Is your job good for your health?
From the factory floor to the phone bank, from the boardroom to the emergency room, it's a complicated question to consider as we pursue paychecks and navigate careers.
"Health isn't just what we eat and how physically active we are," said Yvonne Michael, professor of epidemiology at Drexel University's School of Public Health in Philadelphia. "It's also what's happening at work that may allow us either to be more healthy or keep us from being healthy."
Sometimes the answer isn't a surprise.
A 2016 report by the Centers for Disease Control and Prevention compared seven cardiovascular health metrics – smoking, physical activity, blood pressure, blood sugar, body weight, cholesterol and healthy diet – among people with 22 different occupations.
Truck drivers, who tend to sit for long hours and eat on the go, were high on the unhealthy list, while farm, forestry and fishing employees had the best health metrics scores.
A study published in January in the Journal of Occupational and Environmental Medicine evaluated the 20 most common jobs among more than 65,000 older women. It found bookkeeping and accounting clerks, supervisors of sales workers and administrative support workers, and nursing and home health aides were among those who had higher than average risk of poor cardiovascular health, such as high cholesterol, high blood pressure and high blood sugar. Teachers, counselors and real estate brokers were among those less likely to have poor cardiovascular health.
The research did not examine why some jobs were more detrimental to health than others, but Michael, who was senior author of the study, said the findings suggest sedentary jobs, stress and the burdens of supervising others could be involved.
"If we can find out the factors associated with cardiovascular health, we can prevent cardiovascular disease from occurring," she said. "It might be possible for physicians to screen for occupations as a way to identify women who may have higher risk."
But the answers aren't always clear, nor can workers switch jobs after every new study. For example, an analysis published this month in the European Heart Journal of more than 280,000 people in England determined that people working night shifts had a higher risk of atrial fibrillation, a heart rhythm disorder, than people working days. It offered no clues as to the cause.
"It can be frustrating," Michael said. "A lot of people don't have choices about the jobs they have."
While exercise is widely regarded as good for the heart, a study of nearly 17,000 workers in the U.S. indicated people who had high levels of physical activity on the job, especially lifting and carrying, were more likely to have cardiovascular disease.
"Physical activity you do at work is potentially different for cardiovascular health compared to exercise you do outside work," said Tyler Quinn, who led the study, published in March in the journal Occupational and Environmental Medicine. "One hypothesis explaining this is that when you exercise in leisure time you're stressing the body in very specific time periods and letting the body recover. Activity during work often doesn't allow for that recovery time.
"So people who do continuous physical activity during the workday may end up with a higher cardiovascular load, higher blood pressure and heart rate, throughout the whole 24-hour day, and we know that is associated with lower cardiovascular health over time."
At the same time, said Quinn, a research physiologist with the CDC's National Institute for Occupational Safety and Health, the U.S. workforce has trended toward desk jobs, fostering a sedentary lifestyle that's not good for cardiovascular health either.
"We need to moderate some of the effects of those extremes," he said. "We want people who are moving all day at work to move a little bit less and take breaks, and people who are sitting at work to take breaks by moving. The body likes variety."
Whatever their jobs, Quinn said, workers can help themselves by following basic heart-healthy guidelines: keeping physically fit, eating well and not smoking.
But employers also can help, he said, by providing more breaks and different tasks for people with strenuous jobs, and more opportunities for desk-bound workers to get up and move around, while looking for ways to ease job stress and allow more control of the work environment.
Michael agreed. "We spend a lot of time at work, and workplaces have a lot of ability to shape their workers' opportunities for good health."
The COVID-19 pandemic that forced many more people to work from home added a new element to the work-health equation. Not having to commute could free up more time to exercise or cook healthy meals. But a home office also could mean fewer limits on snacking or even reaching for a cigarette.
"The virtual workplace does create a lot of flexibility, and we've seen benefits of that," Michael said. "But it's cut off some healthy aspects, like having social connections at work. We can look at it as kind of an experiment. I know employers are eager to see what worked and what didn't, and if we can take those lessons to make the workplace healthier."
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