TY - JOUR
T1 - Physical demands at work, physical fitness, and 30-year ischaemic heart disease and all-cause mortality in the Copenhagen male study
AU - Holtermann, Andreas
AU - Mortensen, Ole Steen
AU - Burr, Hermann
AU - Søgaard, Karen
AU - Gyntelberg, Finn
AU - Suadicani, Poul
PY - 2010/9
Y1 - 2010/9
N2 - Objective: No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis. Method: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 employed men aged 40-59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO2Max)] using the Åstrand cycling test and determined physical work demands with two self-reported questions. Results: In the Copenhagen Male Study, 587 men (11.9%) died due to ischaemic heart disease (IHD). Using men with low physical work demands as the reference group, Cox analyses - adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, and hypertension - showed that high physical work demands were associated with an increased risk of IHD mortality in the least fit [VO2Max range 15-26, N=892, hazard ratio (HR) 2.04, 95% confidence interval (95% CI) 1.20-3.49] and moderately fit (VO2Max range 27-38, N=3037, HR 1.75, 95% CI 1.24-2.46), but not among the most fit men (VO 2Max range 39-78, N=1014, HR 1.08, 95% CI 0.52-2.17). We found a similar, although slightly weaker, relationship with respect to all-cause mortality. Conclusions: The hypothesis was supported. Men with low and medium physical fitness have an increased risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects.
AB - Objective: No previous long-term prospective studies have examined if workers with low cardiorespiratory fitness have an increased risk of cardiovascular mortality due to high physical work demands. We tested this hypothesis. Method: We carried out a 30-year follow-up of the Copenhagen Male Study of 5249 employed men aged 40-59 years. We excluded from follow-up 274 men with a history of myocardial infarction, prevalent symptoms of angina pectoris, or intermittent claudication. We estimated physical fitness [maximal oxygen consumption (VO2Max)] using the Åstrand cycling test and determined physical work demands with two self-reported questions. Results: In the Copenhagen Male Study, 587 men (11.9%) died due to ischaemic heart disease (IHD). Using men with low physical work demands as the reference group, Cox analyses - adjusted for age, blood pressure, smoking, alcohol consumption, body mass index, diabetes, and hypertension - showed that high physical work demands were associated with an increased risk of IHD mortality in the least fit [VO2Max range 15-26, N=892, hazard ratio (HR) 2.04, 95% confidence interval (95% CI) 1.20-3.49] and moderately fit (VO2Max range 27-38, N=3037, HR 1.75, 95% CI 1.24-2.46), but not among the most fit men (VO 2Max range 39-78, N=1014, HR 1.08, 95% CI 0.52-2.17). We found a similar, although slightly weaker, relationship with respect to all-cause mortality. Conclusions: The hypothesis was supported. Men with low and medium physical fitness have an increased risk of cardiovascular and all-cause mortality if exposed to high physical work demands. Ours observations suggest that, among men with high physical work demands, being physically fit protects against adverse cardiovascular effects.
KW - Cardiovascular health
KW - Occupational health
KW - Occupational physical activity
UR - http://www.scopus.com/inward/record.url?scp=77956245650&partnerID=8YFLogxK
U2 - 10.5271/sjweh.2913
DO - 10.5271/sjweh.2913
M3 - Article
C2 - 20352174
AN - SCOPUS:77956245650
SN - 0355-3140
VL - 36
SP - 357
EP - 365
JO - Scandinavian Journal of Work, Environment and Health
JF - Scandinavian Journal of Work, Environment and Health
IS - 5
ER -