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Gupta N, Dencker-Larsen S, Lund Rasmussen C, McGregor D, Rasmussen CDN, Thorsen SV, Jørgensen MB, Chastin S, Holtermann A. The physical activity paradox revisited: a prospective study on compositional accelerometer data and long-term sickness absence. Int J Behav Nutr Phys Act 2020; 17:93. [PMID: 32690043 PMCID: PMC7370435 DOI: 10.1186/s12966-020-00988-7] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/22/2020] [Indexed: 12/24/2022] Open
Abstract
Background The ‘physical activity paradox’ advocates that leisure physical activity (PA) promotes health while high occupational PA impairs health. However, this paradox can be explained by methodological limitations of the previous studies—self-reported PA measures, insufficient adjustment for socioeconomic confounding or not addressing the compositional nature of PA. Therefore, this study investigated if we still observe the PA paradox in relation to long-term sick absence (LTSA) after adjusting for the abovementioned limitations. Methods Time spent on moderate-to-vigorous physical activity (MVPA) and remaining physical behaviors (sedentary behavior, standing, light PA and time in bed) at work and in leisure was measured for 929 workers using thigh accelerometry and expressed as isometric log-ratios (ilrs). LTSA was register-based first event of ≥6 consecutive weeks of sickness absence during 4-year follow-up. The association between ilrs and LTSA was analyzed using a Cox proportional hazards model adjusted for remaining physical behaviors and potential confounders, then separately adjusting for and stratifying by education and type of work. Results During the follow-up, 21% of the workers experienced LTSA. In leisure, more relative MVPA time was negatively associated with LTSA (20% lower risk with 20 min more MVPA, p = 0.02). At work, more relative MVPA time was positively associated with LTSA (15% higher risk with 20 min more MVPA, p = 0.02). Results remained unchanged when further adjusted for or stratified by education and type of work. Conclusion These findings provide further support to the ‘PA paradox’.
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Affiliation(s)
- Nidhi Gupta
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen Ø, Denmark.
| | - Sofie Dencker-Larsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen Ø, Denmark.,Business Information & Analytics, Copenhagen Business School, Solbjerg Plads 3, DK-2000, Frederiksberg, Denmark
| | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen Ø, Denmark.,Department of Public Health, Section of Social Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Duncan McGregor
- School of Health and Life Science, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland.,Biomathematics and Statistics Scotland, JCMB, The King's Buildings, Peter Guthrie Tait Road, Edinburgh, EH9 3FD, Scotland, UK
| | | | - Sannie Vester Thorsen
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen Ø, Denmark
| | - Marie Birk Jørgensen
- Occupational Health and Safety, Department of Ergonomic and Technical Counselling, Municipality of Copenhagen, Copenhagen, Denmark
| | - Sebastien Chastin
- School of Health and Life Science, Glasgow Caledonian University, Cowcaddens Road, Glasgow, G4 0BA, Scotland.,Department of Movement and Sport Sciences, Ghent University, Ghent, Belgium
| | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkalle 105, DK-2100, Copenhagen Ø, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
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Hallman DM, Holtermann A, Dencker-Larsen S, Birk Jørgensen M, Nørregaard Rasmussen CD. Are trajectories of neck-shoulder pain associated with sick leave and work ability in workers? A 1-year prospective study. BMJ Open 2019; 9:e022006. [PMID: 30898794 PMCID: PMC6475446 DOI: 10.1136/bmjopen-2018-022006] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVES The study aimed to determine the extent to which latent trajectories of neck-shoulder pain (NSP) are associated with self-reported sick leave and work ability based on frequent repeated measures over 1 year in an occupational population. METHODS This longitudinal study included 748 Danish workers (blue-collar, n=620; white collar, n=128). A questionnaire was administered to collect data on personal and occupational factors at baseline. Text messages were used for repeated measurements of NSP intensity (scale 0-10) over 1 year (14 waves in total). Simultaneously, self-reported sick leave (days/month) due to pain was assessed at 4-week intervals, while work ability (scale 0-10) was assessed using a single item (work ability index) at 12-week intervals over the year. Trajectories of NSP, distinguished by latent class growth analysis, were used as predictors of sick leave and work ability in generalised estimation equations with multiple adjustments. RESULTS Sick leave increased and work ability decreased across all NSP trajectory classes (low, moderate, strong fluctuating and severe persistent pain intensity). In the adjusted model, the estimated number of days on sick leave was 1.5 days/month for severe persistent NSP compared with 0.1 days/month for low NSP (relative risk=13.8, 95% CI 6.7 to 28.5). Similarly, work ability decreased markedly for severe persistent NSP (OR=12.9, 95% CI 8.5 to 19.7; median 7.1) compared with low NSP (median 9.5). CONCLUSION Severe persistent NSP was associated with sick leave and poor work ability over 1 year among workers. Preventive strategies aiming at reducing severe persistent NSP among working populations are needed.
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Affiliation(s)
| | - Andreas Holtermann
- Musculoskeletal Disorders and Physical Work demands, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Sofie Dencker-Larsen
- Musculoskeletal Disorders and Physical Work demands, National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Marie Birk Jørgensen
- Musculoskeletal Disorders and Physical Work demands, National Research Centre for the Working Environment, Copenhagen, Denmark
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Dencker-Larsen S, Rasmussen CL, Thorsen SV, Clays E, Lund T, Labriola M, Mortensen OS, Jørgensen MB, Gupta N, Rasmussen CDN, Holtermann A. Technically measured compositional physical work demands and prospective register-based sickness absence (PODESA): a study protocol. BMC Public Health 2019; 19:257. [PMID: 30832631 PMCID: PMC6398236 DOI: 10.1186/s12889-019-6581-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Accepted: 02/22/2019] [Indexed: 11/16/2022] Open
Abstract
Background Various physical work demands are shown to be associated with sickness absence. However, these studies have: (a) predominantly used self-reported data on physical work demands that have been shown to be inaccurate compared with technical measurements, (b) principally focused on various physical work demands in ‘isolation’, i.e. ignoring their co-dependency – compositional nature –, and (c) mainly used register data on long-term sickness absence. The present article describes the protocol of a study with the objective of investigating the association between technically measured compositional data on physical work demands and prospective long- and short-term register-based data on sickness absence. Methods ‘The technically measured compositional Physical wOrk DEmands and prospective association with register-based Sickness Absence study (PODESA)’ comprises data from two Danish cohorts (NOMAD and DPhacto) primarily on blue-collar workers. In the PODESA cohort, data on 1108 workers were collected at baseline (between 2011 and 2014). The cohort data comprise, e.g., self-reported information on descriptives, lifestyle, workday, and health, as well as accelerometer-based measurements of physical work demands (physical activity, movements, and postures). These baseline measurements are linked with prospective register-based data on sickness absence for up to four years after baseline. The prospective association between physical work demands and sickness absence will be analysed using a Compositional Data Analysis approach. Discussion PODESA provides a unique possibility of unravelling which combinations of physical work demands are associated with prospective sickness absence. PODESA employs technically measured information on physical work demands (taking into account the compositionality of physical work demand data) and prospective sickness absence data. The findings from PODESA can be used to develop strengthened preventive interventions for sickness absence. Results are expected in 2019–2021.
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Affiliation(s)
- Sofie Dencker-Larsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.
| | - Charlotte Lund Rasmussen
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.,Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark
| | - Sannie Vester Thorsen
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark
| | - Els Clays
- Department of Public Health and Primary Care, Ghent University, 4K3 (ingang 42), Corneel Heymanslaan 10, B-9000, Ghent, Belgium
| | - Thomas Lund
- Center for Social Medicine, Frederiksberg and Bispebjerg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
| | - Merete Labriola
- Department of Public Health, Aarhus University, Bartholins Allé 2, 8000, Aarhus, Denmark
| | - Ole Steen Mortensen
- Section of Social Medicine, University of Copenhagen, Øster Farimagsgade 5, 1014, Copenhagen, Denmark.,Department of Occupational and Social Medicine, Holbæk Hospital, Smedelundsgade 60, 4300, Holbæk, Denmark
| | - Marie Birk Jørgensen
- Department of Forensic Science, University of Copenhagen, 2100, Copenhagen, Denmark
| | - Nidhi Gupta
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark
| | | | - Andreas Holtermann
- National Research Centre for the Working Environment, Lersø Parkallé 105, Copenhagen, Denmark.,Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Campusvej 55, 5230, Odense, Denmark
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Svane-Petersen AC, Dencker-Larsen S. The impact of self-reported health and register-based prescription medicine purchases on re-employment chances: A prospective study. SSM Popul Health 2016; 2:580-586. [PMID: 29349173 PMCID: PMC5757886 DOI: 10.1016/j.ssmph.2016.08.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2016] [Revised: 08/11/2016] [Accepted: 08/12/2016] [Indexed: 11/03/2022] Open
Abstract
In this paper, we investigate the influence of self-reported health and register-based prescription medicine purchases on re-employment chances, and whether these health indicators measure similar aspects of health in this analysis. Data came from a 2006 Danish unemployment survey among a random sample of unemployed individuals enriched with register data (2006–2008, N=1806). The survey participants all received unemployment benefits from the welfare system and had been unemployed for more than 20 weeks at the time of the interview in 2006. We combined these data with longitudinal register data on individual prescription medicine purchases for somatic illnesses and prescription medicine purchases for mental illnesses, information on re-employment and various socio-demographic variables. We conducted binary logistic regression analyses to investigate the impact of self-reported health and prescription medicine purchases measured in 2006 on re-employment chances in 2007 and 2008. Our analyses show that unemployed workers with poor self-reported health and workers who had prescription medicine purchases for mental illnesses were less likely to be re-employed in 2007 and 2008. Furthermore, the impact of both prescription medicine purchases for somatic illnesses and for mental illnesses increased when adding self-reported health to the model although prescription purchases for somatic illnesses became statistically insignificant. The impact of prescription medicine purchases for somatic illnesses was mediated by self-reported health, whilst prescription medicine purchases for mental illnesses was only partly mediated. Finally, SRH seemed a much stronger prediction than prescription medicines. From these results, we propose, when possible, the inclusion of both an indicator of self-reported health and an indicator of mental health in studies on re-employment. Poor health negatively affects re-employment chances of unemployed workers. Self-reported health indicates somatic health over prescription medicine purchases. Both self-reported health and mental health are relevant to re-employment chances.
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Affiliation(s)
- Annemette Coop Svane-Petersen
- SFI - The Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-1052 Copenhagen K, Denmark.,Department of Sociology, University of Copenhagen, Øster Farimagsgade 5, Building 16, DK-1014 Copenhagen K, Denmark
| | - Sofie Dencker-Larsen
- SFI - The Danish National Centre for Social Research, Herluf Trolles Gade 11, DK-1052 Copenhagen K, Denmark.,Department of Sociology, University of Copenhagen, Øster Farimagsgade 5, Building 16, DK-1014 Copenhagen K, Denmark
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