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Dose–response relation between physical activity and sick leave
  1. K I Proper1,
  2. S G van den Heuvel2,
  3. E M De Vroome3,
  4. V H Hildebrandt2,
  5. A J Van der Beek4
  1. 1Body@Work, Research Centre for Physical Activity, Work and Health, TNO-VUmc, Amsterdam, Netherlands
  2. 2TNO Quality of Life, Body@Work, Research Centre for Physical Activity, Work and Health, TNO-VUmc
  3. 3TNO Quality of Life, Work and Employment, TNO-VUmc
  4. 4Department of Public and Occupational Health, EMGO-Institute, TNO-VUmc
  1. Correspondence to:
 Dr Karin I Proper
 Body@Work, Research Centre for Physical Activity, Work and Health, TNO-VUmc, Amsterdam, Netherlands; ki.proper{at}


Objective: To investigate the dose–response relation between moderate and vigorous physical activity and sick leave in a working population.

Methods: Data were used from three large Dutch databases: two continuous, cross sectional surveys among a representative sample of the Dutch population and one prospective cohort study. A distinction was made between duration, frequency and intensity of physical activity. The outcome measure was the number of days of sick leave. Analyses of variance were used to compare sick leave (in days) for workers with different amounts of physical activity, in particular workers meeting the physical activity recommendations v those who did not. Linear and logistic regression analyses were used to obtain effect estimates in the prospective cohort study, with the generalised estimating equation (GEE) method.

Results: No relation was found between moderate physical activity and sick leave. In two databases, workers meeting the recommendation of vigorous physical activity (active at a vigorous level for at least three times a week) had significantly less sick leave: more than one day over two months and more than four days over a year. The duration of vigorous physical activity was not associated with sick leave.

Conclusion: Physical activity at a vigorous intensity level for at least three times a week, as in the CDC/ACSM recommendation, has a positive effect on sick leave.

  • MET, metabolic equivalent
  • OBiN, Ongevallen en Bewegen in Nederland (Injuries and Physical Activity in the Netherlands)
  • POLS, Permanent Onderzoek LeefSituatie (Permanent Study Living Conditions)
  • SMASH, Study on Musculoskeletal disorders, Absenteeism, Stress and Health
  • SQUASH, Short Questionnaire to Assess Health-Enhancing Physical Activity
  • physical activities
  • absenteeism
  • workers
  • longitudinal study
  • cross sectional study

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  • Competing interests: none declared