Physical Labor Linked to Higher Risks of Heart Disease, Death; Leisure Exercise Linked to Lower Risks

A new study published in the European Heart Journal shows that physical activity during leisure time and occupational physical activity have opposite, and independent, associations with cardiovascular disease risk and longevity. Higher levels of physical leisure activity were associated with a decreased risk of major adverse cardiac events (MACE) and overall risk of death, whereas higher levels of physical labor had the opposite effect.

The study followed 104,046 individuals aged 20-100 years from the Copenhagen General Population Study with baseline measurements from 2003-2014. The participants completed questionnaires on physical activity during leisure and employment, which were then sorted into categories of low, moderate, high, or very high activity. In a median follow-up after 10 years, there had been 9846 deaths from all causes and 7913 MACE.

After adjusting for age, sex, lifestyle, health, and education, the results showed that moderate, high, and very high activity were associated with 26%, 41%, and 40% reduced risks of death, respectively, and 14%, 23%, and 15% reduced risks of MACE, respectively. In contrast, high and very high activity were associated with 13% and 27% increased risks of death, respectively, and 15% and 35% increased risks of MACE, respectively, compared to low work activity.

“Many people with manual jobs believe they get fit and healthy by their physical activity at work and therefore can relax when they get home,” said Andreas Holtermann, PhD, in a press release. “Unfortunately, our results suggest that this is not the case. And while these workers could benefit from leisure physical activity, after walking 10,000 steps while cleaning or standing seven hours in a production line, people tend to feel tired so that's a barrier.”

The study did not investigate the reasons behind these opposite associations in occupational and leisure activity. However, Holtermann said work activity often does not sufficiently raise heart rate to improve fitness, and work involving lifting for several hours a day increases blood pressure for many hours, potentially raising heart disease risk.

In contrast, physical leisure activity elevates heart rate for extended periods while only briefly impacting blood pressure. Holtermann recommends reorganizing occupational activity to mimic the benefits of leisure exercise, such as rotating workers between workstations on a production line so that employees have a mixture of sitting, standing, and lifting during a shift.

“Societies need adults with sufficient health and fitness to work longer since the retirement age is increasing,” Holtermann said. “We need to find ways to make active work good for health.”


Leisure physical activity is linked with health benefits but work activity is not [news release]. EurekAlert; April 8, 2021. Accessed April 13, 2021.