Occupational Medicine 2006 56(3):210-212; doi:10.1093/occmed/kqj026
© The Author 2006. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Leisure time physical activity and sickness absenteeism; a prospective study
Ludovic G. P. M. van Amelsvoort1,
Mark G. Spigt2,
Gerard M. H. Swaen1,3 and
IJmert Kant1
1 Department of Epidemiology, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
2 Department of General Practice, Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands
3 Currently at the Dow Chemical Corporation
Correspondence to: Ludovic G. P. M. van Amelsvoort, Department of Epidemiology, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands. Tel: +31 43 3882363; fax: +31 43 3884128; e-mail: lgpm.vanamelsvoort{at}epid.unimaas.nl
 |
Abstract
|
|---|
Aim To establish whether workers with frequent leisure time
physical activities are at higher or lower risk of sickness
absence compared to inactive workers.
Method Self reported and company recorded sickness absence data were collected during 18 months of follow-up for 8902 workers. Frequency of leisure time physical activities was queried at baseline.
Results Overall, we found that workers active in their leisure time twice or more each week reported significantly less sickness absence compared to inactive workers (14.8 versus 19.5 days/year), mainly due to a decrease in sick leave because of musculoskeletal disorders.
Conclusion Demotivating sports participation by making workers liable for workdays lost due to sporting injuries might be counter-productive in decreasing absenteeism and its related costs. Promoting worker participation in sport might lead to reduced absenteeism.
Keywords Musculoskeletal disorder; sickness absence; sport
|
Introduction
|
|---|
The balance between the health benefits and burden of leisure
time sports in terms of injury risk and subsequent use of healthcare
resources, workers absenteeism and commercial costs is important
and has been discussed in national parliaments [
1,
2]. Absenteeism
resulting from leisure time physical activities is often easily
identified and may lead to the worker being ‘blamed’.
In contrast, the positive health effects of leisure time physical
activity are much more diffuse and not recognizable as such.
Surprisingly, however, scientific data on the overall effect
of leisure time physical activity on worker absenteeism are
limited. Although some studies reported a beneficial effect
of leisure time physical activity on long-term sickness absence
[
3] or absenteeism due to musculoskeletal disorders [
4], none
reported on the overall effects on sick leave. The aim of this
study was to determine the relationship between leisure time
physical activity and sickness absence.
|
Methods
|
|---|
For the current analysis, data from a prospective cohort study
were used, which has been described elsewhere [
5]. In short,
in this study, workers from 45 companies were followed for 54
months from May 1998. Information on the frequency of leisure
time physical activities [
6] and sickness absenteeism information
provided by study participants and their employers was used.
Workers were categorized as being ‘inactive’, indicating
leisure time physical activity once a week or never, or being
‘active’ two or more times a week. Two independent
sources of sickness absence data were gathered. Firstly, the
self-reported duration, frequency and reason for sickness absence
between 8 and 12 months after baseline. The reason for sickness
absence was coded by a trained coder using the Dutch version
of the International Classification of Primary Care (ICPC) [
7].
Secondly, employer sickness absence records during 1 year starting
6 months after the baseline measurement. Logistic regression
was used to analyse differences in sickness absence risk, Poisson
regression to analyse difference in duration of sickness absence
(in calendar days), between active and inactive workers. Due
to the complex logistics involved in sending out the questionnaires
and gathering the company sickness absence data we could not
exactly match the time windows of both data collection methods.
|
Results
|
|---|
A total of 12 140 workers were eligible for inclusion. We excluded
workers who reported having a chronic condition at baseline
(
n = 2397), were pregnant or laid off during the observation
period (
n = 360) and who reported to be on sickness absence
at baseline (
n = 481). This left 8902 workers for analysis.
Of the workers, 31% were categorized as inactive and 69% as
active. Self-reported sickness absence data were available for
6837 (77%) and employer sickness absence data for 6375 workers
(72%). Reasons for non-availability of sickness absence data
were changed employer (
n = 460) and inability of the employer
to provide data (
n = 2067).
The results for the self-reported duration, frequency and number of sickness absence days in total and per ICPC group and the company provided sickness absence records are shown in Table 1. Overall, for the self-reported data, active workers reported significantly less frequently sickness absence (OR: 0.87; 95% CI: 0.78–0.97), especially for musculoskeletal disorders of the spinal column (OR: 0.62; 95% CI: 0.45–0.84), compared to the inactive workers. Also the duration of sickness absence was, on average, 1 day shorter for active workers. This was mainly due to a shorter duration of diseases of the digestive tract. The overall number of self-reported sickness absence days was significantly lower (19%) in the active workers, with less absent days for most disease categories, except for psychological problems (no difference) and social problems (more absent days).
View this table:
[in this window]
[in a new window]
|
Table 1. Company recorded and ICPC coded self-reported reason of the number of days, duration and frequency of sickness absence for inactive versus active workers
|
|
The number of sickness absence days as provided by the employer
showed only a slightly lower sickness absence risk for the active
workers. However, the mean duration of the sickness absence
periods was 23% shorter in the active compared to the inactive
workers (
P < 0.001). Also, the annual number of sickness
absence days per worker was lower in the active compared to
the inactive workers (respectively, 14.8 and 19.5 days a year).
Adjustment for age, gender and educational level, did not change
the results for any of the reported relations (specific data
not shown).
|
Discussion
|
|---|
In summary, we found that workers who reported being physically
active more than once a week reported significantly less sickness
absence. So far, this relationship has only been investigated
elsewhere in detail in relation to musculoskeletal disorders
[
4], with findings similar to ours. For psychological problems,
also an important cause of sickness absence, we found a small
positive effect, although not significant. Exercise is an accepted
method of treating patients with depression [
8]. The positive
effects are explained through the positive influence of physical
exercise on both psychosocial and physiological health [
9,
10].
Only for sickness absence due to social problems was a small
but significant effect found in favour of inactive workers.
One could speculate that for workers with social problems, sport
might be a way of release. Although the study is of a longitudinal
design, some limitations remain. Possibly, workers' health problems
simultaneously reduce the ability of the worker to participate
in sports and lead to increased sick leave. Although, by excluding
all workers reporting a chronic condition and workers at sick
leave at baseline, we tried to minimize this bias. Also some
differences were found between the self reported and company
recorded sickness absence data, especially in the mean duration
and total number of sick leave days. This is probably caused
by the difference in observation periods (4 months versus 1
year) which excludes long-term sickness absence periods for
the self-reported data. Calculating the costs due to lost productive
workdays (using Dutch labour cost data [
11]) being leisure time
inactive was associated with a decreased productivity of
488
per worker per year.
We conclude that being physically active in leisure time is related to lower absenteeism rates. Leisure time physical activity should therefore not be discouraged by making workers liable for workdays lost work due to leisure time sporting injury. In our view, it is more important to keep people, and workers in particular, physically active.
|
Conflicts of interest
|
|---|
None declared.
|
References
|
|---|
- House of Commons. House of Commons Hansard Debates for 18 Dec 2002. London: The Stationery Office, 2002.
- Tweede Kamer der Staten Generaal. Tweede Kamer, vergaderjaar 2002–2003, Aanhangsel: 312. Vragen gesteld door de leden der Kamer, met de daarop door de regering gegeven antwoorden. 's-Gravenhage: Sdu Uitgevers ed, 2003; 653.
- Eriksen W, Bruusgaard D. Physical leisure-time activities and long-term sick leave: a 15-month prospective study of nurses' aides. J Occup Environ Med 2002;44:530–538.[Web of Science][Medline]
- Hildebrandt VH, Bongers PM, Dul J, van Dijk FJ, Kemper HC. The relationship between leisure time, physical activities and musculoskeletal symptoms and disability in worker populations. Int Arch Occup Environ Health 2000;73:507–518.[CrossRef][Web of Science][Medline]
- Kant IJ, Bultmann U, Schroer KA, Beurskens AJ, van Amelsvoort LG, Swaen GM. An epidemiological approach to study fatigue in the working population: the Maastricht Cohort Study. Occup Environ Med 2003;60(Suppl. 1):i32–i39.[Abstract/Free Full Text]
- Schechtman KB, Barzilai B, Rost K, Fisher EB, Jr. Measuring physical activity with a single question. Am J Public Health 1991;81:771–773.[Abstract/Free Full Text]
- De Kanter J, Lamberts H, Mulder J. ICPC. International Classification of Primary Care (Dutch Translation). Utrecht: Nederlands Huisartsengenootschap, 1989.
- Lawlor DA, Hopker SW. The effectiveness of exercise as an intervention in the management of depression: systematic review and meta-regression analysis of randomised controlled trials. Br Med J 2001;322:763–767.[Abstract/Free Full Text]
- Paluska SA, Schwenk TL. Physical activity and mental health: current concepts. Sports Med 2000;29:167–180.[CrossRef][Web of Science][Medline]
- Scully D, Kremer J, Meade MM, Graham R, Dudgeon K. Physical exercise and psychological well being: a critical review. Br J Sports Med 1998;32:111–120.[Abstract/Free Full Text]
- Centraal Bureau voor de Statistiek. Statline. Voorburg, the Netherlands: Centraal Bureau voor de Statistiek (Central Bureau of Statistics), 2003.
CiteULike 
Connotea 
Del.icio.us What's this?
Top
Abstract
Introduction