Influence of the workplace on physical activity and cardiometabolic health: Results of the multi-centre cross-sectional Champlain Nurses' study

Background: Nurses are the largest professional group within the health care workforce, and their work is perceived as being physically demanding. Regular physical activity helps to prevent or ameliorate cardiometabolic conditions (e.g. cardiovascular disease, diabetes). It is not known whether Canadian nurses are meeting current physical activity guidelines. Objective: To assess the influence of the workplace on the physical activity and cardiometabolic health of nurses from hospitals in the Champlain region of Ontario, Canada. Design: A multi-centre, cross-sectional study. Setting: Hospitals in the Champlain Local Health Integration Network of Ontario. Methods: Nurses wore an ActiGraph accelerometer to objectively assess levels of moderate-to-vigorous intensity physical activity measured in minutes/day in bouts >= 10 min. All completed the Perceived Workplace Environment (PWE) scale and International Physical Activity Questionnaire (IPAQ). Height, body mass, waist circumference, blood pressure and heart rate were measured, and body mass index (BMI) was determined. Each nurse's 5-year cardiovascular risk was calculated using the Harvard Score. Findings: A total of 410 nurses (94% female; mean +/- SD: age = 43 +/- 12 years) from 14 hospitals participated. Nurses spent an average of 96 +/- 100 min/week in bouts >= 10 min of moderate-to-vigorous intensity physical activity; 23% of nurses met recommended physical activity guidelines. Nurses working 8- vs. 12-h shifts (16 +/- 16 vs. 10 +/- 11 min/day, p = 0.026), fixed vs. rotating shifts (15 +/- 15 vs. 12 +/- 13 min/day, p = 0.012) and casual vs. full-time (29 +/- 17 vs. 13 +/- 15 min/day, p < 0.001) or vs. part-time (29 +/- 17 vs. 13 +/- 12 min/day, p = 0.001) accumulated more moderate-to-vigorous intensity physical activity in bouts a 10 min. The average PWE score was 2.4 +/- 0.9, with no association between PWE scores and moderate-tovigorous intensity physical activity in bouts >= 10 min (p > 0.05). Nurses working 8-h shifts, fixed shifts and in urban hospitals reported better PWE scores (p < 0.05). Nurses working fixed vs. rotating shifts had higher systolic blood pressure (median: 114 vs. 112 mmHg, p = 0.043), and nurses working in rural vs. urban hospitals had higher BMI (median: 27.8 vs. 25.6 kg/m(2) , p = 0.007) and waist circumference (median: 82.3 vs. 78.6 cm, p = 0.015). Conclusions: Nurses are not meeting current physical activity guidelines (150 min of moderate-to-vigorous intensity physical activity per week in 10-min bouts), yet exceeded these recommendations when examining their continuous (i.e. non bouts) physical activity levels. No association between the PWE and moderate-to-vigorous intensity physical activity was observed. Rotating vs. fixed shifts, 12- vs. 8-h shifts, and/or full-time or part-time vs. casual hours may impede nurses' ability to meet recommended physical activity levels. The low physical activity levels and poor cardiometabolic health of Canadian nurses warrant attention.