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Objective Emerging evidence suggests that excessive sitting has negative health effects. However, this evidence largely relies on research using self-reported sitting time, which is known to be biased. To correct this bias, we aimed at developing a calibration model estimating "true" sitting from self-reported sitting. Methods Occupational sitting time was estimated by self-reports (the International Physical Activity Question-naire) and objective measurements (thigh-worn accelerometer) among 99 Swedish office workers at a governmental agency, at baseline and 3 and 12 months afterwards. Following compositional data analysis procedures, both sitting estimates were transformed into isometric log-ratios (ILR). This effectively addresses that times spent in various activities are inherently dependent and can be presented as values of only 0−100%. Linear regression was used to develop a simple calibration model estimating objectively measured "true" sitting ILR (dependent variable) from self-reported sitting ILR (independent variable). Additional self-reported variables were then added to construct a full calibration model. Performance of the models was assessed by root-mean-square (RMS) differences between estimated and objectively measured values. Models developed on baseline data were validated using the follow-up datasets. Results Uncalibrated self-reported sitting ILR showed an RMS error of 0.767. Simple and full calibration models (incorporating body mass index, office type, and gender) reduced this error to 0.422 (55%) and 0.398 (52%), respectively. In the validations, model performance decreased to 57%/62% (simple models) and 57%/62% (full models) for the two follow-up data sets, respectively. Conclusion Calibration adjusting for errors in self-reported sitting led to substantially more correct estimates of "true" sitting than uncalibrated self-reports. Validation indicated that model performance would change somewhat in new datasets and that full models perform no better than simple models, but calibration remained effective.

Purpose: To evaluate the effectiveness of an individually tailored intervention for improvement in lifestyle behavior, health indicators, and prevention and reduction of overweight among construction workers. Design: Randomized controlled trial. Setting: Various blue-collar departments of a large construction company in the Netherlands. Participants: Blue-collar workers randomized to an intervention (n = 162) or a control group (n = 152). Intervention: The intervention group received individual coaching sessions, tailored information, and materials to improve lifestyle behavior during a 6-month period, and the control group received usual care. Measures: Body weight, body mass index (BMI), waist circumference, physical activity (PA) levels, dietary behavior, blood pressure, and blood cholesterol were assessed. Analysis: Effectiveness of the intervention on outcome measures at 6- and 12-month follow-up was assessed by using linear and logistic regression models adjusting for baseline levels. Results: After 6 months, a statistically significant intervention effect was found on body weight ( B = −1.06, P = .010), BMI ( B = −0.32, P = .010), and waist circumference ( B = −1.38, P = .032). At 6 months, the percentage of those meeting public health guidelines for PA increased significantly in the intervention group compared to the control group ( B = 2.06, P = .032), and for sugar-sweetened beverages, an intervention effect was found at 6 months as well ( B = −2.82, P = .003). At 12 months, for weight-related outcomes, these differences were slightly smaller and no longer statistically significant. The intervention was not effective on the total amount of moderate to vigorous PA and other dietary and health outcomes. Conclusion: Intervention participants showed positive changes in vigorous PA and intake of sugar-sweetened beverages compared to controls, as well as effects on weight-related outcomes at 6 months. Long-term effects were still promising but not statistically significant.

Abstract Background The health problems that working people suffer can affect their functional abilities and, consequently, can cause a mismatch between those abilities and the demands of the work, leading to sickness absence. A lasting decrease in functional abilities can lead to long-term sickness absence and work disability, with negative consequences for both the worker and the larger society. The objective of this study was to identify common disability characteristics among large groups of long-term sick-listed and disabled employees. Methods As part of the disability benefit entitlement procedure in the Netherlands, an insurance physician assesses the functional abilities of the claimant in a standardised form, known as the List of Functional Abilities (LFA), which consists of six sections containing a total of 106 items. For the purposes of this study, we compiled data from 50,931 assessments. These data were used in an exploratory factor analyses, and the results were then used to construct scales. The stability of dimensional structure of the LFA and of the internal consistency of the scales was studied using data from 80,968 assessments carried out earlier, under a slightly different legislation. Results Three separate factor analyses carried out on the functional abilities of five sections of the LFA resulted in 14 scale variables, and one extra scale variable was based on the items from the sixth section. The resulting scale variables showed Cronbach's Alphas ranging from 0.59 to 0.97, with the exception of one of 0.54. The dimensional structure of the LFA in the verification population differed in some aspects. The Cronbach's Alphas of the verification population ranged from 0.58 to 0.97, again with the exception of the same scale: Alpha = 0.49. Conclusion The differences between the dimensional structures of the primary data and the earlier data we found in this study restrict the possibilities to generalise the results. The scales we constructed can be utilised to produce a compact description of the functional abilities of groups of claimants in the Netherlands. Moreover, the matching work demands can be used to identify jobs low on those demands as being the most accessible for the specific type of disabled employees, particularly severely disabled individuals.

Purpose. Evaluate counselors' adherence to an intervention protocol, counselors' competence, and the associations between three process indicators and body weight at follow-up in a 6-month individually based lifestyle intervention for construction workers. Design. Process evaluation with qualitative and quantitative data. Setting. Occupational health service. Subjects. A total of 408 male construction workers with an elevated risk of cardiovascular disease received the intervention, and 27 occupational health professionals delivered the intervention. Intervention. Seven counseling sessions, the first during which four prescribed items had to be discussed. Motivational interviewing (MI) was used as a counseling technique. Measures and Analysis. The number of sessions and the items discussed were registered by the counselors. Adherence to MI was determined by expert scoring of transcripts of random segments of 19 counseling sessions. Counselors' competence was rated by participants and counselors separately. Associations between three process indicators and body weight at follow-up were determined by linear and logistic regression analyses. Results. Two-thirds of all participants attended five or more sessions, and 38.5% attended all seven sessions. In 90.2% of all cases, the counselor discussed all obligatory items in the first session. MI adherence was reached in one audiotaped fragment. Most (86.3%) of all participants agreed with the counselor being competent. Neither counselors' competence nor number of sessions or items discussed was significantly associated with body weight loss. Conclusions. Performing five sessions and discussing four prescribed items was feasible for the counselors, whereas performing MI was not. Still, participants were positive about the counselors' competence and willing to attend the intervention sessions. Investigators are encouraged to report the evaluation of their intervention process to improve future lifestyle interventions in research or in practice.

Objectives - To achieve a coherent programme of topics for research in occupational health and safety, with well founded priorities and to relate them to perceived gaps and needs in The Netherlands. Methods - In the first phase of the study 33 key informants were interviewed. In the second phase questionnaires were sent to 150 Dutch experts (including the key informants). Four groups were recruited, originating from: occupational health and safety services; scientific research institutes; governmental and other administrative bodies; and companies. Using the Delphi technique, the experts were asked to prioritise several topics, which were placed under different headings. In the third phase five workshops were organised to elaborate on the highly prioritised topics. Results - The response rates were 86% for the first and 81% for the second questionnaire. In the second round consistency was reached and consensus proved to be satisfactory, so that the Delphi process was stopped. There were surprisingly few differences in opinion between the four groups. The most important heading was 'design/implementation/evaluation of measures', in which the topic cost-benefit analysis of measures had the highest score. 'Assessment of relations between exposure and effect' was the second most important heading. Under this heading, topics on work stress were generally judged to be more important than topics on musculoskeletal disorders, which in turn had higher scores than topics on safety and biological, chemical, and physical hazards. The headings 'occupational rehabilitation/sociomedical guidance' and 'occupational health occupational health services' had about the same priority, closely following the heading 'assessment of relations between exposure and effect'. Conclusions - The general agreement on priorities should provide a sufficiently broad basis for decision makers to initiate a long term programme for occupational health research and development in The Netherlands.

Abstract Background Identification of factors associated with work disability in cancer survivors on long term sick leave may support these survivors in choosing effective measures to facilitate vocational rehabilitation and return to work. Therefore, this study aims to disclose factors associated with work disability in cancer survivors at 24 months of sick leave. Methods A cross sectional study was conducted. The study population consisted of employed sick-listed cancer survivors, aged between 18 and 64 years. They received a questionnaire at 24-month sick leave, the maximum period of sick leave allowed by Dutch social security legislation. Data were linked with the outcome of work disability assessment, as performed by the Dutch social security agency. A hierarchical multivariate logistic regression analysis was performed to identify factors associated with work disability. Results Data of 351 valid cases were analysed. The multivariate analysis showed that, for cancer survivors at 24-month sick leave, Dutch nationality, higher education, receiving hormone therapy, metastatic disease, physical limitations and low self-reported work ability were associated with an increased risk for work disability. Conclusions This study identified factors associated with work disability of employed cancer survivors at 24 months of sick leave. The results of the current study may serve as a starting point to investigate the course of work disability beyond the maximum period of 24 months of sick leave. In order to enhance work participation of cancer survivors beyond this term, prospective data on work disability in the Netherlands are required.

Introduction Socioeconomic health differences have often been described, but remain insufficiently understood. Recent evidence suggests that workers who are high (compared with low) physically active at work are less healthy. Moreover, workers who are highly physically active at work are predominantly physically inactive during leisure time. These observations suggest that workers with a lower socioeconomic status may be exposed to negative health consequences of occupational physical activity and may only benefit to a limited extent from health benefits of leisure-time physical activity. Physical activity may therefore be an important driver of socioeconomic health differences. We describe the rationale and protocol of the active worker study, an individual participant data meta-analysis aimed at exploring socioeconomic health differences by differential doses of physical activity at work and leisure time. Methods and analysis Using database and scoping searches (we searched in PubMed, Embase, CINAHL, PsycINFO and Evidence-Based Medicine Reviews from database inception to 14 September 2017), we have identified 49 published and unpublished prospective studies in which the association of occupational and leisure-time physical activity with cardiovascular or all-cause mortality was assessed. Principal investigators of these studies will be invited to participate in the active worker consortium, after which data will be retrieved. After data merging and harmonising, we will perform multilevel survival analysis assessing the combined association of occupational and leisure-time physical activity with mortality. We will also test the mediating effect of physical activity on the association of socioeconomic status and mortality (ie, socioeconomic health differences). Discussion The Medical Ethical Committee of the VU University Medical Center has declared, according to Dutch legislation, that the 'Dutch Medical Research Involving Human Subjects Act' does not apply to the current study. As such, no ethics approval is required. We intent to publish outcomes of the active worker Study in scientific peer-reviewed journals.

Job rotation is often advocated to reduce workload, but its efficacy has seldom been investigated. The aim of this study is to compare the work demands, workload, and recovery among truck driving, refuse collecting, and rotating between these two jobs, between days and during the day. Three teams of 3 employees each participated in this study. Work demands were assessed by systematic observation of tasks and activities. Workload was quantified by means of heart rate, oxygen uptake, subjective ratings, and urinary excretion rates of catecholamines. Recovery was quantified by excretion rates of catecholamines after work. Job rotation between driving and collecting is an effective measure to reduce physical workload as compared with collecting only and to decrease mental workload as compared with driving only. However, job rotation resulted in increased physical workload as compared with driving only. Job rotation did not increase mental workload as compared with collecting only. No effects were seen on recovery. No differences were found between rotating between days and during the day. Actual or potential applications of this research include the recommendation that before job rotation is introduced, its efficacy be determined in terms of well-chosen workload measures because a reduction in work demands does not directly imply a reduction in workload. Therefore, job rotation might be less effective than expected.

Purpose.To determine the effects of the physical activity promotion programs Rehabilitation & Sports (R&S) and Active after Rehabilitation (AaR) on sport and daily physical activity 1 year after in- or outpatient rehabilitation.Design.Subjects in intervention rehabilitation centers were randomized into a group receiving R&S only (n = 315) and a group receiving R&S and AaR (n = 284). Subjects in six control centers (n = 603) received usual care.Setting.Ten Dutch rehabilitation centers.Subjects.Subjects consisted of 1202 rehabilitation patients. Most frequent diagnoses were stroke, neurological disorders, and back disorders.Intervention.Both the sport stimulation program (R&S) and the daily physical activity promotion program (AaR) consisted of personalized tailored counseling.Measures.Two sport outcomes and two daily physical activity outcomes were assessed with questionnaires at baseline and 1 year after rehabilitation.Analysis.Multilevel analyses comparing both intervention groups to the control group.Results.The R&S program showed no significant effects. Intention-to-treat analyses in the R&S + AaR group showed borderline significant improvements in one sport (odds ratio [OR] = 1.66, p = .02) and both physical activity outcomes (OR = 1.68, p = .01 and regression coefficient = 10.78, p = .05). On-treatment analyses in the R&S + AaR group showed similar but stronger effects.Conclusions.The combination of the R&S and AaR programs improved physical activity behavior and sport participation 1 year after in- or outpatient rehabilitation. The R&S program alone did not have any effects.

Objective This paper summarizes the main findings and recommendations of an advisory report on health and prolonging working life, which was requested by the Dutch Minister of Social Affairs and Employment. Methods The advisory report was compiled by a multidisciplinary committee of ten scientists appointed by the Health Council of The Netherlands. The committee's aims were to (i) describe the health of the ageing population, (ii) describe how prolonging working life influences health, (iii) describe determinants, besides health, for prolonging working lives, and (iv) review the literature on interventions aimed at retaining or improving employability of older workers. Results The report was presented to the Minister on 26 June 2018. As the likelihood of health problems increases with age, prolonging working life may be difficult. In general, life expectancy increases and gains in life years and health seem mainly attributable to people aged >75 years. Work is good for mental health. However, it may be beneficial for mental health to stop working around the retirement age. Besides health, financial factors, lifestyle, motivation to work, and working conditions play a role in prolonging working life. A systematic review of the evidence indicated that interventions such as worksite health promotion or career development workshops can support older workers in this matter. Conclusions The Health Council advised the Dutch Government to focus on worksite health promotion and career development interventions as well as the improvement of their implementation. This requires a tailored approach as there is a large diversity in health among older workers and particularly between low- and higheducated people. With this in mind, it was further recommended to explore whether flexible pension schemes might better suit this diversity.

Objective This paper summarizes the main findings and recommendations of an advisory report on health and prolonging working life, which was requested by the Dutch Minister of Social Affairs and Employment. Methods The advisory report was compiled by a multidisciplinary committee of ten scientists appointed by the Health Council of The Netherlands. The committee's aims were to (i) describe the health of the ageing population, (ii) describe how prolonging working life influences health, (iii) describe determinants, besides health, for prolonging working lives, and (iv) review the literature on interventions aimed at retaining or improving employability of older workers. Results The report was presented to the Minister on 26 June 2018. As the likelihood of health problems increases with age, prolonging working life may be difficult. In general, life expectancy increases and gains in life years and health seem mainly attributable to people aged >75 years. Work is good for mental health. However, it may be beneficial for mental health to stop working around the retirement age. Besides health, financial factors, lifestyle, motivation to work, and working conditions play a role in prolonging working life. A systematic review of the evidence indicated that interventions such as worksite health promotion or career development workshops can support older workers in this matter. Conclusions The Health Council advised the Dutch Government to focus on worksite health promotion and career development interventions as well as the improvement of their implementation. This requires a tailored approach as there is a large diversity in health among older workers and particularly between low- and higheducated people. With this in mind, it was further recommended to explore whether flexible pension schemes might better suit this diversity.

Objective This paper summarizes the main findings and recommendations of an advisory report on health and prolonging working life, which was requested by the Dutch Minister of Social Affairs and Employment. Methods The advisory report was compiled by a multidisciplinary committee of ten scientists appointed by the Health Council of The Netherlands. The committee's aims were to (i) describe the health of the ageing population, (ii) describe how prolonging working life influences health, (iii) describe determinants, besides health, for prolonging working lives, and (iv) review the literature on interventions aimed at retaining or improving employability of older workers. Results The report was presented to the Minister on 26 June 2018. As the likelihood of health problems increases with age, prolonging working life may be difficult. In general, life expectancy increases and gains in life years and health seem mainly attributable to people aged >75 years. Work is good for mental health. However, it may be beneficial for mental health to stop working around the retirement age. Besides health, financial factors, lifestyle, motivation to work, and working conditions play a role in prolonging working life. A systematic review of the evidence indicated that interventions such as worksite health promotion or career development workshops can support older workers in this matter. Conclusions The Health Council advised the Dutch Government to focus on worksite health promotion and career development interventions as well as the improvement of their implementation. This requires a tailored approach as there is a large diversity in health among older workers and particularly between low- and high-educated people. With this in mind, it was further recommended to explore whether flexible pension schemes might better suit this diversity.

Objective This paper summarizes the main findings and recommendations of an advisory report on health and prolonging working life, which was requested by the Dutch Minister of Social Affairs and Employment. Methods The advisory report was compiled by a multidisciplinary committee of ten scientists appointed by the Health Council of The Netherlands. The committee's aims were to (i) describe the health of the ageing population, (ii) describe how prolonging working life influences health, (iii) describe determinants, besides health, for prolonging working lives, and (iv) review the literature on interventions aimed at retaining or improving employability of older workers. Results The report was presented to the Minister on 26 June 2018. As the likelihood of health problems increases with age, prolonging working life may be difficult. In general, life expectancy increases and gains in life years and health seem mainly attributable to people aged >75 years. Work is good for mental health. However, it may be beneficial for mental health to stop working around the retirement age. Besides health, financial factors, lifestyle, motivation to work, and working conditions play a role in prolonging working life. A systematic review of the evidence indicated that interventions such as worksite health promotion or career development workshops can support older workers in this matter. Conclusions The Health Council advised the Dutch Government to focus on worksite health promotion and career development interventions as well as the improvement of their implementation. This requires a tailored approach as there is a large diversity in health among older workers and particularly between low- and high-educated people. With this in mind, it was further recommended to explore whether flexible pension schemes might better suit this diversity.