职业体力活动 (OPA) 与死亡风险之间的关联尚无定论。我们的目的是检查 (1) 单独的 OPA 和 (2) 与休闲时间体力活动 (LTPA) 联合使用与全因风险、心血管疾病 (CVD) 和癌症死亡率之间的关联，四十年来，每一次都会更新暴露和协变量。 6-8 岁。特罗姆瑟研究调查特罗姆瑟 3-特罗姆瑟 7 (1986-2016) 中年龄 20-65 岁的成年人均包括在内。我们将 OPA 分为低（久坐）、中（步行工作）、高（步行举重工作）或非常高（重体力劳动），LTPA 分为不活动、中度和剧烈。我们使用 Cox/Fine 和 Gray 回归来检查关联性，并根据年龄、体重指数、吸烟、教育、饮食、酒精和 LTPA（仅目标 1）进行调整。在 29 605 名参与者中，总共 44 140 个观察值，其中 4131 名 (14.0%)随访期间，1057 人 (25.6%) 死于 CVD，1660 人 (40.4%) 死于癌症（中位时间：29.1 年，第 25-75 年：16.5.1-35.3）。在男性中，与低 OPA 相比，高 OPA 与较低的全因死亡率（HR 0.83，95% CI 0.74 至 0.92）和 CVD（次分布 HR (SHR) 0.68，95% CI 0.54 至 0.84）相关，但与癌症死亡率无关（ SHR 0.99，95% CI 0.84 至 1.19），而中度或极高 OPA 则没有观察到相关性。在使用非活动 LTPA 和低 OPA 作为参考的联合分析中，积极的 LTPA 与较低的全因死亡率相关，并伴有低死亡率（HR 0.75，95% CI 0.64 至 0.89）、高死亡率（HR 0.67，95% CI 0.54 至 0.82）和非常高的 OPA（HR 0.74，95% CI 0.58 至 0.94），但中等 OPA 则不然。在女性中，OPA 或 OPA 和 LTPA 组合与死亡率之间没有关联。高 OPA（但不是中度和极高 OPA）与男性较低的全因死亡风险和 CVD 死亡风险相关，但与女性无关。对于低、高和极高 OPA 的男性，强力 LTPA 与较低的死亡风险相关，但中度 OPA 则不然。© 作者（或其雇主）2023。禁止商业重复使用。请参阅权利和权限。由英国医学杂志出版。

Associations between occupational physical activity (OPA) and mortality risks are inconclusive. We aimed to examine associations between (1) OPA separately and (2) jointly with leisure time physical activity (LTPA), and risk of all-cause, cardiovascular disease (CVD) and cancer mortality, over four decades with updated exposure and covariates every 6-8 years.Adults aged 20-65 years from the Tromsø Study surveys Tromsø3-Tromsø7 (1986-2016) were included. We categorised OPA as low (sedentary), moderate (walking work), high (walking+lifting work) or very high (heavy manual labour) and LTPA as inactive, moderate and vigorous. We used Cox/Fine and Gray regressions to examine associations, adjusted for age, body mass index, smoking, education, diet, alcohol and LTPA (aim 1 only).Of 29 605 participants with 44 140 total observations, 4131 (14.0%) died, 1057 (25.6%) from CVD and 1660 (40.4%) from cancer, during follow-up (median: 29.1 years, 25th-75th: 16.5.1-35.3). In men, compared with low OPA, high OPA was associated with lower all-cause (HR 0.83, 95% CI 0.74 to 0.92) and CVD (subdistributed HR (SHR) 0.68, 95% CI 0.54 to 0.84) but not cancer mortality (SHR 0.99, 95% CI 0.84 to 1.19), while no association was observed for moderate or very high OPA. In joint analyses using inactive LTPA and low OPA as reference, vigorous LTPA was associated with lower all-cause mortality combined with low (HR 0.75, 95% CI 0.64 to 0.89), high (HR 0.67, 95% CI 0.54 to 0.82) and very high OPA (HR 0.74, 95% CI 0.58 to 0.94), but not with moderate OPA. In women, there were no associations between OPA, or combined OPA and LTPA, with mortality.High OPA, but not moderate and very high OPA, was associated with lower all-cause and CVD mortality risk in men but not in women. Vigorous LTPA was associated with lower mortality risk in men with low, high and very high OPA, but not moderate OPA.© Author(s) (or their employer(s)) 2023. No commercial re-use. See rights and permissions. Published by BMJ.