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Lifetime high occupational physical activity and total and cause-specific mortality among 320 000 adults in the NIH-AARP study: a cohort study
  1. David Martinez Gomez1,2,3,
  2. Pieter Coenen4,
  3. Carlos Celis-Morales5,6,
  4. Jorge Mota7,
  5. Fernando Rodriguez-Artalejo1,2,3,
  6. Charles Matthews8,
  7. Pedro F Saint-Maurice8
  1. 1Preventive Medicina and Public Health, Universidad Autonoma de Madrid, Madrid, Spain
  2. 2Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP), Madrid, Spain
  3. 3IMDEA Food Institute, Campus de Excelencia Internacional UAM+CSIC, Madrid, Spain
  4. 4Department of Public and Occupational Health, Amsterdam UMC - Locatie VUMC, Amsterdam, Netherlands
  5. 5Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
  6. 6Institute of Cardiovascular and Medical Sciences, Glasgow, UK
  7. 7Research Center on Physical Activity, Health and Leisure, Faculty of Sport, University of Porto, Porto, Portugal
  8. 8National Cancer Institute, Bethesda, Maryland, USA
  1. Correspondence to Dr David Martinez Gomez, Preventive Medicina and Public Health, Universidad Autonoma de Madrid, Madrid, 28049 Madrid, Spain; d.martinez{at}


Objectives We examined the associations of history and duration in high occupational physical activity (OPA) with long-term total and cause-specific mortality.

Methods The sample included 322 126 participants (135 254 women) from the National Institutes of Health–AARP Diet and Health Study, established in 1995–1996. History and duration in high OPA were reported by participants. All-cause, cardiovascular, cancer and other cause mortality records available through 31 December 2011.

Results The prevalence of high OPA was 52.1% in men and 16.1% in women. During 13.6 years (SD, 3.3) of follow-up, 73 563 participants (25 219 women) died. In age-adjusted models, the risk of death was higher among men (HR 1.14, 95% CI 1.12 to 1.16) and women (HR 1.22, 95% CI 1.18 to 1.26) with a history of high OPA. However, these associations were substantially attenuated in women (HR 1.04, 95% CI 1.00 to 1.07, an 81.8% attenuation) and eliminated in men (HR 1.02, 95% CI 0.99 to 1.04, 85.7% attenuation) after multivariable adjustments. Similar important attenuation results were found when examining duration in high OPA, as well as using cause-specific deaths as the outcomes. Educational attainment and smoking patterns were the main contributors in the excess mortality among people working in highly physically active jobs in both men and women.

Conclusion Participating in high OPA was not consistently associated with a higher mortality risk, after adjustments for education and smoking factors. Workers in high OPA should be aware that they might not be getting all well-known health benefits of being physically active if they are only very active at work.

  • mortality
  • exercise
  • preventive medicine
  • occupational health
  • physical exertion

Data availability statement

No data are available.

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  • Contributors DMG, CM and PFS-M had full access to the data. All authors were involved in the analysis of data, interpretation and writing of the report, and had final responsibility for the decision to submit for publication.

  • Funding The NIH-AARP Diet and Health Study was supported by the Intramural Research Programme of the National Cancer Institute, National Institutes of Health. CM and PFS-M were supported by the National Institutes of Health’s Intramural Research Programme: National Cancer Institute. DMG is supported by a ’Ramon y Cajal’ contract (RYC-2016-20546).

  • Disclaimer The findings and conclusions in this article are those of the authors and do not necessarily represent the official position of the National Institutes of Health and the author’s Universities. The National Institutes of Health was responsible for all data collection and management of baseline and mortality follow-up data but had no role in the design of this study, the analysis and interpretation of the results, or drafting of the manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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