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The Association Between Physical Activity, Productivity, and Health Care Utilization Among Employees in Brazil

Fonseca, Vera Regina PhD; Nobre, Moacyr Roberto Cuce PhD; Pronk, Nicolaas P. PhD; Santos, Luciana Alves PhD

Journal of Occupational and Environmental Medicine: July 2010 - Volume 52 - Issue 7 - p 706-712
doi: 10.1097/JOM.0b013e3181e41cda
Original Articles

Objective: To document the relationship between physical activity, absenteeism, presenteeism, health care utilization, and morbidity among Brazilian automotive workers.

Methods: Eligible employees (N = 620) completed a questionnaire. Univariate correlations, multivariate logistic regression, and Pearson's product-moment correlation coefficient were used.

Results: Work absenteeism was associated with physical activity at work (OPA) (odds ratio, [OR] = 1.63, 95% confidence interval [CI] = 1.31 to 2.02) and leisure physical activity time excluding sport (OR = 0.73, 95% CI = 0.58 to 1.00). Health care utilization was associated with OPA (OR = 1.25, 95% CI = 0.99 to 1.58) and leisure physical activity time excluding sport (OR = 0.76, 95% CI = 0.57 to 1.02). Presenteeism showed an indirect relationship with OPA (r = 0.099, P = 0.014). Referred morbidity was associated with OPA (OR = 1.3, 95% CI = 1.06 to 1.61) and sports during leisure time (OR = 0.67, 95% CI = 0.54 to 0.82).

Conclusions: Physical activity components seem to have differential relationships to the studied outcomes. Associations measured indicate negative impacts of OPA on absenteeism, health care utilization, and morbidity, although overall physical activity did not show these relationships.

From the Department of Clinical Epidemiology (Dr Fonseca, Dr Nobre, Dr Santos), Heart Institute, University of São Paulo Medical School, São Paulo, SP, Brazil; JourneyWell Division and HealthPartners Research Foundation (Dr Pronk), HealthPartners, Minneapolis, Minn.

This article is the product of a doctorate thesis, defended by the Cardiology Post-Graduate Program of the University of São Paulo Medical School, Brazil, which was supported by the automotive industry General Motors, Brazil.

Address correspondence to: Vera Regina da Fonseca, PhD, Instituto do Coração (InCor), Unidade de Epidemiologia Clínica, Av. Dr Enéas de Carvalho Aguiar, 44, Cerqueira César, São Paulo, SP, CEP 05403-000, Brazil; E-mail:

©2010The American College of Occupational and Environmental Medicine