Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986-2021

Edvard H Sagelv; Knut Eirik Dalene; Anne Elise Eggen; Ulf Ekelund; Marius Steiro Fimland; Kim Arne Heitmann; Andreas Holtermann; Kristoffer Robin Johansen; Maja-Lisa Løchen; Bente Morseth; Tom Wilsgaard

doi:10.1136/bjsports-2023-107282

Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986-2021

Br J Sports Med. 2024 Jan 3;58(2):81-88. doi: 10.1136/bjsports-2023-107282.

Authors

Affiliations

¹ School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway edvard.h.sagelv@uit.no.
² Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway.
³ Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁴ Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway.
⁵ Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway.
⁶ Unicare Helsefort Rehabilitation Centre, Rissa, Norway.
⁷ School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.
⁸ National Research Centre for the Working Environment, Copenhagen, Denmark.
⁹ Department of Sport Science and Biomechanics, University of Southern Denmark, Odense, Denmark.
¹⁰ Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway.

PMID: 37914386
DOI: 10.1136/bjsports-2023-107282

Abstract

Objective: Associations between occupational physical activity (OPA) and mortality risks are inconclusive. We aimed to examine associations between (1) OPA separately and (2) jointly with leisure time physical activity (LTPA), and risk of all-cause, cardiovascular disease (CVD) and cancer mortality, over four decades with updated exposure and covariates every 6-8 years.

Methods: Adults aged 20-65 years from the Tromsø Study surveys Tromsø3-Tromsø7 (1986-2016) were included. We categorised OPA as low (sedentary), moderate (walking work), high (walking+lifting work) or very high (heavy manual labour) and LTPA as inactive, moderate and vigorous. We used Cox/Fine and Gray regressions to examine associations, adjusted for age, body mass index, smoking, education, diet, alcohol and LTPA (aim 1 only).

Results: Of 29 605 participants with 44 140 total observations, 4131 (14.0%) died, 1057 (25.6%) from CVD and 1660 (40.4%) from cancer, during follow-up (median: 29.1 years, 25th-75th: 16.5.1-35.3). In men, compared with low OPA, high OPA was associated with lower all-cause (HR 0.83, 95% CI 0.74 to 0.92) and CVD (subdistributed HR (SHR) 0.68, 95% CI 0.54 to 0.84) but not cancer mortality (SHR 0.99, 95% CI 0.84 to 1.19), while no association was observed for moderate or very high OPA. In joint analyses using inactive LTPA and low OPA as reference, vigorous LTPA was associated with lower all-cause mortality combined with low (HR 0.75, 95% CI 0.64 to 0.89), high (HR 0.67, 95% CI 0.54 to 0.82) and very high OPA (HR 0.74, 95% CI 0.58 to 0.94), but not with moderate OPA. In women, there were no associations between OPA, or combined OPA and LTPA, with mortality.

Conclusion: High OPA, but not moderate and very high OPA, was associated with lower all-cause and CVD mortality risk in men but not in women. Vigorous LTPA was associated with lower mortality risk in men with low, high and very high OPA, but not moderate OPA.

Keywords: Cardiovascular Diseases; Epidemiology; Observational study; Physical activity.

MeSH terms

Adult
Cardiovascular Diseases*
Exercise
Female
Humans
Leisure Activities
Male
Neoplasms*
Risk Factors