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Occupational physical activity and risk of mortality in women and men: the Tromsø Study 1986–2021
  1. Edvard H Sagelv1,
  2. Knut Eirik Dalene2,
  3. Anne Elise Eggen3,
  4. Ulf Ekelund2,4,
  5. Marius Steiro Fimland5,6,
  6. Kim Arne Heitmann1,
  7. Andreas Holtermann7,8,
  8. Kristoffer Robin Johansen1,
  9. Maja-Lisa Løchen9,
  10. Bente Morseth1,
  11. Tom Wilsgaard3
  1. 1 School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
  2. 2 Department of Chronic Diseases, Norwegian Institute of Public Health, Oslo, Norway
  3. 3 Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
  4. 4 Department of Sports Medicine, Norwegian School of Sports Sciences, Oslo, Norway
  5. 5 Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
  6. 6 Unicare Helsefort Rehabilitation Centre, Rissa, Norway
  7. 7 National Research Centre for the Working Environment, Copenhagen, Denmark
  8. 8 Department of Sport Science and Biomechanics, University of Southern Denmark, Odense, Denmark
  9. 9 Department of Clinical Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Norway
  1. Correspondence to Edvard H Sagelv, School of Sport Sciences, Faculty of Health Sciences, UiT The Arctic University of Norway, Tromsø, Troms, Norway; edvard.h.sagelv{at}uit.no

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.

  • Physical activity
  • Cardiovascular Diseases
  • Epidemiology
  • Observational study

Data availability statement

Data may be obtained from a third party and are not publicly available. The data underlying this article were provided by the Tromsø Study under licence, and so are not publicly available. Data can be shared on application to the Tromsø Study Data and Publication Committee: https://uit.no/research/tromsostudy https://uit.no/research/tromsostudy.

https://doi.org/10.1136/bjsports-2023-107282

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    Data availability statement

    Data may be obtained from a third party and are not publicly available. The data underlying this article were provided by the Tromsø Study under licence, and so are not publicly available. Data can be shared on application to the Tromsø Study Data and Publication Committee: https://uit.no/research/tromsostudy https://uit.no/research/tromsostudy.

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    Footnotes

    • Twitter @edvardhsagelv, @knuteirik47, @mariusfimland, @KimAHeitmann, @profHoltermann, @KristofferRJ89, @majalisalochen1, @MorsethBente

    • Contributors EHS designed the study and act as guarantor for the study. AEE, M-LL and TW contributed to acquisition and processing of raw Tromsø Study data. EHS performed statistical analyses. TW provided statistical expertise. EHS wrote the initial draft of the manuscript. All authors critically reviewed the study's results, contributed to revisions and approved the final version of the manuscript.

    • Funding This work was funded by the High North Population Studies, an internally funded research project at UiT The Arctic University of Norway to EHS (no grant number). The remaining authors are funded through their respective positions/tenures.

    • Competing interests M-LL has received lecture fees from Bayer, Sanofi and BMS/Pfizer not related to this study. The remaining authors declare no conflict of interest.

    • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.