Daily Archives: January 10, 2017

Is Occupational Sitting Related to the Risk of Death From Coronary Heart Disease? An Answer From 1962

I have been interested in the relationship between Mediterranean Diet and Dementia which has led me to the Seven Countries Study – the first study to characterise the diet and the health benefits. One of the papers linked to the study involved US railroad workers and is freely available here. The research team included Dr Ancel Keys (see citation in Appendix B). Although my main question was about Dementia, this study asked about the health effects of sitting behaviour which I have written about previously in several posts.

As a slight aside, when I was reading through this paper which dates back to 1962 I was intrigued to see a reference to the London transport executive who at that time were undertaking a study on the relationship between physical activity and coronary artery disease in bus drivers and conductors. It was also interesting to see the reference to the use of IBM punch cards by the railworkers, a software program written to analyse the data, as well as the use of ICD-6 (International Classification of Diseases) by the researchers.

The researchers looked at three groups of workers – office workers, signal men and section men. Office workers were characterised as having more sedentary jobs. Signal men were considered intermediate in physical activity and included foremen. Section men were responsible for maintenance of the railroad and were characterised as more physically active.

Section men had more violent deaths than office workers. Office workers on the other hand had more deaths from coronary artery disease than section men and in the age group 60-64 this difference was particularly marked.

ASHD deaths account for 76 per cent of the difference in nonviolent death rates between clerks and section men

where ASHD refers to atherosclerotic heart disease.

Indeed in the age group 60-64 the mortality (non-violent deaths) in the clerks was 19 per 1000 compared to 10 in section men. In other words there was almost a two fold increase in the mortality in the sedentary workers.

The last word about this question can’t be from 1962 but it’s interesting to note that there is more recent work that supports this.

Appendix A – Technical Details

The main hypothesis was that ‘men in sedentary occupations have more coronary heart disease than those in occupations requiring moderate to heavy physical activity’

Age adjusted mortality for ASHD was
(a) Clerks 5.7/1000
(b) Switchmen 3.9/1000
(c) Section men 2.8/1000

In Table 3, the researchers present a 95% confidence interval for the non-violent mortality rates (per 1000). For the 60-64 year age group the values are
(a) Clerks: 19.28 +/- 2.054
(b) Switchmen: 15.59 +/- 1.929
(c) Section men: 9.93 +/- 1.966
The researchers use a Chi-squared test to analyse the difference between the groups and chose a 5% value for significance.

Appendix B – Full Citation

Taylor HL, Klepetar E, Keys A, Parlin W, Blackburn H, Puchner T. Death Rates Among Physically Active and Sedentary Employees of the Railroad Industry. American Journal of Public Health and the Nations Health. 1962;52(10):1697-1707.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

The Arkansas Healthcare Information Exchange – SHARE

This is a brief discussion of the benefits of SHARE, the Arkansas Health Information Exchange.

We hear Dr Leslie talking about a very common problem in practice – getting blood results for a clinic based in one organisation from a hospital in another organisation. In this case, the administration team received faxes from the hospital and would then need to physically upload them onto the clinic system.

In the video, we hear how SHARE enables this process to be automated allowing the administration team to focus on other tasks. The results are also sent to the doctor’s e-mail inbox for review.

From my perspective that is a very useful benefit of a healthcare information exchange.

There are a few more in-depth videos about SHARE on the SHARE YouTube channel.

Appendix A – Other Posts in the Series on Health Information Exchanges

Arizona Statewide Health Information Exchange

Health Information Exchanges

HIPPA and Health Information Exchanges

Creating a Health Information Exchange in Arizona

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.