Leisure-time and commuting physical activity and subsequent sickness absence among young and early midlife employees: a register-linked follow-up study 2017-2020.

PURPOSE: We examined leisure-time physical activity (LTPA) and active commuting (AC) and their associations with subsequent sickness absence (SA) among young and early midlife employees. METHODS: The 2017 Helsinki Health Study survey among employees of the City of Helsinki aged 19-39 was prospectively linked to register-based data on total, short- and long-term SA spells (2017-2020). LTPA (n=3618) and AC (n=3513) were assessed as weekly metabolic equivalent (MET) hours in 2017. LTPA was categorized into five groups based on intensity and weekly volume (inactivity, moderate, moderate-to-vigorous, vigorous and high vigorous) and AC into four groups (inactive, low moderate, moderate-to-vigorous, vigorous). Analyses were stratified by sex and adjusted for sociodemographic and lifestyle factors using negative binomial regression to estimate incidence rate ratios (IRRs) and their 95% confidence intervals (CIs). RESULTS: Women had more SA than men (135 vs 97 days per 10 person-years; p<0.001). Women with moderate-to-vigorous LTPA had, compared to the inactive, lower rates of total SA (IRR 0.69, 95% CI 0.60-0.80) short SA and long SA after full adjustments for covariates. Men with vigorous LTPA remained protective in total SA days (IRR 0.60, 95% CI 0.44-0.81) and short SA spells after adjustment. For AC, protective associations were observed only among women. CONCLUSION: LTPA including vigorous-intensity activity was associated with lower SA over the follow-up, although patterns differed by sex and activity level. Associations for AC were weaker and confirmed for women only. Vigorous-intensity physical activity may be beneficial for reducing SA already in early working life.