TY - JOUR

T1 - Acute myocardial infarction in relation to physical activities at work

T2 - a nationwide follow-up study based on job-exposure matrices

AU - Bonde, Jens Peter Ellekilde

AU - Flachs, Esben Meulengracht

AU - Madsen, Ida Eh

AU - Petersen, Sesilje Bondo

AU - Andersen, Johan Hvid

AU - Hansen, Johnni

AU - Jørgensen, Esben Budtz

AU - Kolstad, Henrik

AU - Holtermann, Andreas

AU - Schlünssen, Vivi

AU - Svendsen, Susanne Wulff

PY - 2020/5/1

Y1 - 2020/5/1

N2 - Objective This study aimed to evaluate sex-specific risks of acute myocardial infarction (AMI) according to lifting and standing/walking at work. Methods The study population included 1.15 million Danish wage earners. Annual job codes from 1976 onwards were linked to specific exposures using job-exposure matrices (JEM). Cases of AMI during follow-up 1996-2016 were retrieved from national registers. Incidence rate ratios (IRR) were computed by Poisson regression adjusting for demographic and JEM-assessed lifestyle factors. Models addressed physical activities at work the previous 0-2 years (short-term risk) and cumulative physical activities (long-term risk). Results During 21.4 million person-years of follow-up, 22 037 AMI occurred in men and 6942 in women. Exposure-response relationships between recent physical activities at work and AMI were not evident. In men, the fully adjusted long-term IRR for the highest of five exposure categories compared to the lowest were 1.09 [95% confidence interval (CI) 1.03-1.15] for lifting and 1.01 (95% CI 0.96-1.07) for standing/walking. In women, the corresponding figures were 1.27 (95% CI 1.15-1.40) and 1.18 (95% CI 1.07-1.30). The latter risk estimate was strongly attenuated, and the trend became insignificant when adjusted for lifting. Findings were only partially supported by sensitivity analyses. Conclusion The study provides limited support to the hypothesis that long-term lifting and standing/walking at work is related to increased risk of AMI. Possible effects of acute physical exertion are not addressed and bias towards the null because of crude exposure assignment cannot be ruled out.

AB - Objective This study aimed to evaluate sex-specific risks of acute myocardial infarction (AMI) according to lifting and standing/walking at work. Methods The study population included 1.15 million Danish wage earners. Annual job codes from 1976 onwards were linked to specific exposures using job-exposure matrices (JEM). Cases of AMI during follow-up 1996-2016 were retrieved from national registers. Incidence rate ratios (IRR) were computed by Poisson regression adjusting for demographic and JEM-assessed lifestyle factors. Models addressed physical activities at work the previous 0-2 years (short-term risk) and cumulative physical activities (long-term risk). Results During 21.4 million person-years of follow-up, 22 037 AMI occurred in men and 6942 in women. Exposure-response relationships between recent physical activities at work and AMI were not evident. In men, the fully adjusted long-term IRR for the highest of five exposure categories compared to the lowest were 1.09 [95% confidence interval (CI) 1.03-1.15] for lifting and 1.01 (95% CI 0.96-1.07) for standing/walking. In women, the corresponding figures were 1.27 (95% CI 1.15-1.40) and 1.18 (95% CI 1.07-1.30). The latter risk estimate was strongly attenuated, and the trend became insignificant when adjusted for lifting. Findings were only partially supported by sensitivity analyses. Conclusion The study provides limited support to the hypothesis that long-term lifting and standing/walking at work is related to increased risk of AMI. Possible effects of acute physical exertion are not addressed and bias towards the null because of crude exposure assignment cannot be ruled out.

KW - Cohort study

KW - Epidemiology

KW - Heart disease

KW - Heavy lifting

KW - JEM

KW - Occupation

KW - Standing

KW - Strenuous work

KW - Walking

UR - http://www.scopus.com/inward/record.url?scp=85084961316&partnerID=8YFLogxK

U2 - 10.5271/sjweh.3863

DO - 10.5271/sjweh.3863

M3 - Journal article

C2 - 31725896

VL - 46

SP - 268

EP - 277

JO - Scandinavian Journal of Work, Environment and Health

JF - Scandinavian Journal of Work, Environment and Health

SN - 0355-3140

IS - 3

ER -