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Men with highly active jobs tend to die earlier than men with inactive jobs

Physical activity guidelines should differentiate between occupational and leisure physical activity

Louise Prime

Tuesday, 15 May 2018

Men who are highly physically active at work are at significantly higher risk of dying early than men with mostly inactive jobs – even when leisure time physical activity was taken into account – according to research* published today in the British Journal of Sports Medicine. The researchers behind the study said their findings suggest that physical activity guidelines should differentiate between occupational and leisure physical activity.

Most international activity guidelines recommend that people take at least 30 minutes’ moderate level (or harder) physical activity each day, but they do not take account of whether that activity occurs at work or in leisure time. But researchers from The Netherlands cited recent evidence suggesting there might be a physical activity paradox, with beneficial health outcomes associated with leisure time physical activity, but detrimental health outcomes for those engaging in high-level occupational physical activity, and they decided to investigate further.

They conducted a quantitative systematic review of evidence regarding the association between occupational physical activity and all-cause mortality, analysing 33 papers (covering 26 studies) and using the results from 17 studies (with a total of 193,696 participants) in a meta-analysis.

This showed that men with high-level occupational physical activity had an 18% increased risk of early mortality compared with men engaging in low-level occupational physical activity (hazard ratio HR 1.18). But they observed no such association among women, for whom instead there was a tendency for an inverse association (HR 0.90).

The study authors said: “This systematic review shows that men with high levels of occupational physical activity experience higher mortality risks from all causes compared with those engaging in low levels of occupational activity, even after controlling for relevant factors (including leisure time physical activity). These findings suggest that a physical activity paradox may exist in male workers. The mechanisms behind this should be explored further.”

And they concluded: “If the observed associations are causal, then physical activity guidelines should differentiate between occupational and leisure time physical activity. Meeting current general physical activity guidelines through occupational physical activity instead of leisure time physical activity may not provide the intended health benefits or may even confer health risks.”


*Coenen P, Huysmans MA, Holtermann A, et al. Do highly physically active workers die early? A systematic review with meta analysis of data from 193,696 participants. Br J Sports Med 2018; 0: 1–9. doi:10.1136/bjsports-2017-09854.

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