The relationship between physical activity and health at work

By Louise Fleng Sandal, Associate Professor, University of Southern Denmark, Department of Sports Science and Clinical Biomechanics, Research Unit for Physical Activity and Health in working life.

Physical activity

Often physical activity in relation to health is seen as a continuum ranging from inactive to active, with the preconception that being inactive is unhealthy and active as good and beneficial for physical and mental health. When looking at recommendations, such as from the World Health Organization or National Health Institutes, for level of physical activity in relation to health, being physically active above a cut-point is considered health promoting and beneficial overall. However, physical activity can be categorized in different settings, and it is interesting to have a closer look at the relationship between physical activity at leisure time as opposed to an occupational setting.

The paradox between physical activity at leisure vs. occupational exposure.

There is a paradox to address in the relationship between physical health and level of physical activity. When talking about physical activity performed as leisure time activity, such as going for a run or walk, participating in sports or active transportation such as biking or walking, the relationship between physical activity and health is as expected and incremental. Consequently, meeting the recommendations for amount and intensity of physical activity or exceeding the recommendation has a beneficial and health promoting effect on physical health.1 However, the relationship is reversed when talking about physical activity performed in an occupational setting.3 Consequently, being highly physically active at work is associated with higher rates of disease and premature health.1 Most commonly mentioned occupational types associated with poor physical health often involve heavy lifting and awkward postures. However, occupational types include high amounts of physical activity such as high amounts of walking as seen in cleaners and health care workers is similarly associated with poorer physical health often as musculoskeletal pain.

Physical activity as “cause”

When physical activity is seen as a “cause” of poor physical health it often relates to the relationship between physical work demands and physical capacity.2 The relationship can be viewed as seesaw; if the physical work demands exceed the physical capacity of the individual, then the seesaw tips towards an “unhealthy” cycle, where the individual has insufficient time to counteract the high physical work demands resulting in poor physical health. If the individual’s physical capacity is greater then the physical work demands, then the seesaw is balanced or tips towards a “healthy” cycle of building health. One might wonder why, the occupational physical activity that a cleaner performs at work results in poor when the volume of the physical activity easily exceeds the recommended level of 10.000 steps pr. day? While many factors contribute, a primary mechanism is the intensity of the physical activity being performed. Consequently, although a cleaner walks, stands and moves much during a day, then intensity of the physical activity is too low to result in a positive effect for cardiovascular health and instead the high volume becomes burdensome of the individual.

Exercise as “cure”

Still keeping our cleaner in mind, physical activity performed at sufficient intensity and volume can counteract the occupational work demand and shift the seesaw to a being in balance or even towards a healthy relationship. The characteristics of the occupational profile and work demands need to be addressed in exercise for the worker. As an example, an office worker who is mostly sedentary at work and has pain in their neck and lower back needs more focus on exercise for aerobic capacity and exercises strengthening their upper extremities, where as a carpenter may need heavy resistance exercise for lower extremities and lower back to counteract heavy lifting and pain during to awkward postures. Consequently, offering workers access and guidance to exercise programmes that factors in their occupational profile can result in better health and reduced disability. Also, there is often a need for guidance and support from a managerial level to support such participation and a need for clear communication as to why the worker needs to be more active rather than relaxing when off from work.

Intelligent Physical Exercise Training (IPET)

The Research Unit for Physical Activity and Health in Working Life has developed the conceptual model of Intelligent Physical Exercise Training (IPET), an algorithm-based exercise program that takes occupational profile and the health issues of the individual worker into account when designing exercise for occupational health that can be implemented at the workplace. If you want to know more about the concepts please see our overview article here: https://doi.org/10.1186/1471-2458-14-652 or see an example with videos for sedentary work here: https://www.sdu.dk/da/intelligenttraening.  

References:

1Holtermann, A., Hansen, J. V., Burr, H., Sogaard, K., & Sjogaard, G. (2012). The health paradox of occupational and leisure-time physical activity. British Journal of Sports Medicine, 46(4), 291-295. https://doi.org/10.1136/bjsm.2010.079582

2Sogaard, K., & Sjogaard, G. (2017). Physical Activity as Cause and Cure of Muscular Pain: Evidence of Underlying Mechanisms [Review]. Exercise and Sport Sciences Reviews, 45(3), 136-145. https://doi.org/10.1249/JES.0000000000000112

3Sjogaard, G., Christensen, J. R., Justesen, J. B., Murray, M., Dalager, T., Fredslund, G. H., & Sogaard, K. (2016). Exercise is more than medicine: The working age population’s well-being and productivity. J Sport Health Sci, 5(2), 159-165. https://doi.org/10.1016/j.jshs.2016.04.004

4Sjogaard, G., Justesen, J. B., Murray, M., Dalager, T., & Sogaard, K. (2014). A conceptual model for worksite intelligent physical exercise training–IPET–intervention for decreasing life style health risk indicators among employees: a randomized controlled trial [Article]. BMC Public Health, 14(1), 652, Article 652. https://doi.org/10.1186/1471-2458-14-652