Danish Workers Research Articles

Do organisational and ward-level factors explain the variance in multi-site musculoskeletal pain in eldercare workers? A multi-level cross-sectional study.

Multi-site musculoskeletal pain (MSP) is highly prevalent among eldercare workers, leading to increased incidence of sickness absence and early retirement. Most research on MSP in eldercare workers has focused on individual-level factors reported by the employees, with limited focus at the organisation and ward level. To address this gap, the aim of this study was to investigate whether organisation and ward-level factors explain the variance in MSP among Danish eldercare workers. A multi-level cross-sectional study was conducted among 20 Danish nursing homes, containing 126 wards, and 418 workers who participated in measurements of organisational factors, working environment factors, and MSP (classified as reporting pain in 2 or more body regions). Data were collected at the level of the organisation, ward, and individual. The proportion of variance in MSP explained by each level was estimated using variance components analysis. The association between factors at each level of the organisation and MSP was investigated using generalised linear mixed-effects regression. Sixty seven percent of participants reported having MSP. The organisational and ward-level factors explained 0% of the variance in MSP, while the individual-level factors explained 100% of the variance in MSP. Moreover, no factors at the organisational and ward levels showed statistically significant associations with MSP. Individual-level perceived physical exertion and quantitative demands had a statistically significant association with a higher prevalence of MSP. The organisation and ward levels did not contribute to explaining any of the variance in MSP. All variance in MSP was explained at the individual level.

The working class and early retirement in Denmark: individual push factors

AbstractPrevious research finds that members of the working class have a higher risk of early retirement compared to professionals because they are pushed into early retirement. This indicates that not all workers can respond to incentives to extend their working life. Yet, little previous work has been conducted to quantify systematically the extent to which push factors explain why members of the working class have a higher risk of early retirement compared to professionals. Using longitudinal data on Danish workers, the results suggest that members of the working class have an increased risk of early retirement compared to professionals, but poor health, previous spells of unemployment and low job quality mediate a large part of this effect. Among men, the push factors mediate 57 and 86 per cent of the effect of social class on early retirement for skilled manual and unskilled manual workers, respectively. Among women, the push factors mediate 43 and 55 per cent of the effect of social class on early retirement for skilled manual and unskilled manual workers, respectively. Overly physical work demands is the most important mediator, which explains between 23 and 31 per cent of the total effect of belonging to the working class on early retirement. Moreover, the magnitudes of the indirect effects of the push factors depend on the particular pathway into retirement.

Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study

BackgroundMusculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between physical work demands and work ability in workers with musculoskeletal pain.MethodsWorkers with physically demanding jobs (n = 5377) participated in the Danish Work Environment Cohort Study in 2010. Associations between physical work ability and various physical work demands were modeled using cumulative logistic regression analyses while controlling for possible confounders.ResultsIn the fully adjusted model, bending and twisting/turning of the back more than a quarter of the workday (reference: less than a quarter of the workday) was associated with higher odds of lower work ability in workers with low-back pain (OR: 1.38, 95% CI: 1.09–1.74) and neck-shoulder pain (OR: 1.29, 95% CI: 1.01–1.64). When adding up the different types of demands, being exposed to two or more physical work demands for more than a quarter of the workday was consistently associated with lower work ability.ConclusionsWork that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain. Regardless of the specific type of physical work demand, being exposed to multiple physical work demands for more than a quarter of the workday was also associated with lower work ability.

Secondary traumatisation, burn-out and functional impairment: findings from a study of Danish child protection workers

ABSTRACT Background: Child-protection workers are at elevated risk for secondary traumatization. However, research in the area of secondary traumatization has been hampered by two major obstacles: the use of measures that have unclear or inadequate psychometric properties and equivocal findings on the degree of associated functional impairment. Objective: To assess the relationship between secondary traumatization and burnout using exploratory structural equation modelling (ESEM) and to assess the relationship between secondary traumatization and functional impairment. Methods: A survey of Danish child-protection workers was conducted through the Danish Children Centres (N = 667). Secondary traumatization was measured using the Professional Quality of Life-5 (ProQoL-5) and burnout using the Oldenburg Burnout Inventory. Results: A three-factor ESEM model provided the best fit to the data, reflecting factors consistent with the structure of secondary traumatization and burnout. The factors were differentially related to trauma-related and organizational variables in ways consistent with existing evidence. All factors were significantly related to functional impairment. Conclusion: The findings supported the discriminant validity of secondary traumatization and burnout while highlighting methodological issues around the current use of sum-score approaches to investigating secondary traumatization. The current study supported the clinical relevance of secondary traumatization by linking it explicitly to social and cognitive functional impairment.

High leisure-time physical activity reduces the risk of long-term sickness absence.

This study examined the association of leisure-time physical activity (LTPA) with the risk of long-term sickness absence (LTSA). A total of 10427 subjects from the general working population in Denmark answered questions about physical activity habits, health and work environment in the 2010 Danish Work Environment Cohort Study (DWECS). Data on LTSA (≥6 consecutive weeks during 2-year follow-up) were obtained from the Danish Register for Evaluation of Marginalization (DREAM). Cox regression analysis censored for competing events and adjusted for potential confounders (age, sex, BMI, smoking habits, depression, cancer, back diseases, previous LTSA, occupational social class, and psychosocial work environment) estimated the association between the predictor (LTPA) and the outcome variable (LTSA). During the 2-year follow-up period, 9.2% of the studied population experienced LTSA. In the general working population, moderate LTPA was not associated with LTSA (HR=0.89, 95% CI: 0.72-1.09), while high LTPA showed a tendency (HR=0.77, 95% CI: 0.59-1.01). In subgroup analyses, women below the age of 45years with high LTPA showed a significantly lower risk of LTSA when compared with their low LTPA counterparts (HR=0.44, 95% CI: 0.25-0.78). The results suggest that high levels of physical activity during leisure are associated with a lowered risk of LTSA, especially among younger women.

Accelerometer-Measured Physical Activity at Work and Need for Recovery: A Compositional Analysis of Cross-sectional Data.

ObjectivesPrevious research has shown strong associations between occupational physical activity (OPA) and need for recovery (NFR). However this research has only utilized self-reported measures of OPA which may be biased. Thus, there is a need for investigating if the previously documented association between self-reported OPA and NFR can be found when using technical measures of OPA. There is also the need to investigate whether older workers are particularly susceptible to increased NFR, since age-related declines in physical capacity mean that it is likely these workers will have a higher NFR for a given physical activity. The aim of this study was to investigate the association between technically measured OPA and NFR, and whether this relationship is modified by age.MethodsThis study utilized data from the Danish Physical Activity Cohort with Objective Measurements cohort—comprising Danish workers (n = 840) from the cleaning, manufacturing, and transportation sectors. OPA was measured by accelerometers attached to the thigh and upper back for at least one work day and classified into four physical behaviour categories (sedentary, standing, light, or moderate/vigorous). NFR was measured using a shortened version of the Danish NFR scale. Analysis was conducted using linear regression and isotemporal substitution analyses for compositional data.ResultsThe overall association between OPA and NFR was statistically significant in the unadjusted model (P < 0.001), but not when adjusted for age, sex, occupation, and shift work (P = 0.166). Isotemporal substitution showed small but significant reductions in NFR when increasing sedentary time relative to other behaviours (adjusted: ΔNFR = −0.010 [−0.019; −0.001]). There were no significant interactions between age and OPA (P = 0.409).ConclusionsThis study found significant associations between OPA and NFR, but the effect sizes were small. Reallocating 30 min to sedentary behaviours from other behaviours was associated with a reduced NFR, but the effect size may not be practically relevant. Moreover, no clear modifying effects of age were identified.

Studying the importance of change leadership and change management in layoffs, mergers, and closures

PurposeThe purpose of this paper is to investigate the importance of change leadership (informing, communicating, involving and supporting) and change management (reasons and competencies for change) for organisational change processes and their outcomes across public and private organisations. The study includes three specific change situations: first, layoffs; second, mergers; and third, closures, relocations and outsourcing, focusing on how change leadership and change management relate to employees’ experience of the change processes and their outcomes across these change situations.Design/methodology/approachThe study is based on panel data forming a representative sample of the Danish working population. A total of 2,120 responses were collected, 1,000 from public organisations and 1,120 from private organisations. Structural equation modelling was used to test the hypotheses.FindingsThe study findings show that both change leadership and change management predict positive change experiences and change consequences – and that they do so similarly across public and private sectors. Despite this similarity, the study reveals important sectorial differences, with public sector employees reporting less positive change experiences and consequences.Originality/valueThe paper provides valuable knowledge for researchers and public and private leaders interested in the impact of change leadership and change management on change outcomes.

Exposure-response relationships between cumulative occupational shoulder exposures and different diagnoses related to surgery for subacromial impingement syndrome.

The aim was to examine associations between cumulative occupational shoulder exposures and different diagnoses related to surgery for subacromial impingement syndrome (SIS). We re-analysed data from a previous register-based cohort study of the Danish working population (2,374,403 persons) with follow-up 2003-2008. The outcomes were eight different SIS-related diagnosis codes (M19, M75.1-5, and M75.8-9) in combination with SIS-related surgery codes. Occupational shoulder exposures were estimated by combining occupational codes with an expert-rated job exposure matrix. Cumulative exposure estimates were calculated for 10-year time windows and expressed as exposure-years. We used a logistic regression technique equivalent to discrete survival analysis. Exposure-response relationships were found between most occupational shoulder exposures and the different SIS-related diagnosis codes. For arm-elevation-years, M19, M75.1, and M75.4 reached maximum adjusted odds ratio (ORadj) of 2.0-2.4, while the maximum ORadj for M75.3 was 1.6; we found intermediate values for the remaining diagnoses. The relationships were almost similar for repetition-years and shoulder-load-years. For force-years, maximum ORadj of 1.7-1.9 was seen for M19, M75.1, and M75.4, while M75.3 reached a maximum ORadj of 1.3. For HAV-years, M19, M75.1, and M75.4 reached maximum ORadj of 1.5-1.7, while M75.3 reached a maximum ORadj of 1.1. We found associations between all occupational shoulder exposures and the eight different SIS-related diagnoses; exposure-response relationships were found for most diagnoses. The highest risks were seen for M19 (acromioclavicular osteoarthritis), M75.1 (rotator cuff syndrome), and M75.4 (impingement syndrome), and the lowest for M75.3 (calcific tendinitis).

Job control and risk of disability pension in the nationwide Danish Work Life Course Cohort

Abstract Background A large number of studies have found job control to be consistently associated with an increased risk of disability pension. However, most previous studies have measured job control by self-report, introducing possible reporting bias inflating the risk estimates. Furthermore, previous studies have not accounted for the potential selection of individuals with pre-existing risk factors for disability pensioning into low control jobs. Methods We analyzed data from the nationwide register-based Danish Work Life Course Cohort (DAWCO; n = 960,562 with approx. 6 million person-years). We measured job control annually by a job exposure matrix, based on a scale of five self-reported items from The Danish Work Environment Cohort Study, and disability pension using registers on public transfer payments. To account for potential selection into occupations with lower levels of job control, we included numerous life course confounders, including parental socioeconomic position and psychiatric and somatic diagnoses. Results Employees in jobs with lower levels of job control had increased risk of disability pensioning. The association attenuated after adjustment for confounders but was not explained by selection into job groups with lower levels of job control (hazard ratio: 1.16 (95% CI: 1.03-1.31). Conclusions Our findings suggest that lower levels of job control are associated with an increased risk of disability pension, and that this association is explained by neither reporting bias nor a selection of individuals with an increased risk of disability pensioning into job groups with lower levels of job control. Key messages Lower levels of job control appear associated with an increased risk of disability pension independent of life course confounders. Further research is needed on preventive measures in occupations with low levels of job control.

Cohort profile: the Danish Work Life Course Cohort study (DaWCo)

PurposeThe Danish Work Life Course Cohort (DaWCo) was initiated to study relations between working conditions, health and labour market affiliation using repeated measures of these factors throughout the working life,...

Emotional demands at work and risk of depressive disorder: A nationwide Danish cohort study

Abstract Background Studies suggest that high emotional demands at work are associated with increased risk of depression. However, most previous studies have measured emotional demands using self-report and estimates may be inflated due to reporting bias. Furthermore, no study has yet accounted for the potential selection of individuals with increased risk of depressive disorder into occupations with high emotional demands. Methods We analyzed data from two separate nationwide register-based Danish cohorts, The Danish Work Life Course Cohort (n = 955,712; person-years=6.99 mill.), and the JEMPAD study (n = 1,680,214; person-years=21.73 mill.). We measured emotional demands annually by job exposure matrices, and depressive disorder using registers on psychiatric hospital treatment. Emotional demands were categorized as quartiles. To account for selection into jobs with high emotional demands, we adjusted for numerous confounders, including health services use before workforce entry, parental socioeconomic position, and psychiatric and somatic diagnoses. The present abstract reports preliminary results based on a subset of the study population used as a development sample (n = 16,163, person-years=168,889). Final results will be available for the conference. Results Preliminary findings showed a tendency towards an increased risk of depressive disorder for employees in occupations with the highest level of emotional demands (hazard ratio: 1.20 (95% CI: 0.85-1.69). The association was similar with and without adjustment for confounders and was not explained by selection into occupations with high emotional demands. Conclusions If confirmed in analyses of the full study population, our results suggest that high emotional demands at work may be associated with increased risk of depressive disorder, and that this association is explained by neither reporting bias nor a selection of individuals vulnerable to depression into occupations with high emotional demands. Key messages Emotional demands may be associated with an increased risk of depressive disorder. Further research is needed to explore the potential for workplace prevention of high emotional demands.

“That’s (not) it”. Inger Christensen’s Det as Litanic Verse

Abstract Inger Christensen’s poem collection Det is one of the most recognizable and significant contemporary Danish works. Its complex and elaborate form and message have already been a subject of innumerous investigations and analyses, but neither of them has addressed its litanic traits. Basing on Witold Sadowski’s methodological apparatus, we intend to demonstrate that Christensen’s work can be perceived as litanic verse in terms of its form and generic worldview. As it appears from our investigation, in Det one litanic gene, the polyonymic, is most discernible, which translates into repetitive structures and enumerations, as well as the lyrical person’s humbleness in face of the greatness of creation.

Lacking social skills: A social investment state’s concern for marginalized citizens’ ways of being

The Danish state is preoccupied with its citizens’ social skills, which are seen as important for the nations’ competitiveness. Such skills regard self-presentation, communication, emotional control etc. This article relies primarily on interviews with Danish social workers who are involved either in assessing young marginalized welfare clients’ personal readiness for schooling or employment or in preparing them for this through social skills training. Secondarily, it relies on fieldwork data from young Danes at the margins of the educational system and/or the labour market, who are frequently confronted with a devaluation of their personal ways of being. As personal resources related to ways of being, communicating, handling emotions etc. are ascribed social value, especially at the labour market they may work as a form of capital, while the lack of them may be a source of marginalization. These findings are discussed as signs of more general social normative demands, theoretically grasped in the meeting point of Bourdieu’s understanding of embodied cultural capital, of Skeggs’ analysis of how subjects are attributed value or not, and of Illouz’s investigation of the emotional demands contemporary capitalism puts on employees. Understanding the experiences of those who fail to comply with implicit social requirements for personal resources thus shed light on contemporary requirements regarding how to behave and communicate with other people as well as on the state’s investments in the most personal spheres of its citizens.

Psychosocial working conditions and depressive disorder: disentangling effects of job control from socioeconomic status using a life-course approach

PurposeJob control, the combination of skill discretion and decision authority, is considered a central component of the psychosocial working environment. This longitudinal study examines the relation between job control and risk of incident depressive disorder using a life-course approach.MethodsWe analyze data from The Danish Work Life Course Cohort study, including all Danish individuals aged 15–30 who entered the Danish labor market during 1995–2009 and were free from depressive disorder at entry (955,573 individuals). We measured job control using a job exposure matrix. Depressive disorders were measured using information from nationwide registers of psychiatric in- and outpatient admissions. Using Cox regression models we estimated the prospective association between job control and risk of incident depressive disorders. Analyses accounted for a range of potential confounders prior to workforce entry including socioeconomic status in adolescence and parental psychiatric and somatic diagnoses prior to labor market entry, together with potential confounders in adulthood including income, education, and demographics.ResultsLower levels of past year job control were associated with a higher risk of depressive disorder after adjustment for all covariates (HR = 1.27, 95% CI 1.16–1.38). Results stratified by gender showed associations for both men (HR = 1.38, 95% CI 1.19–1.61) and women (HR = 1.19, 95% CI 1.08–1.32). Conclusions: Our findings suggest that the level of job control at work affects the risk of clinically diagnosed depressive disorder, and that this association is not due to confounding by socioeconomic status.

Shift work and risk of occupational, transport and leisure-time injury. A register-based case-crossover study of Danish hospital workers

IntroductionShift work has been associated with sleepiness. Sleepiness from shift work may increase the risk of occupational injuries, but could also continue outside of work and increase risk of injury during commuting and leisure time. In this study, we assessed the associations between evening shifts, night shifts and quick returns, and risk of occupational, transport and leisure-time injuries. Material and methodWe used a case-crossover design to compare characteristics of the shift right before an injury with shifts in previous control periods (i.e. without an injury) within the same individual. Shift information was derived from the Danish Working Hour Database (DWHD) and linked to information on injuries from The National Patient Register. The study populations included a total of 13 337 occupational injuries, 2722 transport injuries and 9768 leisure-time injuries. Data were analysed by conditional logistic regression. ResultsIn the adjusted analyses, the odds of an occupational injury were higher during evening compared with day shifts (OR 1.54, 95%CI 1.43–1.66) and quick returns compared with regular returns (OR 1.26, 95%CI 1.10–1.44). No higher odds of a leisure-time injury or leisure time transport injury were observed after evening shift or night shifts vs. day shifts, or quick returns vs. regular returns. ConclusionOur findings support the evidence of a higher risk of occupational injuries during evening shifts and after quick returns. Findings on leisure-time transport and commuting injuries were inconclusive, while we found no support for a higher risk of injury during leisure-time after evening shifts, night shifts or quick returns.

Movement behavior profiles and obesity: a latent profile analysis of 24-h time-use composition among Danish workers

Background/objectivesAn element of obesity prevention is increasing total physical activity energy expenditure. However, this approach does not incorporate the balance of various movement behaviors—physical activity, sedentary behaviors and sleep—across domains of the day. We aimed to identify time-use profiles over work and leisure, termed ‘movement behavior profiles’ and to investigate their association with obesity.Subjects/methodsEight-hundred-and-seven workers completed (a) thigh accelerometry and diaries to determine their 24-h composition of behaviors (sedentary and standing, light physical activity and moderate-to-vigorous physical activity at work and leisure, and time in bed) and (b) obesity measurements. Movement behavior profiles were determined using latent profile analyses of isometric log-ratios of the 24-h composition, and labeled according to animal movement behavior traits. Linear models were applied to determine the association between profiles and obesity.ResultsFour profiles were identified, labeled as “Chimpanzees” (n = 226), “Lions” (n = 179), “Ants” (n = 244), and “Koalas” (n = 158). “Chimpanzees” work time was evenly distributed between behaviors while their leisure time was predominantly active. Compared to Chimpanzees, “Lions” were more active at work and sedentary during leisure and spent more time in bed; “Ants” were more active at work and during leisure; “Koalas” were more sedentary at work and leisure and spent similar time in bed. With “Chimpanzees” as reference, “Lions” had least favorable obesity indicators: +2.0 (95% confidence interval [CI] 0.6, 3.4) %body fat, +4.3 cm (1.4, 7.3) waist circumference and +1.0 (2.0, 0.0) Body Mass Index (BMI), followed by “Koalas” +2.0 (0.4, 3.7) %body fat, +3.1 cm (0.1, 6.0) waist circumference, and +0.8 (−0.30, 1.94) BMI. No significant differences were found between “Chimpanzees” and “Ants”.ConclusionsMovement behavior profiles across work and leisure time-use compositions are associated with obesity. Achieving adequate balance between work and leisure movement behaviors should be further investigated as a potential obesity prevention strategy.

'Insanity in Classical Antiquity', by JL Heiberg (1913).

Heiberg's 1913 text on psychopathological concepts and terms in classical times remains important because of its freshness and historiographical value. A philologist and classical scholar, he seemed puzzled by the assumption of nosological continuity between classical categories of madness and current ones that prevailed at the time among historians of medicine and psychiatry. Heiberg's text acts as a bridge or transition between the nosological antiquarianism of the 19th century and histories of psychiatry that later warned of the dangers of an anachronistic reading of earlier medical texts. It also shows how important has been the contribution of classical philologists to the study of the history of madness. To our knowledge, this is the first rendition into English of the complete Danish work.

Midlife Forgetfulness and Risk of Dementia in Old Age: Results from the Danish Working Environment Cohort Study

Background: Despite the current evidence of a high prevalence of forgetfulness in middle-aged individuals, and the evidence of a link between midlife memory complaints and biological changes in the brain, no previous study has yet investigated midlife forgetfulness in relation to risk of dementia in old age. Aims: We investigated whether midlife forgetfulness was an indicator of an increased risk of dementia in old age. Methods: We used data from 3,136 employed men and women who participated in the Danish Work Environment Cohort Study in 1990. These data were linked to Danish national registers. Participants were asked whether their closest relative had ever told them that they were forgetful. Incidence rate ratios (IRR) were estimated using Poisson regression analysis. Results: At baseline, 749 (24%) study participants were categorized as forgetful, and 86 (2.7%) participants were diagnosed with dementia during a total of 31,724 person-years at risk. After adjusting for sociodemographic factors, comorbidities, and work-related factors, midlife forgetfulness was associated with a higher risk of dementia (IRR = 1.82; 95% CI: 1.12–2.97). Conclusions: This study is the first to investigate midlife forgetfulness and dementia, and the results suggest that midlife forgetfulness is an early indicator of an increased risk of dementia in old age.

Night work and postpartum depression: a national register-based cohort study.

Objective We aimed to investigate the association of night work during pregnancy with the risk of severe postpartum depression (PPD). Methods We performed a nationwide register-based cohort study of workers in all Danish public hospitals. Daily information on working hours was retrieved from the Danish Working Hour Database from January 2007 to December 2015. Pregnancies, covariates and outcome were identified from national registries for births and hospital contacts. We performed logistic regression of the risk of severe PPD in relation to the number and duration of night shifts, spells of consecutive night shifts, and short shift intervals during the first 32 pregnancy weeks. Analyses were adjusted for age, body mass index, socioeconomic status, parity, sickness absence three months prior to pregnancy, and prior diagnosis of severe depression. Results The study cohort comprised 25 009 singleton pregnancies from 19 382 workers. The majority were nurses or physicians. Overall, we did not observe an increased risk of PPD for any of the dimensions of night work analyzed. We found, however, an increased risk of PPD (adjusted odds ratio 2.08, 95% confidence interval 1.09-4.00) among women who stopped working night shifts after the first pregnancy trimester (N=3094). Conclusion Overall, our results do not support night work during pregnancy as a risk factor for severe PPD among hospital employees. However, we observed a 2-fold increased risk of PPD among women who stopped working night shifts after the first pregnancy trimester. This may reflect the influence of the healthy worker survivor effect and warrants further attention.

Are Insomnia Type Sleep Problems Associated With a Less Physically Active Lifestyle? A Cross-Sectional Study Among 7,700 Adults From the General Working Population.

Background: Sleep problems are common in the general population and negatively affect both private and work life. A vicious circle may exist between poor sleep and an unhealthy lifestyle. For example, poor sleep may drain the energy to do health-promoting physical activity during leisure-time after work. The aim of the present study was to investigate the association between sleep problems and the duration of low- and high-intensity leisure-time physical activity in sedentary and physical workers.Methods: This cross-sectional study employ data from the Danish Work Environment Cohort Study in 2010, where currently employed wage-earners in Denmark on daytime schedule (N = 7,706) replied to questions about sleep quality (cf. the Bergen Insomnia Scale) and participation in low- and high-intensity leisure-time physical activity. Associations were modeled using general linear models controlling for various confounders.Results: Workers with high levels of sleep problems reported less high-intensity leisure-time physical activity. Specifically, the weekly duration of high-intensity leisure-time physical activity was 139 (95%CI 111–168), 129 (95%CI 101–158), and 122 (95%CI 92–151) min in sedentary workers with sleep problems < 1, 1–3, and ≥3 days per week, respectively. The same pattern was observed among physical workers. In sedentary workers ≥50 years, the fully adjusted model showed a weekly duration in high-intensity physical activity during leisure of 122 (95%CI 83–161), 102 (95%CI 64–141), and 90 (95%CI 51–130) among those with sleep problems < 1, 1–3, and ≥3 days per week, respectively.Conclusions: Workers, particularly sedentary older workers, having sleep problems report less high-intensity leisure-time physical activity. These data suggest that a vicious circle may indeed exist between poor sleep and reduced leisure-time physical activity.