Jouni Lahti

The impact of physical activity on sickness absence

The aim of this study was to examine whether the volume and intensity of physical activity are associated with subsequent sickness absence spells of different lengths, and how much of these associations can be explained by socioeconomic position, body mass index (BMI) and physical health functioning. Baseline data were collected by questionnaire surveys in 2000–2002 among 40–60‐year‐old employees of Helsinki City (n=6465, 79% women). Sickness absence data were derived from the employers registers (mean follow‐up time 3.9 years). Associations of physical activity with shorter (≤14 days) and longer (>14 days) sickness absence spells were examined, using Poissons regression analysis. The volume of physical activity was weakly and somewhat inconsistently associated with sickness absence. However, men and women who were vigorously active systematically had reduced risk of sickness absence, whereas the same volume of moderately intensive physical activity did not reduce the risk of sickness absence. Adjusting for BMI and in particular physical health functioning attenuated these associations, after which the associations lost statistical significance. The results suggest that vigorous physical activity is associated with sickness absence and may contribute to better work ability.

Changes in leisure-time physical activity after transition to retirement: a follow-up study

BackgroundRetirement is a major life change that is likely to affect lifestyles. The aim of this study was to examine changes in leisure-time physical activity of moderate and vigorous intensity among ageing employees facing transition to retirement over a follow-up of 5-7 years.MethodsThe baseline data were collected by questionnaire surveys in 2000-2002 among 40-60-year-old employees of the City of Helsinki. A follow-up survey was conducted among the baseline respondents in 2007 (n = 7332, response rate 83%). Those who were on disability retirement at the follow-up were distinguished from old-age retirees. Leisure-time physical activity was measured using similar questions in both surveys.ResultsOld-age retirees increased significantly their time spent in moderate-intensity physical activity: women 31 minutes per week and men 42 minutes per week on average. Such changes were not found among disability retirees or those remaining employed. There were no changes in vigorous activity. Leisure-time physical inactivity at follow-up was lower among old-age retirees compared with employees of nearly the same age. Adjustments made for potential baseline covariates had no effects on these findings.ConclusionsTransition to old-age retirement was associated with an increase in moderate-intensity leisure-time physical activity and a decrease in the proportion of inactive. Encouraging people to leisure-time physical activity after retirement is worthwhile as the increase in free time brings new possibilities for it.

Changes in occupational class differences in leisure-time physical activity: a follow-up study

BackgroundPhysical activity is known to have health benefits across population groups. However, less is known about changes over time in socioeconomic differences in leisure-time physical activity and the reasons for the changes. We hypothesised that class differences in leisure-time physical activity would widen over time due to declining physical activity among the lower occupational classes. We examined whether occupational class differences in leisure-time physical activity change over time in a cohort of Finnish middle-aged women and men. We also examined whether a set of selected covariates could account for the observed changes.MethodsThe data were derived from the Helsinki Health Study cohort mail surveys; the respondents were 40-60-year-old employees of the City of Helsinki at baseline in 2000-2002 (n = 8960, response rate 67%). Follow-up questionnaires were sent to the baseline respondents in 2007 (n = 7332, response rate 83%). The outcome measure was leisure-time physical activity, including commuting, converted to metabolic equivalent tasks (MET). Socioeconomic position was measured by occupational class (professionals, semi-professionals, routine non-manual employees and manual workers). The covariates included baseline age, marital status, limiting long-lasting illness, common mental disorders, job strain, physical and mental health functioning, smoking, body mass index, and employment status at follow-up. Firstly the analyses focused on changes over time in age adjusted prevalence of leisure-time physical activity. Secondly, logistic regression analysis was used to adjust for covariates of changes in occupational class differences in leisure-time physical activity.ResultsAt baseline there were no occupational class differences in leisure-time physical activity. Over the follow-up leisure-time physical activity increased among those in the higher classes and decreased among manual workers, suggesting the emergence of occupational class differences at follow-up. Women in routine non-manual and manual classes and men in the manual class tended to be more often physically inactive in their leisure-time (<14 MET hours/week) and to be less often active (>30 MET hours/week) than those in the top two classes. Adjustment for the covariates did not substantially affect the observed occupational class differences in leisure-time physical activity at follow-up.ConclusionsOccupational class differences in leisure-time physical activity emerged over the follow-up period among both women and men. Leisure-time physical activity needs to be promoted among ageing employees, especially among manual workers.

The impact of physical activity on physical health functioning--a prospective study among middle-aged employees.

OBJECTIVE To examine whether physical activity contributes to physical health functioning five to seven years later among middle-aged employees. METHODS Baseline data were collected in 2000-2002 by questionnaire surveys among 40-60-year-old employees of Helsinki City. A follow-up survey was conducted among baseline respondents in 2007 (n=7330, response rate 83%). Physical activity during leisure time or commuting within the previous 12 months was asked at baseline. Physical health functioning was measured by physical component summary (PCS) of the Short-Form 36 questionnaire. PCS mean scores were examined, as were poor and good PCS scores. RESULTS Vigorously active and conditioning exercisers had better subsequent physical health functioning than did the inactive and moderately active. Baseline health and functioning explained a major part of the differences found. Smoking, alcohol use and BMI further explained some of the differences. No clear differences in physical health functioning mean scores emerged during follow-up. In good physical health functioning, however some differences between conditioning and inactive women remained after adjustments. CONCLUSIONS Prospective associations between physical activity and physical health functioning were relatively weak, but high physical activity may help in maintaining good physical health functioning. Vigorous activity may be more beneficial than moderate activity.

Physical activity and anxiety: A perspective from the World Health Survey

BACKGROUND Despite the known benefits of physical activity (PA) among people with anxiety, little is known about PA levels in people with anxiety at the population level. This study explored the global prevalence of anxiety and its association with PA. METHODS Cross-sectional, community-based data from the World Health Survey was analyzed. Prevalence of anxiety was estimated for 237,964 individuals (47 countries). PA was categorized as low, moderate, and high based on the International Physical Activity Questionnaire (short form). The association between PA and anxiety was assessed by multivariable logistic regression. RESULTS The overall global prevalence of anxiety was 11.4% (47 countries). Across 38 countries with available data on PA, 62.5%, 20.2%, and 17.3% of the sample engaged in high, moderate, and low levels of PA respectively. The prevalence of low physical activity in those with and without anxiety was 22.9% vs. 16.6% (p<0.001) (38 countries, n=184,920). In the pooled model adjusted for socio-demographics, depression, and country, individuals engaging in low PA (vs. high PA) had 1.32 (95% CI=1.17-1.47) times higher odds for anxiety than those with high PA. Female sex, older age, lower education and wealth, and depression were also associated with low PA. At the individual country level, there was a significant positive association between low PA and anxiety in 17 of the 38 countries. CONCLUSION Low PA levels are associated with increased prevalence of anxiety. There is a need for longitudinal research to establish the directionality of the relationships observed.

Leisure-Time Physical Activity and All-Cause Mortality

Background Physical inactivity is a major public health problem associated with increased mortality risk. It is, however, poorly understood whether vigorous physical activity is more beneficial for reducing mortality risk than activities of lower intensity. The aim of this study was to examine associations of the intensity and volume of leisure-time physical activity with all-cause mortality among middle-aged women and men while considering sociodemographic and health related factors as covariates. Methods Questionnaire survey data collected in 2000-02 among 40–60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on mortality (74% gave permission to the linkage) providing a mean follow-up time of 12-years. The analysis included 6429 respondents (79% women). The participants were classified into three groups according to intensity of physical activity: low moderate, high moderate and vigorous. The volume of physical activity was classified into three groups according to tertiles. Cox regression analysis was used to calculate hazard ratios (HR) and 95% confidence intervals (CIs) for all-cause mortality. Results During the follow up 205 participants died. Leisure-time physical activity was associated with reduced risk of mortality. After adjusting for covariates the vigorous group (HR = 0.54, 95% CI 0.34–0.86) showed a reduced risk of mortality compared with the low moderate group whereas for the high moderate group the reductions in mortality risk (HR = 0.72, 95% CI 0.48–1.08) were less clear. Adjusting for the volume of physical activity did not affect the point estimates. Higher volume of leisure-time physical activity was also associated with reduced mortality risk; however, adjusting for the covariates and the intensity of physical activity explained the differences. Conclusions For healthy middle-aged women and men who engage in some physical activity vigorous exercise may provide further health benefits preventing premature deaths.

Leisure-time physical activity and psychotropic medication: A prospective cohort study

BACKGROUND Physical inactivity is a major public health problem associated with an increased risk of mental health problems. The aim of this study was to examine the associations of leisure-time physical activity with subsequent psychotropic medication among middle-aged people employed at baseline. METHODS Questionnaire survey data collected in 2000-02 among 40-60-year-old employees of the City of Helsinki (N = 8960) were linked with register data on prescribed psychotropic medication (74% gave permission to linkage). The mean follow-up time was 4.2 years. The analysis included 5961 respondents (78% women). The participants were classified into four groups according to physical activity recommendations. Cox regression analysis was used to calculate hazard ratios (HR) for the first psychotropic medication purchase. RESULTS Leisure-time physical activity was associated with decreased risk of any psychotropic medication. After adjusting for prior psychotropic medication conditioning exercisers (HR = 0.65, 95% CI, 0.53-0.80), the vigorously active (HR = 0.83, 95% CI, 0.71-0.98) and the moderately active (HR = 0.85, 95% CI, 0.74-0.97) all showed a reduced risk of medication compared with the inactive. The associations were similar for the two main groups of psychotropic medication: antidepressants as well as sedatives and sleep medication. CONCLUSIONS Leisure-time physical activity is potentially important for preventing mental health problems among the middle-aged.

Changes in leisure-time physical activity and subsequent sickness absence: a prospective cohort study among middle-aged employees.

OBJECTIVE The aim of this study was to examine how changes over time in leisure-time physical activity are associated with subsequent sickness absence. METHODS Helsinki Health Study cohort baseline questionnaire survey data were collected in 2000-2002 among 40-60-year-old employees of the City of Helsinki, Finland. A follow-up survey was conducted in 2007. 4182 (83% women) respondents were available for the analyses. Leisure-time physical activity was asked using identical questions in both surveys. Sickness absence data were derived from the employers registers (mean follow-up time 2.8 years). Associations of changes over time in leisure-time physical activity with self-certified (≤ 3 days) and medically certified (>3 days) sickness absence spells were examined, using Poisson regression analysis. RESULTS Inactive women and men who increased their physical activity to vigorously active had a significantly lower risk of both self-certified (RR=0.80, 95% CI 0.65-0.97) and medically certified (RR=0.63, 95% CI 0.49-0.83) subsequent sickness absence spells compared with the persistently inactive. The persistently active with vigorous intensity had the lowest risk of sickness absence. Adjusting for changes in physical health functioning attenuated but did not abolish the lowered risk found. CONCLUSIONS For reducing sickness absence more emphasis should be given to the potential contribution of vigorous physical activity.

Joint associations of smoking and physical activity with disability retirement: a register-linked cohort study

Objectives We examined the risk of disability retirement by smoking and physical activity, and particularly whether the risk due to smoking is affected by the level of physical activity. Additionally, the contribution of baseline health, sociodemographic and work-related factors to the joint associations of smoking and physical activity with disability retirement was considered. Design Cohort study. Setting Helsinki, Finland. Participants Employees of the City of Helsinki, aged 40–60 years at baseline in 2000–2002, were followed up using complete register data from the Finnish Centre of Pensions until the end of 2010 (n=6390, with a consent to register linkage from 74%). Primary outcome measure All-cause disability retirement (ICD-10). Results Altogether, 608 employees (9.5%) retired due to disability during the follow-up. Cox regression models were fitted to examine the joint associations of smoking and physical activity with subsequent disability retirement. Never-smokers, ex-smokers and moderate smokers who were inactive or moderately active had an increased risk of disability retirement, but if they were vigorously active, they had no excess risk. Instead, all heavy smokers (15 or more cigarettes per day among women, and 20 or more among men), irrespective of physical activity, had an increased risk of disability retirement. The examined associations attenuated but remained for ex-smokers and heavy smokers after adjustments for gender, age, socioeconomic position, mental and physical workload, problem drinking, body mass index and self-rated health. No gender interactions were found. Conclusions Vigorous physical activity might help prevent disability retirement not only among never-smokers, but even among ex-smokers and moderate smokers. However, among heavy smokers, physical activity is not sufficient to eliminate the adverse effects of smoking on health and work ability.

The associations between psychosocial working conditions and changes in common mental disorders: a follow-up study

BackgroundCommon mental disorders (CMD) are prevalent in working populations and have adverse consequences for employee well-being and work ability, even leading to early retirement. Several studies report associations between psychosocial working conditions and CMD. However, there is a lack of longitudinal research within a broad framework of psychosocial working conditions and improvement in CMD. The aim of this study was to examine the associations between several psychosocial working conditions and deteriorating and improving CMD among ageing employees over a five-to-six-year follow-up period.MethodsThe study is based on the Helsinki Health Study baseline survey in 2001–2002 and a follow-up in 2007 (N = 4340, response rate 83%) conducted among 40-60-year-old female and male employees. The General Health Questionnaire (GHQ-12) was used to measure common mental disorders. Psychosocial working conditions were measured in terms of job strain, organisational justice, work-family interface, social support and workplace bullying. The covariates included sociodemographic and health factors.ResultsFollowing adjustment for all the covariates, family-to-work (OR 1.41, 95% Cl 1.04-1.91) and work-to-family conflicts (OR 1.99, 95% Cl 1.42-2.78) and workplace bullying (OR 1.40, 95% Cl 1.09-1.79) were associated with deterioration, and family-to-work conflicts (OR 1.65, 95% Cl 1.66-2.34) and social support (OR 1.47, 95% Cl 1.07-2.00) with improvement in CMD.ConclusionsAdverse psychosocial working conditions contribute to poor mental health among employees. Preventing workplace bullying, promoting social support and achieving a better balance between work and family may help employees to maintain their mental health.