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BMJ Open. 2012 Feb 13;2(1):e000556. doi: 10.1136/bmjopen-2011-000556. Print 2012.

Occupational and leisure time physical activity: risk of all-cause mortality and myocardial infarction in the Copenhagen City Heart Study. A prospective cohort study.

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National Research Centre for the Working Environment, Copenhagen, Denmark.



Men with low physical fitness and high occupational physical activity are recently shown to have an increased risk of cardiovascular disease and all-cause mortality. The association between occupational physical activity with cardiovascular disease and all-cause mortality may also depend on leisure time physical activity.


A prospective cohort study.


The Copenhagen City Heart Study.


7819 men and women aged 25-66 years without a history of cardiovascular disease who attended an initial examination in the Copenhagen City Heart Study in 1976-1978.


Myocardial infarction and all-cause mortality. Occupational physical activity was defined by combining information from baseline (1976-1978) with reassessment in 1981-1983. Conventional risk factors were controlled for in Cox analyses.


During the follow-up from 1976 to 1978 until 2010, 2888 subjects died of all-cause mortality and 787 had a first event of myocardial infarction. Overall, occupational physical activity predicted all-cause mortality and myocardial infarction in men but not in women (test for interaction p=0.02). High occupational physical activity was associated with an increased risk of all-cause mortality among men with low (HR 1.56; 95% CI 1.11 to 2.18) and moderate (HR 1.31; 95% CI 1.05 to 1.63) leisure time physical activity but not among men with high leisure time physical activity (HR 1.00; 95% CI 0.78 to 1.26) (test for interaction p=0.04). Similar but weaker tendencies were found for myocardial infarction. Among women, occupational physical activity was not associated with subsequent all-cause mortality or myocardial infarction.


The findings suggest that high occupational physical activity imposes harmful effects particularly among men with low levels of leisure time physical activity.

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