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Quinn TD, Lane A, Pettee Gabriel K, Sternfeld B, Jacobs DR, Smith P, Barone Gibbs B. Associations between occupational physical activity and left ventricular structure and function over 25 years in CARDIA. Eur J Prev Cardiol 2024; 31:425-433. [PMID: 37950421 PMCID: PMC10911945 DOI: 10.1093/eurjpc/zwad349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 10/23/2023] [Accepted: 11/01/2023] [Indexed: 11/12/2023]
Abstract
AIMS Leisure time physical activity (LTPA) confers cardiovascular health benefits, while occupational physical activity (OPA) may have paradoxically negative health associations. This study tested the explanatory hypothesis that unfavourable cardiac remodelling may result from chronic OPA-induced cardiovascular strain. METHODS AND RESULTS Longitudinal associations of OPA and left ventricular (LV) structure and function were examined in 1462 participants {50.0% female, 56.4% White, aged 30.4 ± 3.4 years at baseline [Year 5 exam (1990-91)]} from the Coronary Artery Risk Development in Young Adults study. Left ventricular structure and function were measured as LV mass (LVMi), end-diastolic volume (LVEDVi), end-systolic volume (LVESVi), ejection fraction (LVEF), stroke volume (LVSVi), and e/a-wave ratio (EA ratio) via echocardiography at baseline and 25 years later. Occupational physical activity was reported at seven exams during the study period as months/year with 'vigorous job activities such as lifting, carrying, or digging' for ≥5 h/week. The 25-year OPA patterns were categorized into three trajectories: no OPA (n = 770), medium OPA (n = 410), and high OPA (n = 282). Linear regression estimated associations between OPA trajectories and echocardiogram variables at follow-up after adjusting for baseline values, individual demographic/health characteristics, and LTPA. Twenty-five-year OPA exposure was not significantly associated with LVMi, LVEDVi, LVSVi, or EA ratio (P > 0.05). However, higher LVESVi (β = 1.84, P < 0.05) and lower LVEF (β = -1.94, P < 0.05) were observed at follow-up among those in the high- vs. no-OPA trajectories. CONCLUSION The paradoxically adverse association of OPA with cardiovascular health was partially supported by null or adverse associations between high OPA and echocardiogram outcomes. Confirmation is needed using more precise OPA measures.
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Affiliation(s)
- Tyler D Quinn
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, 1 Medical Drive, Morgantown, WV 26506, USA
| | - Abbi Lane
- Department of Exercise Science, Arnold School of Public Health, University of South Carolina, 921 Assembly Street, Columbia, SC 29201, USA
- Department of Applied Exercise Science, School of Kinesiology, University of Michigan, 830 N University Ave, Ann Arbor, MI 48130, USA
| | - Kelley Pettee Gabriel
- Department of Epidemiology, The University of Alabama at Birmingham, 170 2nd Ave. South, RPHB 230J, Birmingham, AL 35294, USA
| | - Barbara Sternfeld
- Division of Research, Kaiser Permanente Northern California, 2000 Broadway, Oakland, CA 94611, USA
| | - David R Jacobs
- Mayo Professor of Public Health, Division of Epidemiology and Community Health, University of Minnesota, 1300 2nd Streetm Suite 300, Minneapolis, MN 55454, USA
| | - Peter Smith
- Institute for Work and Health, 400 University Avenue, Suite 1800, Toronto, ON, M5G 1S5, Canada
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON, M5T 3M7, Canada
- Department of Epidemiology and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC 3004, Australia
| | - Bethany Barone Gibbs
- Department of Epidemiology and Biostatistics, West Virginia University School of Public Health, 1 Medical Drive, Morgantown, WV 26506, USA
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Ekblom-Bak E, Ekblom B, Paulsson S, Wallin P, Väisänen D. Revisiting the physical activity paradox: the role of cardiorespiratory fitness in workers with high aerobic demands. Scand J Public Health 2024; 52:123-127. [PMID: 36732911 PMCID: PMC10913308 DOI: 10.1177/14034948221151137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 12/26/2022] [Accepted: 12/29/2022] [Indexed: 02/04/2023]
Abstract
In contrast to leisure time physical activity, occupational physical activity may have adverse health effects-a phenomenon known as the "Physical activity paradox". Characteristics such as long duration, low intensity, static and restricted movement, body position and insufficient recovery are possible explanations as to why physical activity in the occupational context may "wear one out" rather than provide health benefits. We emphasise the role of low cardiorespiratory fitness as a potential contributor to the physical activity paradox, and present data suggesting that only 25% to 50% of Swedish workers in occupations with higher aerobic demands may have "sufficient" cardiorespiratory fitness to maintain good health during their employment. More research is needed to fully understand the complexity of the role of other confounding factors when examining the relationship between cardiorespiratory fitness and occupational workload. However, we believe that there is an increasing need for general awareness amongst Swedish authorities, employees and employers of the potential health consequences of low levels of cardiorespiratory fitness, especially among workers with high occupational workloads. Importantly, when developing interventions targeting the working situation and/or cardiorespiratory fitness levels among workers, researchers should actively involve the relevant population in the design of the study in order to maximize the effect of the interventions on health outcomes.
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Affiliation(s)
- Elin Ekblom-Bak
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | - Björn Ekblom
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
| | - Sofia Paulsson
- HPI Health Profile Institute, Research Department, Danderyd, Sweden
| | - Peter Wallin
- HPI Health Profile Institute, Research Department, Danderyd, Sweden
| | - Daniel Väisänen
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Sweden
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Lee W, Lin JH, Howard N, Bao S. Physiological responses, trunk posture, and work pace in commercial building cleaning in Washington State: An observational field study. JOURNAL OF SAFETY RESEARCH 2023; 86:107-117. [PMID: 37718037 DOI: 10.1016/j.jsr.2023.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 01/25/2023] [Accepted: 05/17/2023] [Indexed: 09/19/2023]
Abstract
INTRODUCTION This study aimed to investigate whether work pace is a critical indicator for predicting a janitor's risk of work-related musculoskeletal disorders (WMSDs). METHOD Field measurements were obtained from commercial building janitors as well as the determination of work pace. Physiological responses collected were heart rate, energy expenditure (calories), activity level (METs), steps, trunk posture. Data were obtained using direct measurements, along with a time study, which was performed by shadowing 13 janitors in Washington State. The measured values were summarized descriptively, and five of the most common janitorial tasks were compared. The relationships between work pace and the physiological response variables were determined by calculating the Pearson product-moment correlation coefficients. RESULTS The highest average percent heart rate reserve (47.4%) was reported during restroom cleaning, while the highest activity and energy expenditure levels (3.6 METs and 217.1 calories/h) were reported for mopping. The top 90% of trunk flexion angles and the highest percentage of time in trunk flexion from 20° to 60° were recorded during restroom cleaning. Restroom cleaning showed the highest correlation between all the physiological response variables and work pace. In most of the tasks, a high work pace may have increased the degree and duration of severe trunk flexion. CONCLUSION Overall, when several tasks were considered, the extent of physiological responses, trunk joint angles, and exposure time to awkward postures tended to increase with an increase in work pace. PRACTICAL APPLICATIONS This study showed the feasibility of using the work pace measured from time studies as a predictive indicator of WMSDs risks. Using this information, managers may compose a schedule that can minimize WMSDs risks while considering actual work pace deviations that may impact a janitor's ability to complete assigned tasks properly within a shift.
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Affiliation(s)
- Wonil Lee
- Ergonomist, Safety & Health Assessment & Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Box 44330, Olympia, WA 98504, USA.
| | - Jia-Hua Lin
- Ergonomist, Safety & Health Assessment & Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Box 44330, Olympia, WA 98504, USA.
| | - Ninica Howard
- Ergonomist, Safety & Health Assessment & Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Box 44330, Olympia, WA 98504, USA.
| | - Stephen Bao
- Senior Epidemiologist, Safety & Health Assessment & Research for Prevention (SHARP) Program, Washington State Department of Labor and Industries, Box 44330, Olympia, WA 98504, USA.
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Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. Re: Cillekens B, Huysmans MA, Holtermann A, van Mechelen W, Straker L, Krause N, van der Beek AJ, Coenen P. 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. Scand J Work Environ Health. 2022;48(2):86-98. doi:10.5271/sjweh.3993. Scand J Work Environ Health 2023; 49:231-244. [PMID: 37000459 PMCID: PMC10621902 DOI: 10.5271/sjweh.4090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Indexed: 04/01/2023] Open
Abstract
Objectives Emerging evidence suggests contrasting health effects for leisure-time and occupational physical activity. In this systematic review, we synthesized and described the epidemiological evidence regarding the association between occupational physical activity and cardiovascular disease (CVD) mortality. Methods A literature search was performed in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews, from database inception to 17 April 2020. Articles were included if they described original observational prospective research, assessing the association between occupational physical activity and CVD mortality among adult workers. Reviews were included if they controlled for age and gender and at least one other relevant variable. We performed meta-analyses on the associations between occupational physical activity and CVD mortality. Results We screened 3345 unique articles, and 31 articles (from 23 studies) were described in this review. In the meta-analysis, occupational physical activity showed no significant association with overall CVD mortality for both males [hazard ratio (HR) 0.97, 95% confidence interval (CI) 0.84–1.12] and females (HR 0.97, 95% CI 0.82–1.15). Additional analysis showed that higher levels of occupational physical activity were non-significantly associated with a 9% increase in studies reporting on the outcome ischemic heart disease mortality (HR 1.09, 95% CI 0.82–1.43). Conclusions While the beneficial association between leisure-time physical activity and CVD mortality has been widely documented, occupational physical activity was not found to have a beneficial association with CVD mortality. This observation may have implications for our appreciation of the association between physical activity and health for workers in physically demanding jobs, as occupational physical activity may not be health enhancing.
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Affiliation(s)
| | | | | | | | | | | | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, VU University Medical Centre (VUmc), Van der Boechorststraat 7, 1081 BT, Amsterdam, The Netherlands.
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Korshøj M, Gupta N, Mortensen OS, Jørgensen MB, Holtermann A. Intensity of occupational physical activity in blue-collar workers: do self-reported rating and device-worn measurements agree? Eur J Appl Physiol 2022; 122:1293-1301. [PMID: 35267075 DOI: 10.1007/s00421-022-04920-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 02/17/2022] [Indexed: 11/03/2022]
Abstract
PURPOSE High intensity occupational physical activity (OPA) seem to aggravate health and increase risk of sick leave and early retirement. Most intensity of OPA monitoring has been self-reported, e.g. by rating of perceived exertion (RPE). However, no studies have investigated the precision and risk of bias in RPE reporting during free-living OPA. This study investigated the agreement between OPA intensity in percentage of the heart rate reserve (%HRR) estimated from RPE and device-measured heart rate (HR), and potential bias factors on this agreement. METHODS The CR10 scale measured RPE at work. The Actiheart monitor measured HR during 24-h a day for 2-4 days. Both RPE and device-worn HR were converted to %HRR. The difference between both %HRR and their limits of agreement was determined in a Bland Altman plot. To detect bias factors, the difference between both %HRR was regressed on age, sex, cardiorespiratory fitness, occupational lifting, medication, consequences of musculoskeletal disorders and the interactions between these factors with device-work %HRR. RESULTS Six hundred and twenty-three participants were included in the analysis. Mean difference between RPE-based and device-worn %HRR was 54.6% (SD 19.5). The limits of agreement were wide (11.6-90.1%HRR). Age (0.48%HRR, 95% CI 0.18-0.79) occupational lifting (9.84%HRR, 95% CI 3.85-15.83) and cardiorespiratory fitness (0.41%HRR, 95% CI 0.03-0.79) significantly biased the agreement between the estimations of OPA intensity. CONCLUSION RPE overestimated OPA intensity, and was biased by several factors. Device-worn %HRR should be preferred when evaluating OPA intensity among workers with physically demanding jobs.
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark. .,Department of Occupational and Social Medicine, Holbæk Sygehus, Part of Copenhagen University Hospital, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark.
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
| | - Ole Steen Mortensen
- Department of Occupational and Social Medicine, Holbæk Sygehus, Part of Copenhagen University Hospital, Gl. Ringstedvej 4B, 4300, Holbæk, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Marie Birk Jørgensen
- Occupational Health and Safety, Copenhagen Municipality, Enghavevej 82, 2450, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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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. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19052751. [PMID: 35270444 PMCID: PMC8910306 DOI: 10.3390/ijerph19052751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/25/2021] [Revised: 02/14/2022] [Accepted: 02/15/2022] [Indexed: 12/04/2022]
Abstract
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. The 2 year average of musculoskeletal pain (sum of 9 pain scores; scale 0–27) was regressed on time spent during work and leisure above three thresholds of percentage heart rate reserve (%HRR), i.e., ≥20 %HRR, ≥30 %HRR, and ≥40 %HRR, using a novel ilr structure in compositional data analysis. 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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Quinn TD, Kline CE, Nagle E, Radonovich LJ, Alansare A, Barone Gibbs B. Cardiovascular responses to physical activity during work and leisure. Occup Environ Med 2021; 79:94-101. [PMID: 34321351 DOI: 10.1136/oemed-2021-107551] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Accepted: 06/27/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Recent evidence suggests that occupational physical activity (OPA) is associated with adverse cardiovascular health, whereas leisure time physical activity is protective. This study explored explanatory physiological mechanisms. METHODS Nineteen males (68% white, age=46.6±7.9 years, body mass index=27.9±5.1 kg/m2) with high self-reported OPA wore activity (ActiGraph and activPAL) and heart rate (HR) monitors for 7 days and an ambulatory blood pressure (BP) monitor on one workday and one non-workday. Mixed effects models compared cardiovascular variables (24-hour, nocturnal, waking and non-work time HR and BP) and nocturnal HR variability (HRV) on workdays versus non-workdays. Additional models examined associations of daily activity (steps, light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA)) with cardiovascular variables. Workday by daily activity interactions were examined. RESULTS 24-hour and waking HR and diastolic BP as well as non-work diastolic BP were significantly higher on workdays versus non-workdays (p<0.05 for all). However, no difference in systolic BP or nocturnal HR or BP was observed between work and non-workdays (p>0.05 for all). Low-frequency and high-frequency power indices of nocturnal HRV were lower on workdays (p<0.05 for both). Daily steps and LPA were positively associated with 24-hour and waking HR on work and non-workdays. Significant interactions suggested MVPA increases HR and lowers nocturnal HRV during workdays, with the opposite effect on non-workdays. CONCLUSIONS Cardiovascular load was higher on workdays versus non-workdays with no compensatory hypotensive response following workdays. Daily MVPA may differentially affect ambulatory cardiovascular load and nocturnal HRV on workdays versus non-workdays, supporting the physical activity health paradox hypothesis.
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Affiliation(s)
- Tyler David Quinn
- National Personal Protective Technology Laboratory, National Institute for Occupational Safety and Health, Pittsburgh, Pennsylvania, USA .,Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Christopher E Kline
- Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Elizabeth Nagle
- Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Lewis J Radonovich
- Respiratory Health Division, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA
| | - Abdullah Alansare
- Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.,Department of Exercise Physiology, King Saud University, Riyadh, Saudi Arabia
| | - Bethany Barone Gibbs
- Health and Human Development, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Prince SA, Rasmussen CL, Biswas A, Holtermann A, Aulakh T, Merucci K, Coenen P. The effect of leisure time physical activity and sedentary behaviour on the health of workers with different occupational physical activity demands: a systematic review. Int J Behav Nutr Phys Act 2021; 18:100. [PMID: 34284795 PMCID: PMC8290554 DOI: 10.1186/s12966-021-01166-z] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 06/30/2021] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Although it is generally accepted that physical activity reduces the risk for chronic non-communicable disease and mortality, accumulating evidence suggests that occupational physical activity (OPA) may not confer the same health benefits as leisure time physical activity (LTPA). It is also unclear if workers in high OPA jobs benefit from LTPA the same way as those in sedentary jobs. Our objective was to determine whether LTPA and leisure time sedentary behaviour (LTSB) confer the same health effects across occupations with different levels of OPA. METHODS Searches were run in Medline, Embase, PsycINFO, ProQuest Public Health and Scopus from inception to June 9, 2020. Prospective or experimental studies which examined the effects of LTPA or LTSB on all-cause and cardiovascular mortality and cardiovascular disease, musculoskeletal pain, diabetes, metabolic syndrome, arrhythmias and depression among adult workers grouped by OPA (low OPA/sitters, standers, moderate OPA/intermittent movers, high OPA/heavy labourers) were eligible. Results were synthesized using narrative syntheses and harvest plots, and certainty of evidence assessed with GRADE. RESULTS The review includes 38 papers. Across all outcomes, except cardiovascular mortality, metabolic syndrome and atrial fibrillation, greater LTPA was consistently protective among low OPA, but conferred less protection among moderate and high OPA. For cardiovascular mortality and metabolic syndrome, higher levels of LTPA were generally associated with similar risk reductions among all OPA groups. Few studies examined effects in standers and none examined effects of LTSB across OPA groups. CONCLUSIONS Evidence suggests that LTPA is beneficial for all workers, but with larger risk reductions among those with low compared to high OPA jobs. This suggests that, in our attempts to improve the health of workers through LTPA, tailored interventions for different occupational groups may be required. More high-quality studies are needed to establish recommended levels of LTPA/LTSB for different OPA groups. PROTOCOL REGISTRATION PROSPERO # CRD42020191708 .
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Affiliation(s)
- Stephanie A Prince
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, 785 Carling Avenue, Ottawa, Ontario, K1A 0K9, Canada.
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada.
| | | | - Aviroop Biswas
- Institute for Work & Health, Toronto, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Tarnbir Aulakh
- School of Kinesiology and Health Studies, Queen's University, Kingston, Canada
| | | | - Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Development and Implementation of 'Just Right' Physical Behavior in Industrial Work Based on the Goldilocks Work Principle-A Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094707. [PMID: 33925078 PMCID: PMC8125316 DOI: 10.3390/ijerph18094707] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 11/17/2022]
Abstract
The Goldilocks Work Principle expresses that productive work should be redesigned to comprise physical behaviors of different intensities in a composition promoting workers' health and fitness. This study is the first to assess the feasibility of redesigning work in an industrial setting according to the Goldilocks Work Principle. We recruited workers (n = 20) from a brewery in Denmark, and we conducted a participatory 16-week intervention including a workshop and two consultations. The workshop aimed to support the workers in modifying their work, while the consultations assisted the eventual implementation. Feasibility was evaluated as per three aspects: (1) developing modifications of work, (2) implementing these modifications, and (3) changing physical behavior and self-reported fatigue, pain and energy. The three aspects were addressed through records completed by the workers, measurements of workers' physical behavior and intensity during 'control' workdays (i.e., usual work) and 'intervention' workdays (i.e., modified work), and self-reported fatigue, pain and energy level following both types of workday. Five modifications to work were developed, and three of these five modifications were implemented. To some extent, physical behavior and intensity changed as intended during 'intervention' workdays compared to 'control' workdays. Workers were also less fatigued, had less pain, and had more energy after 'intervention' workdays. These results suggest that it is feasible to develop and implement modified work based on the Goldilocks Work Principle among industrial workers. However, we also identified several barriers to the implementation of such modifications.
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The Relation between Domain-Specific Physical Behaviour and Cardiorespiratory Fitness: A Cross-Sectional Compositional Data Analysis on the Physical Activity Health Paradox Using Accelerometer-Assessed Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17217929. [PMID: 33137943 PMCID: PMC7662405 DOI: 10.3390/ijerph17217929] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 10/20/2020] [Accepted: 10/26/2020] [Indexed: 12/11/2022]
Abstract
In contrast to leisure time physical activity (LTPA), occupational physical activity (OPA) does not have similar beneficial health effects. These differential health effects might be explained by dissimilar effects of LTPA and OPA on cardiorespiratory fitness (CRF). This study investigated cross-sectional associations between different physical behaviours during both work and leisure time and CRF by using a Compositional Data Analysis approach. Physical behaviours were assessed by two accelerometers among 309 workers with various manual jobs. During work time, more sedentary behaviour (SB) was associated with higher CRF when compared relatively to time spent on other work behaviours, while more SB during leisure time was associated with lower CRF when compared to other leisure time behaviours. Reallocating more time to moderate-to-vigorous physical activity (MVPA) from the other behaviours within leisure time was positively associated with CRF, which was not the case for MVPA during work. The results of our study are in line with the physical activity health paradox and we call for further study on the interaction between LTPA and OPA by implementing device-worn measures in a longitudinal design. Our results highlight the need for recommendations to take into account the different effects of OPA and LTPA on CRF.
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Lerche AF, Vilhelmsen M, Schmidt KG, Kildedal R, Launbo N, Munch PK, Lidegaard M, Jacobsen SS, Rasmussen CL, Mathiassen SE, Straker L, Holtermann A. Can Childcare Work Be Designed to Promote High Intensity Physical Activity for Improved Fitness and Health? A Proof of Concept Study of the Goldilocks Principle. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207419. [PMID: 33053791 PMCID: PMC7600739 DOI: 10.3390/ijerph17207419] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Revised: 09/18/2020] [Accepted: 10/04/2020] [Indexed: 12/12/2022]
Abstract
Childcare workers are reported to have high variation in physical activity during work hours, but also to sit for about half of the workday and have almost no high intensity physical activity (HIPA). No study has investigated if their work can be re-designed to introduce HIPA, thus promoting fitness and health according to the Goldilocks principle. This study investigated the feasibility of designing pedagogical games (‘Goldilocks-games’) intended to lead to more HIPA. Heart rate was measured in nineteen childcare workers during Goldilocks-games, and compared to measurements during a regular workday. Worker perceptions of feasibility, and researcher observations of contextual factors were also collected. The Goldilocks-games (33 min) elicited significantly more HIPA (18/33 min) compared to the most active period of equal length on a regular workday (0.5/33 min). Seventy-four-percent of the childcare workers reported that it was feasible to integrate the Goldilocks-games pedagogically, and seventy-two-percent could see themselves using them. Thus, we found it possible to re-design a work task in childcare according to the Goldilocks principle so that it leads to substantial time with HIPA. The sustainability of Goldilocks-games in childcare, and their effectiveness in improving fitness and health among childcare workers, needs to be tested in further studies.
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Affiliation(s)
- Anders Fritz Lerche
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, 5230 Odense, Denmark
- Correspondence:
| | - Maja Vilhelmsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Kathrine Greby Schmidt
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Rasmus Kildedal
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Natja Launbo
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Pernille Kold Munch
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Mark Lidegaard
- Novo Nordisk Health & Safety, Novo Nordisk A/S, 2880 Bagsværd, Denmark;
| | - Sandra Schade Jacobsen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
| | - Charlotte Lund Rasmussen
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
| | - Svend Erik Mathiassen
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, 801 76 Gävle, Sweden;
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, WA 6102, Australia;
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, 2100 Copenhagen, Denmark; (M.V.); (K.G.S.); (R.K.); (N.L.); (P.K.M.); (S.S.J.); (C.L.R.); (A.H.)
- Department of Public Health, Section of Social Medicine, University of Copenhagen, 1165 Copenhagen, Denmark
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12
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Sotrate Gonçalves J, de Oliveira Sato T. Factors associated with musculoskeletal symptoms and heart rate variability among cleaners - cross-sectional study. BMC Public Health 2020; 20:774. [PMID: 32448172 PMCID: PMC7247127 DOI: 10.1186/s12889-020-08928-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 05/17/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The professionals who perform cleaning activity constitute a major economic sector in Brazil. Cleaners may develop health problems related to the musculoskeletal and cardiovascular systems. It is necessary to understand the working and health conditions of cleaners in Brazil. Thus, the aim of this study was to identify factors associated with musculoskeletal symptoms and heart rate variability (HRV) among cleaners. METHODS A cross-sectional study conducted at a public higher education institution with 45 outsourced cleaners following approval from the institutional ethics committee. The participants answered a questionnaire addressing sociodemographic, occupational and health data, the Nordic Musculoskeletal Questionnaire, the Physical Activity Questionnaire (work and leisure) and the short version of the Copenhagen Psychosocial Questionnaire. Clinical data (height, body mass, waist-to-hip ratio and blood pressure) and heart rate variability (HRV) were also collected. Logistic and linear regression models were created to identify factors associated with symptoms and HRV. RESULTS The sample consisted of women (100%) predominantly older than 50 years of age (44%), without a conjugal life (64%), with three or more children (59%), low educational level (58%) and who worked less than 12 months at the company (87%). Systemic arterial hypertension (23%) was the most reported health problem. The highest frequency of musculoskeletal symptoms was identified in the lower limbs (ankles/feet: 31% in the previous 12 months and 24% in the previous 7 days; knees: 31% in the previous 12 months and 20% in the previous 7 days). Moreover, the workers reported not practicing physical activity during leisure time (84%). Psychosocial aspects indicated health risks for the dimensions "influence at work" (74%), "burnout" (59%) and "stress" (52%). Associations were found between ankle/foot symptoms and body mass index, shoulder symptoms and predictability, and knee symptoms and self-rated health and burnout. HRV indices were associated with age. CONCLUSIONS This study outlined the profile of female cleaners and identified risk factors. The workers exhibited musculoskeletal symptoms, which were associated with the body mass index and some psychosocial factors. HRV indices were associated with age. Thus, health promotion and prevention measures should be taken to benefit this population of workers.
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Affiliation(s)
- Josiane Sotrate Gonçalves
- Physical Therapy Department, Laboratory of Preventive Physical Therapy and Ergonomics (LAFIPE), Physical Therapy Postgraduate Program, Federal University of São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil
| | - Tatiana de Oliveira Sato
- Physical Therapy Department, Laboratory of Preventive Physical Therapy and Ergonomics (LAFIPE), Physical Therapy Postgraduate Program, Federal University of São Carlos, Rodovia Washington Luís, km 235, Monjolinho, São Carlos, SP, 13565-905, Brazil.
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13
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Holtermann A, Straker L, Lee IM, van der Beek AJ, Stamatakis E. Long overdue remarriage for better physical activity advice for all: bringing together the public health and occupational health agendas. Br J Sports Med 2020; 54:1377-1378. [PMID: 32376672 DOI: 10.1136/bjsports-2019-101719] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/15/2020] [Indexed: 11/03/2022]
Affiliation(s)
- Andreas Holtermann
- Department of musculoskeletal disorders and physical workload, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Leon Straker
- School of Physiotherapy and Exercise Science, Curtin University, Perth, Western Australia, Australia
| | - I-Min Lee
- Division of Preventive Medicine, Brigham & Women's Hospital and Harvard Medical School; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Allard J van der Beek
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, Netherlands
| | - Emmanuel Stamatakis
- Charles Perkins Centre, Faculty of Medicine and Health, School of Health Sciences, University of Sydney, Sydney, New South Wales, Australia
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Zeiher J, Duch M, Kroll LE, Mensink GBM, Finger JD, Keil T. Domain-specific physical activity patterns and cardiorespiratory fitness among the working population: Findings from the cross-sectional German Health Interview and Examination Survey. BMJ Open 2020; 10:e034610. [PMID: 32345698 PMCID: PMC7213860 DOI: 10.1136/bmjopen-2019-034610] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2019] [Revised: 03/06/2020] [Accepted: 03/12/2020] [Indexed: 01/02/2023] Open
Abstract
OBJECTIVES This study aimed to investigate associations between occupational physical activity patterns (physical work demands linked to job title) and leisure time physical activity (assessed by questionnaire) with cardiorespiratory fitness (assessed by exercise test) among men and women in the German working population. DESIGN Population-based cross-sectional study. SETTING Two-stage cluster-randomised general population sample selected from population registries of 180 nationally distributed sample points. Information was collected from 2008 to 2011. PARTICIPANTS 1296 women and 1199 men aged 18-64 from the resident working population. OUTCOME MEASURE Estimated low maximal oxygen consumption ([Formula: see text]), defined as first and second sex-specific quintile, assessed by a standardised, submaximal cycle ergometer test. RESULTS Low estimated [Formula: see text] was strongly linked to low leisure time physical activity, but not occupational physical activity. The association of domain-specific physical activity patterns with low [Formula: see text] varied by sex: women doing no leisure time physical activity with high occupational physical activity levels were more likely to have low [Formula: see text] (OR 6.54; 95% CI 2.98 to 14.3) compared with women with ≥2 hours of leisure time physical activity and high occupational physical activity. Men with no leisure time physical activity and low occupational physical activity had the highest odds of low [Formula: see text] (OR 4.37; 95% CI 2.02 to 9.47). CONCLUSION There was a strong association between patterns of leisure time and occupational physical activity and cardiorespiratory fitness within the adult working population in Germany. Women doing no leisure time physical activity were likely to have poor cardiorespiratory fitness, especially if they worked in physically demanding jobs. However, further investigation is needed to understand the relationships between activity and fitness in different domains. Current guidelines do not distinguish between activity during work and leisure time, so specifying leisure time recommendations by occupational physical activity level should be considered.
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Affiliation(s)
- Johannes Zeiher
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Maurice Duch
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
- Department of Sports and Health Sciences, University of Potsdam, Potsdam, Brandenburg, Germany
| | - Lars E Kroll
- Department for Health Services Research, System Analysis and Data Science, Central Research Institute of Ambulatory Health Care, Berlin, Germany
| | - Gert B M Mensink
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Jonas D Finger
- Department of Epidemiology and Health Monitoring, Robert Koch Institut, Berlin, Germany
| | - Thomas Keil
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Bayern, Germany
- Institute for Social Medicine, Epidemiology and Health Economics, Charité Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Würzburg, Würzburg, Germany
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15
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Physical performances show conflicting associations in aged manual workers. Sci Rep 2020; 10:2254. [PMID: 32042126 PMCID: PMC7010773 DOI: 10.1038/s41598-020-59050-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Accepted: 01/14/2020] [Indexed: 12/13/2022] Open
Abstract
Ageing is associated with a decrease in physical performance implying that aged manual workers may be unable to match the physical requirements of their jobs. In this cross-sectional study, 96 male manual workers aged 51–72 years were recruited. Outcomes included handgrip strength (HGS), fat-free mass (FFM), fat percentage, cardiorespiratory fitness (\documentclass[12pt]{minimal}
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\begin{document}$$\dot{{\rm{V}}}$$\end{document}V˙O2max), forced vital capacity (FVC), forced expiratory volume after 1 s (FEV1), spinal flexibility, sit-to-stand test performance and static balance. Covariates included height, smoking habits, leisure-time physical activity and systemic inflammation from blood samples. Outcomes were also compared with general populations. Age was negatively related to FFM and FEV1, whereas static balance (velocity of displacement) was positively associated with age. Greater HGS, but poorer \documentclass[12pt]{minimal}
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\begin{document}$$\dot{{\rm{V}}}$$\end{document}V˙O2max and FEV1/FEV ratio were found compared with general populations. Age was negatively related with physical performances although a large part of the variance in performance could be explained by factors other than age such as smoking and systemic inflammation. The manual workers had greater muscle strength but had poorer cardiorespiratory fitness and lung function when compared with general populations. Specific health interventions targeting specifically cardiorespiratory fitness, lung function, and balance may be needed to maintain physical performances among manual workers.
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Gupta N, Hallman DM, Dumuid D, Vij A, Rasmussen CL, Jørgensen MB, Holtermann A. Movement behavior profiles and obesity: a latent profile analysis of 24-h time-use composition among Danish workers. Int J Obes (Lond) 2019; 44:409-417. [PMID: 31341260 PMCID: PMC6997119 DOI: 10.1038/s41366-019-0419-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2018] [Revised: 05/07/2019] [Accepted: 05/26/2019] [Indexed: 11/10/2022]
Abstract
BACKGROUND/OBJECTIVES An element of obesity prevention is increasing total physical activity energy expenditure. However, this approach does not incorporate the balance of various movement behaviors-physical activity, sedentary behaviors and sleep-across domains of the day. We aimed to identify time-use profiles over work and leisure, termed 'movement behavior profiles' and to investigate their association with obesity. SUBJECTS/METHODS Eight-hundred-and-seven workers completed (a) thigh accelerometry and diaries to determine their 24-h composition of behaviors (sedentary and standing, light physical activity and moderate-to-vigorous physical activity at work and leisure, and time in bed) and (b) obesity measurements. Movement behavior profiles were determined using latent profile analyses of isometric log-ratios of the 24-h composition, and labeled according to animal movement behavior traits. Linear models were applied to determine the association between profiles and obesity. RESULTS Four profiles were identified, labeled as "Chimpanzees" (n = 226), "Lions" (n = 179), "Ants" (n = 244), and "Koalas" (n = 158). "Chimpanzees" work time was evenly distributed between behaviors while their leisure time was predominantly active. Compared to Chimpanzees, "Lions" were more active at work and sedentary during leisure and spent more time in bed; "Ants" were more active at work and during leisure; "Koalas" were more sedentary at work and leisure and spent similar time in bed. With "Chimpanzees" as reference, "Lions" had least favorable obesity indicators: +2.0 (95% confidence interval [CI] 0.6, 3.4) %body fat, +4.3 cm (1.4, 7.3) waist circumference and +1.0 (2.0, 0.0) Body Mass Index (BMI), followed by "Koalas" +2.0 (0.4, 3.7) %body fat, +3.1 cm (0.1, 6.0) waist circumference, and +0.8 (-0.30, 1.94) BMI. No significant differences were found between "Chimpanzees" and "Ants". CONCLUSIONS Movement behavior profiles across work and leisure time-use compositions are associated with obesity. Achieving adequate balance between work and leisure movement behaviors should be further investigated as a potential obesity prevention strategy.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark.
| | - David M Hallman
- Centre for Musculoskeletal Research, Department of Occupational Health Sciences and Psychology, University of Gävle, Gävle, Sweden
| | - Dorothea Dumuid
- Alliance for Research in Exercise, Nutrition and Activity (ARENA), School of Health Sciences, University of South Australia, Adelaide, South Australia, Australia
| | - Akshay Vij
- Institute for Choice, University of South Australia, Adelaide, Australia
| | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Lund Rasmussen C, Palarea-Albaladejo J, Korshøj M, Gupta N, Nabe-Nielsen K, Holtermann A, Jørgensen MB. Is high aerobic workload at work associated with leisure time physical activity and sedentary behaviour among blue-collar workers? A compositional data analysis based on accelerometer data. PLoS One 2019; 14:e0217024. [PMID: 31170169 PMCID: PMC6553845 DOI: 10.1371/journal.pone.0217024] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2019] [Accepted: 04/30/2019] [Indexed: 01/01/2023] Open
Abstract
Objective This study aimed to investigate the hypothesized negative association between duration of work time spent at a high relative aerobic workload and leisure time movement behaviours among blue-collar workers. Methods This was a cross-sectional study based on heart rate and accelerometer data from 803 blue-collar workers (447 men and 356 women). Relative aerobic workload was measured as percentage of heart rate reserve during work (%HRR). Leisure time movement behaviours were expressed in terms of leisure time spent in sedentary and active behaviours in uninterrupted bouts (i.e. <10 min, ≥10–30 min and >30 min). Compositional regression and isotemporal substitution models were used to assess the association between the predominance of work time spent at ≥40%HRR and leisure time spent in sedentary and active bouts. All analyses were stratified by sex. Results For men, there was no statistically significant association between the predominance of work time spent at ≥40%HRR and leisure time movement behaviours. Among women, the predominance of ≥40%HRR at work was negatively associated with relative leisure time spent in ≥10 min bouts of active behaviour ( β^ = -0.21, p = 0.02) and a theoretical 15 min reallocation of work time from <40%HRR to ≥40%HRR was estimated to decrease active behaviour by 6 min during leisure time. Conclusion Our result highlights the need for considering work-related barriers for an active leisure time in high-risk populations. Longitudinal studies are warranted to disentangle the relationship between physically demanding work characteristics and leisure time movement behaviours in such populations.
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Affiliation(s)
- Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | | | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kirsten Nabe-Nielsen
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Section of Social Medicine, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Prince SA, Elliott CG, Scott K, Visintini S, Reed JL. Device-measured physical activity, sedentary behaviour and cardiometabolic health and fitness across occupational groups: a systematic review and meta-analysis. Int J Behav Nutr Phys Act 2019; 16:30. [PMID: 30940176 PMCID: PMC6444868 DOI: 10.1186/s12966-019-0790-9] [Citation(s) in RCA: 96] [Impact Index Per Article: 19.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/08/2019] [Indexed: 12/19/2022] Open
Abstract
BACKGROUND With approximately 8 hours of one's waking day spent at work, occupational tasks and environments are important influencers on an individual's physical activity (PA) and sedentary behaviours. Little research has compared device-measured physical activity, sedentary behaviour and cardiometabolic outcomes between occupational groups. OBJECTIVE To compare device-measured movement (sedentary time [ST], light intensity physical activity [LPA], moderate-to-vigorous intensity physical activity [MVPA], and steps) across occupations. The secondary objective was to examine whether cardiometabolic and fitness outcomes differed by occupation. METHODS Five bibliographic databases were searched to identify all studies which included working age, employed adults from high-income countries, and reported on device-measured movement within occupations. Risk of bias within and across studies was assessed. Results were synthesized using meta-analyses and narrative syntheses. RESULTS The review includes 132 unique studies with data from 15,619 participants. Working adults spent ~ 60% of their working and waking time engaged in sedentary behaviour; a very small proportion (~ 4%) of the day included MVPA. On average, workers accumulated 8124 steps/day. Office and call center workers' steps/day were among the lowest, while those of postal delivery workers were highest. Office workers had the greatest ST and the lowest time in LPA both at work and during wakeful time. However, office workers had the greatest minutes sent in MVPA during wakeful hours. Laborers had the lowest ST and spent a significantly greater proportion of their work time in LPA and MVPA. Healthcare and protective services workers had higher levels of LPA at work compared to other occupations. Workers in driving-based occupations tended to have a higher body mass index and blood pressure. CONCLUSION This review identifies that occupational and wakeful time PA and ST differed between occupations. Future studies are needed to assess whether patterns differ by age and sex, describe leisure-time movement and movement patterns, and the relationship with cardiometabolic health. SYSTEMATIC REVIEW REGISTRATION PROSPERO CRD42017070448 .
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Affiliation(s)
- Stephanie A. Prince
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- Centre for Surveillance and Applied Research, Public Health Agency of Canada, Ottawa, Canada
| | - Cara G. Elliott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
| | - Kyle Scott
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sarah Visintini
- Berkman Library, University of Ottawa Heart Institute, Ottawa, Canada
| | - Jennifer L. Reed
- Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, 40 Ruskin Street, Ottawa, Ontario K1Y 4W7 Canada
- School of Human Kinetics, Faculty of Health Sciences, University of Ottawa, Ottawa, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
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Coenen P, Huysmans MA, Holtermann A, Troiano R, Mork PJ, Krokstad S, Clays E, van Mechelen W, van der Beek AJ. Can socioeconomic health differences be explained by physical activity at work and during leisure time? Rationale and protocol of the active worker individual participant meta-analysis. BMJ Open 2018; 8:e023379. [PMID: 30373782 PMCID: PMC6224722 DOI: 10.1136/bmjopen-2018-023379] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 08/07/2018] [Accepted: 09/25/2018] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Socioeconomic health differences have often been described, but remain insufficiently understood. Recent evidence suggests that workers who are high (compared with low) physically active at work are less healthy. Moreover, workers who are highly physically active at work are predominantly physically inactive during leisure time. These observations suggest that workers with a lower socioeconomic status may be exposed to negative health consequences of occupational physical activity and may only benefit to a limited extent from health benefits of leisure-time physical activity. Physical activity may therefore be an important driver of socioeconomic health differences. We describe the rationale and protocol of the active worker study, an individual participant data meta-analysis aimed at exploring socioeconomic health differences by differential doses of physical activity at work and leisure time. METHODS AND ANALYSIS Using database and scoping searches (we searched in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews from database inception to 14 September 2017), we have identified 49 published and unpublished prospective studies in which the association of occupational and leisure-time physical activity with cardiovascular or all-cause mortality was assessed. Principal investigators of these studies will be invited to participate in the active worker consortium, after which data will be retrieved. After data merging and harmonising, we will perform multilevel survival analysis assessing the combined association of occupational and leisure-time physical activity with mortality. We will also test the mediating effect of physical activity on the association of socioeconomic status and mortality (ie, socioeconomic health differences). DISCUSSION The Medical Ethical Committee of the VU University Medical Center has declared, according to Dutch legislation, that the 'Dutch Medical Research Involving Human Subjects Act' does not apply to the current study. As such, no ethics approval is required. We intent to publish outcomes of the active worker Study in scientific peer-reviewed journals. PROSPERO REGISTRATION NUMBER CRD42018085228.
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Affiliation(s)
- Pieter Coenen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Maaike A Huysmans
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Richard Troiano
- Risk Factor Assessment Branch, Division of Cancer Control and Population Sciences, US National Cancer Institute, Rockville, Maryland, USA
| | - Paul Jarle Mork
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Steinar Krokstad
- Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Els Clays
- Department of Public Health, Ghent University, Ghent, Belgium
| | - Willem van Mechelen
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Allard J van der Beek
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
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Holtermann A, Stamatakis E. Do all daily metabolic equivalent task units (METs) bring the same health benefits? Br J Sports Med 2018; 53:991-992. [PMID: 29794085 PMCID: PMC6691932 DOI: 10.1136/bjsports-2017-098693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2018] [Indexed: 11/04/2022]
Affiliation(s)
- Andreas Holtermann
- National Research Centre for the Working Environment (NRCWE), Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Emmanuel Stamatakis
- Epidemiology Unit, Charles Perkins Centre, University of Sydney, Sydney, New South Wales, Australia.,Prevention Research Collaboration, School of Public Health, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia
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Coenen P, Huysmans MA, Holtermann A, Krause N, van Mechelen W, Straker LM, van der Beek AJ. Do highly physically active workers die early? A systematic review with meta-analysis of data from 193 696 participants. Br J Sports Med 2018; 52:1320-1326. [DOI: 10.1136/bjsports-2017-098540] [Citation(s) in RCA: 159] [Impact Index Per Article: 26.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2018] [Indexed: 12/28/2022]
Abstract
ObjectiveRecent evidence suggests the existence of a physical activity paradox, with beneficial health outcomes associated with leisure time physical activity, but detrimental health outcomes for those engaging in high level occupational physical activity. This is the first quantitative systematic review of evidence regarding the association between occupational physical activity and all-cause mortality.DesignSystematic review with meta-analysis.Data sourceA literature search was performed in electronic databases PubMed, Embase, CINAHL, PsycINFO and Cochrane.Eligibility criteria for selecting studiesWe screened for peer reviewed articles from prospective studies assessing the association of occupational physical activity with all-cause mortality. A meta-analysis assessed the association of high (compared with low) level occupational physical activity with all-cause mortality, estimating pooled hazard ratios (HR) (with 95% CI).Results2490 unique articles were screened and 33 (from 26 studies) were included. Data from 17 studies (with 193 696 participants) were used in a meta-analysis, showing that men with high level occupational physical activity had an 18% increased risk of early mortality compared with those engaging in low level occupational physical activity (HR 1.18, 95% CI 1.05 to 1.34). No such association was observed among women, for whom instead a tendency for an inverse association was found (HR 0.90, 95% CI 0.80 to 1.01).ConclusionsThe results of this review indicate detrimental health consequences associated with high level occupational physical activity in men, even when adjusting for relevant factors (such as leisure time physical activity). These findings suggest that research and physical activity guidelines may differentiate between occupational and leisure time physical activity.
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Coenen P, Korshøj M, Hallman DM, Huysmans MA, van der Beek AJ, Straker LM, Holtermann A. Differences in heart rate reserve of similar physical activities during work and in leisure time – A study among Danish blue-collar workers. Physiol Behav 2018; 186:45-51. [DOI: 10.1016/j.physbeh.2018.01.011] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2017] [Revised: 12/27/2017] [Accepted: 01/12/2018] [Indexed: 11/16/2022]
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Lund Rasmussen C, Nielsen L, Linander Henriksen M, Søgaard K, Krustrup P, Holtermann A, Korshøj M. Acute effect on ambulatory blood pressure from aerobic exercise: a randomised cross-over study among female cleaners. Eur J Appl Physiol 2017; 118:331-338. [PMID: 29209783 PMCID: PMC5767212 DOI: 10.1007/s00421-017-3773-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2017] [Accepted: 11/25/2017] [Indexed: 01/04/2023]
Abstract
Purpose High occupational physical activity (OPA) is shown to increase the risk for elevated blood pressure, cardiovascular diseases and mortality. Conversely, aerobic exercise acutely lowers the blood pressure up to 25 h post exercise. However, it is unknown if this beneficial effect also apply for workers exposed to high levels of OPA. Cleaners constitute a relevant occupational group for this investigation because of a high prevalence of OPA and cardiovascular disease. Accordingly, the objective was to investigate the acute effects on ambulatory blood pressure from a single aerobic exercise session among female cleaners. Methods Twenty-two female cleaners were randomised to a cross-over study with a reference and an aerobic exercise session. Differences in 24-h, work hours, leisure time, and sleep ambulatory blood pressure (ABP) were evaluated using repeated measure 2 × 2 mixed-models. Results After the aerobic exercise session, the 24-h systolic ambulatory blood pressure was significantly lowered by 2.4 mmHg (p < 0.01) compared to the reference session. The 24-h diastolic ABP was unaltered. During work hours, a lowered systolic ABP of 2.2 mmHg (p = 0.02) and a higher diastolic ABP of 1.5 mmHg (p = 0.03) were found after the aerobic exercise session. During leisure time, the systolic ABP was lowered by 1.7 mmHg (p = 0.04) and the diastolic ABP was unaltered. During sleep, the systolic and diastolic ABP was unaltered. Conclusion A single aerobic exercise session lowered 24-h systolic ABP of 2.4 mmHg. Thus, an aerobic exercise session seems to be beneficial for lowering the risk of hypertension among cleaners.
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Affiliation(s)
- Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.
| | | | | | - Karen Søgaard
- Occupational and Environmental Medicine, University Hospital Odense, Odense, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, UK
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen, Denmark
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Lidegaard M, Søgaard K, Krustrup P, Holtermann A, Korshøj M. Effects of 12 months aerobic exercise intervention on work ability, need for recovery, productivity and rating of exertion among cleaners: a worksite RCT. Int Arch Occup Environ Health 2017; 91:225-235. [PMID: 29103065 PMCID: PMC5797214 DOI: 10.1007/s00420-017-1274-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 10/30/2017] [Indexed: 11/28/2022]
Abstract
Purpose This study assessed the effects of a worksite aerobic exercise intervention among cleaners on: work ability, need for recovery, productivity, and rating of exertion. Methods In a monocentric randomised controlled trial in Denmark, 116, of 250 invited, cleaners were cluster-randomised (work location; sex; age; length of service) to aerobic exercise [N = 57, 44.9 years, 75.4% female, body mass index (BMI) 26.2], receiving 2 weekly aerobic exercise sessions during 12 months, or a reference group (N = 59, 45.7 years, 76.3% female, BMI 27.1), receiving health-promoting lectures. Self-reported data on outcomes and sociodemographic information were collected at baseline, and at 4 and 12 month follow-up. All outcomes were analysed in a linear repeated-measures 2 × 2 mixed-model by an intention-to-treat analysis approach. Results Drop-out was 26 and 33% at 4 and 12 months, respectively. Aerobic exercise adherence was 51% during the first 4 months. At 4 month follow-up no effects were found. At 12 month follow-up, work ability significantly increased by 0.59 on a 0–10 scale (95% CI 0.05–1.13) and need for recovery significantly decreased by − 11.0 on a 0–100 scale (95% CI − 19.8 to − 2.2) in the aerobic exercise group compared to the reference group. Productivity and rating of exertion were unaltered. Analysis stratified on age showed significant effects only among the participants aged ≤ 45 years. Conclusions After 12 months work ability improved and need for recovery decreased. A period of 4 months was insufficient to affect these outcomes emphasising that longer interventions may be needed to induce effects on work ability and need for recovery.
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Affiliation(s)
- Mark Lidegaard
- Centre for Ergonomics, Occupational Safety and Health, School of Health Sciences, College of Health, Massey University, Palmerston North, New Zealand.
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Peter Krustrup
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, UK
| | - Andreas Holtermann
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
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Korshøj M, Birk Jørgensen M, Lidegaard M, Mortensen OS, Krustrup P, Holtermann A, Søgaard K. Decrease in musculoskeletal pain after 4 and 12 months of an aerobic exercise intervention: a worksite RCT among cleaners. Scand J Public Health 2017; 46:846-853. [DOI: 10.1177/1403494817717833] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Background: Prevalence of musculoskeletal pain is high in jobs with high physical work demands. An aerobic exercise intervention targeting cardiovascular health was evaluated for its long term side effects on musculoskeletal pain. Objective: The objective was to investigate if aerobic exercise affects level of musculoskeletal pain from baseline to 4- and 12-months follow-up. Methods: One-hundred-and-sixteen cleaners aged 18–65 years were cluster-randomized. The aerobic exercise group ( n = 57) received worksite aerobic exercise (30 min twice a week) and the reference group ( n = 59) lectures in health promotion. Strata were formed according to closest manager (total 11 strata); clusters were set within strata (total 40 clusters, 20 in each group). Musculoskeletal pain data from eight body regions was collected at baseline and after 4- and 12-months follow-up. The participants stated highest pain in the last month on a scale from 0, stating no pain, up to 10, stating worst possible pain. A repeated-measure 2 × 2 multi-adjusted mixed-models design was applied to compare the between-groups differences in an intention to treat analysis. Participants were entered as a random effect nested in clusters to account for the cluster-based randomization. Results: Clinically significant reductions (>30%, f 2 > 0.25) in the aerobic exercise group, compared to the reference group, in pain intensity in neck, shoulders, arms/wrists were found at 12-months follow-up, and a tendency ( p = 0.07, f 2 = 0.18) to an increase for the knees. At 4-months follow-up the only significant between-group change was an increase in hip pain. Conclusions: This study indicates that aerobic exercise reduces musculoskeletal pain in the upper extremities, but as an unintended side effect may increase pain in the lower extremities. Aerobic exercise interventions among workers standing or walking in the majority of the working hours should tailor exercise to only maintain the positive effect on musculoskeletal pain.
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | | | - Mark Lidegaard
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Centre for Ergonomics, Occupational Safety and Health, Massey University, Palmerston North, New Zealand
| | - Ole Steen Mortensen
- Department of Occupational Medicine, Copenhagen University Hospital Holbæk, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, University of Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Copenhagen, Denmark
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Karen Søgaard
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
- Occupational and Environmental Medicine, University Hospital, Odense, Denmark
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Agopian AJ, Kim J, Langlois PH, Lee L, Whitehead LW, Symanski E, Herdt ML, Delclos GL. Maternal occupational physical activity and risk for orofacial clefts. Am J Ind Med 2017; 60:627-634. [PMID: 28524264 DOI: 10.1002/ajim.22731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/13/2017] [Indexed: 11/10/2022]
Abstract
OBJECTIVES To perform a case-control study of maternal occupational physical activity and risk for orofacial clefts in Texas during 1999-2009. METHODS We used logistic regression to assess 14 measures of physical activity estimated from a job exposure matrix, using the maternal occupation reported on the birth certificate, among 887 children with cleft lip with or without cleft palate (CLP), 436 children with cleft palate only (CP), and 1932 controls. RESULTS After adjusting for several potential confounders, seven measures of physical activity (as a categorical and/or continuous variable) were significantly associated with CLP, CP, or both. Positive associations were seen for keeping balance, kneeling, standing, and walking/running (odds ratio 95% confidence interval range 1.0-1.9 for fourth versus first quartile). A significant positive trend was also seen for bending/twisting. Negative associations were seen for repetitive motion and sitting. CONCLUSIONS Maternal occupational physical activity may be related to the etiology of orofacial clefts.
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Affiliation(s)
- A. J. Agopian
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
| | - Jihye Kim
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
| | - Peter H. Langlois
- Birth Defects Epidemiology and Surveillance Branch; Texas Department of State Health Services; Austin Texas
| | - Laura Lee
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
| | - Lawrence W. Whitehead
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
| | - Elaine Symanski
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
| | - Michele L. Herdt
- Center for Environmental Health; New York State Department of Health; Albany New York
| | - George L. Delclos
- Department of Epidemiology, Human Genetics and Environmental Sciences; UTHealth School of Public Health; Houston Texas
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Effect of an aerobic exercise intervention on cardiac autonomic regulation: A worksite RCT among cleaners. Physiol Behav 2017; 169:90-97. [DOI: 10.1016/j.physbeh.2016.11.031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/30/2016] [Accepted: 11/22/2016] [Indexed: 12/11/2022]
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Koch M, Lunde LK, Gjulem T, Knardahl S, Veiersted KB. Validity of Questionnaire and Representativeness of Objective Methods for Measurements of Mechanical Exposures in Construction and Health Care Work. PLoS One 2016; 11:e0162881. [PMID: 27649499 PMCID: PMC5029916 DOI: 10.1371/journal.pone.0162881] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/30/2016] [Indexed: 11/24/2022] Open
Abstract
Objectives To determine the criterion validity of a questionnaire on physical exposures compared to objective measurements at construction and health care sites and to examine exposure variation over several working days. Methods Five hundred ninety-four construction and health care workers answered a baseline questionnaire. The daily activities (standing, moving, sitting, number of steps), postures (inclination of the arm and the trunk), and relative heart rate of 125 participants were recorded continuously over 3–4 working days. At the end of the first measurement day, the participants answered a second questionnaire (workday questionnaire). Results All objective activity measurements had significant correlations to their respective questions. Among health care workers, there were no correlations between postures and relative heart rate and the baseline questionnaire. The questionnaires overestimated the exposure durations. The highest explained variance in the adjusted models with self-reported variables were found for objectively measured sitting (R2 = 0.559) and arm inclination > 60° (R2 = 0.420). Objective measurements over several days showed a higher reliability compared to single day measurements. Conclusions Questionnaires cannot provide an accurate description of mechanical exposures. Objective measurements over several days are recommended in occupations with varying tasks.
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Affiliation(s)
- Markus Koch
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
- * E-mail:
| | - Lars-Kristian Lunde
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Tonje Gjulem
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Stein Knardahl
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
| | - Kaj Bo Veiersted
- Department of Work Psychology and Physiology, National Institute of Occupational Health, Oslo, Norway
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Korshøj M, Lidegaard M, Krustrup P, Jørgensen MB, Søgaard K, Holtermann A. Long Term Effects on Risk Factors for Cardiovascular Disease after 12-Months of Aerobic Exercise Intervention - A Worksite RCT among Cleaners. PLoS One 2016; 11:e0158547. [PMID: 27513932 PMCID: PMC4981369 DOI: 10.1371/journal.pone.0158547] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 06/18/2016] [Indexed: 01/09/2023] Open
Abstract
Objectives Occupational groups exposed to high occupational physical activity have an increased risk for cardiovascular disease (CVD). This may be explained by the high relative aerobic workload. Enhanced cardiorespiratory fitness reduces the relative aerobic workload. Thus, the aim was to evaluate the 12-months effects of worksite aerobic exercise on risk factors for CVD among cleaners. Methods One hundred and sixteen cleaners aged 18–65 years were randomized to a group performing aerobic exercise and a reference group receiving lectures. Outcomes were collected at baseline and after 12-months. A repeated measures 2×2 multi-adjusted mixed-model design was applied to compare the between-group differences using intention-to-treat analysis. Results Between-group differences (p<0.05) were found favouring the aerobic exercise group: cardiorespiratory fitness 2.15 (SE 1.03) mlO2/min/kg, aerobic workload -2.15 (SE 1.06) %HRR, resting HR -5.31 (SE 1.61) beats/min, high sensitive C-reactive protein -0.65 (SE 0.24) μg/ml. The blood pressure was unaltered. Stratified analyses on relative aerobic workload at baseline revealed that those with relative aerobic workloads ≥30% of HRR seems to impose a notable adverse effect on resting and ambulatory blood pressure. Conclusion This long-term worksite aerobic exercise intervention among cleaners led to several beneficial effects, but also potential adverse effects among those with high relative aerobic workloads. Trial Registration Controlled-Trials.com ISRCTN86682076
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- * E-mail:
| | - Mark Lidegaard
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark
- Sport and Health Sciences, College of Life and Environmental Sciences, St. Luke's Campus, University of Exeter, Exeter, United Kingdom
| | - Marie Birk Jørgensen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Heavy Physical Work: Cardiovascular Load in Male Construction Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2016; 13:356. [PMID: 27023574 PMCID: PMC4847018 DOI: 10.3390/ijerph13040356] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/11/2016] [Revised: 03/09/2016] [Accepted: 03/21/2016] [Indexed: 12/18/2022]
Abstract
This study aimed to elucidate cardiovascular loads (CVL) in construction workers during work and leisure by relative heart rate (RHR) over several days. Furthermore, we sought to evaluate the level of CVL in relation to individual factors, work ability, musculoskeletal pain and subjective general health. From a group of 255 construction workers responding to the baseline questionnaire, the CVL during work and leisure time was determined by recording RHR in 42 workers over 3–4 days. Almost 60% of the workday was spent below 20% RHR. The mean RHR during work for all participants was 16% RHR, with large differences between professions. On average, the 42 workers spent 14% of the workday at a RHR above 33%, and four subjects (10%) had a mean RHR above 33% during work. Eight (19%) of the participants had a mean length of their workday exceeding calculated maximal acceptable work time. Seven persons (17%) experienced on average one or more episode(s) of 5 min or more continuously above 33% RHR. The cardiovascular load at work was significantly associated with age and V˙O2max, but not with work ability, musculoskeletal pain or subjective general health.
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Korshøj M, Clays E, Lidegaard M, Skotte JH, Holtermann A, Krustrup P, Søgaard K. Is aerobic workload positively related to ambulatory blood pressure? A cross-sectional field study among cleaners. Eur J Appl Physiol 2015; 116:145-52. [PMID: 26363639 DOI: 10.1007/s00421-015-3259-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 09/04/2015] [Indexed: 10/23/2022]
Abstract
PURPOSE Cardiovascular disease is prevalent among workers with high levels of occupational physical activity. The increased risk may be due to a high relative aerobic workload, possibly leading to increased blood pressure. However, studies investigating the relation between relative aerobic workload and ambulatory blood pressure (ABP) are lacking. The aim was to explore the relationship between objectively measured relative aerobic workload and ABP. METHODS A total of 116 cleaners aged 18-65 years were included after informed consent was obtained. A portable device (Spacelabs 90217) was mounted for 24-h measurements of ABP, and an Actiheart was mounted for 24-h heart rate measurements to calculate relative aerobic workload as percentage of relative heart rate reserve. A repeated-measure multi-adjusted mixed model was applied for analysis. RESULTS A fully adjusted mixed model of measurements throughout the day showed significant positive relations (p < 0.001): a 1% increase in mean relative aerobic workload was associated with an increase of 0.42 ± 0.05 mmHg (95% CI 0.32-0.52 mmHg) in systolic ABP and 0.30 ± 0.04 mmHg (95% CI 0.22-0.38 mmHg) in diastolic ABP. Correlations between relative aerobic workload and ABP were significant. CONCLUSIONS Because workers may have an elevated relative aerobic workload for several hours each working day, this relationship may elucidate a mechanism behind the increased risk for cardiovascular disease among workers exposed to high levels of occupational physical activity.
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Affiliation(s)
- Mette Korshøj
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark. .,Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark.
| | - Els Clays
- Department of Public Health, Ghent University, De Pintelaan 185, 9000, Ghent, Belgium
| | - Mark Lidegaard
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Jørgen H Skotte
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Andreas Holtermann
- The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.,Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, 2200, Copenhagen N, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, UK
| | - Karen Søgaard
- Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
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Korshøj M, Ravn MH, Holtermann A, Hansen ÅM, Krustrup P. Aerobic exercise reduces biomarkers related to cardiovascular risk among cleaners: effects of a worksite intervention RCT. Int Arch Occup Environ Health 2015; 89:239-49. [PMID: 26139093 PMCID: PMC4724374 DOI: 10.1007/s00420-015-1067-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 06/16/2015] [Indexed: 11/25/2022]
Abstract
Purpose Blue-collar workers have an increased risk of cardiovascular disease. Accordingly, elevated levels of biomarkers related to risk of cardiovascular disease, such as high-sensitive C-reactive protein, have been observed among blue-collar workers. The objective was to examine whether an aerobic exercise worksite intervention changes the level of inflammation biomarkers among cleaners. Methods The design was a cluster-randomized controlled trial with 4-month worksite intervention. Before the 116 cleaners aged 18–65 years were randomized, they signed an informed consent form. The reference group (n = 59) received lectures, and the aerobic exercise group (n = 57) performed worksite aerobic exercise (30 min twice a week). Levels of biomarkers (high-sensitive C-reactive protein, fibrinogen, cholesterol, low- and high-density lipoprotein cholesterol and triglyceride) were collected at baseline and after 4 months. A repeated-measure, multi-adjusted, mixed-model intention-to-treat analysis was applied to compare between-group differences. The study was registered as ISRCTN86682076. Results Significant (p < 0.05) between-group reductions from baseline to follow-up were found for high-sensitive C-reactive protein (−0.54 ± 0.20 µg/ml; 95 % CI −0.94, −0.14), low-density lipoprotein cholesterol (−0.32 ± 0.11 mmol/L; 95 % CI −0.54, −0.10) and the ratios of LDL/HDL (−0.30 ± 0.08; 95 % CI −0.46, −0.14), and LDL/TC cholesterol (−0.04 ± 0.02; 95 % CI −0.07, −0.01). Conclusion This study indicates that an aerobic exercise intervention among cleaners leads to reduced levels of high-sensitive C-reactive protein and low-density lipoprotein cholesterol, and an unaltered level of fibrinogen. The aerobic exercise seems to improve inflammatory levels and lipoprotein profile among cleaners, with no signs of cardiovascular overload.
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Affiliation(s)
- Mette Korshøj
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark. .,Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen N, 2200, Denmark.
| | - Marie Højbjerg Ravn
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.,Institute of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense M, Denmark
| | - Åse Marie Hansen
- National Research Centre for the Working Environment, Lersø Parkallé 105, 2100, Copenhagen Ø, Denmark.,Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, Copenhagen K, 1014, Denmark
| | - Peter Krustrup
- Department of Nutrition, Exercise and Sports, Copenhagen Centre for Team Sport and Health, University of Copenhagen, Nørre Allé 51, Copenhagen N, 2200, Denmark.,Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, St. Luke's Campus, Exeter, UK
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Kersten N, Backé E. Occupational noise and myocardial infarction: considerations on the interrelation of noise with job demands. Noise Health 2015; 17:116-22. [PMID: 25774615 PMCID: PMC4918664 DOI: 10.4103/1463-1741.153403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The present analysis aims to differentiate the association of noise on myocardial infarction (MI) by job specific demands using International Standard Classification of Occupations (ISCO)-88 codes as a proxy. Data of a German case-control study were supplemented by job descriptions (indicated by ISCO-88). It was examined whether the demands in the various occupational groups modify the effect of noise. Noise and occupational groups are combined to form new exposure categories. Conditional logistic regression models were fitted to identify effects of combined job-noise categories. For the highest noise range (95-124 dB(A)) we found a significant odds-ratio (OR) of 2.18 (confidence interval [CI]0.95 = 1.17-4.05) independent of the profession. Some interesting results were found indicating ISCO groups with possible risk. In men, noticeable effects for the exposure category between 62 dB(A) and 84 dB(A) are calculated in the group of legislators and senior officials (ISCO-group 11; OR=1.93; CI0.95 = 0.50-7.42), the group consisting of life science and health professionals (ISCO-group 22; OR=2.18; CI0.95 = 0.36-13.1), the group of life science and health associate professionals (ISCO-group 32; OR = 2.03; CI0.95 = 0.50-8.24), and the group of “precision, handicraft, printing, and related trades workers” (ISCO-group 73; OR = 2.67; CI0.95 = 0.54-13.0). In the exposure range of 85-94 dB(A), high ORs are calculated for “skilled agricultural, fishery, and forestry workers” (ISCO-group 6; OR = 4.31; CI0.95 = 0.56-33.3). In women, there are high (nonsignificant) ORs in ISCO-group 1 (OR = 2.43; CI0.95 = 0.12-50.0), ISCO-group 2 (OR = 1.80; CI0.95 = 0.31-10.5), and ISCO-group 9 (OR = 2.45; CI0.95 = 0.63-9.51) for a noise exposure between 62 dB(A) and 84 dB(A). When investigating noise at the workplace in relation to cardiovascular diseases it is important to take the specific requirements of a job into account. Thus, work tasks with high health risks can be identified that helps to develop appropriate prevention strategies.
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Affiliation(s)
- Norbert Kersten
- Department of Work and Health, Federal Institute for Occupational Safety and Health, Berlin, Germany
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Sjøgaard G, Justesen JB, Murray M, Dalager T, Søgaard K. A conceptual model for worksite intelligent physical exercise training--IPET--intervention for decreasing life style health risk indicators among employees: a randomized controlled trial. BMC Public Health 2014; 14:652. [PMID: 24964869 PMCID: PMC4081016 DOI: 10.1186/1471-2458-14-652] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2013] [Accepted: 06/11/2014] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Health promotion at the work site in terms of physical activity has proven positive effects but optimization of relevant exercise training protocols and implementation for high adherence are still scanty. METHODS/DESIGN The aim of this paper is to present a study protocol with a conceptual model for planning the optimal individually tailored physical exercise training for each worker based on individual health check, existing guidelines and state of the art sports science training recommendations in the broad categories of cardiorespiratory fitness, muscle strength in specific body parts, and functional training including balance training. The hypotheses of this research are that individually tailored worksite-based intelligent physical exercise training, IPET, among workers with inactive job categories will: 1) Improve cardiorespiratory fitness and/or individual health risk indicators, 2) Improve muscle strength and decrease musculoskeletal disorders, 3) Succeed in regular adherence to worksite and leisure physical activity training, and 3) Reduce sickness absence and productivity losses (presenteeism) in office workers. The present RCT study enrolled almost 400 employees with sedentary jobs in the private as well as public sectors. The training interventions last 2 years with measures at baseline as well as one and two years follow-up. DISCUSSION If proven effective, the intelligent physical exercise training scheduled as well as the information for its practical implementation can provide meaningful scientifically based information for public health policy. TRIAL REGISTRATION ClinicalTrials.gov, number: NCT01366950.
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Affiliation(s)
- Gisela Sjøgaard
- Institute of Sport Science and Clinical Biomechanics, University of Southern University, Campusvej 55, DK 5230 Odense, Denmark
| | - Just Bendix Justesen
- Institute of Sport Science and Clinical Biomechanics, University of Southern University, Campusvej 55, DK 5230 Odense, Denmark
| | - Mike Murray
- Institute of Sport Science and Clinical Biomechanics, University of Southern University, Campusvej 55, DK 5230 Odense, Denmark
| | - Tina Dalager
- Institute of Sport Science and Clinical Biomechanics, University of Southern University, Campusvej 55, DK 5230 Odense, Denmark
| | - Karen Søgaard
- Institute of Sport Science and Clinical Biomechanics, University of Southern University, Campusvej 55, DK 5230 Odense, Denmark
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Kakarot N, Müller F. Assessment of physical strain in younger and older subjects using heart rate and scalings of perceived exertion. ERGONOMICS 2014; 57:1052-1067. [PMID: 24761802 DOI: 10.1080/00140139.2014.910613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
UNLABELLED Physical strain is usually evaluated physiologically by using the heart rate (HR) or psychologically using scaled perceived exertion (PE). In order to explore the relationship between these approaches, we compared the series of both measurements taken simultaneously during work on a bicycle ergometer. A total of 29 participants aged between 27 and 41, 42 and 56, and 57 and 71 years took part in 28 minutes of cycling with systematically increased and decreased load as well as in 7 hours of continuous cycling with low to medium exertion, interrupted by brief peak loads at high to very high exertion levels. Results revealed that, while both measurements are suitable to capture physical strain, HR is not as specific as PE. The older participants further perceived comparable physical loads as more demanding as the younger participants. With an aging workforce, results have potential implications for the organisation of work places. PRACTITIONER SUMMARY The organisation of work processes is a key issue in the prevention of strain and hence of interest to ergonomists. Our study suggests that workers can, independent of age, perform physical work all day as long as they work at subjectively equal, moderate intensities.
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Affiliation(s)
- Nadine Kakarot
- a LüneLab, Institute of Experimental Industrial Psychology, Leuphana University , Wilschenbrucher Weg 84a, 21335 Lueneburg , Germany
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