Are sitting occupations associated with increased all-cause, cancer, and cardiovascular disease mortality risk? A pooled analysis of seven British population cohorts

Abstract

Background: There is mounting evidence for associations between sedentary behaviours and adverse health outcomes, although the data on occupational sitting and mortality risk remain equivocal. The aim of this study was to determine the association between occupational sitting and cardiovascular, cancer and all-cause mortality in a pooled sample of seven British general population cohorts.

Methods: The sample comprised 5380 women and 5788 men in employment who were drawn from five Health Survey for England and two Scottish Health Survey cohorts. Participants were classified as reporting standing, walking or sitting in their work time and followed up over 12.9 years for mortality. Data were modelled using Cox proportional hazard regression adjusted for age, waist circumference, self-reported general health, frequency of alcohol intake, cigarette smoking, non-occupational physical activity, prevalent cardiovascular disease and cancer at baseline, psychological health, social class, and education.

Results: In total there were 754 all-cause deaths. In women, a standing/walking occupation was associated with lower risk of all-cause (fully adjusted hazard ratio [HR] = 0.68, 95% CI 0.52-0.89) and cancer (HR = 0.60, 95% CI 0.43-0.85) mortality, compared to sitting occupations. There were no associations in men. In analyses with combined occupational type and leisure-time physical activity, the risk of all-cause mortality was lowest in participants with non-sitting occupations and high leisure-time activity.

Conclusions: Sitting occupations are linked to increased risk for all-cause and cancer mortality in women only, but no such associations exist for cardiovascular mortality in men or women.

Figure 1. The combined association of main activity at work and non-occupational physical activity in women (N = 5214).

Lo PA/Sit Occ: Low physical activity/Sitting occupation; Lo PA/NonSit Occ: Low physical activity/standing or walking occupation; Hi PA/Sit Occ: High physical activity/Sitting occupation; High physical activity/standing or walking occupation. ^†Adjusted for age, self-reported general health, alcohol drinking frequency, cigarette smoking, prevalent cardiovascular disease at baseline (angina/stroke/ischaemic heart disease), prevalent cancer at baseline, occupational social class and age finished education.

Figure 2. The combined association of main activity at work and non-occupational physical activity in men (N = 5620).

Lo PA/Sit Occ: Low physical activity/Sitting occupation; Lo PA/NonSit Occ: Low physical activity/standing or walking occupation; Hi PA/Sit Occ: High physical activity/Sitting occupation; High physical activity/standing or walking occupation. ^†Adjusted for age, self-reported general health, alcohol drinking frequency, cigarette smoking, prevalent cardiovascular disease at baseline (angina/stroke/ischaemic heart disease), prevalent cancer at baseline, occupational social class and age finished education.