Health Impacts of Physically Demanding Work

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Ashley: Hello and welcome to Health and Safety To Go, a CCOHS podcast. With physical activity being an important part of a healthy lifestyle, you might think workers in more physically demanding jobs are healthier than those whose work is more sedentary. This isn’t necessarily the case.

We’re joined today by Dr. Avi Biswas, scientist at the Institute for Work and Health and assistant professor at the University of Toronto, to discuss the impacts workers’ daily physical activity levels have on their health and how employers can encourage safe and practical physical activity.

Dr. Biswas, it’s great to have you here.

Dr. Biswas: Thank you for having me, great to be here.

Ashley: You've spoken about the paradox of physically demanding work? What is this? And why should employers and workers be concerned?

Dr. Biswas: So, to talk about the paradox, it's important to talk about what it is and what it isn't. And so, what it isn't is exercise or physical activity that we associate for health, and so, the reason it isn't that is because we've shown in numerous studies that being active is really good for your heart health, great for your metabolism and important for your overall wellness and well-being.

Now, promoting that has been a part of the national guidelines in terms of prevention and promotion of overall health. But we tend to promote these guidelines kind of broadly across all populations.

We say children, adults, and adults among adults and workers during work, during leisure time, during your commute, all should be engaging in some form of activity. Doing 150 minutes of activity is great. If you can't do that, doing some is better than none.

But then there are certain jobs which are physically demanding and physically demanding in a way that it isn't because you're doing exercise on the job but because you're doing work that is physically strenuous on your body. And so that can involve pushing, pulling, lifting and so think of your construction workers, think of even your childcare worker, think of your grocery clerk working at the cash register who is standing for long periods of time.

And it's really only in the workplace setting, where you spend long periods of time doing physically strenuous work without a lot of break time. So, you're involving a lot of chronic stress on your body. And in that, there's some emerging research that suggests that this is either not promoting your health, in the same way that exercise does, or it can even be bad for your health.

Ashley: Well, that's fascinating, you're going to be joining us at CCOHS Forum soon to discuss a study on the daily movement patterns of Canadian workers and their heart health. What can delegates expect to learn in that session?

Dr. Biswas: So, what I'll be sharing is a study that I recently completed looking at what are the typical activity patterns of working people in Canada. What we did was we had a data source that tracked movements of workers using a medically used version of the Fitbit. So, a research version of the Fitbit or Apple iWatch. And people wore that on their waist and we had a sample of over 9,000 people. And in that sample, we were able to just track in very detailed ways the typical movements people do while at work and outside of work and we wanted to see what are workers typically doing, what are their patterns like, and so we identified six distinct patterns and then we wanted to see what is their risk, these different patterns for heart disease over a 10-year time span.

And so I'll be sharing those findings. And there's some interesting findings there in terms of the paradox that you talked about. So, there's a certain group of workers that are in that paradox group and there's other groups of workers as well.

We found six unique profiles of workers, in terms of the activities that they did in a typical day. As you would expect a large chunk of this working group were what we call the “sedentary.” They were people who were quite sedentary either during working hours or outside of working hours. And we use this as a comparison group, we compared all other groups to this group, to see how our other groups were benefiting or less benefiting from moving more than this group in terms of their overall heart health over ten-year time span.

And at the other end of the extreme, there was a probably the smallest group, which are the people who are the exercisers. They exercised a lot or were quite active over the day and they're active during daytime hours and active in the evening. We're not really sure what they're doing in terms of context, but they're active. And that group has a 42 per cent lower risk of heart disease compared to the most sedentary.

Ashley: Well, that makes sense.

Yeah, it supports what we know which is that exercise and being active is really good for your heart health. But then there's another group, which is similar, but different in one way in that they're quite active in the daytime, but not very active in the evening, or it's outside of what we think are typical work hours. And that group has no extra benefit, or is no different to the sedentary group, in terms of their overall heart health. And so we think that that group being active in the daytime, are probably doing very physically demanding work and it supports what we think is this physical activity paradox, where physically demanding work either has no added benefit or increases your risk. And so that's interesting to us and the reason we think that might be the case is because something about that strain you put on your body isn't doing a lot in terms of strengthening your heart, helping it pump blood around your body efficiently, it doesn't help your metabolism in the same way as exercise does. But it may actually introduce risks. You know, if you're putting strain on your vessels, you're standing for long periods of time and you're not really doing much for your metabolism, these things are quite different to the benefits that exercise might have on your body.

Ashley: That's interesting. I'd like to say I find myself reflected in the active group but I think I'm probably more of a sedentary.

Dr. Biswas: I'm one of those sedentary people as well.

Ashley: So, with all this in mind, what can employers do in terms of promoting health and wellness at work to ensure better health outcomes for workers?

Dr. Biswas: So, I think employers have an important role to play because what we're also recognizing is that if we put the onus on an individual, we don't tend to make a lot of change. We have to really recognize that the workplace, if it can be supportive of workers, then they can make healthier decisions for themselves.

And as the study that I outlined shows, there's quite a lot of nuance in the type and ways in which workers move. And one way that employers can really support healthier workers is to recognize that we need to really meet workers where they are.

OK, so I think one way is to recognize that it is in an employer's best interest to promote physical activity among workers and promoting a healthy workforce is good for an employer's bottom line.

It leads to a healthy productive workforce. It ensures that people are healthier on the job. There's been links with improved safety behaviours as well. And then, you know, I think if we can get more employers on board with that message, promote a culture of health, then I think most simple message is that exercise is still good. And if we can create situations where we can promote activity among the workforce, and we found that, you know, it may be challenging because work gets in the way – you don't have opportunities sometimes to incorporate exercise and activity because you’re working.

And, so, if we can find ways in which we can allow our employees to make time in their day, you know, flexible opportunities to incorporate activities, if there's an exercise classes or it could be calisthenics, it could be yoga, or something that workers could incorporate in the day or outside of work hours, then that could be an opportunity.

And then also recognizing that this really benefits those sedentary workers, mostly, but there are workers who are active in the day who may need other solutions. So, if they're very active because of their job, maybe they need to think about supporting them through breaks.

I've noticed in grocery stores more and more clerks have seats. I'm not sure if that's the right word, so I’m going to say grocery store workers at the checkout desks have seats to sit on, to take a break and so maybe that is a solution. And if you are promoting a culture of health as well, letting people know that, you know, it's OK. You don’t have to be active during work hours if you're tired. Maybe find ways on the weekend to incorporate more activity. And so just coming up with nuanced messaging around that would be helpful.

Ashley: Right, now you mentioned, you know, as workers we aren't always reminded to be active. What are ways that workers can proactively protect themselves and their cardiovascular health?

Dr. Biswas: So, I think it really helps for us to be aware of the benefits. I think there's certainly a place there for information and communication of the value of being active. Not everybody recognizes that. I recognize it because I study this for a living, but I know from conversations with even family members, not everybody does. You know, we hear about the importance of exercise but it isn't something that we all think about all the time.

And so, I think it's about reiterating the message, really building communication and ensuring that workers understand why it's important to be active, what it can do for your health and your well-being. Once we can do that, I think that allows people to then think about solutions that work for them, recognizing the conditions of their work, what is possible for them during working hours. Recognizing what is possible for them outside of work.

You know, if you are somebody who has to care give, then understanding that it isn't always easy because you have other things going on in your day. And, so, I think there's certainly a dialogue that can be made between workers and people in their lives who maybe have information to give. And I think workplaces can be those people who can provide information and resources. It can also be something where, you know, we can seek out resources through our communities, through our community centres. Also just try to, you know, find time to go for a walk.

So, like I said in the beginning, something is better than nothing. So, you don't have to go hard, just do something a little more than what you were doing before.

Ashley: Right. Simple steps.

Dr. Biswas: Simple steps.

Ashley:Yeah and it seems like, you know, maybe emphasizing the connection between the psychological benefits and mental health as well.

Dr. Biswas: Yeah, I think finding a message that really aligns with what you were looking for from exercise – the beauty of activity and exercise is that it is associated with benefits that are not only physical, but mental health benefits. And, so, if that's what is going to get you more interested, if it means, you feel better, by all means promote that.

I think that is something that can align with what people are looking for in their lives. They're hoping to feel better, and to be more well. And it doesn't have to always be something like losing weight, or cardiovascular health might not resonate with everybody, but feeling good, just feeling good is something that might resonate more.

Ashley: Absolutely. Is there anything else you'd like our listeners to know?

Dr. Biswas: I think one thing I'd like to say is that I think the connection between health and safety and physical activity isn't always clear to a lot of people. And I think it should be made more clear because there's a lot of strong evidence that suggests that being active and getting the benefits of activity is very much aligned with the benefits of health and safety, which is a safe, healthy and well worker.

And, so, when we can recognize that, and it might mean that we need to get more employers on board, it might mean we need to provide more resources for employers to really get that and promote a culture of health, then that is the most important step towards getting more workers to really recognize that, you know, we have an opportunity here for you to really use these resources in the workplace to be healthy and be supported to meet those goals.

Ashley: Absolutely. Dr. Biswas, it’s been a pleasure. Thanks for sharing your expertise with us today.

Dr. Biswas: My pleasure.

Ashley: To learn more about this and many other workplace health and safety topics, visit our website, ccohs.ca. Thanks for listening.