{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,7]],"date-time":"2026-01-07T14:04:56Z","timestamp":1767794696513,"version":"3.49.0"},"reference-count":41,"publisher":"BMJ","issue":"2","license":[{"start":{"date-parts":[[2025,12,8]],"date-time":"2025-12-08T00:00:00Z","timestamp":1765152000000},"content-version":"unspecified","delay-in-days":160,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["bmjph"],"accepted":{"date-parts":[[2025,7,2]]},"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Evidence on the health effects of occupational physical activity (OPA) remains inconsistent, and potential sex-based differences in physical activity outcomes are understudied. Our goal was to investigate the relationships between OPA and leisure time physical activity (LTPA), both separately and in combination, and the risk of cancer, cardiovascular disease and all-cause mortality by sex.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Using data from the NHANES 2007\u20132018 database, the study involved 29\u2009404 adults aged 20 years and older with OPA. Physical activity was assessed through the Global Physical Activity Questionnaire, subjects were classified as inactive, insufficiently active, sufficiently active or highly active OPA. Mortality outcomes were determined by linking to the National Death Index records. Cox\/Fine-Gray regressions were employed to investigate sex-specific multivariable-adjusted associations. Covariates including age, race, body mass index, smoking status, hypertension, diabetes mellitus, alcohol consumption, education, income to poverty ratio, marriage status, access to medical care, self-rated health, LTPA and history of diseases were adjusted in the multivariable models.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median follow-up of 6.7 (3.7, 9.8) years for men and 6.8 (3.8,9.8) years for women, 1560 deaths in men and 1150 deaths in women occurred. For men, highly active OPA compared with inactivity was associated with 23% lower risk of all-cause mortality. For women, sufficiently active OPA compared with inactivity was associated with 36% lower risk of all-cause mortality. According to joint analyses that used inactive LTPA and inactive OPA as reference, \u2265150\u2009min LTPA was linked to the lowest risk of all-cause mortality (HR: 0.25; 95%\u2009CI 0.12 to 0.54) and cardiovascular mortality (HR 0.27, 95%\u2009CI 0.12 to 0.64) in women when combined with \u2265150\u2009min OPA.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>OPA had a beneficial association with cancer mortality in women and risk of all-cause mortality in both sexes. OPA and LTPA were jointly linked to a further decreased risk of death from all causes and cardiovascular disease in women.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjph-2024-002164","type":"journal-article","created":{"date-parts":[[2025,12,10]],"date-time":"2025-12-10T07:20:20Z","timestamp":1765351220000},"page":"e002164","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Occupational physical activity and risk of all-cause, cardiovascular disease and cancer mortality among adults in the USA: a national cohort study"],"prefix":"10.1136","volume":"3","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-6888-0361","authenticated-orcid":false,"given":"Yinchu","family":"Li","sequence":"first","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7806-5387","authenticated-orcid":false,"given":"Jingkuo","family":"Li","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7137-3025","authenticated-orcid":false,"given":"Lubi","family":"Lei","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fang","family":"Yu","sequence":"additional","affiliation":[{"name":"Binzhou Medical University, Binzhou, Shandong, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yanwu","family":"Yu","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhenyan","family":"Zhao","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lihua","family":"Zhang","sequence":"additional","affiliation":[{"name":"Fuwai Hospital, Beijing, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2025,12,9]]},"reference":[{"key":"2026010703072141000_3.2.e002164.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)61031-9"},{"key":"2026010703072141000_3.2.e002164.2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2018.14854"},{"key":"2026010703072141000_3.2.e002164.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2019.03.009"},{"key":"2026010703072141000_3.2.e002164.4","doi-asserted-by":"crossref","DOI":"10.1186\/s12966-020-01042-2","article-title":"Advancing the global physical activity agenda: recommendations for future research by the 2020 WHO physical activity and sedentary behavior guidelines development group","volume":"17","author":"DiPietro","year":"2020","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2026010703072141000_3.2.e002164.5","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2022-105669"},{"key":"2026010703072141000_3.2.e002164.6","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2010.079582"},{"key":"2026010703072141000_3.2.e002164.7","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehab087"},{"key":"2026010703072141000_3.2.e002164.8","doi-asserted-by":"crossref","first-page":"104470","DOI":"10.1016\/j.ijnurstu.2023.104470","article-title":"Leisure-time physical activity, occupational physical activity and the physical activity paradox in healthcare workers: A systematic overview of the literature","volume":"141","author":"Janssen","year":"2023","journal-title":"Int J Nurs Stud"},{"key":"2026010703072141000_3.2.e002164.9","doi-asserted-by":"crossref","DOI":"10.1080\/07853890.2023.2245429","article-title":"Leisure time and occupational physical activity, overall and cardiovascular mortality: a 24-year follow-up in the OPERA study","volume":"55","author":"Suutari-J\u00e4\u00e4sk\u00f6","year":"2023","journal-title":"Ann Med"},{"key":"2026010703072141000_3.2.e002164.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2020-102587"},{"key":"2026010703072141000_3.2.e002164.11","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3993"},{"key":"2026010703072141000_3.2.e002164.12","doi-asserted-by":"crossref","DOI":"10.1186\/s12966-021-01166-z","article-title":"The effect of leisure time physical activity and sedentary behaviour on the health of workers with different occupational physical activity demands: a systematic review","volume":"18","author":"Prince","year":"2021","journal-title":"Int J Behav Nutr Phys Act"},{"key":"2026010703072141000_3.2.e002164.13","doi-asserted-by":"crossref","unstructured":"Coenen P , Huysmans M , Holtermann A , et al . 0018\u2005Do highly active workers die early? elucidating the physical activity health paradox in a systematic review with meta-analyses. 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