title: Health and lifestyle among office and construction workers: insights for forming future intervention strategies
Creators: name: Alfeheid, Hesham Abdullah F.
Publisher: name: University of Glasgow
Year: 2025

description: Background:
Non-communicable diseases are increasingly imposing a significant burden globally, with modifiable lifestyle factors like physical inactivity, unhealthy diets, excessive alcohol consumption, and smoking being important contributors to the risk. Preventing these diseases necessitates a comprehensive understanding of such lifestyle behaviours across different domains, including both office and manual (e.g. construction) workplace settings. This knowledge is essential to tailor and guide future preventative strategies effectively. Consequently, this PhD project is focused on exploring lifestyle behaviours and related aspects, such as mental health and well-being, among individuals in office settings and, more specifically, in construction workers—a demographic notably underrepresented in existing research, to help inform and direct future workplace interventions.

Methods:
To achieve the intended aim of this PhD project, four main studies were conducted and are as follows:

i) A cross-sectional secondary data analysis of a large data set of employees from a public sector organisation (Office workers) to look at demographic, social, organisational, health and behavioural factors and whether they were associated with employee absenteeism and presenteeism to help inform potential targets for future interventions to improve health (Chapter 2).

ii) A systematic review to identify previously undertaken workplace-based health interventions (physical activity, diet, weight, and smoking) in construction workers targeting improvement in physical activity, diet,
weight, and smoking to see what has been previously done and the degree of
its effectiveness. (Chapter 3).

iii) A cross-sectional study quantifying demographic, physical and mental health risk factors, and lifestyle-related health behaviours amongst construction workers (workers at Multiplex and their subcontractors) to help guide future interventions by highlighting which health behaviours to target for interventions (Chapter 4).

iv) A qualitative study with the aim to further build up on findings from the prior cross-sectional study (Objective iii) explaining the lifestyle choices of people working in the construction industry and the potential barriers and facilitators towards improving their current lifestyle choices, and in addition, their views on available workplace health promotion programs provided by their organisation. (Chapter 5).

Results:
In Chapter 2, the cross-sectional secondary data analysis of office workers (N = 2846) revealed a number of health concerns. 8.1% were current smokers, and elevated blood pressure was observed in 13.9% of participants, with the majority, 47.6%, falling into the Stage 1 hypertension category. Similarly, a high number, 36.1%, were classified as overweight. Mental health concerns were also prevalent, with 19.1% and 31.8% of workers showing borderline abnormal and abnormal levels of anxiety, respectively, and 23.6% and 13.9% showing symptoms of borderline abnormal and abnormal depression. Key predictors of sickness absence included stress, depression, or anxiety (Coef = 2.653), lower levels of physical activity (Coef = -0.024), and smoking habits (Coef = -0.113). Additionally, stress, depression, or anxiety (Coef = 6.786) and long working hours (Coef = -0.038) were identified as significant predictors of increased presenteeism days. Despite these concerns, physical activity levels were in line with the NHS’s recommendations, with an average of 1240.8 MET.min/week.

In Chapter 3, the systematic review, moderate evidence of workplace interventions’ effectiveness was noted in physical activity and exercise-related outcomes. Two workplace intervention studies contributed to the improvement of physical activity, in which one identified a significant increase in recreational physical activity, while the other reported a significant increase in meeting public health guidelines for vigorous physical activity. Similarly, two intervention studies reported improvement in exercise-related outcomes, as one intervention reported that 30 minutes of daily exercise was linked with a significant increase in muscle strength or muscle tone, while the other intervention study noted a significant increase in the maximum rate of oxygen consumption (Vo2max) among the participants. Similar moderate evidence of workplace interventions’ effect on the reduction of sugar-sweetened beverage consumption, as one study noted a significant decrease in sugar-sweetened beverage intake by one glass per week, whereas the control group demonstrated an increase in consumption, and similarly, the other intervention study reported a significant reduction in sugary drinks consumption.

In Chapter 4, the cross-sectional study on construction workers (N = 43) showed that 20.0% were smokers and a significant portion, 51.7%, had elevated blood pressure, with 30.2% categorised under Stage 1 hypertension. Additionally, 32.6% of the workers were classified under overweight. In terms of mental health, the majority, 74.3%, fell into the medium mental well-being category as per the WEMWBS scale, while 57.1% exhibited minimal depression signs as per the PHQ-9 questionnaire. Despite these health concerns, the study found that physical activity levels met the NHS’s recommendations, with an average time spent in moderate physical activity of 253.1 ± 97.5 minutes per day on weekdays (194.8 ± 92.4 minutes during working hours and 58.2 ± 15.6 minutes during leisure time) and 183.3 ± 54.2 minutes on weekends.

In Chapter 5, the qualitative study, data were obtained through interviewing 14 participants working in the construction industry. The findings from this chapter indicated that healthier eating habits were closely linked to an active lifestyle or when meals are prepared by a partner (female). Individuals who have a more active lifestyle (intense exercises) were usually driven to improve their fitness level, sports performance, mental health, and physical appearance, whereas individuals engaging in less intensive forms of physical activity were often hindered by reported barriers to exercise, which was only work. Work-related stress, pressure, and anxiety were the primary contributors to mental health concerns. Moreover, work-related factors such as long working hours and job strain not only exacerbated mental health issues but were also associated with unhealthy dietary choices, smoking retention, reduced physical activity, and sleep disturbances, highlighting the intricate relationship between the work environment and overall health and well-being. Finally, there was a notable dissatisfaction or lack of awareness regarding workplace health programs, even with the presence of a number of them, such as cycle schemes, sedentary behaviour prevention, and mental health initiatives, suggesting a gap in support or communication by the organisation.

Conclusion:
The PhD project uncovered that both office and construction workers grapple with mental health challenges exacerbated by work-related factors — particularly in construction workers — alongside prevalent issues of elevated and high blood pressure, being overweight, and smoking, which notably emerged as a more common habit among construction workers. Although the prevalence of these health issues may not reach the levels observed in the broader UK population, particularly concerning overweight, obesity, and hypertension, these insights may elevate the potential of future workplace health promotion programmes to enhance the health of both office and construction workers. Such interventions could not only foster a healthier, more productive workforce but may also contribute to reducing the overall prevalence of these risk factors in the general population.