Blue collar workers with high occupational physical activity (OPA) are well known to have an increased risk for cardiovascular disease. However, there are considerable knowledge-gaps about (1) if OPA impairs instead of promotes cardiovascular health like leisure time physical activity (LTPA), and (2) if workers with high OPA should be advised to be highly physically active during leisure.

These questions are important for public and occupational health because

1. A sizeable fraction of the working population all over the world still has high OPA

2. LTPA may provide an effective preventive measure for workers with high OPA

3. International recommendations and guidelines regarding OPA and cardiovascular health are lacking.

The study by Harari et al1 helps to fill these research gaps. The study, on 4819 male industrial workers, showed a multiadjusted higher incidence rate of coronary heart disease (CHD) mortality and all-cause mortality among men with moderate-hard OPA compared with men with none-mild OPA. In contrast, men performing high LTPA (ie, 30 min at least twice a week) had a multiadjusted reduced …