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Associations between occupational relative aerobic workload and resting blood pressure among different age groups: a cross-sectional analysis in the DPhacto study.

ABSTRACT: OBJECTIVE:High levels of occupational physical activity (OPA) increase heart rate, blood pressure (BP) and the risk of hypertension. Older workers may be more vulnerable to high levels of OPA due to age-related degeneration of the cardiovascular system and cardiorespiratory fitness. This study investigates the association of relative aerobic workload (RAW) with resting BP and examines if this relation is moderated by age. DESIGN:Cross-sectional epidemiological study. SETTING:Data were collected among employees of 15 Danish companies in the cleaning, manufacturing and transport sectors. PARTICIPANTS:2107 employees were invited for participation, of these 1087 accepted and 562 (42% female and 4% non-Westerns) were included in the analysis based on the criteria of being non-pregnant, no allergy to bandages, sufficient amount of heart rate data corresponding to ?4 work hours per workday or 75% of average work hours, and no missing outcome and confounder values. PRIMARY AND SECONDARY OUTCOME MEASURES:The primary outcome measure was BP. RESULTS:Heart rate reserve was estimated from ambulatory 24-hour heart rate measures covering 2.5 workdays per participant (SD 1.0?day). Age significantly moderated the association between RAW and BP. Mean intensity and duration of high RAW (?30%?heart rate reserve) showed positive associations with diastolic BP and negative associations with pulse pressure (PP) among participants ?47 years old. Tendencies towards negative associations between RAW and BP were seen among participants <47 years old. CONCLUSIONS:Mean intensity and duration of RAW increased diastolic BP among participants ?47 years old. Negative associations with PP may be due to healthy worker selection bias. Prevention of hypertension should consider reductions in RAW for ageing workers.

SUBMITTER: Korshoj M

PROVIDER: S-EPMC6773343 | biostudies-literature | 2019 Sep

REPOSITORIES: biostudies-literature

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Associations between occupational relative aerobic workload and resting blood pressure among different age groups: a cross-sectional analysis in the DPhacto study.

Korshøj Mette M Clays Els E Krause Niklas N Gupta Nidhi N Jørgensen Marie Birk MB Holtermann Andreas A

BMJ open 20190924 9

<h4>Objective</h4>High levels of occupational physical activity (OPA) increase heart rate, blood pressure (BP) and the risk of hypertension. Older workers may be more vulnerable to high levels of OPA due to age-related degeneration of the cardiovascular system and cardiorespiratory fitness. This study investigates the association of relative aerobic workload (RAW) with resting BP and examines if this relation is moderated by age.<h4>Design</h4>Cross-sectional epidemiological study.<h4>Setting</h ...[more]

PMID: 31551379

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Project description:IntroductionOccupational physical activity (OPA), including occupational lifting (OL), seems to increase the risk of cardiovascular disease (CVD). Knowledge about the association between OL and risk of CVD is sparse, but repeated OL is assumed to result in prolonged raised blood pressure and heart rate (HR) eventually augmenting the risk of CVD. To disentangle parts of the mechanisms behind the raised 24-hour ambulatory blood pressure measurement (24h-ABPM), by exposure to OL, this study aimed to explore the acute differences in 24h-ABPM, relative aerobic workload (RAW) and OPA across workdays with and without OL, and secondary to assess the feasibility and rater agreement of direct field observations of the frequency and load of occupational lifting.MethodsThis controlled cross-over study investigates associations between moderate to high OL and 24h-ABPM, RAW in per cent of heart rate reserve (%HRR) and level of OPA. This included 2x24h monitoring of 24h-ABPM (Spacelabs 90217), PA (Axivity) and HR (Actiheart), comprising a workday containing OL and a workday without. The frequency and burden of OL were directly observed in field. The data were time synchronized and processed in the Acti4 software. Differences across workdays with and without OL in 24h-ABPM, RAW and OPA were evaluated using repeated 2 × 2 mixed-models among 60 blue-collar workers in Denmark.. Exposure to OL was estimated by direct manual field observation, registering burden and frequency of OL. Interrater reliability tests were performed across 15 participants representing 7 occupational groups. Interclass correlation coefficient (ICC) estimates of total burden lifted and frequency of lifts were calculated, based on a mean-rating (k = 2), absolute-agreement, 2 way mixed-effects model, indicating the raters as fixed effects.ResultsOL led to non-significant increases in ABPM during work-time (systolic Δ1.79 mmHg, 95%CI -4.49-8.08, diastolic Δ0.43 mmHg, 95%CI -0.80-1.65), and on 24-hours basis (systolic Δ1.96 mmHg, 95%CI -3.80-7.72, diastolic Δ0.53 mmHg, 95%CI -3.12-4.18), significant increases in RAW during work (Δ7.74 %HRR, 95%CI 3.57-11.91) as well as a raised level of OPA (Δ4156.88 steps, 95%CI 1898.83-6414.93, Δ-0.67 hours of sitting time, 95%CI -1.25-0.10, Δ-0.52 hours of standing time, 95%CI -1.03-0.01, Δ0.48 hours of walking time, 95%CI 0.18-0.78). ICC estimates were 0.998 (95% CI 0.995-0.999) for total burden lifted and 0.992 (95% CI 0.975-0.997) for frequency of lift.DiscussionOL increased both intensity and volume of OPA among blue-collar workers, which supposedly to contributes to an augmented risk of CVD. Although this study finds hazardous acute effects, further investigations are needed to evaluate the long-term effects of OL on ABPM, HR and volume of OPA, also effects of cumulative exposure to OL would be relevant to investigate.ConclusionOL significantly raised the intensity and volume of OPA. Direct field observation of occupational lifting showed an excellent interrater reliability.

Project description:BackgroundThe knowledge, from laboratory studies dating back to the 1950s on the importance of the association between cardiorespiratory fitness and aerobic workload for workers health, is fundamental for promoting sustainable healthy employability among ageing blue-collar workers today. However, the association between cardiorespiratory fitness and aerobic workload has not yet been documented during daily work, and we do not know if it applies to the normal work of blue-collar workers in different age groups. We aim to investigate the association between cardiorespiratory fitness and aerobic workload among blue-collar workers using measurements of 24-h heart rate collected over consecutive working days.MethodsWe analyzed baseline cardiorespiratory fitness, assessed using a sub-maximal cycle ergometer test, and 1-4 days of 24-h heart rate measurement from 497 blue-collar workers participating in the DPHACTO study. We investigated the association between cardiorespiratory fitness and aerobic workload defined as the average percentage of heart rate reserve (%HRR), maximum %HRR and the duration time spent at a high HRR (> 30%) during working hours. The association was assessed using multivariate linear regression models adjusted for age, sex, self-rated health, shift-work, prescription medication and occupation, as well as for different age strata.ResultsHigher cardiorespiratory fitness was significantly associated with decreased mean %HRR -0.32 [95% CI -0.39 to -0.25], maximum %HRR -0.35 [95% CI -0.45 to -0.25] and time spent at ≥ 30% HRR; -1.8% [95% CI -2.2 to -1.5%]. These associations were evident across age groups, with slightly stronger associations for workers aged 46-51 (total range 18-68).ConclusionsHigher cardiorespiratory fitness was associated with the decreased aerobic workload during normal work across all age groups and levels of work intensity. Our findings highlight the importance of cardiorespiratory fitness when considering the workload and its relevance in the promotion of healthy sustainable employment.

Project description:This study aimed to determine physical performance criteria of different occupational groups by investigating physical activity and energy expenditure in healthy Swiss employees in real-life workplaces on workdays and non-working days in relation to their aerobic capacity (VO2max). In this cross-sectional study, 337 healthy and full-time employed adults were recruited. Participants were classified (nine categories) according to the International Standard Classification of Occupations 1988 and merged into three groups with low-, moderate- and high-intensity occupational activity. Daily steps, energy expenditure, metabolic equivalents and activity at different intensities were measured using the SenseWear Mini armband on seven consecutive days (23 hours/day). VO2max was determined by the 20-meter shuttle run test. Data of 303 subjects were considered for analysis (63% male, mean age: 33 yrs, SD 12), 101 from the low-, 102 from the moderate- and 100 from the high-intensity group. At work, the high-intensity group showed higher energy expenditure, metabolic equivalents, steps and activity at all intensities than the other groups (p<0.001). There were no significant differences in physical activity between the occupational groups on non-working days. VO2max did not differ across groups when stratified for gender. The upper workload limit was 21%, 29% and 44% of VO2max in the low-, moderate- and high-intensity group, respectively. Men had a lower limit than women due to their higher VO2max (26% vs. 37%), when all groups were combined. While this study did confirm that the average workload limit is one third of VO2max, it showed that the average is misrepresenting the actual physical work demands of specific occupational groups, and that it does not account for gender-related differences in relative workload. Therefore, clinical practice needs to consider these differences with regard to a safe return to work, particularly for the high-intensity group.

Project description:BackgroundThe magnitude of socioeconomic health inequalities differs across age groups. It is less clear whether socioeconomic health inequalities differ across age groups by other factors that are known to affect the relation between socioeconomic position and health, like the indicator of socioeconomic position, the health outcome, gender, and as to whether socioeconomic health inequalities are measured in absolute or in relative terms. The aim is to investigate whether absolute and relative socioeconomic health inequalities differ across age groups by indicator of socioeconomic position, health outcome and gender.MethodsThe study sample was derived from the baseline measurement of the LifeLines Cohort Study and consisted of 95,432 participants. Socioeconomic position was measured as educational level and household income. Physical and mental health were measured with the RAND-36. Age concerned eleven 5-years age groups. Absolute inequalities were examined by comparing means. Relative inequalities were examined by comparing Gini-coefficients. Analyses were performed for both health outcomes by both educational level and household income. Analyses were performed for all age groups, and stratified by gender.ResultsAbsolute and relative socioeconomic health inequalities differed across age groups by indicator of socioeconomic position, health outcome, and gender. Absolute inequalities were most pronounced for mental health by household income. They were larger in younger than older age groups. Relative inequalities were most pronounced for physical health by educational level. Gini-coefficients were largest in young age groups and smallest in older age groups.ConclusionsAbsolute and relative socioeconomic health inequalities differed cross-sectionally across age groups by indicator of socioeconomic position, health outcome and gender. Researchers should critically consider the implications of choosing a specific age group, in addition to the indicator of socioeconomic position and health outcome, as findings on socioeconomic health inequalities may differ between them.

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Associations between occupational relative aerobic workload and resting blood pressure among different age groups: a cross-sectional analysis in the DPhacto study.

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Associations between occupational relative aerobic workload and resting blood pressure among different age groups: a cross-sectional analysis in the DPhacto study.

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