{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T02:58:54Z","timestamp":1790305134944,"version":"4.1.0"},"reference-count":35,"publisher":"BMJ","issue":"10","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2021,1,30]]},"published-print":{"date-parts":[[2021,10]]},"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Emerging evidence, predominately from European and Asian countries, describes opposing effects of occupational physical activity (OPA) and leisure-time physical activity (LTPA) on cardiovascular health. This analysis examined cardiovascular disease (CVD) prevalence associated with OPA and LTPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This cross-sectional analysis of 2015 National Health Interview Survey data (n=16 974) employed logistic regression to estimate odds (OR) of self-reported CVD (coronary heart disease, heart attack, stroke or angina) with self-reported total occupational activity (TOA), occupational exertion (OE), occupational standing and walking (OSW) and LTPA. OPA was measured using two questions: \u2018How often does your job involve\u2026\u2019 (1) \u2018repeated lifting, pushing, pulling or bending?\u2019 (OE) and (2) \u2018standing or walking around?\u2019 (OSW) with responses on a 5-item Likert scale (0=never, 4=always). TOA was categorised similarly after summing OE and OSW scores. LTPA was defined as 0, 1\u2013149 or \u2265150 min\/week of moderate-to-vigorous activity. All models adjusted for common socioeconomic variables and additional analyses were stratified by sex, smoking status and LTPA.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Odds for CVD were higher when \u2018always\u2019 performing TOA (OR 1.99 95% CI 1.12 to 3.53), OE (OR 2.15, 95% CI 1.45 to 3.19) or OSW (OR 1.84, 95% CI 1.07 to 3.17) compared with \u2018never\u2019. When restricting to never-smokers, odds for CVD were higher when \u2018always\u2019 performing TOA (OR 3.00, 95% CI 1.38 to 6.51) and OE (OR 3.00, 95% CI 1.80 to 5.02) versus \u2018never\u2019.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Associations of high OPA with CVD were equally apparent across sexes, stronger in lower LTPA levels and stronger in never-smokers. While uncontrolled confounding is still possible, even after extensive adjustment, the seemingly paradoxical adverse associations with OPA and CVD should be investigated further.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oemed-2020-106948","type":"journal-article","created":{"date-parts":[[2021,3,18]],"date-time":"2021-03-18T17:21:14Z","timestamp":1616088074000},"page":"724-730","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Occupational physical activity and cardiovascular disease in the United States"],"prefix":"10.1136","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0172-062X","authenticated-orcid":false,"given":"Tyler D.","family":"Quinn","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick L.","family":"Yorio","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8286-4563","authenticated-orcid":false,"given":"Peter M.","family":"Smith","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongsuk","family":"Seo","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Geoffrey P.","family":"Whitfield","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bethany","family":"Barone Gibbs","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2021,3,18]]},"reference":[{"key":"2024110805101929000_78.10.724.1","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.167.22.2453"},{"key":"2024110805101929000_78.10.724.2","unstructured":"Physical Activity Guidelines Advisory Committee . Physical activity guidelines Advisory Committee scientific report. Washington, DC: US Department of Health and Human Services, 2018."},{"key":"2024110805101929000_78.10.724.3","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jshs.2012.07.009","article-title":"Chronic disease and the link to physical activity","volume":"2","author":"Durstine","year":"2013","journal-title":"J Sport Health Sci"},{"key":"2024110805101929000_78.10.724.4","doi-asserted-by":"crossref","first-page":"184","DOI":"10.1123\/jpah.2013-0198","article-title":"Effects of leisure-time and occupational physical activity on total mortality risk in NHANES III according to sex, ethnicity, central obesity, and age","volume":"12","author":"Richard","year":"2015","journal-title":"J Phys Act Health"},{"key":"2024110805101929000_78.10.724.5","unstructured":"Physical Activity Guidelines Advisory Committee . 2018 physical activity guidelines for Americans. Washington D.C: U.S. Department of Health and Human Services, 2018."},{"key":"2024110805101929000_78.10.724.6","doi-asserted-by":"publisher","DOI":"10.1097\/00005768-199707000-00009"},{"key":"2024110805101929000_78.10.724.7","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-098540"},{"key":"2024110805101929000_78.10.724.8","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.1357"},{"key":"2024110805101929000_78.10.724.9","doi-asserted-by":"publisher","DOI":"10.1136\/bjsm.2010.079582"},{"key":"2024110805101929000_78.10.724.10","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097965"},{"key":"2024110805101929000_78.10.724.11","doi-asserted-by":"crossref","first-page":"409","DOI":"10.1038\/s41366-019-0419-8","article-title":"Movement behavior profiles and obesity: a latent profile analysis of 24-h time-use composition among Danish workers","volume":"44","author":"Gupta","year":"2020","journal-title":"Int J Obes"},{"key":"2024110805101929000_78.10.724.12","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2018-100344"},{"key":"2024110805101929000_78.10.724.13","unstructured":"National Center for Health Statistics . Survey Desciption. Hyattsville, Maryland: National Health Interview Survey, 2015."},{"key":"2024110805101929000_78.10.724.14","unstructured":"Centers for Disease Control and Prevention . 2008 physical activity guidelines for Americans: centers for disease control and prevention, 2008."},{"key":"2024110805101929000_78.10.724.15","unstructured":"Description S . National health interview survey, 2017. Hyattsville, Maryland: National Center for Health Statistics, 2018."},{"key":"2024110805101929000_78.10.724.16","doi-asserted-by":"crossref","first-page":"1037","DOI":"10.1093\/sleep\/33.8.1037","article-title":"Sleep duration and cardiovascular disease: results from the National health interview survey","volume":"33","author":"Sabanayagam","year":"2010","journal-title":"Sleep"},{"key":"2024110805101929000_78.10.724.17","doi-asserted-by":"publisher","DOI":"10.1016\/S0895-4356(98)00146-2"},{"key":"2024110805101929000_78.10.724.18","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a009653"},{"key":"2024110805101929000_78.10.724.19","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2004.04.005"},{"key":"2024110805101929000_78.10.724.20","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1093\/aje\/kwx298","article-title":"The relationship between occupational standing and sitting and incident heart disease over a 12-year period in Ontario, Canada","volume":"187","author":"Smith","year":"2018","journal-title":"Am J Epidemiol"},{"key":"2024110805101929000_78.10.724.21","doi-asserted-by":"crossref","DOI":"10.1161\/JAHA.115.002495","article-title":"Quantifying the association between physical activity and cardiovascular disease and diabetes: a systematic review and meta\u2010analysis","volume":"5","author":"Wahid","year":"2016","journal-title":"J Am Heart Assoc"},{"key":"2024110805101929000_78.10.724.22","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.010710"},{"key":"2024110805101929000_78.10.724.23","unstructured":"Control CfD, . Prevention. health behaviors of adults: United States, 2011\u20132014, 2014."},{"key":"2024110805101929000_78.10.724.24","doi-asserted-by":"publisher","DOI":"10.1007\/s10654-014-9883-6"},{"key":"2024110805101929000_78.10.724.25","doi-asserted-by":"crossref","first-page":"89","DOI":"10.1016\/j.ypmed.2014.01.025","article-title":"Impact of different domains of physical activity on cause-specific mortality: a longitudinal study","volume":"62","author":"Wanner","year":"2014","journal-title":"Prev Med"},{"key":"2024110805101929000_78.10.724.26","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.22405"},{"key":"2024110805101929000_78.10.724.27","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-12-1070"},{"key":"2024110805101929000_78.10.724.28","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.2913"},{"key":"2024110805101929000_78.10.724.29","doi-asserted-by":"publisher","DOI":"10.1177\/1010539512471966"},{"key":"2024110805101929000_78.10.724.30","doi-asserted-by":"crossref","first-page":"976","DOI":"10.1002\/ajim.22756","article-title":"Physical activity and 22-year all-cause and coronary heart disease mortality","volume":"60","author":"Krause","year":"2017","journal-title":"Am J Ind Med"},{"key":"2024110805101929000_78.10.724.31","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2009.05339.x"},{"key":"2024110805101929000_78.10.724.32","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0177042","article-title":"On the health paradox of occupational and leisure-time physical activity using objective measurements: effects on autonomic imbalance","volume":"12","author":"Hallman","year":"2017","journal-title":"PLoS One"},{"key":"2024110805101929000_78.10.724.33","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3475"},{"key":"2024110805101929000_78.10.724.34","doi-asserted-by":"crossref","first-page":"444","DOI":"10.1093\/ajh\/hpw197","article-title":"Does Aerobic Exercise Increase 24-Hour Ambulatory Blood Pressure Among Workers With High Occupational Physical Activity?-A RCT","volume":"30","author":"Korsh\u00f8j","year":"2017","journal-title":"Am J Hypertens"},{"key":"2024110805101929000_78.10.724.35","doi-asserted-by":"publisher","DOI":"10.1080\/02701367.2000.10608875"}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oemed-2020-106948","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,8]],"date-time":"2024-11-08T13:12:08Z","timestamp":1731071528000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oemed-2020-106948"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,18]]},"references-count":35,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2021,9,15]]},"published-print":{"date-parts":[[2021,10]]}},"alternative-id":["10.1136\/oemed-2020-106948"],"URL":"https:\/\/doi.org\/10.1136\/oemed-2020-106948","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,18]]}}}