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OBJECTIVE: Leisure-time physical activity (PA) has been hypothesized to reduce the likelihood of occupational injuries, but it is unclear whether this association varies between workplace and commuting injuries. The aim of this study was to examine the association between PA and risk of workplace and commuting injuries. METHODS: Data were derived from the Finnish Public Sector study including 82 716 person-observations (48 116 participants). PA was requested repeatedly in four questionnaire surveys between 2000–2012. The average level of PA from two subsequent questionnaires was used to assess long-term PA. To obtain a 1-year incidence of injuries, participants were linked to occupational injury records from the national register. Logistic regression analysis with generalized estimating equations was used to examine the association between PA and injury risk. The analysis was adjusted for age, sex, education, work schedule, job demand, sleep difficulties, cardiovascular diseases, diabetes, and depression for workplace and commuting injuries, and workplace injuries were additionally adjusted for physical heaviness of an occupation and injury risk by occupation. RESULTS: Higher level of PA was associated with a lower risk of workplace injuries compared to inactive participants [odds ratio (OR) 0.85, 95% confidence interval (CI) 0.73–0.98]. This association was most marked in the ≥50-year-old age group (OR 0.78, 95% CI 0.64–0.99). No association between the PA and the risk for commuting injuries was observed. CONCLUSION: Higher PA is associated with lower risk of workplace injuries particularly among older employees.

Abstract Background To study the effect of hip fracture type on physical performance, functional ability and change in mobility four to six months after the injury. Methods A total of 1331 patients out of consecutive 2052 patients aged ≥ 65 years who underwent hip fracture surgery were included in the study. Patient information was collected on admission, during hospitalization, by phone interview and at the geriatric outpatient clinic 4 to 6 months after the fracture. Of the 1331 eligible patients, Grip strength, Timed Up and Go -test (TUG), Elderly Mobility Scale (EMS), mobility change compared to pre-fracture mobility level, Basic Activities of Daily Living (BADL) and Instrumental Activities of Daily Living (IADL) were used to determine physical performance and functional ability. Logistic regression was used for the analyses which was adjusted for gender, age, American Society of Anesthesiologists score, diagnosis of cognitive disorder, pre-fracture living arrangements, mobility and need of mobility aid. Results Patients with pertrochanteric hip fracture had an EMS lower than 14 (Odds Ratio (OR) 1.38, 95% confidence intervals (CI) 1.00–1.90), TUG time ≥ 20 s (OR 1.69, 95% CI 1.22–2.33) and they had declined in mobility (OR 1.58, 95% CI 1.20–2.09) compared to femoral neck fracture patients 4 to 6 months post-hip fracture in multivariable-adjusted logistic regression analyses. Grip strength and functional ability (IADL, BADL) 4 to 6 months after hip fracture did not differ between fracture types. There were no statistically significant differences in physical performance in patients with a subtrochanteric fracture compared to patients with a femoral neck fracture. Conclusions Pertrochanteric hip fracture independently associated with poorer physical performance 4 to 6 months post hip fracture compared to other hip fracture types. Pertrochanteric hip fracture patients should be given special attention in terms of regaining their previous level of mobility.

Purpose The Finnish Retirement and Aging (FIREA) Study was set up to study changes in health behavioural and cardiometabolic risk factors across retirement transition, and to examine the long-term consequences of work and retirement on health and functioning with advancing age.Participants Public sector workers whose estimated statutory retirement date was in 2014–2019 were invited to participate by sending them a questionnaire 18 months prior to their estimated retirement date. In the first phase of the FIREA Study, participants were followed up with annual surveys, accelerometer and clinical measurements during retirement transition into post-retirement years. The FIREA survey cohort includes 6783 participants, of which 908 belong also to the activity substudy and 290 to the clinical substudy.Findings to date Collected data include survey measures about health, lifestyle factors, psychosocial distress, work-related factors as well as retirement intentions. Accelerometer and GPS devices are used to measure 24-hour movement behaviours. Clinical examination includes blood and hair sample, measurements of anthropometry, cardiovascular function, physical fitness, physical and cognitive function. Our results suggest that in general retirement transition seems to have beneficial influence on health behaviours as well as on physical and mental health, but there are large individual differences, and certain behaviours such as sedentariness tend to increase especially among those retiring from manual occupations.Future plans The second phase of the FIREA Study will be conducted during 2023–2025, when participants are 70 years old. The FIREA Study welcomes research collaboration proposals that fall within the general aims of the project.

This study examined the association between daily working hours and accelerometer-based sleep duration, sleep efficiency, and number of awakenings per hour of sleep on the following night among 800 older public sector employees in Finland (mean age 63 years in the first measurement they participated in, 87% women) with 4,818 measurement nights in total. Information on working hours was derived from daily logs and categorized into: 1) 6 h, 2) 7, hours 3) 8 h, 4) 9 h, and 5) 10 or more hours of work. The most common category (i.e. workdays with 8 h of work) was used as the reference category in the analyses. Nights followed by a workday and a free day were analyzed separately. No differences were observed in sleep duration between the reference group and the other working hour categories when the next day was a workday nor when the next day was a free day. After a 6-hour workday, sleep efficiency was on average 1.0 percentage points higher and there were on average 0.13 less awakenings per hour of sleep when compared with the reference category. When the next day was a free day, no differences in sleep quality were observed. Thus, no clear indication of a dose-response relationship between working hours and either duration or quality of sleep was found. Furthermore, future research should further examine the possibility that the association between working hours and sleep is somewhat different depending on whether the workday is followed by another workday or a free day.

Abstract Background In the Finnish policy on older people preventive activities, which maintain functional capacity and independent living, are emphasized. The Turku Senior Health Clinic, aimed at maintaining independent coping of all home-dwelling 75-year-old citizens in the city of Turku, was founded in the beginning of 2020. The aim of this paper is to describe design and protocol of the Turku Senior Health Clinic Study (TSHeC) and provide results of the non-response analysis. Methods The non-response analysis used data from 1296 participants (71% of those eligible) and 164 non-participants of the study. Sociodemographic, health status, psychosocial and physical functional ability indicators were included in the analysis. Participants and non-participants were also compared in respect to their neighborhood socioeconomic disadvantage. Differences between participants and non-participants were tested using the Chi squared or Fisher´s exact test for categorical variables and t-test for continuous variable. Results The proportions of women (43% vs. 61%) and of those with only satisfying, poor or very poor self-rated financial status (38% vs. 49%) were significantly lower in non-participants than in participants. Comparison of the non-participants and participants in respect to their neighborhood socioeconomic disadvantage showed no differences. The prevalence of hypertension (66% vs. 54%), chronic lung disease (20% vs. 11%), and kidney failure (6% vs. 3%) were higher among non-participants compared to participants. Feelings of loneliness were less frequent among non-participants (14%) compared to participants (32%). The proportions of those using assistive mobility devices (18% vs. 8%) as well as those having previous falls (12% vs. 5%) were higher in non-participants than in participants. Conclusions The participation rate of TSHeC was high. No neighborhood differences in participation were found. Health status and physical functioning of non-participants seemed to be slightly worse than those of the participants, and more women than men participated. These differences may weaken the generalizability of the findings of the study. The differences have to be taken into account when recommendation for the content and implementation of preventive nurse-managed health clinic in primary health care in Finland is going to be given. Trial registration ClinicalTrials.gov Identifier: NCT05634239; registration date; 1st of December 2022. Retrospectively registered.

Objectives The aim of the study was to evaluate concurrent changes in physical activity and self-rated health during retirement transition over 4 years by multivariate trajectory analysis and to examine whether sociodemographic and lifestyle factors predict the probability of being classified to a certain subgroup of observed changes.Design Prospective cohort study.Setting Public sector employees.Participants 3550 participants of the Finnish Retirement and Aging study.Primary and secondary outcome measures Participants estimated on a yearly questionnaire their weekly hours of different types of activities converted to metabolic equivalent of task-hour/week. Self-rated health was assessed on a 5-point Likert-like scale from poor to excellent and dichotomised as suboptimal and optimal. Multivariate trajectory analysis was used to distinguish different subgroups of trajectories. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain trajectory group.Results Three trajectory groups were identified, all displaying increasing activity during retirement with a simultaneous decrease in perceived suboptimal health. Physical activity peaked at 18 months after retirement and then slightly decreased, except for initially highly physically active participants (9%) with good self-rated health, who demonstrated a constant high level of physical activity. Male gender, professional occupation, being married or cohabiting, body mass index

Abstract Background Transition to retirement is shown to affect sleep, sedentary time and physical activity, but no previous studies have examined how retirement changes the distribution of time spent daily in these movement behaviors. The aim of this study was to examine longitudinally how the composition of 24-h movement behaviors changes during the transition to retirement using compositional data analysis (CoDA). Methods We included 551 retiring public sector workers (mean age 63.2 years, standard deviation 1.1) from the Finnish Retirement and Aging study. The study participants wore a wrist-worn ActiGraph accelerometer for one week 24 h per day before and after retirement, with one year between the measurements. The daily proportions to time spent sleeping, in sedentary behavior (SED), light physical activity (LPA) and moderate-to-vigorous physical activity (MVPA) were estimated using the GGIR package. Changes in the daily proportions of movement behaviors were examined using Compositional Data Analysis version of linear mixed models. Results In general, the proportion of time spent in active behaviors decreased relative to time spent in passive behaviors after retirement (p

Abstract We utilized compositional data analysis (CoDA) to study changes in the composition of the 24-h movement behaviors during an activity tracker based physical activity intervention. A total of 231 recently retired Finnish retirees were randomized into intervention and control groups. The intervention participants were requested to use a commercial activity tracker bracelet with daily activity goal and inactivity alerts for 12 months. The controls received no intervention. The 24-h movement behaviors, i.e., sleep, sedentary time (SED), light physical activity (LPA), and moderate-to-vigorous physical activity (MVPA) were estimated from wrist-worn ActiGraph data using the GGIR R-package. Three balance coordinates describing the composition of movement behaviors were applied: ratio of active vs. passive behaviors, LPA vs. MVPA, and sleep vs. SED. A linear mixed model was used to study changes between the baseline and 6-month time point. Overall, the changes in the 24-h movement behaviors were small and did not differ between the groups. Only the ratio of LPA to MVPA tended to change differently between the groups (group*time interaction p = 0.08) as the intervention group increased LPA similarly to controls but decreased their MVPA. In conclusion, the use of a commercial activity tracker may not be enough to induce changes in the 24-h movement behaviors among retirees.

BackgroundPhysical activity and physical functioning have been reported to change over retirement transition, but the results have been inconsistent, and the two constructs have not been studied concurrently. The objective of this study was to examine concurrent changes in physical activity and physical functioning during transition to retirement among public sector employees, and to examine if occupation, sex, marital status, body mass index (BMI), alcohol consumption and smoking status are associated with observed different multi-trajectory paths.Methods3,550 participants of the Finnish Retirement and Aging study responded to an annual survey on physical activity and physical functioning (SF-36) before and after retirement. Group-based multi-trajectory analysis was used to identify clusters with dissimilar concurrent changes in physical activity and physical functioning. Multinomial regression analysis was used to describe the associations between covariates and the probability of being classified to a certain cluster.ResultsParticipants were 63.4 (SD 1.4) years old, 83% women, 65% professional workers. Four trajectories of concurrent changes in physical activity and physical functioning were identified, one with decreasing physical functioning and low activity, one with increasing high activity and stable high functioning and two with fluctuating moderate physical activity and stable high functioning. Single, women, obese participants and risk-users of alcohol were more likely to be classified into group with low physical activity and declining physical functioning.ConclusionsLow physical activity below the level usually recommended was associated with lower physical functioning during retirement transition. These findings could be useful when planning interventions for retirees to maintain their physical functioning level.

Objective Activity trackers appear cost-effective and acceptable intervention tools for promoting physical activity among older adults, particularly in the short-term. However, long-term studies focused on participants’ experiences continue to be scarce. This study evaluated participants’ experiences of a 12-month activity tracker-driven physical activity intervention. Methods Participants’ experiences were assessed qualitatively using open-ended questionnaire items ( n = 113) and semi-structured interviews conducted after the 12-month intervention ( n = 27). Quantitative items assessed the perceived ease-of-use and usefulness of the activity tracker during the intervention. Qualitative data was analyzed using thematic analysis and Wilcoxon signed-rank tests were used to examine changes in the perceived ease-of-use and usefulness over time. Results The 113 participants completing the 12-month intervention were on average 65.2 ( SD 1.0) years old and 81.4% women with 92.3% providing activity tracker data on at least 2 weeks per each intervention month. In the qualitative analysis, four main themes with 20 subthemes were identified: (a) burdens of participation, (b) affective attitudes of using the activity tracker, (c) perceived effects of using the activity tracker, and (d) no perceived behavioral effects. At 12 months, the participants found activity trackers mainly easy to use (mean 4.6, SD 0.6), reliable (mean 3.6, SD 1.2), motivating (mean 3.9, SD 1.0), and helpful in reducing sitting (mean 3.7, SD 1.0) with no changes observed during the intervention. Conclusions The participants’ experiences were highly varied suggesting that tailored intervention designs are likely to be required for effectively using activity trackers to promote long-term changes in daily activity among older adults.

There is limited knowledge on the characteristics of employees who engage in catch-up sleep, the extension of sleep duration on free days to compensate for sleep loss accumulating during workdays. This study examined associations of accelerometer-measured free day catch-up sleep with sleep duration, sleep timing, and socio-demographic, health and lifestyle factors among older employees. We measured sleep repeatedly with accelerometers among 824 public sector employees in Finland (mean age 63 years; 86% women). On average, the participants provided 1.7 annual accelerometer measurements and 1,437 person-observations in total. Catch-up sleep was defined as longer average sleep duration on free days compared with average sleep duration on workdays. Prevalence of catch-up sleep was 78%. On average, the catch-up sleep group extended their sleep on free days by 1 hour 22 min (95% confidence interval [CI] 1 h 19 min – 1 h 26 min), whereas the non-catch-up sleep group reduced their sleep duration by 45 min (95% CI -50 min – -40 min). Catch-up sleep was mainly associated with delayed awakening time on free days (by 1 h 57 min, 95% CI 1 h 52 min – 2 h 2 min). We also observed a greater social jetlag in the catch-up sleep group in comparison to the non-catch-up sleep group, whereas no differences were observed in chronotype, self-reported sleep, or other individual characteristic. In conclusion, accelerometer-measured catch-up sleep is common among older employees in Finland and major differences in duration and timing of sleep occur between those with and without catch-up sleep.

Summary: Background: Heavy alcohol consumption increases the risk of several chronic diseases. In this multicohort study, we estimated the number of life-years without major chronic diseases according to different characteristics of alcohol use. Methods: In primary analysis, we pooled individual-level data from up to 129,942 adults across 12 cohort studies with baseline data collection on alcohol consumption, drinking patterns, and history between 1986 and 2005 (the IPD-Work Consortium). Self-reported alcohol consumption was categorised according to UK guidelines – non-drinking (never or former drinkers); moderate consumption (1–14 units); heavy consumption (>14 units per week). We further subdivided moderate and heavy drinkers by binge drinking pattern (alcohol-induced loss of consciousness). In addition, we assessed problem drinking using linked data on hospitalisations due to alcohol abuse or poisoning. Follow-up for chronic diseases for all participants included incident type 2 diabetes, coronary heart disease, stroke, cancer, and respiratory disease (asthma and chronic obstructive pulmonary disease) as ascertained via linkage to national morbidity and mortality registries, repeated medical examinations, and/or self-report. We estimated years lived without any of these diseases between 40 and 75 years of age according to sex and characteristics of alcohol use. We repeated the main analyses using data from 427,621 participants in the UK Biobank cohort study. Findings: During 1·73 million person-years at risk, 22,676 participants in IPD-Work cohorts developed at least one chronic condition. From age 40 to 75 years, never-drinkers [men: 29·3 (95%CI 27·9–30·8) years, women 29·8 (29·2–30·4) years)] and moderate drinkers with no binge drinking habit [men 28·7 (28·4–29·0) years, women 29·6 (29·4–29·7) years] had the longest disease-free life span. A much shorter disease-free life span was apparent in participants who experienced alcohol poisoning [men 23·4 (20·9–26·0) years, women 24·0 (21·4–26·5) years] and those with self-reported heavy overall consumption and binge drinking [men: 26·0 (25·3–26·8), women 27·5 (26·4–28·5) years]. The pattern of results for alcohol poisoning and self-reported alcohol consumption was similar in UK Biobank. In IPD-Work and UK Biobank, differences in disease-free years between self-reported moderate drinkers and heavy drinkers were 1·5 years or less. Interpretation: Individuals with alcohol poisonings or heavy self-reported overall consumption combined with a binge drinking habit have a marked 3- to 6-year loss in healthy longevity. Differences in disease-free life between categories of self-reported weekly alcohol consumption were smaller. Funding: Medical Research Council, National Institute on Aging, NordForsk, Academy of Finland, Finnish Work Environment Fund.

OBJECTIVES: This study aimed to examine the contribution of shift work, work time control (WTC) and informal caregiving, separately and in combination, to sleep disturbances in ageing employees. METHODS: Survey data were obtained from two prospective cohort studies with repeated measurements of working conditions, informal caregiving, and sleep disturbances. We used fixed-effect conditional logistic regression analysis to examine whether within-individual changes in shift work, WTC and informal caregiving were associated with changes in sleep. Secondary analyses included between-individuals comparison using standard logistic regression models. Results from the two cohorts were pooled using meta-analysis. RESULTS: Low WTC and informal caregiving were associated with sleep disturbances in within-individual analyses [odds ratios (OR) ranging between 1.13 (95% confidence interval 1.01–1.27) and 1.48 (95% CI 1.29–1.68)] and in between-individuals analyses [OR 1.14 (95% CI 1.03–1.26) to 1.33 (1.19–1.49)]. Shift work alone was not associated with sleep disturbances, but accumulated exposure to shift work, low WTC and informal caregiving was associated with higher risk of sleep disturbances (OR range 1.21–1.76). For some of the sleep outcomes, informal caregiving was related to a higher risk of sleep disturbances when WTC was low and a lower risk when WTC was high. CONCLUSIONS: Informal caregiving and low WTC are associated with risk of sleep disturbances among ageing employees. The findings also suggest that low WTC in combination with informal caregiving may increase the risk of sleep disturbances whereas high WTC may alleviate the adverse impact of informal caregiving on sleep.

BackgroundPhysical activity and body mass index (BMI) have been reported to change around retirement. The objective was to examine the concurrent changes in physical activity and BMI around retirement, which have not been studied before. In addition, the associations of different demographic characteristics with these changes were examined.MethodsThe prospective cohort study consisted of 3,351 participants in the ongoing Finnish Retirement and Ageing Study (FIREA). Repeated postal survey, including questions on physical activity and body weight and height, was conducted once a year up to five times before and after the retirement transition, the mean follow-up time being 3.6 years (SD 0.7). Group-based multi-trajectory modeling was used to identify several clusters with dissimilar concurrent changes in physical activity and BMI within the studied cohort.ResultsOf the participants, 83% were women. The mean age at the last wave before retirement was 63.3 (SD 1.4) years. Four clusters with different trajectories of physical activity and BMI were identified. BMI remained stable around retirement transition in all four clusters, varying from normal weight to class II obesity. The association of BMI trajectories with physical activity levels were inverse, however, each activity trajectory showed a temporary increase during the retirement transition.ConclusionsRetirement seems to have more effect on physical activity than BMI, showing a temporary increase in physical activity at the time of retirement.

The REACT is a commercial activity tracker based intervention, which primarily aimed to increase physical activity. This study examines the secondary outcomes of the physical activity intervention on body composition and cardiometabolic health indicators. Overall 231 recently retired Finnish men and women [65.2 (SD 1.1) years, 83% women] took part to the study. The participants were randomized into intervention (n = 117) and control (n = 114) groups. The intervention group members used a commercial activity tracker (Polar Loop 2, Polar, Kempele, Finland) with a daily activity goal and inactivity alerts every day for 12 months. Controls received no intervention. Secondary health outcomes included body weight, fat mass, fat free mass, waist circumference, blood pressure, indicators of glucose and lipid metabolisms, and high-sensitivity C-reactive protein, and they were measured at baseline and at 12-months end point. Hierarchical linear mixed models were used to examine the differences between the groups over time, and no differences in the mean changes of the body composition and cardiometabolic health indicators between the groups were found (group*time interaction >0.20 for all measures). Fat free mass, waist circumference, blood pressure, and low density lipoprotein levels decreased in both groups over the 12 months. These findings state that 1-year daily use of commercial activity tracker does not induce different cardiometabolic health effects when compared to the non-user controls among general population of recent retirees.

Summary: Background: Observational studies have identified a link between unfavourable neighbourhood characteristics and increased risk of morbidity, but it is unclear whether changes in neighbourhoods affect future disease risk. We used a data-driven approach to assess the impact of neighbourhood modification on 79 health outcomes. Methods: In this prospective cohort study, we used pooled, individual-level data from two Finnish cohort studies: the Health and Social Support study and the Finnish Public Sector study. Neighbourhood characteristics (mean educational level, median income, and employment rate of residents, and neighbourhood green space) and individual lifestyle factors of community-dwelling individuals were assessed at baseline (at different waves starting between 1998 and 2013). We repeated assessment of neighbourhood characteristics and lifestyle factors approximately 5 years from each baseline assessment, after which follow-up began for health conditions diagnosed according to the WHO International Classification of Diseases for 79 common health conditions using linkage to electronic health records. We used Cox proportional hazard regression models to compute adjusted hazard ratios (HRs) of incident disease associated with neighbourhood characteristics and changes in neighbourhood characteristics over time and logistic regression analysis to compute adjusted odds of association between changes in neighbourhood characteristics and individual lifestyle factors. Findings: 114 786 individuals (87 012 [75·8%] women; mean age 44·4 years [SD 11·1]) had complete data and were included in this cohort study. During 1·17 million person-years at risk, we recorded 164 368 new-onset health conditions and 3438 deaths. Favourable changes in neighbourhood characteristics were associated with reduced risk of all-cause mortality and incidence of 19 specific health conditions. Unfavourable changes were correspondingly associated with increased risk of mortality and 27 specific health conditions. Among participants who did not move residence during the observation period, relative to individuals who continually lived in disadvantaged neighbourhoods, those who experienced favourable modifications in neighbourhood characteristics had a lower risk of future diabetes (HR 0·84, 95% CI 0·75–0·93), stroke (0·49, 0·29–0·83), skin disease (0·72, 0·53–0·97), and osteoarthritis (0·87, 0·77–0·99). Living in a neighbourhood with improving characteristics was also associated with improvements in individual-level health-related lifestyle factors. Among participants who lived in advantaged residential environments at baseline, unfavourable changes in neighbourhood characteristics were associated with an increased risk of diabetes, stroke, skin disease, and osteoarthritis compared with individuals who lived in advantaged neighbourhoods throughout the study period. Interpretation: Favourable modifications to residential neighbourhoods showed robust, longitudinal associations with a range of improvements in health outcomes, including improved health behaviours and reduced risk of cardiometabolic, infectious, and orthopaedic conditions. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, and Academy of Finland.

Objective: Besides traditional risk factors, other factors such as life stressors are linked with incident cardiovascular disease. However, the underlying mechanisms for this association remain mostly unknown. We studied the relation of life stressors (job strain, sleep loss due to worry, illness or death in family, financial difficulties and caregiving) and their accumulation with arterial stiffness, an independent predictor of cardiovascular disease. Methods: 258 participants (mean age 62.4 years, 82% women) from the Finnish Retirement and Aging Study underwent measurements for carotid-femoral Pulse Wave Velocity (PWV), a standard criterion for assessing arterial stiffness and responded to a survey inquiring life stressors. Using analysis of covariance, we estimated group means adjusted for age, gender, occupation, lifestyle factors and hypertension. Results: Participants with recent illness or death in family (8.04 m/s; 95% CI, 7.40–8.73 vs. 7.52 m/s; 95% CI, 7.03–8.05) and financial difficulties (8.65 m/s; 95% CI, 7.62–9.81 vs. 7.71 m/s; 95% CI, 7.21–8.24) had increased PWV compared to those who did not have exposed to these stressors independent of lifestyle factors, diabetes and systolic blood pressure. In addition, increasing number of life stressors demonstrated an association towards increased PWV (≥2 stressors: 8.04 m/s; 95% CI, 7.42–8.72 vs. 0 stressors 7.74 m/s; 95% CI, 7.23–8.28; p for trend 0.27) but the association attenuated after adjusting for lifestyle factors, diabetes and systolic blood pressure. Conclusion: Life stress was found to associate with higher arterial stiffness. Increased arterial stiffness could explain some of the increased cardiovascular disease risk related to life stressors. •Arterial stiffness was assesed as carotid-femoral pulse wave velocity. •Illness or death in the family were associated with an increased arterial stiffness. •Financial difficulties were associated with an increased arterial stiffness. •A trend toward increasing number of stressors and higher arterial stiffness exists.

Workplace discrimination may affect the health of the exposed employees, but it is not known whether workplace discrimination is also associated with an increased risk of long-term sickness absence. The aim of this study was to examine the longitudinal associations of changes in and onset of workplace discrimination with the risk of long-term sickness absence. Data on workplace discrimination were obtained from 29,597 employees participating in survey waves 2004, 2006, 2008 and/or 2010 of the Finnish Public Sector Study. Four-year changes in long-term sickness absence (≥10 days of medically certified absence with a mental or non-mental diagnosis) were assessed. This covered successive study waves in analyses of onset of workplace discrimination as well as fixed effect analyses of change in workplace discrimination (concurrent i.e. during the exposure year and 1-year lagged i.e. within one year following exposure), by using each employee as his/her own control. The risk of long-term sickness absence due to mental disorders was greater for employees with vs. without onset of workplace discrimination throughout the 4-year period, reaching a peak at the year when the onset of discrimination was reported (adjusted risk ratio 2.13; 95% confidence interval (CI) 1.80–2.52). The fixed effects analyses showed that workplace discrimination was associated with higher odds of concurrent, but not 1-year lagged, long-term sickness absence due to mental disorders (adjusted odds ratio 1.61; 95% CI 1.33–1.96 and adjusted odds ratio 1.02; 95% CI 0.83–1.25, respectively). Long-term sickness absence due to non-mental conditions was not associated with workplace discrimination. In conclusion, these findings suggest that workplace discrimination is associated with an elevated risk of long-term sickness absence due to mental disorders. Supporting an acute effect, the excess risk was confined to the year when workplace discrimination occurred.

The objective was to investigate the persistence of sleep difficulties for over 16 years amongst a population of working age. In this prospective cohort study, a group-based trajectory analysis of repeated surveys amongst 66,948 employees in public sector (mean age 44.7 [SD 9.4] years, 80% women) was employed. The main outcome measure was sleep difficulties based on Jenkins Sleep Scale (JSS). Up to 70% of the respondents did not experience sleep difficulties whereas up to 4% reported high frequency of notable sleep difficulties through the entire 16-year follow-up. Heavy drinking predicted sleep difficulties (OR 2.3 95% CI 1.6 to 3.3) except for the respondents younger than 40 years. Smoking was associated with sleep difficulties amongst women younger than 40 years (OR 1.2, 95% CI 1.0 to 1.5). Obesity was associated with sleep difficulties amongst men (OR 1.9, 95% CI 1.4 to 2.7) and women (OR 1.2, 95% CI 1.1 to 1.3) of middle age and amongst women older than 50 (OR 1.5, 95% CI 1.2 to 1.8) years. Physical inactivity predicted sleep difficulties amongst older men (OR 1.3, 95% CI 1.1 to 1.6). In this working-age population, sleep difficulties showed a great persistence over time. In most of the groups, the level of sleep difficulties during the follow-up was almost solely dependent on the level of initial severity. Depending on sex and age, increasing sleep problems were sometimes associated with high alcohol consumption, smoking, obesity and physical inactivity, but the strength of these associations varied.

Introduction The Prospective Physical Activity Sitting and Sleep consortium (ProPASS) is an international collaboration platform committed to harmonise thigh-worn accelerometry data. The aim of this paper is to (1) outline observational thigh-worn accelerometry studies and (2) summarise key strategic directions arising from the inaugural ProPASS meeting.Methods (1) We performed a systematic scoping review for observational studies of thigh-worn triaxial accelerometers in free-living adults (n≥100, 24 hours monitoring protocols). (2)Attendees of the inaugural ProPASS meeting were sent a survey focused on areas related to developing ProPASS: important terminology (Q1); accelerometry constructs (Q2); advantages and distinct contribution of the consortium (Q3); data pooling and harmonisation (Q4); data access and sharing (Q5 and Q6).Results (1) Eighty eligible articles were identified (22 primary studies; n~17 685). The accelerometers used most often were the ActivPAL3 and ActiGraph GT3X. The most commonly collected health outcomes were cardiometabolic and musculoskeletal. (2) None of the survey questions elicited the predefined 60% agreement. Survey responses recommended that ProPASS: use the term physical behaviour or movement behaviour rather than ‘physical activity’ for the data we are collecting (Q1); make only minor changes to ProPASS’s accelerometry construct (Q2); prioritise developing standardised protocols/tools (Q4); facilitate flexible methods of data sharing and access (Q5 and Q6).Conclusions Thigh-worn accelerometry is an emerging method of capturing movement and posture across the 24 hours cycle. In 2020, the literature is limited to 22 primary studies from high-income western countries. This work identified ProPASS’s strategic directions—indicating areas where ProPASS can most benefit the field of research: use of clear terminology, refinement of the measured construct, standardised protocols/tools and flexible data sharing.

Summary: Background: Socioeconomic disadvantage is a risk factor for many diseases. We characterised cascades of these conditions by using a data-driven approach to examine the association between socioeconomic status and temporal sequences in the development of 56 common diseases and health conditions. Methods: In this multi-cohort study, we used data from two Finnish prospective cohort studies: the Health and Social Support study and the Finnish Public Sector study. Our pooled prospective primary analysis data comprised 109 246 Finnish adults aged 17–77 years at study entry. We captured socioeconomic status using area deprivation and education at baseline (1998–2013). Participants were followed up for health conditions diagnosed according to the WHO International Classification of Diseases until 2016 using linkage to national health records. We tested the generalisability of our findings with an independent UK cohort study—the Whitehall II study (9838 people, baseline in 1997, follow-up to 2017)—using a further socioeconomic status indicator, occupational position. Findings: During 1 110 831 person-years at risk, we recorded 245 573 hospitalisations in the Finnish cohorts; the corresponding numbers in the UK study were 60 946 hospitalisations in 186 572 person-years. Across the three socioeconomic position indicators and after adjustment for lifestyle factors, compared with more advantaged groups, low socioeconomic status was associated with increased risk for 18 (32·1%) of the 56 conditions. 16 diseases formed a cascade of inter-related health conditions with a hazard ratio greater than 5. This sequence began with psychiatric disorders, substance abuse, and self-harm, which were associated with later liver and renal diseases, ischaemic heart disease, cerebral infarction, chronic obstructive bronchitis, lung cancer, and dementia. Interpretation: Our findings highlight the importance of mental health and behavioural problems in setting in motion the development of a range of socioeconomically patterned physical illnesses. Policy and health-care practice addressing psychological health issues in social context and early in the life course could be effective strategies for reducing health inequalities. Funding: UK Medical Research Council, US National Institute on Aging, NordForsk, British Heart Foundation, Academy of Finland, and Helsinki Institute of Life Science.

Abstract Background Educational attainment is associated with physical activity among older people. However, little is known about its association with sedentary lifestyle in European as well as Asian nations. This study aims to examine the associations between educational attainment and daily television viewing as an indicator of a sedentary lifestyle among older working and retired people in Finland and Japan. Methods We used cross-sectional harmonized data from two cohorts, the Finnish Public Sector study (n = 10,744) and the Japan Gerontological Evaluation Study (n = 2493), evaluating individuals aged 65–75 years old. We defined high-duration television viewing as ≥4 h per day. Poisson regression was used to examine the association between educational attainment and high-duration television viewing, stratified by the current working status. Models were adjusted for age, sex, household size, smoking, alcohol, body mass index, chronic diseases, mental disorders, and physical activity. Results Of the participants, 27% in Finland and 30% in Japan reported high-duration television viewing. Compared with a low education (≤9 years), Finnish and Japanese retirees with a high education (≥13 years) had less high-duration television viewing [prevalence ratio, PR 0.68 (95% confidence interval 0.63–0.73) and 0.66 (0.55–0.79), respectively]. The corresponding PRs for Finnish and Japanese retirees with intermediate education were also lowered [0.89 (0.83–0.95) and 0.79 (0.68–0.91), respectively]. Among older people still at work, educational attainment was associated with high-duration television viewing among the Japanese but not among the Finnish. Conclusion A similar association between educational attainment and high-duration television viewing in Finland and Japan particularly after retirement suggests a robust and consistent impact of educational attainment on a sedentary lifestyle after retirements.

Despite much interest in the health risks associated with behavioral factors, little is known about whether individuals residing in different countries experience a different set of risks. International comparisons of the death risks from major behavioral factors can shed light on whether features of health systems and epidemiological histories modify the health effects of risky behaviors. We used nationally representative samples and mortality linkages spanning the 1971–2014 period from the United States and Finland to examine cross-national differences in the risks of death from cigarette smoking and obesity. We evaluated both current and former smoking and current and prior obesity. In 1990, the approximate midpoint of our study, the death risks from current smoking were about 55% higher in U.S. women compared to Finnish women, but similar for men in the two countries. Death risks from smoking significantly increased over the period for women in both countries and there was no parallel increase in risks among men. Death risks from obesity did not significantly differ in the two countries and no significant trend in the risks were detected in either country. Reasons for the relatively high and increasing risks from smoking among American women warrant further evaluation.

OBJECTIVES: The aim of this study was to examine occupational class differences in working more than six months beyond the mandatory retirement age and factors that may contribute to these differences. METHODS: The study comprised a prospective cohort study of a total of 5331 Finnish municipal employees (73% women) who were not on work disability pension and reached the age eligible for old-age pension in 2005–2011. Occupational class included four categories: managers and professionals, lower grade non-manual, skilled manual, and elementary occupations. Survey responses while at work were linked to national health and pension registers. RESULTS: A total of 921 participants (17.3%) worked beyond the pensionable age. Compared with elementary workers, skilled manual workers had a similar probability [gender-adjusted risk ratio (RR) 0.95, 95% confidence interval (95% CI) 0.72–1.23] while lower grade non-manual workers had a 2.03-fold (95% CI 1.59–2.58), and managers and professionals had a 1.79-fold (95% CI 1.41–2.27) probability of working beyond the pensionable age. Adjustment for physical workload (32.0% in lower non-manual, 36.7% in managers and professionals), work time control (20.4% and 11.4%) and perceived work ability (16.5% and 29.1%) contributed to the largest attenuation for these associations. Analyses using a counterfactual approach suggested greater mediated effects for physical workload and work time control than those observed in traditional mediation analyses. CONCLUSIONS: Employees with higher occupational classes are two times more likely to continue working beyond the retirement age compared to those with lower occupational classes. A large proportion of these differences were explained by having physically light job, better work time control, and better self-rated work ability among employees with high occupational class.

Abstract Background Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics. Methods A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000–2011 and who reported their body weight one to three times prior to (w−3, w−2, w−1), and one to three times after (w+1, w+2, w+3) retirement. Results During the 4-year retirement transition (w+1, vs. w−1) men showed decline in BMI, which was most marked among men with sedentary work (−0.18 kg/m2, 95% CI −.30 to −0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m2, 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m2, 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition. Conclusions In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.

Abstract Background The current political agenda aims to promote active environments and physical activity while commuting to work, but research on it has provided mixed results. This study examines whether the proximity of green space and people’s residence in different travel-related urban zones contributes to commuting physical activity. Methods Population-based cross-sectional health examination survey, Health 2011 study, and geographical information system (GIS) data were utilized. The GIS data on green space and travel-related urban zones were linked to the individuals of the Health 2011 study, based on their home geocoordinates. Commuting physical activity was self-reported. Logistic regression models were applied, and age, gender, education, leisure-time and occupational physical activity were adjusted. Analyses were limited to those of working age, living in the core-urban areas of Finland and having completed information on commuting physical activity (n = 2 098). Results Home location in a pedestrian zone of a main centre (odds ratio = 1.63; 95 % confidence interval = 1.06–2.51) or a pedestrian zone of a sub-centre (2.03; 1.09–3.80) and higher proportion of cycling and pedestrian networks (3.28; 1.71–6.31) contributed to higher levels of commuting physical activity. The contribution remained after adjusting for all the environmental attributes and individuals. Based on interaction analyses, women living in a public transport zone were almost two times more likely to be physically active while commuting compared to men. A high proportion of recreational green space contributed negatively to the levels of commuting physical activity (0.73; 0.57–0.94) after adjusting for several background factors. Based on interaction analyses, individuals aged from 44 to 54 years and living in sub-centres, men living in pedestrian zones of sub-centres, and those individuals who are physically inactive during leisure-time were less likely to be physically active while commuting. Conclusions Good pedestrian and cycling infrastructure may play an important role in promoting commuting physical activity among the employed population, regardless of educational background, leisure-time and occupational physical activity. Close proximity to green space and a high proportion of green space near the home may not be sufficient to initiate commuting physical activity in Finland, where homes surrounded by green areas are often situated in car-oriented zones far from work places.

Summary: Background: Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight. Methods: We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium. BMI was assessed at baseline (1991–2008) and non-communicable diseases (incident type 2 diabetes, coronary heart disease, stroke, cancer, asthma, and chronic obstructive pulmonary disease) were ascertained via linkage to records from national health registries, repeated medical examinations, or self-report. Disease-free years from age 40 years to 75 years associated with underweight (BMI

Self-rated health (SRH) is a valid measure of health status and associated with mortality. Based on individual-level biannual repeat data on SRH we sought to characterize the natural history of poor SRH during the 12 years prior to death in men and women in different age groups. We conducted a retrospective analysis of the Health and Retirement Study participants who died between 1998 and 2010 and had at least two SRH measurements in the 12 years prior to death. We used a nested case-control design to compare SRH trajectories of deceased men and women aged 30-64, 65-79 and 80 years versus surviving participants. The cases comprised 3,350 deceased participants who were matched to surviving controls (n = 8,127). SRH was dichotomized into good vs. poor health. Men and women dying at age 65-79 and ≥ 80 years had 1.5 to 3 times higher prevalence of poor SRH already 11-12 years prior to death compared to surviving controls. The risk estimates remained statistically significant even after adjusting for life-style related risk factors and diagnosed diseases. Prevalence of poor SRH before death was lowest among those aged ≥ 80 years and highest in 30-64 year-olds. In conclusion, men and women who subsequently die perceive their health worse already 11-12 years prior to death compared to their surviving controls.