The Heart at Work & Play

Which is harder on the heart--work or leisure? This question got the full-dress treatment last week by 70 specialists from the U.S., Britain, Canada, Germany, Sweden and Finland, gathered in Milwaukee for a conference* on work and the heart. From studies designed to find out how much work a man can safely do after a heart attack, they developed some startling facts.

Drs. Amasa B. Ford and Herman K. Hellerstein of Cleveland's Western Reserve University noted that by far the most strenuous of all human activity is "play" --carried to the extreme of championship athletics. When energy expenditure is measured by the rate of calorie consumption, a distance runner or skier can burn up 26.5 calories per minute; healthy young men at amateur sports can work up to a fuel consumption of 18 calories per minute. The heaviest rates for steady work have been reported for coal miners as ranging from 4.3 to 5 calories per minute.

The Cleveland researchers studied men doing a wide range of jobs (from clerical to hauling stock around a warehouse) in a light-metals plant, found that their average energy consumption during working hours was only 1.97 calories per minute. This means that the workers spent less energy on the job than they did off the job--because it has been shown that during eight nonworking waking hours an average worker will burn up calories at a rate of 2.96 per minute.

Fatal Flight. With such facts in mind, Dr. William Dock of the Palo Alto medical clinic lashed out at the tendency to attribute a man's death from heart disease to his work, regardless of other activities. He cited a case history: "An electrician, two years after recovery from [a heart attack] dropped dead at lunch, which had included two bottles of beer. The industrial examiner accepted the claim that death was due to the exertion of walking up a flight of stairs an hour before lunch, and refused to consider that a stomach full of iced beer was a far worse stress and probably caused ventricular fibrillation. It was also known that the electrician played handball at least once a week, and had intercourse with his wife at least four times each week, but it was the occupational flight of stairs, not these other and far greater stresses, which was accepted as fatal."

Heart Specialist Dock noted that coughing and contracting the abdominal muscles during bowel movements "impose burdens analogous to those caused by lifting heavy objects . . . Less severe but more sustained circulatory stress is imposed by sexual intercourse . . . Pulse rate is nearly doubled, [the heart's] output per beat is increased nearly 50%, and systolic pressure rises about 30% even in orgasms induced by masturbation, with less emotional or physical stress. This circulatory effect is comparable to that caused by running up two or three flights of stairs, while in intercourse the effect may be two or three times more severe or prolonged."

The Main Factor. Continued Cardiologist Dock, who has alternated his habitat between New York City and the West Coast, is thus familiar with both sardine-packed subways and fin-packed freeways: "Going to or returning from work often provides the most intense physical effort and the most exasperating and frustrating experience of the day . . . From the history of patients with angina or severe breathing difficulties I have concluded that physical stresses due to the job exceed other stresses only among the very small group of workers who need more than 3,500 calories a day to maintain weight . . . that off-the-job causes predominate in light industry and personal services, and far outweigh occupational causes in white-collar groups." Among off-the-job causes of heart attacks, according to Dr. Dock, "sexual activity is the main factor in young and middle-aged women, and equals all other causes in men. Getting to and from work and moving household furnishings become very important factors after age 50 ... Among all the [whitecollar] employees who develop heart trouble, it is unlikely that occupational causes contribute ten percent of the total."

The University of Oklahoma's Dr. Stewart Wolf added another ominous note: a man's heart may speed up and increase its output per beat without his lifting a finger --all he has to do is to think about getting out on the diamond or golf course and belting a long one. This effect is so pronounced that it can be dangerous for subjects with heart disease. For such people, at least, the moral is clear: work hard, but when it comes to playing hard--don't even give it a thought.

*Sponsored by the Wisconsin Heart Association and Marquette University, in cooperation with the American Heart Association, the National Heart Institute and the Industrial Health Council of the A.M.A.

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