Epidemiology Department, Local Health Unit TO3, Piedmont Region, Grugliasco, Torino, Italy.
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, BS8 2BN, UK.
Int Arch Occup Environ Health. 2022 Apr;95(3):607-619. doi: 10.1007/s00420-021-01765-0. Epub 2021 Oct 11.
Several 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.
Among 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.
Occupational 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.
In 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.
最近的几项研究表明存在“体力活动悖论”，即闲暇时间的体力活动有益于健康，但职业体力活动则有害。然而，其他研究表明职业体力活动是有益的。本研究使用来自意大利全国代表性样本的数据，调查体力活动的环境或领域是否对死亡率和冠心病（CHD）事件有影响。
在基线时年龄为 40-55 岁的 40220 名男性和女性中，我们使用 Cox 模型比较了职业、家庭和闲暇时间体力活动与随访期间长达 14 年的死亡率和 CHD 事件风险的关联。我们考虑了社会人口因素、吸烟、体重指数（BMI）、身心健康状况和教育程度。
对于女性，职业体力活动与死亡率或 CHD 事件风险无显著关联，对于男性，职业体力活动与 CHD 事件风险也无显著关联。在粗模型中，与最低职业活动组相比，最高职业活动组的男性死亡率更高（HR 1.26，95%CI 1.01，1.57）。调整健康相关行为、健康状况和教育程度后，这种关联减弱（HR 1.03，95%CI 0.77，1.38）。在粗模型中，仅对于男性，闲暇时间体力活动与死亡率和 CHD 风险降低显著相关。家庭体力活动与两种结局均无关联。
在意大利中年工人的大样本中，我们发现职业体力活动对死亡率或 CHD 事件的有害或有益影响的证据有限。然而，置信区间较宽，结果与多种方向的影响一致。
