Abstract
BackgroundCurrent physical activity guidelines do not distinguish between activity accumulated in different behavioural domains but some studies suggest that occupational physical activity (OPA) may not confer health benefits and could even be detrimental. The purpose of this study was to investigate associations between OPA and mortality outcomes.MethodsFrom baseline (2006–2010), 460,901 UK Biobank participants (aged 40–69 years) were followed for a median 12.0 (IQR: 11.3–12.7) years. OPA was categorised by cross-tabulating degree of manual work and walking/standing work amongst those in paid employment (n = 267,765), and combined with categories of occupational status for those not in paid employment (n = 193,136). Cox proportional hazards models were used to estimate sex-stratified hazard ratios (HR) and 95% confidence intervals (CI) for mortality from all causes, CVD, and cancer by occupational group, and for working hours/week and non-occupational physical activity stratified by occupational group. Models included adjustment for age and a range of lifestyle, socio-economic and health-related covariates.ResultsDuring 5,449,989 person-years of follow-up, 28,740 deaths occurred. Compared to those reporting no heavy manual or walking/standing work (e.g. sedentary office workers) and adjusting for covariates, retirement was associated with lower mortality in women (HR = 0.62, CI: 0.53–0.72) and men (HR = 0.80, CI: 0.71–0.90), whereas unemployment was associated with higher mortality in men only (HR = 1.24, CI: 1.07–1.45). Within the working population, there was no evidence of differences in all-cause, CVD or cancer mortality by OPA group when comparing those reporting higher levels of OPA to the lowest OPA reference group for both women and men. Working < 35 h/week versus 35–40 h/week was associated with lower mortality in women (HR = 0.85, CI: 0.79–0.92) and men (HR = 0.83, CI: 0.78–0.89), with no interaction by OPA. Non-occupational physical activity was associated with lower mortality in working women (HR = 0.89 per 5 kJ/day/kg, CI: 0.84–0.95) and men (HR = 0.87 per 5 kJ/day/kg, CI: 0.84–0.91), with no interaction by OPA group.ConclusionsJobs classified as higher levels of OPA may not be as active as reported, or the types of physical activity performed in those jobs are not health-enhancing. Irrespective of OPA category or employment status, non-occupational physical activity appears to provide health benefits.
Highlights
Current physical activity guidelines do not distinguish between activity accumulated in different behavioural domains but some studies suggest that occupational physical activity (OPA) may not confer health benefits and could even be detrimental
Proposed reasons for these findings include OPA being performed at lower intensities, for protracted periods, and in a static posture [7], the existing evidence has weaknesses including the use of crude self-reported OPA measures, lack of adjustment for nonoccupational physical activity, residual confounding for socio-economic status and lifestyle factors, and limited geographical representation [8, 9]
Baseline characteristics of the 460,901 included participants by sex and occupational status are shown in Table 1, and further details for OPA groups are provided in Supplementary Tables 4, 5, 6 and 7
Summary
Current physical activity guidelines do not distinguish between activity accumulated in different behavioural domains but some studies suggest that occupational physical activity (OPA) may not confer health benefits and could even be detrimental. No distinctions are made between physical activity in leisure-time, transport, home, education, or occupational domains; the total volume of activity is assumed to be beneficial regardless of the domain in which it is accrued. Contradictory to this advice is the suggestion that occupational physical activity (OPA) does not confer the same benefits, and may even be harmful to health [5]. Prior studies within occupational strata have reported that active jobs were associated with lower mortality [10, 11]
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