Lifestyle-associated health risk indicators across a wide range of occupational groups: a cross-sectional analysis in 72,855 workers

Abstract

Background Identify and compare health risk indicators for common chronic diseases between different occupational groups. Methods A total of 72,855 participants (41% women) participating in an occupational health service screening in 2014–2019 were included. Occupation was defined by the Swedish Standard Classification of Occupation, and divided into nine major and additionally eight sub-major groups. These were analysed separately, as white- and blue-collar occupations and as low- and high-skilled occupations. Seven health risk indicators were self-reported: exercise, physical work situation, sitting at work and leisure, smoking, diet, and perceived health, whereas cardiorespiratory fitness, BMI and blood pressure were measured. These were further dichotomized (yes/no) and as clustering of risk indicators (≥3 vs. <3). Results The greatest variation in OR across sub-major and major occupational groups were seen for daily smoking (OR = 0.68 to OR = 5.12), physically demanding work (OR = 0.55 to OR = 45.74) and high sitting at work (OR = 0.04 to OR = 1.86). For clustering of health risk indicators, blue-collar workers had significantly higher clustering of health risks (OR: 1.80; 95% CI 1.71–1.90) compared to white-collar workers (reference). Compared to high-skilled white-collar workers, low-skilled white-collar workers had similar OR (2.00; 1.88–2.13) as high-skilled blue-collar workers (1.98; 1.86–2.12), with low-skilled blue-collar workers having the highest clustered risk (2.32; 2.17–2.48). Conclusion There were large differences in health risk indicators across occupational groups, mainly between high-skilled white-collar occupations and the other occupations, with important variations also between major and sub-major occupational groups. Future health interventions should target the occupational groups identified with the highest risk for effective disease prevention.

Cardiorespiratory Fitness in Occupational Groups—Trends over 20 Years and Future Forecasts

“…Solely in relation to CRF, the annual difference in total and cardiovascular disease related health care costs has been reported to be double (41% and 56% higher) in the group with low CRF (mean 29.4 mL/min/kg) and high CRF (mean 45.5 mL/min/kg) [43]. In the present study, blue-collar low-skilled workers had the lowest mean CRF and the highest prevalence of low CRF-an occupational group which has previously been shown to have the most strenuous physical working situation but the lowest level of leisure time exercise [10]. This combination of low CRF and high physical work demands is deleterious and is suggested to both impair work productivity [11,45], as well as to increase the risk of cardiovascular and all-cause mortality compared with individuals with low physical work demands [46].…”

“…In low-skilled white-collar, high-skilled blue-collar, and low-skilled blue-collar, almost half had low CRF at the end of the study period. Together with the previously reported higher prevalence of daily smoking, poorer diet, no regular exercise, and a higher risk of myocardial infarction in these groups compared with highskilled white-collar occupations [10,44], this highlights the need for targeted lifestyle interventions in these occupational groups for future health and sustainability. Solely in relation to CRF, the annual difference in total and cardiovascular disease related health care costs has been reported to be double (41% and 56% higher) in the group with low CRF (mean 29.4 mL/min/kg) and high CRF (mean 45.5 mL/min/kg) [43].…”

“…Major group 6 of agriculture and forestry was excluded due to a low number of participants (n = 3624). A more detailed description of the occupational groups can be acquired from Vaisanen et al [10].…”

“…In the present study, blue-collar low-skilled occupational groups had the highest prevalence of low CRF, and were at the same time the group with, in general, the most physically demanding work. This makes them a high priority target for future health enhancing interventions [10]. Therefore, it would be advantageous to promote health enhancing physical activity at work, and to diversify the physical activity pattern at work through structural changes of how tasks are performed in all occupational groups.…”

“…We recently compared lifestyle-related risk indicators between different occupational groups, where blue-collar and low-skilled occupations had a higher prevalence of obesity, daily smoking, and poor diet [10]. However, interestingly, the proportion of participants with low CRF differed between occupations, despite having a similar level of education.…”