Berglund Karin, Almroth Melody, Ekblom-Bak Elin, Falkstedt Daniel, Hemmingsson Tomas, Kjellberg Katarina
Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, floor 10, 11 365 Stockholm, Sweden.
Centre for Occupational and Environmental Medicine, Region Stockholm, Solnavägen 4, floor 10, 113 65 Stockholm, Sweden.
Eur J Prev Cardiol. 2025 Jun 12. doi: 10.1093/eurjpc/zwaf344.
To investigate the association between high occupational physical workload in mid-life and subsequent ischemic heart disease (IHD), and if this association is influenced by cardiorespiratory fitness assessed in youth.
A total of 284 436 men, born 1951-1961, were compared in terms of occupational physical workload assessed with a job exposure matrix in 2005 (age 44-54) and followed up regarding IHD incidence and mortality, between 2006-2020 (age 45-69). Cardiorespiratory fitness in youth was assessed during military conscription, using a maximal cycle test. Cox regression and additive interaction modelling, using the synergy index (SI), were applied.
High occupational physical workload in mid-life was associated with an increased risk of incident IHD (HR 1.34, 95% CI 1.29-1.39) and IHD mortality (HR 1.93, 95% CI 1.75-2.14), compared to having low occupational physical workload. The associations attenuated with adjustments for early life factors, e.g. socioeconomic position, body mass index, blood pressure, and highest attained education. However, they remained statistically significant; HR 1.06 (95 % CI 1.02-1.11) for incident IHD and HR 1.38 (95% CI 1.23-1.55) for IHD mortality. Having both low cardiorespiratory fitness in youth and later high physical workload showed the highest risk, indicating an additive interaction, but the SI was non-significant.
High occupational physical workload in mid-life was associated with increased risks of IHD incidence and mortality. The combination of low fitness and high workload showed the highest risks. These results encourage both workplace and public health interventions for variation in occupational physical workload and improvement in cardiorespiratory fitness.
研究中年时期高职业体力负荷与随后发生的缺血性心脏病（IHD）之间的关联，以及这种关联是否受到青年时期评估的心肺适能的影响。
对总共284436名出生于1951年至1961年的男性进行比较，根据2005年（44至54岁）使用工作暴露矩阵评估的职业体力负荷，并在2006年至2020年期间（45至69岁）对IHD发病率和死亡率进行随访。青年时期的心肺适能在征兵期间通过最大自行车测试进行评估。应用Cox回归和使用协同指数（SI）的相加交互作用建模。
与低职业体力负荷相比，中年时期高职业体力负荷与IHD发病风险增加（HR 1.34，95%CI 1.29 - 1.39）和IHD死亡率增加（HR 1.93，95%CI 1.75 - 2.14）相关。对早期生活因素进行调整后，这种关联减弱，例如社会经济地位、体重指数、血压和最高学历。然而，它们在统计学上仍然显著；IHD发病的HR为1.06（95%CI 1.02 - 1.11），IHD死亡率的HR为1.38（95%CI 1.23 - 1.55）。青年时期心肺适能低且后期体力负荷高的风险最高，表明存在相加交互作用，但协同指数不显著。
中年时期高职业体力负荷与IHD发病率和死亡率风险增加相关。低适能与高负荷的组合风险最高。这些结果鼓励在工作场所和公共卫生方面进行干预，以改变职业体力负荷并提高心肺适能。
