Sitting down at work is often blamed for poor health, but office workers are less likely to die early than a builder, according to a new study.
Cleaners, factory workers and building site or farm labourers are more than three times as likely to suffer premature death, according to new research.
Mortality rates differ over three-fold between occupational groups, say scientists.
In some jobs - such as domestic cleaning - women are more likely to die early than they were 20 years ago.
The worst jobs for health include those in factories, construction, farm labouring or housekeeping and call centres, the study shows.
The best include those in medicine, business and public services, finance, teaching and IT.
The study - which tracked about half a million Britons for 20 years - showed low pay and social circumstances play a bigger role in premature death than having a sedentary desk job.
Keep on moving
Lead author Dr Vittal Katikireddi said: “That is not to say moving around at work is not important.
“Recent research has focused on the changing patterns of work in the UK and how having a desk job can raise the risk of an early grave by reducing exercise.
“That of course is true. But we have shown labourers for instance - who are active at work - have high mortality rates.
“There needs to be greater emphasis on helping people lead healthier lives at work.
“It goes beyond advice to encouraging HGV drivers for instance to get out of their cabs regularly and offering them the opportunity to eat healthier foods.
“This could be provided by their companies.”
His researchers also found if occupational death rates in England and Wales applied to Scotland - where mortality is higher - almost 1,000 lives a year would be saved.
Dr Katikireddi said: “Excess deaths in Scotland were concentrated among lower skilled occupations - such as female cleaners.”
He added: “Our results show there were very large differences in death rates by occupation with professional occupations such as doctors and teachers faring far better than factory workers and garment trade workers.”
The highest death rates for both sexes overall were among those who were unemployed.
Dr Katikireddi and colleagues at the Social and Public Health Sciences Unit at Glasgow University looked at records from 1991 to 2011.
Using census and death records they confidentially compared mortality rates with occupational data in England, Wales and Scotland - the first study of its kind in the UK in 30 years.
Dr Katikireddi said: “Detailed assessments of mortality by occupation are scarce.
“Ongoing changes in the labour market make a reassessment of mortality by occupation timely.
“In particular - trends in the job market - such as the rise of so-called zero-hours contracts - could adversely affect health and health inequalities.
“It cannot be assumed patterns identified in the 1970s - which still underpin our contemporary understanding - continue to apply.”
The results showed doctors and other health professionals have very low death rates while factory workers and cleaners have amongst the highest.
During 4.51 million person-years of follow-up among 20 to 59 year-old working age adults there were over three-fold differences in mortality rates among 63 occupations.
Sick men (and women)
Researchers also compared differences in mortality rates between Scotland and the rest of the UK.
This revealed higher rates of death north of the border were concentrated in the lowest skilled occupations.
Dr Katikireddi said: “We studied trends over a twenty year period where we found that in most occupations mortality rates have fallen.
“However, in some they have remained stagnant and for women in some occupational groups, such as cleaners, mortality rates have even increased.”
The study published in The Lancet Public Health also found men who were health professionals - medical doctors, dentists, psychologists, pharmacists, opticians and vets - had the lowest mortality rates.
Among women, teachers and business professionals had the lowest mortality.
However the highest mortality rates overall occurred in men who reported no occupation.
Dr Katikireddi said: “Our study has particular relevance to policymakers in Scotland as there has been considerable concern health outcomes in Scotland are poorer than elsewhere in Western Europe.
“Addressing Scotland’s ‘sick man of Europe’ status requires paying particular attention to improving health amongst people working in low skilled jobs and who are unemployed.”
Computer models suggested if mortality rates by occupation in England and Wales applied to Scotland 631 fewer men and 273 fewer women of working age would die in Scotland every year.
Dr Katikireddi said: “Mortality rates differ greatly by occupation. The excess mortality in Scotland is concentrated among low-skilled workers and, although mortality has improved in men and women in most occupational groups, some groups have experienced increased rates.
“Future research investigating the specific causes of death at the detailed occupational level will be valuable, particularly with a view to understanding the health implications of precarious employment and the need to improve working conditions in very specific occupational groups.”
The study was funded by the Medical Research Council (MRC), The Scottish Government Chief Scientist Office (CSO) and Wellcome.
Ten worst jobs for health: deaths per 100,000 person years
1 Elementary construction occupations - 701
2 Elementary process plant occupations - 672
3 Elementary personal services occupations - 650
4 Elementary agricultural occupations - 623
5 Admin occupations - communications 604
6 Elementary cleaning occupations - 592
7 Textiles and garments trades - 569
8 Housekeeping occupations - 567
9 Metal forming, welding and related trades - 563
10 Elementary sales occupations - 556
Ten best jobs for health
1 Health professionals - 225
2 Business and public services professionals - 228
3 Functional managers - 233
4 Finance institution and office managers - 234
5 Corporate managers and directors - 250
6 Teaching professionals - 262
7 Production managers - 265
8 Protection services occupations - 265
9 IT professionals - 267
10 Business and finance associate professionals - 269