TY - JOUR
T1 - Occupational physical activity and longevity in working men and women in Norway
T2 - a prospective cohort study
AU - Dalene, Knut Eirik
AU - Tarp, Jakob
AU - Selmer, Randi Marie
AU - Ariansen, Inger Kristine Holtermann
AU - Nystad, Wenche
AU - Coenen, Pieter
AU - Anderssen, Sigmund Alfred
AU - Steene-Johannessen, Jostein
AU - Ekelund, Ulf
N1 - Funding Information: The study was funded by the Norwegian Research Council (grant number 249932/F20). The work of KED was also funded internally by the Department of Sports Medicine, the Norwegian School of Sport Sciences (Oslo, Norway). The remaining authors were funded internally by their institutional tenures or positions. The authors acknowledge statistician Hein Stigum at the Norwegian Institute of Public Health, Oslo, Norway, for essential assistance in devolving the Stata code for the flexible parametric survival models. We thank all of those involved in conducting the Norwegian population-based health examination surveys over the years, and most importantly, we thank all of the participants. Funding Information: The study was funded by the Norwegian Research Council ( grant number 249932/F20 ). The work of KED was also funded internally by the Department of Sports Medicine, the Norwegian School of Sport Sciences (Oslo, Norway). The remaining authors were funded internally by their institutional tenures or positions. The authors acknowledge statistician Hein Stigum at the Norwegian Institute of Public Health, Oslo, Norway, for essential assistance in devolving the Stata code for the flexible parametric survival models. We thank all of those involved in conducting the Norwegian population-based health examination surveys over the years, and most importantly, we thank all of the participants. Publisher Copyright: © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license Copyright: Copyright 2021 Elsevier B.V., All rights reserved.
PY - 2021/6
Y1 - 2021/6
N2 - Background: Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. Methods: In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18–65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. Findings: During a median of 28 years (IQR 25–31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI −0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. Interpretation: Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health. Funding: The Norwegian Research Council (grant number 249932/F20).
AB - Background: Studies suggest that high occupational physical activity increases mortality risk. However, it is unclear whether this association is causal or can be explained by a complex network of socioeconomic and behavioural factors. We aimed to examine the association between occupational physical activity and longevity, taking a complex network of confounding variables into account. Methods: In this prospective cohort study, we linked data from Norwegian population-based health examination surveys, covering all parts of Norway with data from the National Population and Housing Censuses and the Norwegian Cause of Death Registry. 437 378 participants (aged 18–65 years; 48·7% men) self-reported occupational physical activity (mutually exclusive groups: sedentary, walking, walking and lifting, and heavy labour) and were followed up from study entry (between February, 1974, and November, 2002) to death or end of follow-up on Dec 31, 2018, whichever came first. We estimated differences in survival time (death from all causes, cardiovascular disease, and cancer) between occupational physical activity categories using flexible parametric survival models adjusted for confounding factors. Findings: During a median of 28 years (IQR 25–31) from study entry to the end of follow-up, 74 203 (17·0%) of the participants died (all-cause mortality), of which 20 111 (27·1%) of the deaths were due to cardiovascular disease and 29 886 (40·3%) were due to cancer. Crude modelling indicated shorter mean survival times among men in physically active occupations than in those with sedentary occupations. However, this finding was reversed following adjustment for confounding factors (birth cohort, education, income, ethnicity, prevalent cardiovascular disease, smoking, leisure-time physical activity, body-mass index), with estimates suggesting that men in occupations characterised by walking, walking and lifting, and heavy labour had life expectancies equivalent to 0·4 (95% CI −0·1 to 1·0), 0·8 (0·3 to 1·3), and 1·7 (1·2 to 2·3) years longer, respectively, than men in the sedentary referent category. Results for mortality from cardiovascular disease and cancer showed a similar pattern. No clear differences in survival times were observed between occupational physical activity groups in women. Interpretation: Our results suggest that moderate to high occupational physical activity contributes to longevity in men. However, occupational physical activity does not seem to affect longevity in women. These results might inform future physical activity guidelines for public health. Funding: The Norwegian Research Council (grant number 249932/F20).
UR - http://www.scopus.com/inward/record.url?scp=85106482670&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/S2468-2667(21)00032-3
DO - https://doi.org/10.1016/S2468-2667(21)00032-3
M3 - Article
C2 - 33932334
SN - 2468-2667
VL - 6
SP - e386-e395
JO - The Lancet Public Health
JF - The Lancet Public Health
IS - 6
ER -