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Jordakieva G, Hasenoehrl T, Steiner M, Jensen-Jarolim E, Crevenna R. Occupational physical activity: the good, the bad, and the proinflammatory. Front Med (Lausanne) 2023; 10:1253951. [PMID: 37869170 PMCID: PMC10587420 DOI: 10.3389/fmed.2023.1253951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 09/11/2023] [Indexed: 10/24/2023] Open
Abstract
Background Physical activity (PA) is beneficial for preventing several conditions associated with underlying chronic inflammation, e. g., cardiovascular disease (CVD) and cancer. While an active lifestyle appears to have anti-inflammatory effects, high levels of occupational PA (OPA) were associated with inflammation and elevated mortality risks. We aimed to summarize the current knowledge (1) on the association between inflammation and OPA and (2) its implications for health and mortality. Methods and results This mini-review summarized relevant literature published before January 2023 using established scientific databases and sources. For the primary outcome, observational studies (S) reporting immunological effects (O) in subjects (P), with high (I) vs. low OPA (C), were included. For secondary outcomes, i.e., morbidity and mortality associated with inflammatory processes, (systematic) reviews were included. While "active" occupations and "moderate" OPA appear to have beneficial effects, low (particularly sedentary) and "high-intensity" OPA (particularly including heavy lifting tasks) were associated with inflammation and (CVD and cancer-related) mortality; higher leisure-time PA has been almost consistently associated with lower proinflammatory markers and all-cause mortality risks. Workplace interventions appear to counter some of the observed health effects of unfavorable work strain. Conclusion The few studies addressing OPA "intensity" and inflammatory markers are largely heterogeneous regarding OPA classification and confounder control. Sedentary and "heavy" OPA appear to promote proinflammatory effects. In addition to targeted management of work-related physical strain and hazardous environmental co-factors, occupational health providers should focus on employer-initiated exercise interventions and the promotion of leisure-time PA.
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Affiliation(s)
- Galateja Jordakieva
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Timothy Hasenoehrl
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Margarete Steiner
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
| | - Erika Jensen-Jarolim
- Center for Pathophysiology, Infectiology and Immunology, Institute of Pathophysiology and Allergy Research, Medical University of Vienna, Vienna, Austria
- The Interuniversity Messerli Research Institute, Medical University of Vienna, Vienna, Austria
| | - Richard Crevenna
- Department of Physical Medicine, Rehabilitation, and Occupational Medicine, Medical University of Vienna, Vienna, Austria
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Strain T, Wijndaele K, Sharp SJ, Dempsey PC, Wareham N, Brage S. Impact of follow-up time and analytical approaches to account for reverse causality on the association between physical activity and health outcomes in UK Biobank. Int J Epidemiol 2020; 49:162-172. [PMID: 31651957 PMCID: PMC7124507 DOI: 10.1093/ije/dyz212] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The advent of very large cohort studies (n > 500 000) has given rise to prospective analyses of health outcomes being undertaken after short (<4 years) follow-up periods. However, these studies are potentially at risk of reverse causality bias. We investigated differences in the associations between self-reported physical activity and all-cause and cardiovascular disease (CVD) mortality, and incident CVD, using different follow-up time cut-offs and methods to account for reverse causality bias. METHODS Data were from n = 452 933 UK Biobank participants, aged 38-73 years at baseline. Median available follow-up time was 7 years (for all-cause and CVD mortality) and 6.1 years (for incident CVD). We additionally analysed associations at 1-, 2- and 4-year cut-offs after baseline. We fit up to four models: (1) adjusting for prevalent CVD and cancer, (2) excluding prevalent disease, (3) and (4) Model 2 excluding incident cases in the first 12 and 24 months, respectively. RESULTS The strength of associations decreased as follow-up time cut-off increased. For all-cause mortality, Model 1 hazard ratios were 0.73 (0.69-0.78) after 1 year and 0.86 (0.84-0.87) after 7 years. Associations were weaker with increasing control for possible reverse causality. After 7-years follow-up, the hazard ratios were 0.86 (0.84-0.87) and 0.88 (0.86-0.90) for Models 1 and 4, respectively. Associations with CVD outcomes followed similar trends. CONCLUSIONS As analyses with longer follow-up times and increased control for reverse causality showed weaker associations, there are implications for the decision about when to analyse a cohort study with ongoing data collection, the interpretation of study results and their contribution to meta-analyses.
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Affiliation(s)
- Tessa Strain
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Katrien Wijndaele
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Stephen J Sharp
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Paddy C Dempsey
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
- Physical Activity & Behavioural Epidemiology Laboratories, Baker Heart and Diabetes Institute, Melbourne, Australia
| | - Nick Wareham
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
| | - Søren Brage
- MRC Epidemiology Unit, Institute of Metabolic Science, University of Cambridge, Cambridge, UK
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Cardiovascular Health Effects of Shift Work with Long Working Hours and Night Shifts: Study Protocol for a Three-Year Prospective Follow-Up Study on Industrial Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020589. [PMID: 31963313 PMCID: PMC7014249 DOI: 10.3390/ijerph17020589] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/08/2020] [Accepted: 01/08/2020] [Indexed: 12/12/2022]
Abstract
There is a plausible association between shift work and cardiovascular disease (CVD), which may be due to disruption of the circadian rhythm causing hormonal changes and metabolic disturbances, resulting in high blood pressure, atherosclerosis, diabetes, and being overweight. However, few studies have investigated the association between several consecutive long work shifts, including night shifts, and risk factors for developing CVD. Moreover, knowledge is lacking on factors that may modify or enhance this suggested relationship. The study period is planned from the third quarter of 2018 to the fourth quarter of 2021, and will involve 125 industrial employees at two Norwegian enterprises producing insulation. The work schedule is either rotating shiftwork (morning, evening, night) or regular day work. At baseline, we will measure blood parameters, including markers of inflammation, lipids, and glycosylated hemoglobin. We will also collect measures of blood pressure, resting heart rate, arterial stiffness, carotid intima-media thickness, and aerobic fitness. At the end of baseline data collection, a subgroup will undergo a supervised high-intensity interval training intervention for eight weeks, initiated by the Occupational Health Service. At one-year follow-up, we repeat baseline measures with added measures of heart rate variability and additional five weeks monitoring of sleep and physical activity, and assessment of respirable dust. At the two year follow-up, we will measure CVD risk factors before and after a planned three-month shutdown in one of the studied plants. We will also assess respirable dust, monitor sleep, and compile a one-year retrospective detailed overview of working hours. A final data collection, similar to the one at baseline, will be carried out after three years. We will use a comprehensive set of methods to identify the effects of shift work with long working hours and night shifts on cardiovascular health. This will provide new knowledge on the association between early manifestations of CVD and occupational exposure to shift work. Further, we can study whether work organization such as extensive overtime, sleep loss, and dust exposure have detrimental effects, and if a three-month cease in shift work or increased physical activity will modify early manifestations of CVD.
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Scapellato ML, Comiati V, Buja A, Buttignol G, Valentini R, Burati V, La Serra L, Maccà I, Mason P, Scopa P, Volpin A, Trevisan A, Spinella P. Combined Before-and-After Workplace Intervention to Promote Healthy Lifestyles in Healthcare Workers (STI-VI Study): Short-Term Assessment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15092053. [PMID: 30235849 PMCID: PMC6164287 DOI: 10.3390/ijerph15092053] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/07/2018] [Accepted: 09/14/2018] [Indexed: 12/23/2022]
Abstract
Health care workers (HCWs) are prone to a heavy psycho-physical workload. Health promotion programs can help prevent the onset of chronic and work-related diseases. The aim of the STI-VI ‘before-and-after’ study, with assessments scheduled at 6 and 12 months, was to improve the lifestyle of HCWs with at least one cardiovascular risk factor. A tailored motivational counseling intervention, focusing on dietary habits and physical activity (PA) was administered to 167 HCWs (53 males; 114 females). BMI, waist circumference, blood pressure, and cholesterol, triglyceride, and blood glucose levels were measured before and after the intervention. The 6-month results (total sample and by gender) showed a marked effect on lifestyle: PA improved (+121.2 MET, p = 0.01), and diets became more similar to the Mediterranean model (+0.8, p < 0.001). BMI dropped (−0.2, p < 0.03), and waist circumference improved even more (−2.5 cm; p < 0.001). Other variables improved significantly: total and LDL cholesterol (−12.8 and −9.4 mg/dL, p < 0.001); systolic and diastolic blood pressure (−4.4 and −2.5 mmHg, p < 0.001); blood glucose (−1.5 mg/dL, p = 0.05); and triglycerides (significant only in women), (−8.7 mg/dL, p = 0.008); but HDL cholesterol levels dropped too. If consolidated at 12 months, these results indicate that our intervention can help HCWs maintain a healthy lifestyle and work ability.
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Affiliation(s)
- Maria Luisa Scapellato
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Vera Comiati
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Alessandra Buja
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Giulia Buttignol
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Romina Valentini
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Valentina Burati
- Department of Medicine, University of Padova, 35128 Padova, Italy.
| | - Lucia La Serra
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Isabella Maccà
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paola Mason
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Pasquale Scopa
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
| | - Anna Volpin
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Andrea Trevisan
- Department of Cardiac Thoracic Vascular Sciences and Public Health, University of Padova, Via Giustiniani 2, 35128 Padova, Italy.
- Preventive Medicine and Risk Assessment Unit, Padova University Hospital, 35128 Padova, Italy.
| | - Paolo Spinella
- Department of Medicine, University of Padova, 35128 Padova, Italy.
- Dietetic and Clinical Nutrition Unit, Padova University Hospital, 35128 Padova, Italy.
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