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      Occupational and leisure-time physical activity and risk of disability pension: prospective data from the HUNT Study, Norway


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          To prospectively investigate the association between occupational physical activity (OPA) and disability pension due to musculoskeletal cause, mental cause or any cause. We also examined the combined association of OPA and leisure-time physical activity (LTPA) with disability pension.


          A population-based cohort study in Norway on 32 362 persons aged 20–65 years with questionnaire data on OPA and LTPA that were followed up for incident disability pension through the National Insurance Database. We used Cox regression to estimate adjusted HRs with 95% CIs.


          During a follow-up of 9.3 years, 3837 (12%) received disability pension. Compared with people with mostly sedentary work, those who performed much walking, much walking and lifting, and heavy physical work had HRs of 1.26 (95% CI 1.16 to 1.38), 1.44 (95% CI 1.32 to 1.58) and 1.48 (95% CI 1.33 to 1.70), respectively. These associations were stronger for disability pension due to musculoskeletal disorders, whereas there was no clear association between OPA and risk of disability pension due to mental disorders. People with high OPA and low LTPA had a HR of 1.77 (95% CI 1.58 to 1.98) for overall disability pension and HR of 2.56 (95% CI 2.10 to 3.11) for disability pension due to musculoskeletal disorders, versus low OPA and high LTPA.


          We observed a positive association between OPA and risk of disability pension due to all causes and musculoskeletal disorders, but not for mental disorders. Physical activity during leisure time reduced some, but not all of the unfavourable effect of physically demanding work on risk of disability pension.

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          Most cited references28

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          Limits to the measurement of habitual physical activity by questionnaires.

          Despite extensive use over 40 years, physical activity questionnaires still show limited reliability and validity. Measurements have value in indicating conditions where an increase in physical activity would be beneficial and in monitoring changes in population activity. However, attempts at detailed interpretation in terms of exercise dosage and the extent of resulting health benefits seem premature. Such usage may become possible through the development of standardised instruments that will record the low intensity activities typical of sedentary societies, and will ascribe consistent biological meaning to terms such as light, moderate, and heavy exercise.
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            The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms

            Background Population based studies are important for prevalence, incidence and association studies, but their external validity might be threatened by decreasing participation rates. The 50 807 participants in the third survey of the HUNT Study (HUNT3, 2006-08), represented 54% of the invited, necessitating a nonparticipation study. Methods Questionnaire data from HUNT3 were compared with data collected from several sources: a short questionnaire to nonparticipants, anonymous data on specific diagnoses and prescribed medication extracted from randomly selected general practices, registry data from Statistics Norway on socioeconomic factors and mortality, and from the Norwegian Prescription Database on drug consumption. Results Participation rates for HUNT3 depended on age, sex and type of symptoms and diseases, but only small changes were found in the overall prevalence estimates when including data from 6922 nonparticipants. Among nonparticipants, the prevalences of cardiovascular diseases, diabetes mellitus and psychiatric disorders were higher both in nonparticipant data and data extracted from general practice, compared to that reported by participants, whilst the opposite pattern was found, at least among persons younger than 80 years, for urine incontinence, musculoskeletal pain and headache. Registry data showed that the nonparticipants had lower socioeconomic status and a higher mortality than participants. Conclusion Nonparticipants had lower socioeconomic status, higher mortality and showed higher prevalences of several chronic diseases, whilst opposite patterns were found for common problems like musculoskeletal pain, urine incontinence and headache. The impact on associations should be analyzed for each diagnosis, and data making such analyses possible are provided in the present paper.
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              Physical work environment risk factors for long term sickness absence: prospective findings among a cohort of 5357 employees in Denmark.

              To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. Prospective cohort study of long term sickness absence among employees in Denmark. 5357 employees interviewed in 2000 about their physical work environment, and various covariates were followed for 18 months in a national sickness absence register. Outcome measurements Cox regression analysis was performed to assess risk estimates for physical risk factors in the work environment and onset of long term sickness absence, defined as receiving sickness absence compensation for eight consecutive weeks or more. 348 participants (6.9%) developed long term sickness absence during follow-up. Of these, 194 (55.7%) were women and 154 (44.3%) were men. For both female and male employees, risk of onset of long term sickness absence was increased by extreme bending or twisting of the neck or back, working mainly standing or squatting, lifting or carrying loads, and pushing or pulling loads. Significant interactions were found for three combinations of physical and psychosocial work environment risk factors among female employees (P<0.05). Uncomfortable working positions, lifting or carrying loads, and pushing or pulling loads increased the risk of onset of long term sickness absence. The study shows a potential for reducing long term sickness absence through modifying work postures straining the neck and back, reducing the risk of work done standing or walking, and reducing the risk associated with handling loads. Dealing with psychosocial stressors simultaneously may improve physical intervention efforts further for female employees.

                Author and article information

                Occup Environ Med
                Occup Environ Med
                Occupational and Environmental Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                January 2018
                11 July 2017
                : 75
                : 1
                : 23-28
                [1 ] departmentDepartment of Public Health and Nursing , Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU) , Trondheim, Norway
                [2 ] departmentDepartment of Physical Medicine and Rehabilitation , St. Olavs Hospital, Trondheim University Hospital , Trondheim, Norway
                [3 ] National Research Centre for the Working Environment , Copenhagen, Denmark
                [4 ] departmentDepartment of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense, Denmark
                [5 ] departmentDepartment of Public Health and Nursing , Faculty of Medicine and Health Sciences, HUNT Research Centre, Norwegian University of Science and Technology (NTNU) , Levanger, Norway
                Author notes
                [Correspondence to ] Dr Marius Steiro Fimland, NTNU, Fakultet for medisin og helsevitenskap, Institutt for samfunnsmedisin og sykepleie, Postboks 8905, MTFS, 7491 Trondheim, Norway; marius.fimland@ 123456ntnu.no
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                : 18 January 2017
                : 25 May 2017
                : 03 June 2017
                Funded by: KLP - Kommunal Landspensjonskasse, Norway.;
                Funded by: FundRef http://dx.doi.org/10.13039/501100005416, Norges Forskningsråd;
                Original Article
                Custom metadata

                Occupational & Environmental medicine
                public health
                Occupational & Environmental medicine
                public health


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