Physical behaviours at work and leisure time was assessed using data from one tri-axial ActiGraph GT3X+ accelerometer (Actigraph, Pensacola, FL, USA). The accelerometer was placed on the right thigh using double-sided adhesive tape (3 M, Hair-Set, St. Paul, MN, USA) and Fixomull (Fixomull BSN medical GmbH, Hamburg, Germany). Accelerometer data were downloaded using the Actilife Software version 5.5 (Actigraph, Pensacola, FL, USA) [29] and analysed using the custom-made MATLAB program Acti4 (The National Research Centre for the Working Environment, Copenhagen, Denmark) [30]. In brief, the Acti4 program derive instantaneous average parameters (i.e. mean and standard deviation of acceleration, inclination) from thigh-worn accelerometer signal using overlapping 2-s intervals. Based on these parameters and a rule-based decision tree, physical behaviours (i.e., cycling, stair climbing, running, walking, standing, sitting and lying) were classified [19]. The Acti4 program has been shown to separate physical behaviours with high sensitivity and specificity under both semi-standardized [30] and non-standardized conditions [31].

Day of the week, daily work hours, leisure time and time-in-bed were defined from the participants’ daily diary. Specifically, leisure time was defined as waking time not at work. Non-workdays were defined as days where the participants had not reported a working period. Only workers having at least 1 day of valid accelerometer measurements of both work and leisure time periods were included in this study. A valid day was defined as having at least 4 h of accelerometer-derived work and leisure time or what corresponded to at least 75% of the individual’s average work and leisure time. To decrease the risk of reverse causality between work periods and leisure time, we only considered leisure time following work. Moreover, time-in-bed was not considered in this study.

Figure 1 shows the flowchart of the study population. A total of 1207 eligible workers answered the questionnaire and/or participated in the physical health check. Of these workers, 40 were excluded as they were department leaders or students, on holiday, pregnant or because they did not want to participate. A total of 204 workers were excluded from the study as they did not valid have leisure time accelerometer measurements on at least one weekday. Therefore, a total of 963 workers were included in the study.

Flow chart of the study population

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