Are psychosocial work environments associated with physical activity and sitting during work time? A systematic review and meta-analysis

BackgroundRapid economic growth and urbanisation in developing countries has led to changes in lifestyle behaviours and contributed to the risk of developing non-communicable diseases such as heart conditions, type 2 diabetes, obesity and cancer. Decreases in occupational physical activity (PA) and sedentary behaviour (SB) are of particular concern. Whereas the evidence base for PA and SB in workers from developed countries is extensive, fewer studies have investigated PA and SB issues in occupational groups from developing countries such as Papua New Guinea (PNG), in the Pacific region currently experiencing major economic change.Aims To contribute insights for health promotion action, the aims of this thesis are to measure and compare the patterns and correlates of self-reported PA and SB in different occupational groups from PNG. The aims are addressed by a detailed review of evidence in developing countries, progressing to the main thesis study on PA, SB, and socio-demographic factors associated with these behaviours in groups of office, blue-collar and retail workers.MethodsFollowing ethics approvals, a convenience sample (n = 402) of office, blue-collar and retail workers was recruited from public and private companies/organisations based in urban areas of Madang Province, PNG. Total and work-related PA and SB data were collected over 6 weeks (October 20th to November 27th, 2018) using an interview-administered survey comprising of items from the International Physical Activity Questionnaire (short form) and the Occupational Sitting and Physical Activity Questionnaire. Survey items also captured other lifestyle behaviours (e.g. smoking, alcohol use), and socio-demographic status (e.g. job type, education); physical measures (height and weight to calculate BMI) were taken by trained researchers. Tests of difference and logistic regression were used to analyse variations between occupational groups, and sociodemographic correlates for total and work time PA and SB.ResultsA total of 398 workers (office [n = 213], blue-collar [n = 133] and retail [n = 52]; 41% aged 26 - 40 years; BMI mean ± SD = 26.31 ± 5.097; n = 208 females) were entered into analyses. Overall, 97% (97% office workers, 99% blue-collar, 98% retail workers) of these workers achieved recommended PA guidelines (>600 MET-mins/week), with PA mostly achieved through walking, as opposed to moderate or vigorous PA; the median total sitting time was 7 hrs/day (Inter Quartile Range [IQR] 5, 9). For occupational comparisons, total PA was higher in retail workers compared to office and blue-collar workers although differences were not significant. Significantly higher (p<0.05) sitting time (total ≥7 hrs/day; and ≥50% of weekly work time) was reported in office compared to blue-collar and retail workers. Similarly, median percentage work hours spent sitting was higher in office compared to blue-collar and retail workers (Table 2. OSPAQ). In adjusted logistic regression analyses, compared to office workers the odds of high sitting in blue collar and retail workers were lower for total and workplace sitting (Table 4). Additionally, participants ≥40 years of age were more likely to report high total sitting and workplace sitting than participants <40 years.Conclusions and RecommendationsThis is the first study to investigate PA and SB differences between PNG occupational groups. While most participants met PA guidelines through walking, the data from the current study suggests that, compared to blue-collar and retail workers, older and office workers in PNG are a high need group for SB intervention. Piloting and use of a validated survey were study strengths. However, the limitation of using self-report measures highlights the need for future studies to use objective monitoring of PA and SB levels in different groups of PNG workers to confirm these results.

BackgroundPhysical activity is a key determinant for health and considered as an important factor in the prevention of lifestyle related-diseases. All physical activity domains are generally considered to be health enhancing. However, accumulating evidence in recent years suggests that occupational physical activity may not have the same beneficial health effect as leisure time physical activity. Our aim was to assess the association of occupational and leisure time physical activity and all-cause mortality.MethodsWe obtained individual participant data from published and unpublished cohort studies and assessed their risk of bias. We harmonized the data, and used Cox survival regression models to assess the association between occupational and leisure time physical activity with all-cause mortality, in a two-stage individual participant data meta-analysis. Different models were performed to assess the impact of relevant confounders including behavioral, health-related and socio-economic factors. Results of the data were reported with hazard ratios (HRs) and 95% confidence intervals (95% CI).ResultsData from 22 prospective cohort studies showed that male workers with high occupational physical activity had an increased risk of all-cause mortality in comparison with sedentary occupational physical activity (HR: 1.12, 95%CI: 1.03- 1.23). For female workers, no such association was found (HR: 1.01, 95%CI: 0.85-1.19). when comparing high with sedentary occupational physical activity.Increasing levels of leisure time physical activity were inversely and dose-dependently associated with a reduced risk of all-cause mortality. For example, high compared with sedentary leisure time physical activity was associated with reduced risks for males (HR: 0.53, 95%CI: 0.36-0.79) and for females (HR: 0.49, 95%CI: 0.31-0.79).All associations remained robust when adjusting for additional relevant confounders, leaving one study out analysis, and when assessing the role of bias and reverse causality.ConclusionWe consistently found a reduced risk of all-cause mortality with increasing levels of leisure time physical activity, but not for occupational physical activity. These findings indicate that occupational activity may not be health-enhancing. These findings suggest that occupational physical activity may not be considered a suitable substitute to leisure time physical activity when striving for health enhancement.

Introduction Growing evidence has shown that occupational physical activity increases the risk for cardiovascular disease and mortality. Performing strenuous physical activities at work remains a daily reality for a significant part of workers in different sectors. There is thus a critical need to develop preventive measures against premature cardiovascular disease risk in workers with high physical demands. It is particularly important to elucidate structural preventive measures at the collective workplace level for primary prevention of cardiovascular disease in this group. The psychosocial work stress environment offers opportunities to counter the harmful effects of physical work demands. Methods and result An overview will be presented of available studies addressing moderating effects of psychosocial stress measures in the relation between occupational physical activity and cardiovascular disease. A limited number of studies have shown that psychosocial resources – like social support at work and level of job control – may buffer the harmful effect on health from physical work demands. In addition, this presentation will focus on the potential mechanisms by which the psychosocial work environment might play a role in the effects of occupational physical activity on cardiovascular health outcomes. Discussion Research showing that occupational physical activity does not produce cardiovascular health benefits – like leisure time physical activity does – has rapidly expanded over the past decade. On the contrary, more and more evidence confirms that engaging in high levels of occupational physical activity generates increased risk of cardiovascular disease. One of the current challenges in this research field is to investigate how the psychosocial work environment may play a role in this relation. Empirical evidence on the buffering effect of psychosocial stress measures in the relation between occupational physical activity and cardiovascular outcomes is still quite scarce. More detailed investigations using objective measurements are needed.

BackgroundWhile moderate and vigorous leisure time physical activities are well documented to decrease the risk for cardiovascular disease, several studies have demonstrated an increased risk for cardiovascular disease in workers with high occupational activity. Research on the underlying causes to the contrasting effects of occupational and leisure time physical activity on cardiovascular health is lacking. The aim of this study was to examine the relation of objective and self-report measures of occupational and leisure time physical activity with 24-h ambulatory systolic blood pressure (BP).MethodsResults for self-reported physical activity are based on observations in 182 workers (60% male, mean age 51 years), while valid objective physical activity data were available in 151 participants. The usual level of physical activity was assessed by 5 items from the Job Content Questionnaire (high physical effort, lifting heavy loads, rapid physical activity, awkward body positions and awkward positions of head or arms at work) and one item asking about the general level of physical activity during non-working time. On a regular working day, participants wore an ambulatory BP monitor and an accelerometer physical activity monitor during 24 h. Associations were examined by means of Analysis of Covariance.ResultsWorkers with an overall high level of self-reported occupational physical activity as well as those who reported to often lift heavy loads at work had a higher mean systolic BP at work, at home and during sleep. However, no associations were observed between objectively measured occupational physical activity and BP. In contrast, those with objectively measured high proportion of moderate and vigorous leisure time physical activity had a significantly lower mean systolic BP during daytime, while no differences were observed according to self-reported level of leisure time physical activity.ConclusionsThese findings suggest that workers reporting static occupational physical activities, unlike general physically demanding tasks characterized by dynamic movements of large muscle groups, are related to a higher daily systolic BP, while high objective levels of moderate and vigorous leisure time physical activity are related to lower daytime systolic BP. Ambulatory systolic BP may be a physiological explanatory factor for the contrasting effects of occupational and leisure time physical activity.

Comparing Ratings of Occupational Physical Activity

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

Musculoskeletal pain is a leading cause of seeking care and imposes an immense economic burden to the healthcare systems. The guidelines recommend physical activity for managing musculoskeletal pain but do not differentiate between occupational and leisure-time physical activity. Research indicates that occupational physical activity may not have similar health benefits as leisure-time physical activity. Thus, we investigated the association between occupational and leisure-time physical activity and musculoskeletal-related primary healthcare utilization. At baseline, physical activity data (sitting, standing, light physical activity, moderate-to-vigorous physical activity and time in bed) were collected from 824 blue-collar workers using a thigh-worn accelerometer during work and leisure for up to five days. Musculoskeletal-related primary healthcare utilization (i.e., contacts with general practitioners, physiotherapists and specialists) was retrieved from the Danish National Health Services Registry during a 4-year follow-up from baseline. The association between occupational and leisure-time physical activity and musculoskeletal-related primary healthcare utilization was analyzed using a generalized linear model adjusted for potential confounders. During follow-up, 62%, 42% and 10% of the workers had at least one musculoskeletal-related contact to the general practitioner, physiotherapist and specialist, respectively. Leisure-time moderate-to-vigorous physical activity was associated with a decreased risk of a general practitioner contact (RR = 0.78; p value = 0.02), a tendency for a decreased risk of a physiotherapist contact (RR = 0.83; p value = 0.23), but with a tendency for increased risk of a specialist contact (RR = 1.49; p value = 0.20). On the contrary, occupational moderate-to-vigorous physical activity was not associated with a decreased risk of a general practitioner contact (RR = 1.04; p value = 0.75), physiotherapist contact (RR = 1.00; p value = 0.99) or a specialist contact (RR = 1.80; p value = 0.05). Our findings indicate that the domain of physical activity is of importance for musculoskeletal-related primary healthcare utilization. While leisure-time physical activity was associated with a decreased risk of a general practitioner and physiotherapist contact, occupational physical activity was not associated with such benefits.

There has been an increasing burden of overweight, obesity, and non-communicable diseases in Vietnam in recent years. To the best of our knowledge, this is the first study conducted to assess the occupational sitting and physical activity habits among employees in a research institute in Vietnam. A cross-sectional study was performed with 292 staff (113 males, and 179 females) currently working in a research institute in Hanoi, Vietnam. The International Physical Activity Questionnaire (IPAQ-SF) was used to assess physical activity habits of the employees in the previous typical week, and the Occupational Sitting and Physical Activity Questionnaire (OSPAQ) was applied to measure physical activities in the workplace during a typical working week. The study found that more than one-third of staff and researchers at the research institute did not meet the minimum physical activity level recommended by the World Health Organization. In terms of occupational sitting and physical activity, they spent 60% of their working hours on sitting, 20% standing, 16% walking, and 4% heavy labor. There were no statistically significant differences between males and females regarding occupational sitting and physical activity (p&gt;0.05). The study found that the staff of the research institute spent their majority of working time sitting. These findings have important implications for workplace interventions aimed at reducing sedentary behavior and promoting physical activity, highlighting the need for policies and initiatives to encourage more standing, and walking in the workplace.

Occupational and leisure-time physical activity and prospective musculoskeletal pain-relief prescribed medication among blue-collar workers: 24-h device-measured physical activity and Danish registers.

Active work, passive leisure? Associations between occupational and non-occupational physical activity on weekdays

ObjectiveThe aim of this study was to test the extent to which physical activity performed during work and leisure is associated with systemic inflammation.MethodsData regarding job history and high-sensitivity C...

Is occupational or leisure physical activity associated with low back pain? Insights from a cross-sectional study of 1059 participants

ObjectivesThis study aimed to investigate the association between recovery from work and insomnia and the role of objectively measured leisure-time physical activity and occupational physical activity in this association.DesignCross-sectional.Setting and...

PurposeSeveral recent studies have suggested a ‘physical activity paradox’ whereby leisure-time physical activity benefits health, but occupational physical activity is harmful. However, other studies imply that occupational physical activity is beneficial. Using data from a nationally representative Italian sample, we investigate if the context, or domain, of physical activity matters for mortality and coronary heart disease (CHD) events.MethodsAmong 40,220 men and women aged 40–55 at baseline, we used Cox models to compare associations of occupational, domestic and leisure-time physical activity with risk of mortality and CHD events over a follow-up period of up to 14 years. We accounted for sociodemographic factors, smoking, body mass index (BMI), physical and mental health, and educational qualifications.ResultsOccupational physical activity was not significantly associated with risk of mortality or CHD events for women, or with CHD events for men. In crude models, risk of mortality was higher for men in the highest occupational activity group, compared to the lowest (HR 1.26, 95% CI 1.01, 1.57). This attenuated with adjustment for health-related behaviours, health, and education (HR 1.03, 95% CI 0.77, 1.38). In crude models, leisure-time physical activity was significantly associated with decreased mortality and CHD risk only for men. Domestic physical activity was not associated with either outcome for either gender.ConclusionIn a large sample of middle-aged Italian workers, we found limited evidence of harmful or beneficial effects of occupational physical activity on mortality or CHD events. However, confidence intervals were wide, and results consistent with a range of effects in both directions.

ObjectivesMen with low physical fitness and high occupational physical activity are recently shown to have an increased risk of cardiovascular disease and all-cause mortality. The association between occupational physical activity...