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Work activity and fatal heart attack studied by multiple logistic risk analysis.

R J Brand, R S Paffenbarger, R I Sholtz

    American Journal of Epidemiology
    |July 1, 1979
    PubMed
    Summary
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    Vigorous physical exertion, measured as high work activity (WA), significantly reduces fatal heart attack (FHA) risk by half in longshoremen. This protective effect of high WA persists even after accounting for various health factors and selective influences.

    Area of Science:

    • Occupational Health
    • Cardiovascular Epidemiology
    • Physical Activity Research

    Background:

    • Heart disease remains a leading cause of mortality, with occupational factors potentially influencing risk.
    • Understanding the relationship between physical exertion at work and cardiovascular health is crucial for public health initiatives.

    Purpose of the Study:

    • To investigate the association between work energy expenditure and the risk of fatal heart attack (FHA) in a cohort of longshoremen.
    • To determine if vigorous physical activity offers a protective effect against FHA, independent of other known risk factors.

    Main Methods:

    • A 22-year prospective cohort study of 3975 San Francisco longshoremen, categorized by annual work activity (WA).
    • Multifactor logistic regression analysis was employed to assess FHA predictors, adjusting for age, race, blood pressure, smoking, BMI, glucose intolerance, and EKG status.

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  • Analysis also considered average WA over four years and the rate of change in WA to address selective factors.

    • Main Results:

    • Men with high work activity (7 kcal/min above basal metabolism) had approximately half the FHA rate compared to those with low WA (1 kcal/min above basal metabolism) (p=0.0003).
    • This reduced risk associated with high WA remained significant even after adjusting for baseline health factors and selective influences (p=0.0006).

    Conclusions:

    • Vigorous physical exertion through demanding work appears to confer a substantial protective effect against fatal heart attacks.
    • Occupational physical activity may be a key modifiable factor in reducing cardiovascular disease risk in working populations.