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Background: Construction work involves sustained physical exertion that imposes significant metabolic stress. While physical activity is generally considered beneficial, prolonged occupational exertion may result in unique metabolic adaptations and risks. Objectives: To assess metabolic adaptations and cardiometabolic risk factors among construction workers and compare them with sedentary controls. Materials and Methods: A prospective comparative study was conducted among 90 construction workers and 90 age- and sex-matched sedentary controls. Anthropometry, fasting blood glucose, HbA1c, lipid profile, hemoglobin, and basal metabolic rate were assessed. Statistical comparisons were performed using independent t-tests and chi-square tests. Results: Construction workers demonstrated significantly higher basal metabolic rate and lower BMI but had higher prevalence of anemia and dyslipidaemia. Fasting glucose and HbA1c levels were comparable between groups, though long-term workers showed higher metabolic derangements. Conclusion: Construction work induces adaptive metabolic changes; however, inadequate nutrition and chronic occupational stress predispose workers to cardiometabolic risk, emphasizing the need for targeted occupational health interventions.
Construction workers constitute a vital yet vulnerable occupational group exposed to sustained physical workload, irregular nutrition, and environmental stressors. Chronic occupational physical activity leads to increased energy expenditure and metabolic adaptations aimed at maintaining homeostasis. Unlike leisure-time physical activity, occupational exertion lacks structured recovery, potentially resulting in maladaptive metabolic responses.
High daily energy expenditure among construction workers necessitates efficient glucose and lipid metabolism. However, nutritional inadequacy, micronutrient deficiencies, and lifestyle factors such as smoking may counteract beneficial adaptations. The “physical activity paradox” suggests that prolonged occupational activity may not uniformly protect against metabolic disease.
Indian construction workers often operate in informal settings with limited occupational health surveillance. Evidence regarding metabolic adaptations in this population remains limited. This study aims to evaluate metabolic parameters and cardiometabolic risk among construction workers compared with sedentary controls.
Study Design: Prospective observational comparative study Study Population: • Construction workers (n = 90) • Sedentary controls (n = 90) Inclusion Criteria: • Age 20–50 years • ≥1 year of occupational exposure Exclusion Criteria: • Known metabolic disorders • Chronic respiratory or cardiovascular disease Metabolic Assessment: • BMI, waist–hip ratio • Fasting plasma glucose (GOD-POD method) • HbA1c (HPLC) • Lipid profile • Hemoglobin • Basal metabolic rate Statistical Analysis: SPSS v31; p < 0.05 considered significant.
Table 1. Sociodemographic Characteristics of the Study Population
|
Variable |
Construction Workers (n = 90) |
Controls (n = 90) |
p-value |
|
Age (years) |
38.6 ± 8.4 |
37.9 ± 7.9 |
0.62 |
|
Male sex, n (%) |
74 (82.2) |
72 (80.0) |
0.71 |
|
Married, n (%) |
68 (75.6) |
66 (73.3) |
0.74 |
|
Education ≤ Secondary, n (%) |
62 (68.9) |
24 (26.7) |
<0.001* |
|
Socioeconomic class (III–V), n (%) |
71 (78.9) |
69 (76.7) |
0.71 |
|
Smoking history, n (%) |
38 (42.2) |
21 (23.3) |
0.01* |
|
Alcohol consumption, n (%) |
41 (45.6) |
26 (28.9) |
0.03* |
Both groups were comparable in age, sex, marital status, and socioeconomic background. Construction workers had significantly lower educational attainment and higher prevalence of smoking and alcohol consumption, which may influence metabolic outcomes.
Table 2. Metabolic Parameters in Construction Workers and Controls
|
Parameter |
Construction Workers (n = 90) |
Controls (n = 90) |
p-value |
|
Body Mass Index (kg/m²) |
22.1 ± 2.4 |
24.3 ± 2.8 |
<0.001* |
|
Waist–Hip Ratio |
0.91 ± 0.05 |
0.88 ± 0.04 |
0.002* |
|
Basal Metabolic Rate (kcal/day) |
1780 ± 210 |
1560 ± 180 |
<0.001* |
|
Hemoglobin (g/dL) |
12.3 ± 1.6 |
13.6 ± 1.4 |
<0.001* |
|
Fasting Plasma Glucose (mg/dL) |
96.4 ± 12.1 |
94.8 ± 10.7 |
0.42 |
|
HbA1c (%) |
5.6 ± 0.6 |
5.5 ± 0.5 |
0.31 |
Construction workers exhibited significantly higher basal metabolic rate and lower BMI, reflecting increased occupational energy expenditure. However, significantly lower hemoglobin levels suggest a high burden of anemia, potentially compromising metabolic efficiency.
Table 3. Lipid Profile and Metabolic Risk Indicators
|
Parameter |
Construction Workers (n = 90) |
Controls (n = 90) |
p-value |
|
Total Cholesterol (mg/dL) |
198.6 ± 34.2 |
186.4 ± 28.9 |
0.02* |
|
LDL-Cholesterol (mg/dL) |
124.1 ± 29.6 |
112.7 ± 24.3 |
0.01* |
|
HDL-Cholesterol (mg/dL) |
42.3 ± 7.6 |
46.9 ± 8.1 |
<0.001* |
|
Triglycerides (mg/dL) |
164.8 ± 51.2 |
138.5 ± 46.7 |
0.003* |
|
Dyslipidaemia, n (%) |
35 (38.9) |
20 (22.2) |
0.01* |
|
Metabolic risk (≥2 abnormalities), n (%) |
28 (31.1) |
14 (15.6) |
0.02* |
Despite lower BMI, construction workers showed a significantly adverse lipid profile, with higher LDL and triglyceride levels and lower HDL cholesterol. This supports the concept that prolonged occupational physical activity does not uniformly protect against metabolic risk.
The present study provides comprehensive evidence of distinct metabolic adaptations among construction workers exposed to prolonged occupational physical activity. While construction workers demonstrated favorable anthropometric and energy expenditure profiles, these adaptive responses were accompanied by significant metabolic risk indicators, underscoring the complex and paradoxical nature of occupational physical activity.
One of the key findings was the significantly higher basal metabolic rate (BMR) and lower body mass index (BMI) among construction workers compared to sedentary controls. These findings reflect chronic metabolic adaptation to sustained physical workload, wherein increased energy expenditure and enhanced muscular activity promote higher resting metabolic demands. Similar observations have been reported in occupational cohorts engaged in heavy manual labor, where repeated activation of large muscle groups enhances oxidative metabolism and energy turnover. Lower BMI in construction workers suggests protection against obesity; however, BMI alone does not fully capture metabolic health, particularly in physically active populations.
Despite these apparently favorable adaptations, construction workers exhibited significantly lower hemoglobin levels and a markedly higher prevalence of anemia. Chronic iron deficiency, inadequate dietary intake, and repeated physical exertion likely contribute to reduced oxygen-carrying capacity, impairing metabolic efficiency and work performance. Anemia in physically active workers has been associated with early fatigue, reduced aerobic efficiency, and long-term cardiovascular strain. These findings highlight the critical role of nutritional inadequacy in modifying metabolic adaptation, especially in unorganized labor sectors.
Another important observation was the adverse lipid profile among construction workers. Higher total cholesterol, LDL cholesterol, and triglyceride levels, along with reduced HDL cholesterol, were observed despite lower BMI and higher physical activity. This finding supports the concept of the “occupational physical activity paradox,” wherein high levels of occupational exertion do not necessarily confer cardiometabolic protection. Unlike structured aerobic exercise, construction work often involves prolonged static loading, heavy lifting, and insufficient recovery, which may induce chronic sympathetic activation and systemic inflammation, adversely affecting lipid metabolism.
The prevalence of dyslipidaemia and clustering of metabolic risk factors among construction workers further emphasizes that sustained occupational activity alone is insufficient to mitigate metabolic risk. Lifestyle factors such as smoking and alcohol consumption, which were more prevalent among construction workers, may exacerbate dyslipidaemia and offset the beneficial effects of physical activity. Additionally, psychosocial stress and irregular work patterns characteristic of construction work may contribute to hormonal dysregulation, further impairing lipid and glucose homeostasis.
Glycaemic parameters, including fasting plasma glucose and HbA1c, were comparable between groups, suggesting preserved glucose regulation in the overall cohort. This finding may reflect the insulin-sensitizing effects of continuous muscular activity. However, subgroup trends indicated worsening glycaemic profiles with increasing duration of occupational exposure, suggesting that long-term cumulative stress may eventually overcome adaptive mechanisms. These findings underscore the importance of duration-dependent metabolic evaluation in occupational health studies.
Collectively, the results indicate that metabolic adaptations in construction workers represent a balance between beneficial conditioning and cumulative metabolic strain. While increased energy expenditure and lower BMI reflect positive adaptations, anemia and dyslipidaemia reveal underlying vulnerability driven by nutritional deficiency, lifestyle factors, and occupational stress. These findings have important public health implications, highlighting the need for integrated occupational health interventions that extend beyond physical workload management.
Regular metabolic screening, nutritional supplementation programs, lifestyle modification counseling, and workplace health education should be incorporated into occupational health policies for construction workers. Addressing these modifiable risk factors is essential to preserve beneficial metabolic adaptations while preventing long-term cardiometabolic morbidity in this vulnerable workforce.
Construction work induces metabolic adaptations that enhance energy utilization but simultaneously predispose workers to anemia and dyslipidaemia. Nutritional support and metabolic screening should be integrated into occupational health programs.
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