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Aims: In epidemiological studies exposure assessment based on questionnaires is the most cost-effective method. A question about lifetime exposure to occupational physical activity (OPA) was used in a population-based survey (part of the Copenhagen Aging and Midlife Biobank, CAMB). The aim of the study was to validate this question through a three-step process. Methodology: Firstly, the response process was studied by cognitive interviewing of 7 persons. Secondly, 64 persons participated in semi-structured interviews about their work-life, and expert judgments of exposure to OPA were compared with questionnaire-data. Exposure was 20 years of work in one of four categories of OPA: sedentary, standing and walking, moderate or high OPA. Kappa values were calculated for agreement and interpreted according to Landis and Koch’s criteria. Agreement was visualized in Bland-Altman plots. Thirdly, intra- and inter-rater reliability of expert judgments was tested. Results: Response process: The question had a complicated instruction, and the respondents found it hard to remember, categorize, and summate exposures. Semi-structured interviews: Kappa value for exposure to sedentary work was ‘substantial’ (0.71) but ‘fair’ for the other categories of OPA (0.27-0.29). Agreement between questionnaire and interview was higher in sedentary jobs and jobs with high OPA. Intra-rater reliability of expert judgments was ‘substantial’ or ‘moderate’ (0.60-0.71). Inter-rater reliability was high in sedentary jobs but lower in the more active jobs. Conclusion: Self-reports of lifetime exposure to sedentary work are valid in the CAMB cohort, whereas the validity of self-reports of exposure to high levels of occupational physical activity (OPA) are questionable. Thorough pre-testing of questions about lifetime OPA is recommended.
ABSTRACT
A atividade física (AF) regular é considerada hábito de vida saudável por reduzir o risco de doenças cardiovasculares. Entretanto, há poucos estudos neste sentido realizados em amostras populacionais. Avaliar o impacto da AF de lazer (AFL), ocupacional (AFO) e mista (AFLO) sobre o risco cardiovascular mensurado pelo escore de Framingham (EF) na população adulta (25-64 anos) de Vitória-ES. Estudo transversal em amostra probabilística (N=1.663; ambos os sexos). Os dados foram coletados por meio de questionário, avaliação clínica e laboratorial (coleta de sangue). A estimativa de gasto calórico semanal em AFL, AFO e AFLO foi feita por meio de entrevista e, dessa forma, 4 grupos foram constituídos: Sedentário (S), AFL, AFO e AFLO. Análises de variância e covariância, bem como testes qui-quadrado e Mantel-Haenszel, foram usados para análise estatística. O grupo AFO apresentou valores inferiores para % gordura (%G), colesterol total (CT) e LDL se comparado ao grupo S. A prevalência de tabagismo foi menor nos grupos AFL (11,5%) e AFLO (10,2%), e maior nos grupos S (26,4%) e AFO(30,2%). O EF e o risco (%) de desenvolvimento de doença arterial coronariana em 10 anos (risco DAC), não ajustados, apresentaram-se menores no grupo AFO (EF= 3; 2,65±6,20; risco DAC= 4; 6,79±6,68%;mediana; média±DP ) se comparado ao grupo S (EF= 5; 3,85±7,07; risco DAC= 6; 8,41±7,74%). Entretanto, após ajuste para idade e CT, o EF e o risco DAC foram menores no grupo AFL (EF:2,54±4,18; risco DAC: 6,55±5,29%; média±DP) se comparado aos grupos S (EF: 3,50±4,17; risco DAC:8,05±5,33%) e AFO (EF: 4,09±4,19; risco DAC: 8,08±5,35%), evidenciando, assim, que as variáveis CT e idade foram as principais determinantes das diferenças iniciais em favor do grupo AFO. O estudo denota impacto positivo da AF de lazer ou laboral na redução do risco cardiovascular populacional.
Regular physical activity (PA) has been considered a healthy habit to reduce thecardiovascular risk. However, there are few studies to determine this association in population-based studies. To evaluate the contribution of leisure-time (LPA), occupational (OPA) and combined physical activity (LOPA) on the cardiovascular risk computed by Framingham score (FS) on the adult population (25-64 y) of Vitória, Brazil. Cross-sectional study in a probabilistic sample (N=1,661; both sexes). Datawere collected by questionnaires and clinical and laboratorial (blood collection) exams. Estimation of week caloric expenditure in LPA, OPA and LOPA were obtained by interview and 4 groups were designed accordingly: Sedentary, LPA, OPA and LOPA. Analysis of variance and covariance, qui-squareand Mantel-Haenszel tests were used for statistical analysis. Before and after adjustment to age, the OPA group showed lower values of body fat, total cholesterol (TC) and LDL-cholesterol compared to the sedentary group. The smoking prevalence was smaller in LPA (11.5%) and LOPA (10.2%) than insedentary (26.4%) and OPA (30.2%) groups. The unadjusted FS and the 10-year risk for coronary heart disease (CHD-risk) were smaller in the OPA (FRS= 3; 2.65±6.20; CHD-risk= 4; 6.79±6.68%; median; mean±SD) compared to the sedentary group (FRS= 5; 3.85±7.07; CHD-risk= 6; 8.41±7.74%). However, after adjustment for age and TC, the FRS and CHD-risk were smaller in the LPA (FR: 2.54±4.18; CHDrisk: 6.55±5.29%; mean±SD) than in the sedentary (FR: 3.50±4.17; CHD-risk: 8.05±5.33%) and OPA (FR: 4.09±4.19; CHD-risk: 8.08±5.35%) groups, showing that age and TC were the main responsible tosupport the initial differences to the OPA group. The study shows positive impact of leisure-time and occupational physical activity to reduce the global cardiovascular risk in the studied population.
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Humans , Male , Female , Adult , Middle Aged , Exercise , Habits , Health Behavior , Motor Activity , Cardiovascular Diseases , Risk , Risk FactorsABSTRACT
Objective To examine the associations between occupational physical activity,heredity factors and metabolic syndrome (MS) in a Chinese population.Methods Based on the MS cohort study in Jiangsu province,subjects were followed-up,and blood samples were collected at the same time for biochemical indicators measurement.Newly confirmed MS patients according to US.National Cholesterol Education Program Adult Treatment Guidelines Ⅲ (NCEP-ATP Ⅲ ) were recruited as eases.Controls were 1 :1 matched with eases by region,gender and age (±2 years).In total,389 MS patients and 389 eontrols were recruited as study subjects.Nested ease-control study was applied for the present analysis.TaqMan fluorescence probe method was used to detect the genetic polymorphism of PPARα intron 1A/C (rs135539).Results (1)Compared to low physical activity group,the subjects with heavy physical activity were positively associated with MS (OR=2.18,95%CI:1.08-4.38).(2)The subjects,with a family history of hypertension (OR= 1.44,95% CI:1.02-2.03 )or type 2 diabetes (OR=3.25,95CI:1.28-8.20),were significantly indreased the occurrence of MS.(3)The genotype(AA,AC,CC) of PPARα intron 1A/C was not found to be related to MS.The OR of AC and CC genotype (compared to the genotype AA) were 0.98(95%CI:0.70-1.36) and 0.75 (95% CI:0.44-1.29) ,respectively.(4) Effect modifications were observed between family history of hypertension and moderate physical activity (OR=2.47,95% CI:1.00-6.06 ) or heavy physical activity (OR=3.82,95%CI:1.31-11.15) on the development of MS.Conclusion Heavy physical activity,with family history of hypertension or type 2 diabetes,seemed to be positively correlated with the risk of MS.Effect modifications were observed between occupational physical activity and family history of hypertension which might be associated with an increased risk of MS.