Duffy Eamon Y, Hiremath Pranoti G, Martinez-Amezcua Pablo, Safeer Richard, Schrack Jennifer A, Blaha Michael J, Michos Erin D, Blumenthal Roger S, Martin Seth S, Cainzos-Achirica Miguel
Department of Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Ciccarone Center for the Prevention of Cardiovascular Disease, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
Am J Prev Cardiol. 2020 Dec 8;5:100136. doi: 10.1016/j.ajpc.2020.100136. eCollection 2021 Mar.
Adult working-class Americans spend on average 50% of their workday awake time at their jobs. The vast majority of these jobs involve mostly physically inactive tasks and frequent exposure to unhealthy food options. Traditionally, the workplace has been a challenging environment for cardiovascular prevention, where cardiovascular guidelines have had limited implementation. Despite the impact that unhealthy lifestyles at the workplace may have on the cardiovascular health of U.S. workers, there is currently no policy in place aimed at improving this. In this review, we discuss recent evidence on the prevalence of physical inactivity among Americans, with a special focus on the time spent at the workplace; and the invaluable opportunity that workplace-based lifestyle interventions may represent for improving the prevention of cardiovascular disease. We describe the current regulatory context, the key stakeholders involved, and present specific, guideline-inspired initiatives to be considered by both Congress and employers to improve the "cardiovascular safety" of US jobs. Additionally, we discuss how the COVID-19 pandemic has forever altered the workplace, and what lessons can be taken from this experience and applied to cardiovascular disease prevention in the new American workplace. For many Americans, long sitting hours at their job represent a risk to their cardiovascular health. We discuss how a paradigm shift in how we approach cardiovascular health, from focusing on leisure time to also focusing on work time, may help curtail the epidemic of cardiovascular disease in this country.
成年美国工人阶级平均将工作日清醒时间的50%用于工作。这些工作绝大多数主要涉及体力活动较少的任务,且经常接触不健康的食物选择。传统上,工作场所一直是心血管疾病预防的挑战性环境,心血管疾病指南在那里的实施有限。尽管工作场所不健康的生活方式可能对美国工人的心血管健康产生影响,但目前尚无旨在改善这种情况的政策。在本综述中,我们讨论了美国人身体活动不足患病率的最新证据,特别关注在工作场所花费的时间;以及基于工作场所的生活方式干预措施对于改善心血管疾病预防可能代表的宝贵机会。我们描述了当前的监管背景、涉及的关键利益相关者,并提出了国会和雇主应考虑的具体的、受指南启发的举措,以提高美国工作岗位的“心血管安全性”。此外,我们讨论了新冠疫情如何永久性地改变了工作场所,以及可以从这段经历中吸取哪些教训并应用于新的美国工作场所的心血管疾病预防。对许多美国人来说,长时间坐在工作岗位上对他们的心血管健康构成风险。我们讨论了在心血管健康方面如何从专注于休闲时间转变为同时关注工作时间,这种范式转变可能有助于遏制该国的心血管疾病流行。