Physical Activity Level and Cardiovascular Risks of Hospital Employees: A Cross-Sectional Study in a Private Hospital.

Main Article Content

Warut Chaiwong
Thitima Wiriya
Supanee Sangiamsak
Somkiat Tonphu
Atitaya Sampantasit
Ratanaporn Bandasak
Ritthikrai Taweecharoen
Chulathip Boonma
Rita Juneja
Ittipon Metathip
Ead Lorprayoon
Chaiyos Kunanusont


OBJECTIVES: To assess physical activity at work of hospital employees in order to identify association between physical activity at work and risks for cardiovascular diseases

MATERIAL AND METHODS: From 3,383 employees of a private hospital in Thailand in 2017, 12 percent were randomly selected based on a ten percent sample size with two percent compensation to represent eight strata of job types. After screening and exclusion, 301 subjects remained in the study. Each subject was asked to fill in the International Physical Activity Questionnaire (IPAQ) and was assessed for body fat composition using an Inbody Bio-electric Impedance Analysis (BIA) R20 model at the initiation. Each subject was equipped with an activity tracker device “Feelfit” for five days during work hours to estimate Metabolic Equivalent of Task (MET) and MET minutes per person per work week. Relevant laboratory data were extracted from annual health checkup database for the assessment of cardiovascular risk factors. Statistical analysis was conducted using STATA version 15.

RESULT: The majority (85.4%) of 301 subjects were female and a little more than half (53.5%) were older than 35 years. Data from Feelfit showed 257/301 (85.4%) employees had sufficient (i.e. 600 or more MET minutes per week) physical activity (PA) at work. Operational or clinical employees were 9.8 times more likely to have adequate PA (OR 9.8, 95%CI 4.3 to 22.4). Associations between adequate PA and Body Mass Index (BMI) and waist circumference were in a different direction. Subjects with high BMI (>23 Kg/sq.m.) were more likely to have adequate PA at work (OR 3.3, 95%CI 1.0, 10.5), while those with abnormal waist circumference were less likely to have adequate PA at work (OR 0.8, 95% CI 0.2, 2.5). Around one-third of our subjects had “normal BMI obesity”, i.e. 54 (34.6%) of 156 normal BMI subjects had high body fat composition. Laboratory findings were inconclusive to demonstrate association with adequate PA.

CONCLUSION: Although most hospital employees had adequate physical activity at work, one-third of subjects still had high fat composition regardless of normal BMI. Back office subjects were almost ten times less likely to have sufficient PA at work, suggesting urgent interventions for them. Relationship between impulsivity and PA was inconclusive, suggesting a larger study with greater sample size.


Download data is not yet available.

Article Details

How to Cite
Chaiwong W, Wiriya T, Sangiamsak S, Tonphu S, Sampantasit A, Bandasak R, Taweecharoen R, Boonma C, Juneja R, Metathip I, Lorprayoon E, Kunanusont C. Physical Activity Level and Cardiovascular Risks of Hospital Employees: A Cross-Sectional Study in a Private Hospital. BKK Med J [Internet]. 2021Feb.27 [cited 2021Apr.23];17(1):34-1. Available from:
Original Article


1. Kaufman ND, Chasombat S, Tanomsingh S, et al. Public health in Thailand: emerging focus on non-communicable diseases. Int J Health Plann Manage. 2011;26(3):e197-212.

2. Virani S, Bilheem S, Chansaard W, Chitapanarux I, et al. National and Subnational Population-Based Incidence of Cancer in Thailand: Assessing Cancers with the Highest Burdens. Cancers (Basel). 2017;9(8)

3. Bouchard C, Shephard RJ. Physical activity, fitness, and health: The model and key concepts. Physical activity, fitness, and health: International proceedings and consensus statement. Champaign, IL, England: Human Kinetics Publishers; 1994:77-88.

4. Blair SN, Brodney S. Effects of physical inactivity and obesity on morbidity and mortality: current evidence and research issues. Med Sci Sports Exerc 1999;31(11 Suppl):S646-62.

5. Chodzko-Zajko WJ, Proctor DN, Fiatarone Singh MA, et al. American College of Sports Medicine position stand. Exercise and physical activity for older adults. Med Sci Sports Exerc 2009;41(7):1510-30.

6. McAuley E. Physical activity and psychosocial outcomes. Physical activity, fitness, and health: International proceedings and consensus statement. Champaign, IL, England: Human Kinetics Publishers; 1994:551-68.

7. Taylor RS, Brown A, Ebrahim S, et al. Exercise-based rehabilitation for patients with coronary heart disease: systematic review and meta-analysis of randomized controlled trials. Am J Med 2004;116(10):682-92.

8. Blair SN, Cheng Y, Holder JS. Is physical activity or physical fitness more important in defining health benefits? Med Sci Sports Exerc 2001;33(6 Suppl):S379-99; discussion S419-20.

9. Blair SN, Kohl HW 3rd, Paffenbarger RS Jr, et al. Physical fitness and all-cause mortality. A prospective study of healthy men and women. JAMA 1989;262(17):2395-401.

10. Paffenbarger RS Jr, Hyde RT, Hsieh CC, et al. Physical activity, other life-style patterns, cardiovascular disease and longevity. Acta Med Scand Suppl 1986;711:85-91.

11. Warburton DE, Gledhill N, Quinney A. Musculoskeletal fitness and health. Can J Appl Physiol 2001;26(2):217-37.

12. Warburton DE, Glendhill N, Quinney A. The effects of changes in musculoskeletal fitness on health. Can J Appl Physiol 2001;26(2):161-216.

13. No Authors listed. Healthy People 2000: national health promotion and disease prevention objectives (excerpts). US Public Health Service. J Allied Health 1990;19(4):297-311.

14. Puett DW, Griffin MR. Published trials of nonmedicinal and noninvasive therapies for hip and knee osteoarthritis. Ann Inter Med 1994;121(2):133-40.

15. Shephard RJ. Absolute versus relative intensity of physical activity in a dose-response context. Med Sci Sports Exerc 2001;33(6 Suppl):S400-18; discussion S19-20.

16. Lee IM, Skerrett PJ. Physical activity and all-cause mortality: what is the dose-response relation? Med Sci Sports Exerc 2001;33(6 Suppl):S459-71; discussion S93-4.

17. Macera CA, Hootman JM, Sniezek JE. Major public health benefits of physical activity. Arthritis Rheum 2003;49(1): 122-8.

18. Macera CA, Powell KE. Population attributable risk: implications of physical activity dose. Med Sci Sports Exerc 2001;33(6 Suppl):S635-9; discussion 40-1.

19. Myers J, Kaykha A, George S, et al. Fitness versus physical activity patterns in predicting mortality in men. Am J Med 2004;117(12):912-8.

20. Wannamethee SG, Shaper AG, Walker M. Physical activity and mortality in older men with diagnosed coronary heart disease. Circulation 2000;102(12):1358-63.

21. Jolliffe JA, Rees K, Taylor RS, et al. Exercise-based rehabilitation for coronary heart disease. Cochrane Database Syst Rev 2001;(1):Cd001800.

22. Helmrich SP, Ragland DR, Paffenbarger RS Jr. Prevention of non-insulin-dependent diabetes mellitus with physical activity. Med Sci Sports Exerc 1994;26(7):824-30.

23. Helmrich SP, Ragland DR, Leung RW, Paffenbarger RS, Jr. Physical activity and reduced occurrence of non-insulindependent diabetes mellitus. New Engl J Med 1991;325(3): 147-52.

24. Manson JE, Nathan DM, Krolewski AS, et al. A prospective study of exercise and incidence of diabetes among US male physicians. JAMA 1992;268(1):63-7.

25. Lynch J, Helmrich SP, Lakka TA, et al. Moderately intense physical activities and high levels of cardiorespiratory fitness reduce the risk of non-insulin-dependent diabetes mellitus in middle-aged men. Arch Intern Med 1996;156(12):1307-14.

26. Lee IM. Physical activity and cancer prevention--data from epidemiologic studies. Med Sci Sports Exerc 2003;35(11): 1823-7.

27. Shephard RJ, Futcher R. Physical activity and cancer: how may protection be maximized? Crit Rev Oncog 1997;8 (2-3):219-72.

28. Thune I, Furberg AS. Physical activity and cancer risk: dose-response and cancer, all sites and site-specific. Med Sci Sports Exerc 2001;33(6 Suppl):S530-50; discussion S609-10.

29. Rohan TE, Fu W, Hiller JE. Physical activity and survival from breast cancer. Eur J Cancer Prev 1995;4(5):419-24.

30. Holmes MD, Chen WY, Feskanich D, et al. Physical activity and survival after breast cancer diagnosis. JAMA 2005;293(20):2479-86.

31. Haydon AM, Macinnis RJ, English DR, et al. Effect of physical activity and body size on survival after diagnosis with colorectal cancer. Gut 2006;55(1):62-7.

32. Cunningham AJ, Edmonds CV, Jenkins GP, et al. A randomized controlled trial of the effects of group psychological therapy on survival in women with metastatic breast cancer. Psychooncology 1998;7(6):508-17.

33. Adamsen L, Midtgaard J, Rorth M, et al. Feasibility, physical capacity, and health benefits of a multidimensional exercise program for cancer patients undergoing chemotherapy. Supportive Care Cancer 2003;11(11):707-16.

34. McKenzie DC. Abreast in a Boat—a race against breast cancer. CMAJ 1998;159(4):376-8.

35. McKenzie DC, Kalda AL. Effect of upper extremity exercise on secondary lymphedema in breast cancer patients: a pilot study. J Clin Oncol 2003;21(3):463-6.

36. Segal RJ, Reid RD, Courneya KS, et al. Resistance exercise in men receiving androgen deprivation therapy for prostate cancer. J Clin Oncol 2003;21(9):1653-9.

37. Galvao DA, Newton RU. Review of exercise intervention studies in cancer patients. J Clin Oncol 2005;23(4):899-909.

38. World Health Organization. Global recommendations on physical activity for health.: Geneva; 2010. 39. Valiyeva E, Russell LB, Miller JE, et al. Lifestyle-related risk factors and risk of future nursing home admission. Archiv Intern Med 2006;166(9):985-90.

40. Salmon J, Ball K, Hume C, et al. Outcomes of a grouprandomized trial to prevent excess weight gain, reduce screen behaviours and promote physical activity in 10-year-old children: switch-play. Intl J Obes (lond) 2008;32(4):601-12.

41. Goldfield GS, Mallory R, Parker T, et al. Effects of modifying physical activity and sedentary behavior on psychosocial adjustment in overweight/obese children. J Pediatr Psychol 2007;32(7):783-93.

42. Ochoa MC, Moreno-Aliaga MJ, Martinez-Gonzalez MA, et al. Predictor factors for childhood obesity in a Spanish case-control study. Nutrition 2007;23(5):379-84.

43. Simon C, Wagner A, DiVita C, et al. Intervention centred on adolescents’ physical activity and sedentary behaviour (ICAPS): concept and 6-month results. Int J Obes Relat Metab Disord 2004;28 Suppl 3:S96-S103.

44. Tanasescu M, Ferris AM, Himmelgreen DA, et al. Biobehavioral factors are associated with obesity in Puerto Rican children. J Nutr 2000;130(7):1734-42.

45. Epstein LH, Paluch RA, Gordy CC, et al. Decreasing sedentary behaviors in treating pediatric obesity. Arch Pediatr Adolesc Med 2000;154(3):220-6.

46. Gortmaker SL, Peterson K, Wiecha J, et al. Reducing obesity via a school-based interdisciplinary intervention among youth: Planet Health. Arch Pediatr Adolesc Med 1999;153(4):409-18.

47. Robinson TN. Reducing children’s television viewing to prevent obesity: a randomized controlled trial. JAMA 1999;282(16):1561-7.

48. Epstein LH, Paluch RA, Kilanowski CK, et al. The effect of reinforcement or stimulus control to reduce sedentary behavior in the treatment of pediatric obesity. Health Psychol 2004;23(4):371-80.

49. Epstein LH, Roemmich JN, Paluch RA, et al. Physical activity as a substitute for sedentary behavior in youth. Ann Behav Med 2005;29(3):200-9.

50. Hancox RJ, Milne BJ, Poulton R. Association between child and adolescent television viewing and adult health: a longitudinal birth cohort study. Lancet 2004;364(9430): 257-62.

51. Dasgupta K, O’Loughlin J, Chen S, et al. Emergence of sex differences in prevalence of high systolic blood pressure: analysis of a longitudinal adolescent cohort. Circulation 2006;114(24):2663-70.

52. Rattanawiwatpong P, Khunphasee A, Pongurgsorn C, et al. Validity and Reliability of the Thai Version of Short Format International Physical Activity Questionnaire (IPAQ). J Thai Rehabil 2006;16(3):147-60.

53. Arnin J, Anopas D, Triponyuwasin P, et al. Development of a novel classification and calculation algorithm for physical activity monitoring and its application. Signal and Information Processing Association Annual Summit and Conference (APSIPA), 2014 Asia-Pacific; 2014 9-12 Dec. 2014.

54. Kaikuk P, Kaimuk V. Physical activity level measurements in the caddie profession. J Sport Sci Technol 2015;15(2):1-9.

55. Oliveros E, Somers VK, Sochor O, et al. The concept of normal weight obesity. Prog Cardiovasc Dis 2014;56(4): 426-33.

56. Fan M, Lyu J, He P. Guidelines for data processing and analysis of the International Physical Activity Questionnaire (IPAQ).2005.4, editor 2014:961-4.

57. Jalayondeja C, Jalayondeja W, Vachalathiti R, et al. CrossCultural Adaptation of the Compendium of Physical Activity: Thai Translation and Content Validity. J Med Assoc Thai 2015;98 Suppl 5:S53-9.

58. Ainsworth BE, Haskell WL, Herrmann SD, et al. 2011 Compendium of Physical Activities: a second update of codes and MET values. Med Sci Sports Exerc 2011;43(8):1575-81.