Associations Of Occupational And Leisure-time Physical Activity With Cardiovascular Disease

Abstract

PURPOSE: Emerging evidence describes opposing effects of occupational and leisure-time physical activity (LTPA) on cardiovascular health although little research has been done in the U.S. This analysis examines cardiovascular disease (CVD) prevalence associated with occupational physical activity and LTPA in a nationally representative U.S. sample. METHODS: This is a cross-sectional analysis of the 2015 National Health Interview Survey (NHIS) data and its occupational health supplement from the National Institute for Occupational Safety and Health (NIOSH) (n=19,429). Logistic regression estimated the odds of self-reported composite CVD (coronary heart disease, heart attack, stroke, or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing (OS), and LTPA. Occupational activity was measured using two questions: “How often does your job involve repeated lifting, pushing, pulling, or bending?” (OE) and "How often does your job involve standing or walking around?” (OS) where participants responded to a 5-item Likert scale (0=Never, 4=Always). Total occupational activity (TOA) was categorized similarly after summing the individual OE and OS scores. LTPA was defined as three categories: 0, 1-149, or ≥150 minutes/week of reported moderate-to-vigorous activity. Additional analyses were stratified by sex, smoking status, and LTPA level. All models were adjusted for age, sex, race/ethnicity, smoking status, alcohol consumption, family income, body mass index, education, U.S. nativity, LTPA, and TOA. RESULTS: “Always” performing TOA, OE, and OS was associated with higher odds for CVD, compared to “never” (OR=1.65, p=0.026, OR=1.63, p=0.003, and OR=1.56, p=0.031, respectively). LTPA level was not associated with odds of CVD (p>0.05). Associations of high OE with CVD outcomes were equally apparent in females and males and stronger in lower LTPA levels. Associations between TOA, OE, and OS with CVD were stronger in the sample restricted to never smokers. CONCLUSIONS: While LTPA was not associated, individuals with higher TOA, OE, and OS had higher rates of CVD. While uncontrolled confounding is still possible even after adjustment, the seemingly paradoxical adverse associations with occupational activity and CVD should be investigated further.