TY - JOUR T1 - Is there a ‘recent occupational paradox’ where highly active physically active workers die early? Or are there failures in some study methods? JF - British Journal of Sports Medicine JO - Br J Sports Med SP - 1557 LP - 1559 DO - 10.1136/bjsports-2018-100344 VL - 53 IS - 24 AU - Roy J Shephard Y1 - 2019/12/01 UR - http://bjsm.bmj.com/content/53/24/1557.abstract N2 - Occupational epidemiology studies in the 1980s and 1990s demonstrated a beneficial effect of physically active employment on risks of premature death,1 with HR of ~1.50 for sedentary employees (see the online supplement for a detailed discussion). However, that accepted wisdom was disputed in a recent meta-analysis which claimed that male employees faced ‘detrimental health consequences associated with high-level occupational activity, even after adjusting for relevant factors’.2 Such a view challenges existing physical activity guidelines and poses the intriguing problem why occupational activity might be bad for men but not women.Here the author scrutinises the choice of articles for this meta-analysis, the characteristics of apparently hazardous activity and potential confounding by covariates, focusing on the male data. Possible reasons why women do not show an occupational paradox are discussed in the online supplemental material.Supplementary file [bjsports-2018-100344supp001.docx] Articles for the meta-analysis were drawn from 13 countries, but 5 of 16 were written by the study authors, leading to some similarities in the determination of active individuals and choice of co-variates. Moreover, participants in 5 of 16 studies lived around Copenhagen, with a potential for subject overlap; the author does not believe that this was evaluated. Studies provided ~30 to 5668 male … ER -