Objectively measured occupational physical activity in blue-collar workers: What is the role of job type, gender and psychosocial resources?

The Association Between Depressive Symptoms and the Weekly Duration of Physical Activity Subset by Intensity and Domain: Population-Based, Cross-Sectional Analysis of the National Health and Nutrition Examination Survey From 2007 to 2018

BACKGROUND

Prior literature suggests a dose-response relationship between physical activity (PA) and depressive symptoms. The intensity and domain of PA are suggested to be critical to its protective effect against depression; however, existing literature has shown mixed results.

OBJECTIVE

The purpose of this population-based study is to examine the associations between depressive symptoms and weekly duration of (1) total PA and (2) PA subset by intensity, domain, or both.

METHODS

A cross-sectional analysis of National Health and Nutrition Examination Survey data from 2007 to 2018 was conducted using multivariable logistic and linear regression models and survey weights. Participants (N=29,730) were 20 years and older and completed the Physical Activity Questionnaire and Depression Screener. The primary outcome was the presence of depressive symptoms, and the secondary outcomes were cognitive-affective and somatic symptoms of depression.

RESULTS

Participants (N=29,730) had a weighted mean age of 47.62 (SD 16.99) years, and 15,133 (51.34%) were female. On average, participants without depressive symptoms engaged in 10.87 hours of total PA per week, whereas participants with depressive symptoms engaged in 8.82 hours (P<.001). No significant associations were seen between the weekly duration of total PA and depressive symptom odds, somatic, or cognitive-affective symptoms (all P>.05). Participants with an increased weekly duration of recreational PA had decreases in depressive symptom odds (adjusted odds ratio [aOR] 0.965, 95% CI 0.944-0.986) and in somatic (adjusted coefficient [aβ]=-0.016, 95% CI -0.022 to -0.009) and cognitive-affective (aβ=-0.015, 95% CI -0.023 to -0.007) symptoms. When recreational PA was subset by intensity, participants with an increased weekly duration of vigorous-intensity recreational PA had decreases in depressive symptom odds (aOR 0.926, 95% CI 0.883-0.972) and in somatic (aβ=-0.021, 95% CI -0.032 to -0.010) and cognitive-affective (aβ=-0.022, 95% CI -0.035 to -0.009) symptoms. However, significant associations were not seen for the weekly duration of work-related, moderate- or vigorous-intensity PAs (all P>.05).

CONCLUSIONS

Findings suggest that recreational, not work-related PA is associated with reduced symptoms of depression. Future studies should explore the impact of the different types and contexts of PA on depressive symptomatology.

Flemish critical care nurses' experiences regarding the influence of work-related demands on their health: a descriptive interpretive qualitative study

BACKGROUND

Critical care nurses (CCNs) around the globe face other health challenges compared to their peers in general hospital nursing. Moreover, the nursing workforce grapples with persistent staffing shortages. In light of these circumstances, developing a sustainable work environment is imperative to retain the current nursing workforce. Consequently, this study aimed to gain insight into the recalled experiences of CCNs in dealing with the physical and psychosocial influences of work-related demands on their health while examining the environments in which they operate. The second aim was to explore the complex social and psychological processes through which CCNs navigate these work-related demands across various CCN wards.

METHODS

A qualitative study following Thorne's interpretive descriptive approach was conducted. From October 2022 to April 2023, six focus groups were organised. Data from a diverse sample of 27 Flemish CCNs engaged in physically demanding roles from three CCN wards were collected. The Qualitative Analysis Guide of Leuven was applied to support the constant comparison process.

RESULTS

Participants reported being exposed to occupational physical activity, emotional, quantitative, and cognitive work-related demands, adverse patient behaviour, and poor working time quality. Exposure to these work-related demands was perceived as harmful, potentially resulting in physical, mental, and psychosomatic strain, as well as an increased turnover intention. In response to these demands, participants employed various strategies for mitigation, including seeking social support, exerting control over their work, utilising appropriate equipment, recognising rewards, and engaging in leisure-time physical activity.

CONCLUSIONS

CCNs' health is challenged by work-related demands that are not entirely covered by the traditional quantitative frameworks used in research on psychologically healthy work. Therefore, future studies should focus on improving such frameworks by exploring the role of psychosocial and organisational factors in more detail. This study has important implications for workplace health promotion with a view on preventing work absenteeism and drop-out in the long run, as it offers strong arguments to promote sufficient risk management strategies, schedule flexibility, uninterrupted off-job recovery time, and positive management, which can prolong the well-being and sustainable careers of the CCN workforce.

Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature

BACKGROUND

Physical activity positively influences cardiovascular health. Results from male-dominated physically active occupations suggest that a high level of occupational physical activity may be detrimental to cardiovascular health. This observation is referred to as the physical activity paradox. Whether this phenomenon can also be observed in female-dominated occupations remains unknown.

OBJECTIVE

We aimed to provide an overview of (1) leisure-time and occupational physical activity in healthcare workers. Therefore, we reviewed studies (2) to assess the relationship between the two physical activity domains and analyzed (3) their effects on cardiovascular health outcomes in relation to the paradox.

METHODS

Five databases (CINAHAL, PubMed, Scopus, Sportdiscus, Web of Science) were systematically searched. Both authors independently screened the titles, abstracts, and full texts and assessed the quality of the studies using the National Institutes of Health's quality assessment tool for observational cohort and cross-sectional studies. All studies that assessed leisure-time and occupational physical activity in healthcare workers were included. The two authors independently rated the risk of bias using the ROBINS-E tool. The body of evidence was evaluated using the GRADE approach.

RESULTS

The review included 17 studies that assessed the leisure-time and occupational physical activity of people working in healthcare, determined the relationship between the domains (n = 7) and/or examined their effects on the cardiovascular system (n = 5). Measurements for leisure-time and occupational physical activity varied between studies. Leisure-time physical activity typically ranged between low and high intensity, with a short duration (approx. 0.8-1.5 h). Occupational physical activity was typically performed at light to moderate intensity with a very long duration (approx. 0.5-3 h). Moreover, leisure-time and occupational physical activity were almost negatively related. The few studies investigating effects on cardiovascular parameters revealed a rather unfavorable effect of occupational physical activity, while leisure-time physical activity was beneficial. The study quality was rated as fair and the risk of bias was moderate to high. The body of evidence was low.

CONCLUSIONS

This review confirmed that leisure-time and occupational physical activity of healthcare workers are opposed in their duration and intensity. Moreover, leisure-time and occupational physical activity seem to be negatively related and should be analyzed according to their relation to each other in specific occupations. Furthermore, results support the relationship between the paradox and cardiovascular parameters.

REGISTRATION

Preregistered on PROSPERO (CRD42021254572). Date of registration on PROSPERO: 19 May 2021.

TWEETABLE ABSTRACT

Does occupational physical activity adversely affect the cardiovascular health of healthcare workers in comparison to leisure-time physical activity?

Occupational and Leisure-Time Physical Activity Have Different Relationships With Health: A Cross-Sectional Survey Study of Working Nurses

BACKGROUND

Recent research has focused on the potential benefits of physical activity in occupational settings in addition to leisure time. However, occupational physical activity (OPA) differs substantially for occupations that require heavy and repetitive physical work, such as nursing. We explored associations between leisure time and OPA and health outcomes in working nurses and midwives.

METHODS

Nurses who were enrolled in the Fit For the Future study (New South Wales, Australia) and who completed physical activity questionnaires (n = 4343) were classified according to high (HO) or low (LO) occupational and high (HL) or low (LL) leisure-time physical activity (LTPA): HO performed walking/heavy labor most/all of the time at work; HL met the guidelines of 150 minutes per week moderate to vigorous LTPA, creating 4 categories: HOLL, HOHL, LOHL, and LOLL.

RESULTS

HL predicted better self-rated health (unstandardized B = 0.51, 95% confidence interval, 0.44 to 0.57) and lower likelihood of ≥3 sick days in the past 12 months (OR: 0.71, 95% confidence interval, 0.61 to 0.83), whereas HO predicted higher likelihood of ≥3 sick days (OR: 1.17, 95% confidence interval, 1.01 to 1.35), adjusting for all variables.

CONCLUSIONS

OPA may not confer the same health benefits as LTPA for nurses. Health-promoting interventions should emphasize the importance of achieving adequate moderate to vigorous LTPA for all, including those undertaking substantial OPA.

What Determines Step-Rate at Work? An Investigation of Factors at the Shift, Worker, Ward, and Nursing Home Levels in Eldercare

Objectives

Current knowledge on the determinants of step-rate at different organizational levels is limited. Thus, our aim was to identify, in eldercare, at what workplace level differences in step-rate occur and to identify determinants of workers’ step-rate at these levels.

Methods

Participants were 420 eldercare workers from 17 nursing homes (126 wards) in Denmark. Accelerometry was used to assess step-rate (steps per hour) of workers over multiple shifts. We assessed various determinants at different levels of the workplace, i.e. at the (i) shift, (ii) worker, (iii) ward, and (iv) nursing home levels. Variance components analysis identified the percentage contribution to total variance in step-rate from each respective level. Multi-level linear regression modelling was used to investigate the association between candidate determinants at each level and step-rate.

Results

Differences in eldercare workers’ step-rate occurred primarily between shifts (within workers; 44.9%) and between workers (within wards; 49.1%). A higher step-rate was associated with: (i) weekend and evening shifts (versus weekday/day); (ii) job as a care helper (versus care aide) and an increased proportion of time spent on direct care tasks; (iii) working in a somatic ward (versus dementia), an increased resident–staff ratio and permission to take unscheduled breaks; and (iv) lack of elevators.

Conclusions

We found that nearly all variability in step-rate in eldercare work occurs between shifts (within workers) and between workers (within wards). The main determinants of step-rate were related to the type of shift, type of work tasks, staffing ratio, break policy, and availability of elevators.

Relationship Between Employment Status, Reported Physical Activity, and Sitting Time During COVID-19 Pandemic

BACKGROUND

The COVID-19 pandemic has changed our working environment and divided workers into essential or nonessential statuses. Employment status is a major factor determining the amount of physical activity performed. Our purpose was to understand how employment status affects physical activity and sitting time.

METHODS

Between April 13 and May 4, 2020, 735 full-time employed individuals responded to a survey investigating daily life and overall health during the COVID-19 pandemic. Participants reported how much physical activity they had performed in the last 7 days. Multiple linear regressions were performed for physical activity and sitting time.

RESULTS

Physical activity was not associated with employment status. An interaction effect between hours worked and employment status was found for sitting time.

CONCLUSIONS

Employment status was not related to physical activity; however, it did affect the amount of time spent sitting, with nonessential employees sitting more and working more hours than essential employees. Because greater amounts of daily total sitting time have been associated with increased risk of all-cause mortality, it is important that increased sitting time be attenuated by greater physical activity.

Head-worn displays and job content: A systematic literature review

Despite the emergence of head-worn displays at work around forty years ago, few studies have appeared about their impact on job content. To investigate this, a systematic literature review was conducted on these devices and job content, defined as job demands and controls. In total, 3481 studies were identified using five scientific databases. After applying selection criteria, reference searches, citation tracking and an in-depth reading, 28 studies were selected for review. Remarkably, the findings of these studies showed contrasting results. Both increases and decreases in job demands and controls were identified. We distinguished across studies two opposite approaches for the deployment of these devices, i.e. a supportive and a directive approach.

Thigh-worn accelerometry for measuring movement and posture across the 24-hour cycle: a scoping review and expert statement

Introduction

The Prospective Physical Activity Sitting and Sleep consortium (ProPASS) is an international collaboration platform committed to harmonise thigh-worn accelerometry data. The aim of this paper is to (1) outline observational thigh-worn accelerometry studies and (2) summarise key strategic directions arising from the inaugural ProPASS meeting.

Methods

(1) We performed a systematic scoping review for observational studies of thigh-worn triaxial accelerometers in free-living adults (n≥100, 24 hours monitoring protocols). (2)Attendees of the inaugural ProPASS meeting were sent a survey focused on areas related to developing ProPASS: important terminology (Q1); accelerometry constructs (Q2); advantages and distinct contribution of the consortium (Q3); data pooling and harmonisation (Q4); data access and sharing (Q5 and Q6).

Results

(1) Eighty eligible articles were identified (22 primary studies; n~17 685). The accelerometers used most often were the ActivPAL3 and ActiGraph GT3X. The most commonly collected health outcomes were cardiometabolic and musculoskeletal. (2) None of the survey questions elicited the predefined 60% agreement. Survey responses recommended that ProPASS: use the term physical behaviour or movement behaviour rather than 'physical activity' for the data we are collecting (Q1); make only minor changes to ProPASS's accelerometry construct (Q2); prioritise developing standardised protocols/tools (Q4); facilitate flexible methods of data sharing and access (Q5 and Q6).

Conclusions

Thigh-worn accelerometry is an emerging method of capturing movement and posture across the 24 hours cycle. In 2020, the literature is limited to 22 primary studies from high-income western countries. This work identified ProPASS's strategic directions-indicating areas where ProPASS can most benefit the field of research: use of clear terminology, refinement of the measured construct, standardised protocols/tools and flexible data sharing.

Identification of gender differences in the factors influencing shoulders, neck and upper limb MSD by means of multivariate adaptive regression splines (MARS)

In the present research, models based on multivariate adaptive regression splines (MARS) are proposed to study the influence of gender in the factors affecting the development of shoulders, neck and upper limb MSD. Two different MARS models, corresponding to men and women, are constructed to identify variables with the strongest effect on the target MSD. Both models are capable to predict successfully the occurrence of the studied disorders. Men seem to be more vulnerable to physical risk factors and some other working conditions, whereas women appear to be more affected by psychosocial risk factors and activities carried out outside their working hours. According to the results, gender needs to be considered to ensure the success and effectiveness of ergonomic interventions on the whole working population.