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  • 1.
    Clays, Els
    et al.
    Department of Public Health, Ghent University, Belgium.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Oakman, J.
    Department of Public Health, La Trobe University, Australia.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Objectively measured occupational physical activities in blue collar jobs: do psychosocial resources matter?2017In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, no 2SArticle in journal (Refereed)
    Abstract [en]

    Aim: Occupational physical activity (OPA), and particularly static postures and physically exerting activities, is known to impact worker health and to increase the risk of cardiovascular disease, musculoskeletal problems, sickness absence and premature retirement. The exploration of structural preventive measures at the workplace against the adverse health effects of excessive OPA is needed. The psychosocial work environment is hypothesised to buffer the adverse effects of OPA, and as such psychosocial resources might directly influence the performance of OPA. However, this has not been previously investigated with detailed objective measurements. The aim of this study is to describe OPA within blue-collar workers, and to examine the role of psychosocial job resources in the performance of OPA.

    Methods: Results are based on a sample of 198 blue-collar workers from the NOMAD (New method for Objective Measurements of physical Activity in Daily living) study, recruited from seven workplaces in Denmark. The sample included 112 men (56.6%) and 86 women (43.4%); the mean age was 44.9 years (SD 9.9). Data were collected with two Actigraph devices placed on the thigh and trunk, during four consecutive days. The accelerometer data were processed and analysed using the Acti4 software, to determine working time spent standing, walking, on feet and in activity of moderate to vigorous intensity level (MVPA). The level of influence and social support at work were assessed by questionnaire, and measured with a four-item scale. Analysis of (co-)variance and (multiple) linear regression models were conducted. All analyses were stratified by gender predominance of occupation.

    Results: The different types of OPA significantly varied by particular job type. Within male predominant occupations, job type accounted for 50–70% of explained variance, depending on the type of OPA. Manufacturing workers showed the highest average proportions of working time standing (33%) and on feet (79%), while garbage collectors had the highest proportion of working time in MVPA (33%). Mobile plant operators and construction workers had the lowest average working time spent walking and in MVPA. Differences in OPA between job types in female predominant occupations were less pronounced, but healthcare workers and cleaners had higher average proportions of time spent walking and in MVPA compared to assembly workers. The addition of age and psychosocial resources to the models did not contribute to a larger explained variance in OPA and the relations with job type remained significant. Social support at work showed an independent positive relation with working on feet, and with standing in female predominant jobs only. Influence at work was not related to OPA.

    Conclusion: The positive relation of social support with working on feet and standing is likely to be explained by the nature of the work tasks, as jobs that require these activities probably comprise more close interactions and as such create more intensified levels of cooperation at the work floor. Overall, our hypothesis that psychosocial job resources would affect the performance of OPA within blue-collar workers was not confirmed. These findings suggest that the performance of OPA within blue-collarjobs – and particularly within male predominant occupations – is mostly affected by work organisational factors related to specific job type, and not by psychosocial job resources.

  • 2.
    Coenen, Pieter
    et al.
    Department of Public and Occupational Health, VU University Medical Center, The Netherlands.
    Korshøj, Mette
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Hallman, David
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    van der Beek, Allard
    Department of Public and Occupational Health, VU University Medical Center, The Netherlands.
    Straker, Leon
    School of Physiotherapy and Exercise Science, Curtin.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Differences in heart rate reserve during occupational and leisure time physical activity in Danish blue-collar workers2017In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, no 2S, p. 33-34Article in journal (Refereed)
    Abstract [en]

    Aim: Physical activity (PA) is considered to be an important factor in the prevention of various cardiovascular diseases. However, recent studies suggest that while leisure time PA promotes cardiovascular health, occupational PA might impair cardiovascular health. An explanation for this PA health paradox may be a difference in the intensity and associated physical demands between occupational and leisure time PA. Occupational PA often consists of low-intensity, long-lasting physically demanding tasks, such as repetitive work and prolonged static working postures, which are presumed to cause sustained elevated heart rate that may stress the cardiovascular system. Despite this notion, the differences in physiological responses between occupational and leisure time PA are not well understood. Therefore, we aimed: (a) to study the difference in intensity of occupational and leisure time PA (expressed in percentage heart rate reserve; % HRR); and b) to assess whether this potential difference varies by gender and cardiorespiratory fitness level.

    Methods: We used data from the NOMAD study, in which Danish blue-collar workers from seven different workplaces took part in a four-day protocol of objective measurements of PA (using hip and thigh-worn accelerometers) and heart rate (using an ambulatory heart rate monitor). During occupational and leisure time, activities of sitting, standing, moving, walking and stair climbing were identified, and %HRR in each of these activities was determined. Differences in %HRR between occupational and leisure time PA were tested using generalised estimating equations (expressed in regression coefficient – beta with 95% confidence interval (CI)) adjusted for personal, health,work and lifestyle confounders.

    Result: In 124 workers with data on PA and heart rate, %HRR was higher for occupational PA compared to leisure time PA (beta1.9, 95% CI2.4,1.4,P<0.001). Differences in %HRR between occupational and leisure time PA were more pronounced in men than in women, and in those with high cardiorespiratory fitness compared to those with low cardiorespiratory fitness.

    Conclusion: This study is the first to assess differences in %HRR between occupational and leisure time PA, using objectiv emeasurements in blue-collarworkers. Cardiovascular intensity was higher in occupational activities (possibly due to additional physical and/or mental workloads) compared to the same activities during leisure time. The increase in cardiovascular intensity at work maybe a contributing factor to the health paradox of occupational and leisure time PA, suggesting negative cardiovascular health consequences for engagement in occupational PA (see Figure 1).

  • 3.
    Eslami, Bahareh
    et al.
    Mittuniversitetet, Avdelningen för hälsovetenskap och Tehran Heart Center, Tehran University of Medical Sciences.
    Macassa, Gloria
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Public health science. Mittuniversitetet, Institutionen för hälsovetenskap och Karolinska institutet.
    Sundin, Örjan
    Mittuniversitetet, Avdelningen för psykologi.
    Khankeh, Hamid Reza
    Karolinska Institutet; University of Social Welfare and Rehabilitation Sciences, Tehran, Iran.
    Soares, Joaquim J.F.
    Mittuniversitetet, Avdelningen för hälsovetenskap och Karolinska Institutet.
    Quality of life and life satisfaction among adults with and without congenital heart disease in a developing country2015In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 22, no 2, p. 169-179Article in journal (Refereed)
    Abstract [en]

    Background Life-expectancy of adults with congenital heart disease (CHD) has improved world-wide, but there are limited data on these patients' experiences of quality of life (QoL), life satisfaction (LS), and their determinants (e.g. social support), particularly among patients from developing countries.

    Design Cross-sectional case-control.

    Methods A total of 347 CHD patients (18-64 years, 52.2% women) and 353 non-CHD participants, matched by sex/age, were recruited from two heart hospitals in Tehran, Iran. LS and QoL served as dependent variables, and demographic/socioeconomic status, mental-somatic symptoms, social support, and clinical factors (e.g. defect category) served as independent variables in multiple regression analyses once among all participants, and once only among CHD patients.

    Results The CHD patients had significantly lower scores in LS and all domains of QoL than the control group. However, having CHD was independently negatively associated only with overall QoL, physical health, and life and health satisfaction. Additionally, multivariate analyses among the CHD patients revealed that female sex, younger age, being employed, less emotional distress, and higher social support were significantly associated with higher perceived QoL in most domains, while LS was associated with female sex, being employed, less emotional distress, and better social support. Neither QoL nor LS was associated with cardiac defect severity.

    Conclusions The adults with CHD had poorer QoL and LS than their non-CHD peers in our developing country. Socio-demographics, emotional health, and social support were important 'determinants' of QoL and LS among the CHD patients. Longitudinal studies are warranted to establish causal links.

  • 4.
    Hallman, David
    et al.
    University of Gävle, Faculty of Health and Occupational Studies, Department of Occupational and Public Health Sciences, Occupational health science. University of Gävle, Centre for Musculoskeletal Research.
    Birk Jørgensen, Marie
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Holtermann, Andreas
    National Research Centre for the Working Environment, Copenhagen, Denmark.
    Contrasting effect of objectively measured physical activity during work and leisure on heart rate variability during sleep2017In: European Journal of Preventive Cardiology, ISSN 2047-4873, E-ISSN 2047-4881, Vol. 24, no 2S, p. 32-33Article in journal (Refereed)
    Abstract [en]

    Aim: Leisure-time physical activity (LTPA) has a beneficial effect on cardiovascular health and longevity, while occupational physical activity (OPA) is associated with an increased risk of cardiovascular diseases and mortality. The physiological mechanism of this apparently contrasting relationship between LTPA and OPA on cardiovascular health remains unknown. A possible explanation is that OPA and LTPA exert different effects on the autonomic nervous system. Thus, we aimed to investigate whether objectively measured OPA and LTPA are differentially associated with cardiac autonomic regulation in an occupational sample.

    Methods: Cross-sectional data from the Danish cohort DPHACTO were analysed. The study comprised 514 bluecollar workers who took part in ambulatory monitoring of physical activity and heart rate variability (HRV). Physical activity (i.e. time spent in walking, climbing stairs, running and cycling) was assessed objectively using accelerometers (Actigraph) worn on the thigh, hip and trunk over 4–5 working days. Simultaneously, a heart rate monitor (Actiheart) was used to collect inter-beat intervals from the ECG signal. Heart rate and HRV indices were analysed during nocturnal sleep as markers of cardiac autonomic activity. Multiple regression analysis was used to determinethe main effects of OPA and LTPA and their interaction on heart rate and HRV indices, adjusting for multiple confounders (age, gender, body mass index, smoking and cardiovascular ailments).

    Results: Time spent in physical activity was on average (SD) 1.4 (0.6) hours/day for OPA and 0.9 (0.4) hours/day for LTPA. OPA showed generally negative associations with nocturnal HRV indices, while positive estimates were observed for LTPA. There was a statistically significant interaction effect between OPA and LTPA on heartrate (P < 0.0001) and HRV indices in time (root mean square of standard deviation, P = 0.004: standard deviation of normal to normal sinus beat, P = 0.019) and frequency domains (high frequency power, P = 0.022; low frequency power, P = 0.033). The favourable effect of LTPA on nocturnal HRV clearly diminished with higher levels of OPA, and high levels of both OPA and LTPA had a detrimental effect. The observed associations persisted after adjustment for possible confounders.

    Conclusion: Our findings suggest that time spent in OPA and LTPA have interactive effects on nocturnal autonomic regulation. Future longitudinal studies should examine whether autonomic regulation is a mediator for the effect of OPA and LTPA on cardiovascular disease and mortality.

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