University of Oulu

Mikkola TM, von Bonsdorff MB, Salonen MK, et al. Physical heaviness of work and sitting at work as predictors of mortality: a 26-year follow-up of the Helsinki Birth Cohort Study. BMJ Open 2019;9:e026280. doi:10.1136/bmjopen-2018-026280

Physical heaviness of work and sitting at work as predictors of mortality : a 26-year follow-up of the Helsinki Birth Cohort Study

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Author: Mikkola, Tuija M1; von Bonsdorff, Mikaela B1,2; Salonen, Minna K1,3;
Organizations: 1Folkhälsan Research Center, Helsinki, Finland
2Gerontology Research Centre, Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
3Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
4Primary Health Care Unit, Kuopio University Hospital, Kuopio, Finland
5Center for Life Course Health Research, University of Oulu, Finland
6Finnish Institute of Occupational Health, Helsinki, Finland
7Department of General Practice and Primary Health Care, University of Helsinki, Helsinki, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
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Language: English
Published: BMJ, 2019
Publish Date: 2019-07-12


Objectives: To examine the relationships of late-career physical heaviness of work and sitting at work with mortality. A national-level job exposure matrix was used to determine the occupation-specific level of physical heaviness and sitting.

Design: Prospective cohort study between years 1990 and 2015.



Participants: 5210 men and 4725 women from the Helsinki Birth Cohort Study with an occupational code at baseline (ages 45–57 years).

Primary and secondary outcome measures: Total, cardiovascular (International Classification of Diseases 10th Revision I00–I99), cancer (C00–C97) and external (S00–Y84) mortality.

Results: The exposures, physical heaviness and sitting had a non-linear, inverse relationship. During the 26-year follow-up, 1536 men and 759 women died. Among men, physical heaviness of work was positively associated and sitting at work was negatively associated with all-cause, cardiovascular and external cause mortality but they were not associated with cancer mortality. The HRs for men in the highest quartile of physical heaviness of work compared with men in the lowest quartile were 1.54 (1.31–1.80) for all-cause mortality, 1.70 (1.30–2.23) for cardiovascular mortality and 3.18 (1.75–5.78) for external cause mortality (adjusted for age and years of education). Compared with the lowest quartile, the HRs for the highest quartile of sitting at work among men were 0.71 (0.61–0.82) for all-cause mortality, 0.59 (0.45–0.77) for cardiovascular mortality and 0.38 (0.22–0.66) for external cause mortality. In women, neither physical heaviness of work nor sitting at work was associated with mortality.

Conclusions: Men in physically heavy work at their late-work career are at higher risk of death than men in physically light work.

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Series: BMJ open
ISSN: 2044-6055
ISSN-E: 2044-6055
ISSN-L: 2044-6055
Volume: 9
Issue: 5
Article number: e026280
DOI: 10.1136/bmjopen-2018-026280
Type of Publication: A1 Journal article – refereed
Field of Science: 3142 Public health care science, environmental and occupational health
Funding: This work was supported by Etera Mutual Pension Insurance Company; Emil Aaltonen Foundation; Finnish Foundation for Diabetes Research; Foundation for Pediatric Research, Novo Nordisk Foundation; Signe and Ane Gyllenberg Foundation; Sigrid Jusélius Foundation; Samfundet Folkhälsan; Finska Läkaresällskapet; Liv och Hälsa; European Commission within the 7th Framework Programme (DORIAN, grant agreement number 278603); and European Union Horizon 2020 programme (DYNAHEALTH grant number 633595; LifeCycle number 733206). The Academy of Finland supported MBvB (grant number 257239) and JGE (grant numbers 129369, 129907, 135072, 129255 and 126775).
EU Grant Number: (633595) DYNAHEALTH - Understanding the dynamic determinants of glucose homeostasis and social capability to promote Healthy and active aging
(733206) LIFECYCLE - Early-life stressors and LifeCycle health
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