doi:10.5271/sjweh.3993

Cited by 65 publications

(61 citation statements)

References 80 publications

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“…The results from our study suggest that the ‘physical activity paradox’ applies even to associations between cardiovascular work intensity and musculoskeletal pain, complementing previous studies of cardiovascular health [ 2 , 3 , 4 ], cancer [ 5 ], and all-cause mortality [ 6 ]. Even though participants spent similar amounts of time in physical activity at work and during leisure (cf.…”

Section: Discussionsupporting

confidence: 85%

“…While it has consistently been shown that regularly engaging in high-intensity leisure-time physical activity (LTPA) is associated with positive health effects, occupational physical activity (OPA) with high intensity is associated with no beneficial, or even negative, health effects. This phenomenon, which is referred to as the ‘physical activity paradox’ [ 1 ], has been shown for various health outcomes such as cardiovascular health [ 2 , 3 , 4 ], some cancers [ 3 , 5 ], sleep quality [ 3 ], and all-cause mortality [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

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An Exploratory Study on the Physical Activity Health Paradox—Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers

Merkus

Coenen

Forsman

et al. 2022

IJERPH

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Using a novel approach, this exploratory study investigated whether the physical activity (PA) paradox extends to cardiovascular load and musculoskeletal pain. At baseline, 1–2 days of 24 h heart rate was assessed in 72 workers from construction and healthcare. Workers then reported pain intensity in 9 body regions (scale 0–3) every 6 months for two years. Using a novel ilr structure in compositional data analysis, time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e., ≥20 %HRR, ≥30 %HRR, and ≥40 %HRR, were regressed on to the 2-year average of musculoskeletal pain (sum of 9 pain scores; scale 0–27). Analyses were stratified for several important variables. Workers spending more time in physical activity at work had higher pain, while workers with more time in physical activity during leisure had less pain (i.e., the PA paradox), but none of the associations were statistically significant. Higher aerobic capacity and lower body mass index lowered the pain score among those with higher physical activity at work. This exploratory study suggests that the PA paradox may apply to musculoskeletal pain and future studies with larger sample sizes and additional exposure analyses are needed to explain why this occurs.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

An Exploratory Study on the Physical Activity Health Paradox—Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers

Merkus

Coenen

Forsman

et al. 2022

IJERPH

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“…PhenoAgeAA was associated with job strain, active work-compared to reference low strain-in both AGING OPA may not be associated with good health, in contrast with leisure-time physical activity [37].…”

Section: Phenoage and Grimaage Aamentioning

confidence: 81%

Work-related stress and well-being in association with epigenetic age acceleration: A Northern Finland Birth Cohort 1966 Study

Sterrantino

Fiorito

d’Errico

et al. 2022

Aging

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Recent evidence indicates consistent association of low socioeconomic status with epigenetic age acceleration, measured from DNA methylation. As work characteristics and job stressors are crucial components of socioeconomic status, we investigated their association with various measures of epigenetic age acceleration. The study population included employed and unemployed men and women (n=604) from the Northern Finland Birth Cohort 1966. We investigated the association of job strain, effort-reward imbalance and work characteristics with five biomarkers of epigenetic aging (Hannum, Horvath, PhenoAge, GrimAge, and DunedinPoAm). Our results indicate few significant associations between work stress indicators and epigenetic age acceleration, limited to a range of ±2 years, and smoking recording the highest effect on GrimAge age acceleration biomarker between current and no smokers (median difference 4.73 years (IQR 1.18, 8.41). PhenoAgeAA was associated with job strain active work (β=-1.301 95%CI -2.391, -0.212), slowing aging of less than 1.5 years, and working as white-collar slowed aging six months (GrimAgeAA β=-0.683, 95%CI -1.264, -0.102) when compared to blue collars. Association was found for working for more than 40 hours per week that increased the aging over 1.5 years, (HorvathAA β =2.058 95%CI 0.517,3.599, HannumAA β=1.567, 95%CI 0.415,2.719). The pattern of associations was different between women and men and some of the estimated effects are inconsistent with current literature. Our results provide the first evidence of association of work conditions with epigenetic aging biomarkers. However, further epidemiological research is needed to fully understand how work-related stress affects epigenetic age acceleration in men and women in different societies.

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“…The favourable effects of leisure time physical activity on the risk of cardiovascular disease (CVD) and mortality are well established [ 1 – 7 ]. In contrast, occupational physical activity may increase the risk of both CVD-specific and all-cause mortality, at least among men [ 8 – 10 ], and evidence on the association between occupational physical activity and risk factors for CVD, risk of ischemic heart disease (IHD), and major cardiovascular events is inconclusive [ 9 – 14 ]. The contrasting health effects from physical activity during leisure and work have been referred to as the physical activity health paradox [ 15 ].…”

Section: Introductionmentioning

confidence: 99%

The physical activity health paradox and risk factors for cardiovascular disease: A cross-sectional compositional data analysis in the Copenhagen City Heart Study

et al. 2022

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Background Studies indicate that physical activity during leisure and work have opposite associations with cardiovascular disease (CVD) risk factors, referred to as the physical activity health paradox. We investigated how sedentary behaviour and physical activity types during leisure and work are associated with systolic blood pressure (SBP), waist circumference (WC), and low-density lipoprotein cholesterol (LDL-C) in an adult general population sample using compositional data analysis. Methods Participants wore accelerometers for 7 days (right thigh and iliac crest; 24 h/day) and had their SBP, WC, and LDL-C measured. Accelerometer data was analysed using the software Acti4 to derive daily time spent in sedentary behaviour and physical activity types. The measure of association was quantified by reallocating time between sedentary behaviour and 1) walking, and 2) high-intensity physical activity (HIPA; sum of climbing stairs, running, cycling, and rowing), during both domains. Results In total, 652 participants were included in the analyses (median wear time: 6 days, 23.8 h/day). During leisure, the results indicated that less sedentary behaviour and more walking or more HIPA was associated with lower SBP, while during work, the findings indicated an association with higher SBP. During both domains, the findings indicated that less sedentary behaviour and more HIPA was associated with a smaller WC and lower LDL-C. However, the findings indicated less sedentary behaviour and more walking to be associated with a larger WC and higher LDL-C, regardless of domain. Conclusions During leisure, less sedentary behaviour and more walking or HIPA seems to be associated with a lower SBP, but, during work, it seems to be associated with a higher SBP. No consistent differences between domains were observed for WC and LDL-C. These findings highlight the importance of considering the physical activity health paradox, at least for some risk factors for CVD.

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Physical activity at work may not be health enhancing. A systematic review with meta-analysis on the association between occupational physical activity and cardiovascular disease mortality covering 23 studies with 655 892 participants

Abstract: While the beneficial association between leisure-time physical activity and cardiovascular disease (CVD) mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality.

Cited by 65 publications

References 80 publications

An Exploratory Study on the Physical Activity Health Paradox—Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers

An Exploratory Study on the Physical Activity Health Paradox—Musculoskeletal Pain and Cardiovascular Load during Work and Leisure in Construction and Healthcare Workers

Work-related stress and well-being in association with epigenetic age acceleration: A Northern Finland Birth Cohort 1966 Study

The physical activity health paradox and risk factors for cardiovascular disease: A cross-sectional compositional data analysis in the Copenhagen City Heart Study

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