Preventive Medicine 54 (2012) 195–200

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Preventive Medicine
journal homepage: www.elsevier.com/locate/ypmed

Cross-sectional associations between occupational and leisure-time sitting, physical

activity and obesity in working adults
Josephine Y. Chau ⁎, Hidde P. van der Ploeg, Dafna Merom, Tien Chey, Adrian E. Bauman
Prevention Research Collaboration, Sydney School of Public Health, University of Sydney, Australia

a r t i c l e i n f o a b s t r a c t

Available online 28 December 2011 Aim. To examine associations between occupational and leisure-time sitting, physical activity and obesity
in working adults.
Keywords: Methods. We analyzed data from workers from the 2007–08 Australian National Health Survey
Sedentary behavior (n = 10,785). Participants reported their activity at work (mostly sitting, standing, walking, or heavy
Sitting
labor), transport-related walking, leisure-time sitting and physical activity. Body mass index was objectively
Physical activity
Work
measured. Adjusted Cox proportional hazard regression models examined associations between occupational
Obesity activity category, leisure-time sitting, physical activity and obesity risk.
Results. Substantial proportions of men (42%) and women (47%) mostly sit at work. Workers with sitting
jobs were significantly more likely to be sufficiently active during leisure-time than workers with mostly stand-
ing, walking or heavy labor jobs (RR = 0.88, 0.80, 0.86 respectively). Workers with mostly sitting jobs had sig-
nificantly higher overweight/obesity risk than workers with mostly standing jobs (RR = 0.88, 95% CI: 0.82–0.95)
independent of physical activity and leisure-time sitting. Workers with leisure-time sitting of less than four
hours per day had significantly lower obesity risk than workers with four or more hours per day of leisure-
time sitting (RR = 0.77, 95%CI: 0.69–0.87) independent of physical activity and occupational activity.
Conclusions. Sitting time and physical activity are independently associated with obesity. Leisure-time sit-
ting may have a stronger association with obesity risk than occupational sitting.
© 2011 Elsevier Inc. All rights reserved.

Introduction
It has been estimated that the global prevalence of overweight and
obesity is 23.2% and 9.8%, respectively (Kelly et al., 2008). If obesity
levels remain unchanged, the growing obesity-related health burden
will have large economic ramifications including costs to the health
system, as well as impacts on the workforce and productivity
(Aitken et al., 2009; Barkin et al., 2010). The rise in obesity is not
explained by declines in leisure-time physical activity (LTPA) alone
on the expenditure side of the energy balance and is possibly also
influenced by increases in sedentary behavior (Allman-Farinelli et
al., 2010; Bauman et al., 2008).
Sedentary behavior, often operationalized as sitting time, refers
to low energy expenditure behaviors of less than 1.5 METs
(Ainsworth et al., 2000). It is distinct from physical inactivity,
which is the lack of moderate-to-vigorous physical activity (Pate
et al., 2008). The literature suggests that sedentary behaviors (e.g.
occupational sitting, leisure-time sitting, TV viewing) may be associ-
ated with overweight and obesity independent of physical activity
⁎ Corresponding author at: Prevention Research Collaboration, Sydney School of
Public Health, Level 2 Medical Foundation Building K25, University of Sydney, NSW
2006, Australia. Fax: + 61 290363184.
E-mail address: josephine.chau@sydney.edu.au (J.Y. Chau).
(Proper et al., 2011; Thorp et al., 2011; van Uffelen et al., 2010).
This has public health implications, because, even though adults
may meet physical activity recommendations for good health, they
may sit for extended periods each day in different settings which
could affect their health.
Working adults spend about one third to one half of their workday
sitting down (Jans et al., 2007; Ki et al., 2010; Miller and Brown, 2004;
Mummery et al., 2005). Adults also spend hours sitting in their
leisure-time (e.g. TV viewing, using a computer, other small screen
recreation, driving) (Dunstan et al., 2005; Ki et al., 2010; Proper et
al., 2007; Salmon et al., 2003). While occupational sitting times vary
for workers in different occupations (Duncan et al., 2010; Jans et al.,
2007), little is known about the relationship between occupational
sitting/activity and sedentary and active behaviors outside work.
One study suggests that workers with higher occupational sitting
time may not reduce their sitting in non-work time (Jans et al.,
2007); while other research reports that occupational sitting time is
not related to leisure-time physical activity (Mummery et al., 2005).
Another study reports that workers in active and sedentary jobs do
not differ in their sitting time or step counts outside work time
(Tigbe et al., 2011). Therefore, it is important to examine the patterns
of sitting and activity in workers during and outside work time and,
furthermore, to assess the associations between occupational and
leisure-time sitting with overweight and obesity.

0091-7435/$ – see front matter © 2011 Elsevier Inc. All rights reserved.
doi:10.1016/j.ypmed.2011.12.020
196 J.Y. Chau et al. / Preventive Medicine 54 (2012) 195–200
This cross-sectional study presents the prevalence of occupational
and leisure-time sitting in a nationally representative sample of Aus-
tralian working adults. We examined the likelihood of workers sitting
and being physically active outside work time according to their oc-
cupational activity category. Furthermore, we investigated the associ-
ations between occupational and leisure-time sitting and physical
activity with risk of being overweight or obese.
Methods
Participants/study population
This study used the 2007–08 Australian National Health Survey
(NHS) which is a nationally representative survey of adults living in
Australian households conducted between August 2007 and June
2008 (Australian Bureau of Statistics, 2009). The survey used a strat-
ified multistage area sample design from which a sample of private
dwellings in urban and rural areas was randomly selected. Trained in-
terviewers visited each dwelling and conducted the survey face-to-
face with respondents using a computer assisted interview. The sur-
vey achieved a response rate of 90.6% of selected households, yielding
a total survey sample of 20,788 participants.
In this study, we conducted secondary analyses with respondents
aged 15 to 69 years who reported working full or part-time (5807
men, 4978 women). Access to the 2007–08 NHS data was approved
by the Australian Bureau of Statistics (ABS).
Sitting and physical activity variables
All participants reported their usual activity at work (mostly sit-
ting, mostly standing, mostly walking, mostly heavy labor or physi-
cally demanding work). Similar categorical measures of
occupational activity with sitting or sedentary as one of the response
options have been used in other population surveys (Gutierrez-Fisac
et al., 2002; Kurtze et al., 2007).
All participants reported the time (hours, minutes) they spent sit-
ting in leisure-time (watching TV, using the computer, other leisure-
time) on a usual week day. Similar leisure-time sitting questions have
been used in other population studies (Patel et al., 2010; Thorp et al.,
2010). Additionally, full-time workers reported the time (hours, mi-
nutes) they spent sitting at work on a usual day. Similar questions
have been used in other surveys (Duncan et al., 2010; Mummery et
al., 2005) and have demonstrated good test–retest reliability
(ICC = 0.63) and sufficient validity (r = 0.45) (Chau et al., 2011). Sit-
ting times were dichotomized at the median 4 h/day for both occupa-
tional and leisure-time sitting (b4 h/day, ≥4 h/day).
All participants reported the number of days and duration (hours,
minutes) they spent walking for fitness, recreation or sport in the last
week. They also reported the number of days and duration (hours,
minutes) they spent engaged in moderate or vigorous exercise in
the last week. These physical activity indicators were combined to
form a leisure-time physical activity variable. Walking for transport
was also measured whereby participants reported the number of
days and total duration they walked continuously for transport for
at least 10 min in the last week. The NHS physical activity measure
has acceptable test–retest reliability for assessing total leisure-time
physical activity (ICC = 0.57) and for classifying activity status
(kappa = 0.40) (Brown et al., 2004).
It is recommended that adults engage in at least 30 min of
moderate-intensity physical activity on at least five days per week
to be sufficiently active for good health (Haskell et al., 2007). In this
study, we looked at being sufficiently active in three ways: (1) at
least 150 min/week of leisure-time physical activity only; (2) at
least 150 min/week of transport-related walking only; or (3) at
least 150 min/week of leisure-time PA and transport-related walking
combined.
Body mass index and other sociodemographic variables
Trained interviewers objectively measured participants’ height with
a stadiometer and weight using digital scales (Australian Bureau of
Statistics, 2009). Body mass index (BMI) was calculated as weight/
height2 (kg/m 2). Overweight was defined as BMI 25–29.9 kg/m2 and
obese as BMI ≥30 kg/m 2 (WHO, 2000).
Sex, age, highest level of non-school education, work status (full-
time, part-time), hours of work and occupation were measured by
self-report. The ABS classified occupations into ten categories using
the Australian and New Zealand Standard Classification of Occupa-
tions and the Australian Standard Classification of Occupations
(Australian Bureau of Statistics, 2009). In this analysis we collapsed
these into eight occupational groups: managers, professionals, techni-
cians and trades workers, community and personal service workers,
clerical and administrative workers, sales workers, machinery opera-
tors and drivers, and laborers.
Statistical analysis
We analyzed data using SAS V9.1.3 (SAS Institute Inc., Cary, NC,
USA, 2002–2003). The ABS computed weighting factors for each re-
cord to reflect the population demographic at the time of the survey,
taking into account the probability of being sampled and the differen-
tial response across the population. The ABS also computed 60 repli-
cate weights for complex survey designs. We used normalized post-
stratification weighting for all statistical modeling and calculated
the standard errors for estimates and 95% confidence intervals using
the 60 replicates delete-a-group jackknife variance technique
(Australian Bureau of Statistics, 2009).
We calculated weighted descriptive statistics by occupational ac-
tivity category for occupational type, work status, age group, level of
highest non-school qualification and BMI category, stratified by gen-
der. We tested for associations between occupational activity catego-
ry, leisure-time sitting, physical activity and risk of overweight or
obesity using multi-variable Robust Cox proportional hazard models
with constant time (time = 1) assigned to everyone (Barros and
Hirakata, 2003; Breslow, 1974; Lee, 1994). This method adapts the
Cox model to estimate prevalence risk ratios for cross-sectional data
and more accurately describes the associations of relative risk be-
tween occupational and leisure-time sitting and overweight and obe-
sity than estimating odds ratios.
We adjusted all models for sex, age and education level, and pre-
sent results as percentage prevalence and relative risk with 95% con-
fidence intervals.
Results
Tables 1A and 1B present participant characteristics by occupa-
tional activity category for men and women, respectively. Substantial
proportions of men and women mostly sit (41.8% and 46.9%, respec-
tively) and mostly stand (20.5% and 25.7%, respectively) at work.
The occupations with the largest proportions of men and women
reporting mostly sitting at work were managers, professionals, cleri-
cal and administrative workers, and machinery operators and drivers.
The occupations with the lowest proportion reporting mostly sitting
were laborers and technicians or trades workers.
On average, full-time workers reported sitting 3.8 ± 3.0 h/day at
work and sitting 3.4 ± 1.7 h/day during leisure-time and mean BMI
was 26.7 ± 5.1 kg/m 2 (data not shown). Full-time workers who
reported mostly sitting at work sat for 6.3 ± 1.8 h/day at work, on av-
erage, while those who reported mostly standing, walking or heavy
labor had mean sitting times of 1.5 ± 1.7 h/day, 1.6 ± 1.4 h/day and
1.2 ± 1.2 h/day at work, respectively. Mean work sitting time differed
significantly across occupational activity categories (p b 0.01). Man-
agers, professionals, and clerical and administrative workers reported
 J.Y. Chau et al. / Preventive Medicine 54 (2012) 195–200 197

Table 1A
Demographic characteristics by occupational activity category for all male workers, 2007–08 Australian National Health Survey (row %).

Usual occupational PA Total n Mostly sitting Mostly standing Mostly walking Mostly heavy labor physically demanding
(column %) n (%) n (%) n (%) n (%)
Characteristics

Men 5807 (100) 2428 (41.8) 1191 (20.5) 1035 (17.8) 1153 (19.9)
Occupationa
Managers 993 (17.1) 539 (54.3) 144 (14.5) 172 (17.3) 138 (13.9)
Professionals 1046 (18.0) 803 (76.7) 139 (13.3) 89 (8.5) 15 (1.5)
Technicians and trades workers 1362 (23.5) 208 (15.2) 412 (30.2) 257 (18.8) 486 (35.7)
Clerical and administrative workers 397 (6.8) 302 (76.1) 32 (7.9) 43 (10.9) 20 (5.0)
Sales workers 368 (6.3) 140 (38.2) 112 (30.6) 96 (26.1) 19 (5.2)
Machinery operators and drivers 658 (11.4) 300 (45.5) 83 (12.7) 112 (17.0) 163 (24.8)
Laborers 693 (12.0) 53 (7.6) 186 (26.9) 176 (25.3) 279 (40.3)
Work status
Part-time 4836 (83.3) 274 (29.8) 295 (32.2) 211 (22.9) 139 (15.1)
Full-time (≥35 h/week) 971 (16.7) 2154 (44.1) 896 (18.3) 824 (16.9) 1014 (20.7)
Age group
15–24 1005 (17.3) 203 (20.2) 313 (31.1) 240 (23.9) 250 (24.8)
25–34 1296 (22.3) 548 (42.3) 262 (20.2) 181 (13.9) 305 (23.5)
35–44 1344 (23.1) 624 (46.4) 248 (18.5) 222 (16.5) 250 (18.6)
45–54 1256 (21.6) 599 (47.7) 223 (17.7) 209 (16.6) 226 (18.0)
55–69 905 (15.6) 454 (50.1) 145 (16.0) 184 (20.3) 123 (13.6)
Level of highest non-school qualificationb
Bachelor or higher degree 1310 (22.9) 944 (72.1) 196 (14.9) 124 (9.5) 46 (3.5)
Diploma or certificate 2116 (37.0) 730 (34.5) 420 (19.8) 414 (19.5) 553 (26.1)
No non-school qualification 2287 (40.0) 713 (31.2) 560 (24.5) 482 (21.1) 533 (23.3)
Measured BMI category (kg/m2)c
Under or normal weight (≤24.9) 1372 (33.4) 489 (35.6) 328 (23.9) 254 (18.5) 301 (22.0)
Overweight (25–29.9) 1739 (42.3) 819 (47.1) 298 (17.1) 291 (16.7) 332 (19.1)
Obese (≥30) 998 (24.3) 433 (43.3) 180 (18.0) 191 (19.1) 195 (19.5)
a
Inadequately described occupation: n = 8.
b
Qualification not available: n = 94.
c
BMI = Body mass index, not measured: n = 1697.

higher average occupational sitting times (range 4.3–5.6 h/day) than Table 2 shows walking for transport, leisure-time sitting and physi-
technicians and trades workers and laborers (range 1.4–1.8 h/day). cal activity levels by occupational activity category. Workers with jobs
Mean sitting in leisure-time was similar for all workers (about that involved mostly walking or heavy labor were significantly more
3.4 h/day). likely to be sufficiently active through transport-related walking only,

Table 1B
Demographic characteristics by occupational activity category for all female workers, 2007–08 Australian National Health Survey (row %).

Usual occupational PA Total n Mostly sitting Mostly standing Mostly walking Mostly heavy labor physically demanding
(column %) n (%) n (%) n (%) n (%)
Characteristics

Women 4978 (100) 2335 (46.9) 1280 (25.7) 1086 (21.8) 277 (5.6)
Occupationa
Managers 521 (10.5) 272 (52.1) 107 (20.5) 117 (22.4) 26 (5.0)
Professionals 1153 (23.2) 625 (54.2) 280 (24.3) 227 (19.7) 20 (1.8)
Technicians and trades workers 254 (5.1) 75 (29.3) 102 (40.0) 46 (17.9) 32 (12.7)
Community and personal service workers 689 (13.9) 144 (20.8) 181 (26.3) 295 (42.8) 69 (10.1)
Clerical and administrative workers 1233 (24.8) 1065 (86.4) 100 (8.1) 64 (5.2) 3 (0.3)
Sales workers 670 (13.5) 104 (15.5) 359 (53.6) 186 (27.7) 22 (3.2)
Machinery operators and drivers 65 (1.3) 36 (55.3) 10 (15.8) 12 (19.0) 6 (9.9)
Laborers 385 (7.7) 14 (3.5) 138 (35.7) 137 (35.4) 98 (25.3)
Work status
Part-time 4238 (85.1) 869 (37.1) 759 (32.3) 583 (24.8) 135 (5.7)
Full-time (≥35 h/week) 740 (14.9) 1466 (55.7) 521 (19.8) 503 (19.1) 142 (5.4)
Age group
15–24 930 (18.7) 296 (31.8) 366 (39.3) 228 (24.5) 40 (4.3)
25–34 1078 (21.7) 597 (55.4) 238 (22.1) 190 (17.6) 53 (4.9)
35–44 1166 (23.4) 582 (49.9) 270 (23.2) 239 (20.5) 75 (6.4)
45–54 1170 (23.5) 545 (46.6) 262 (22.4) 289 (24.7) 73 (6.3)
55–69 634 (12.7) 315 (49.6) 143 (22.6) 140 (22.1) 37 (5.8)
Level of highest non-school qualificationb
Bachelor or higher degree 1297 (26.6) 742 (57.2) 301 (23.2) 221 (17.0) 34 (2.6)
Diploma or certificate 1626 (33.3) 757 (46.6) 383 (23.5) 380 (23.3) 107 (6.6)
No non-school qualification 1958 (40.1) 799 (40.8) 569 (29.1) 463 (23.6) 126 (6.5)
Measured BMI category (kg/m2)c
Under or normal weight (≤24.9) 1642 (48.4) 814 (49.6) 417 (25.4) 339 (20.6) 72 (4.4)
Overweight (25–29.9) 1030 (30.4) 510 (49.5) 232 (22.5) 217 (21.1) 71 (6.9 )
Obese (≥30) 721 (21.3) 359 (49.8) 151 (20.9) 155 (21.5) 57 (7.9)
a
Inadequately described occupation: n = 8.
b
Qualification not available: n = 97.
c
BMI = Body mass index, not measured: n = 1584.
198 J.Y. Chau et al. / Preventive Medicine 54 (2012) 195–200

Table 2
Likelihood of being sufficiently active by occupational activity category and risk of sitting for low or high durations in leisure time, 2007–08 Australian National Health Surveya.

Usual occupational activity Mostly sitting Mostly standing Mostly walking Mostly heavy labor/
physically demanding

Physical activity outside work Total n (%) Ref n (%) RR (95% CI) n (%) RR (95% CI) n (%) RR (95% CI)

Leisure-time physical activity

0–149 min/week 6679 (62.4) 2765 (58.2) 1565 (63.8) 1426 (67.7) 923 (65.8)
≥ 150 min/week 4032 (37.6) 1982 (41.8) 1.00 889 (36.2) 0.88 (0.81–0.97) 681 (32.3) 0.80 (0.74–0.86) 480 (34.2) 0.86 (0.77–0.96)
Walking for transport
0–149 min/week 9049 (84.2) 4068 (85.7) 2120 (86.1) 1685 (79.9) 1175 (82.4)
≥ 150 min/week 1696 (15.8) 679 (14.3) 1.00 343 (13.9) 0.98 (0.82–1.17) 424 (20.1) 1.41 (1.22–1.62) 250 (17.6) 1.23 (1.02–1.48)
Leisure-time physical activity and walking for transport combined
0–149 min/week 5219 (48.4) 2140 (44.9) 1278 (51.7) 1045 (49.3) 757 (52.9)
≥ 150 min/week 5565 (51.6) 2624 (55.1) 1.00 1193 (48.3) 0.90 (0.84–0.96) 1076 (50.7) 0.95 (0.90–1.00) 673 (47.1) 0.90 (0.83–0.97)
b
Leisure-time sitting
b 4 h/day 5688 (52.5) 2499 (52.6) 1226 (49.8) 1118 (52.8) 801 (56.1)
≥ 4 h/day 5144 (47.5) 2253 (47.4) 1.00 1236 (50.2) 1.00 (0.93–1.07) 1000 (47.2) 0.94 (0.87–1.02) 626 (43.9) 0.85 (0.75–0.95)
a
RR adjusted for gender (total), age (5 categories), educational level (3 categories).
b
Leisure-time sitting was dichotomized at the median.

than workers with mostly sitting jobs (RR = 1.41, 95% CI: 1.22–1.62;
RR= 1.23, 95% CI: 1.02–1.48, respectively). However, workers with
mostly sitting jobs tended to be more physically active during leisure-
time which resulted in a greater likelihood (about 10%) of being suffi-
ciently active (based on walking for transport and leisure-time physical
activity), when compared with workers in more active jobs.
Table 3 presents the adjusted risk of being overweight or obese by
occupational activity category and leisure-time sitting. Workers with
b4 h/day leisure-time sitting had significantly lower risk of being over-
weight/obese (RR = 0.93, 95% CI: 0.88–0.97) and obese (RR = 0.77,
95%CI: 0.69–0.87) compared to workers with ≥4 h/day of leisure-time
sitting. Workers with jobs involving mostly sitting had significantly
higher risk of being overweight/obese or obese only compared to
workers with jobs involving mostly standing (RR = 0.88, 95% CI: 0.82–
0.95 and RR= 0.87, 95% CI: 0.76–1.00, respectively).
We found no significant interactions between sex, age and educa-
tion with the sitting and physical activity variables. We also considered
2-way and 3-way interaction terms between occupational activity,
leisure-time sitting and physical activity and found no significant inter-
actions (data not shown).
Further analyses involving occupational sitting time with a sub-
sample of full-time workers found a similar pattern (data not shown).
Discussion
This study examined the sitting and physical activity behaviors of
a nationally representative sample of Australian workers and how
they relate to overweight and obesity. The results showed that sub-
stantial proportions of workers have occupations that involve mostly
sitting. Workers with mostly sitting jobs were more likely to be suffi-
ciently active during leisure-time than workers with more active jobs.
Leisure-time sitting showed a clear positive association with obesity
risk, while the association between occupational sitting/activity and
obesity risk was less distinct.
The results suggest that leisure-time sitting and occupational sit-
ting are independently associated with obesity risk and that leisure-
time sitting may have a stronger association with obesity risk than oc-
cupational sitting. Consistent with findings from other studies
(Dunton et al., 2009; Mozaffarian et al., 2011; Sugiyama et al.,
2008), we found that less sitting in leisure-time may have favorable

Table 3
Adjusted risk of being overweight or obese by leisure-time sitting and occupational activity category, 2007–08 Australian National Health Survey.

All variables in model Total Overweight or obesity BMI ≥ 25 Obesity BMI ≥ 30

N n (%) RR (95% CI) n (%) RR (95% CI)

Total 7400 4423 (59.8) – 1694 (22.9) –

Female (ref) 3340 1716 (51.4) 1.00 704 (21.1) 1.00
Male 4060 2708 (66.7) 1.29 (1.22–1.35) 991 (24.4) 1.13 (1.00–1.28)
Age 15–24 (ref) 1159 460 (39.7) 1.00 158 (13.6) 1.00
Age 25–34 1687 918 (54.4) 1.39 (1.24–1.56) 313 (18.6) 1.48 (1.12–1.95)
Age 35–44 1767 1105 (62.5) 1.59 (1.43–1.77) 408 (23.1) 1.79 (1.40–2.28)
Age 45–54 1696 1160 (68.4) 1.72 (1.53–1.93) 460 (27.2) 2.03 (1.62–2.54)
Age 55 + 1091 779 (71.4) 1.77 (1.57–1.99) 355 (32.5) 2.42 (1.94–3.01)
Education level
No non-school qual. (ref) 2730 1650 (60.4) 1.00 667 (24.4) 1.00
Diploma or cert 2744 1744 (63.6) 1.02 (0.97–1.07) 714 (26.0) 1.05 (0.93–1.18)
Bachelor or higher 1926 1030 (53.5) 0.85 (0.79–0.92) 314 (16.3) 0.67 (0.56–0.78)
Physical activity
Insufficiently active (ref) 3510 2177 (62.0) 1.00 910 (25.9) 1.00
Sufficiently activea 3890 2246 (57.7) 0.96 (0.91–1.02) 785 (20.2) 0.84 (0.75–0.95)
Leisure-time sitting
≥4 h/day (ref) 3548 2194 (61.8) 1.00 916 (25.8) 1.00
b4 h/day 3842 2227 (58.0) 0.93 (0.88–0.97) 777 (20.2) 0.77 (0.69–0.87)
Occupational activity
Mostly sitting (ref) 3364 2084 (62.0) 1.00 777 (23.1) 1.00
Mostly standing 1568 837 (53.4) 0.88 (0.82–0.95) 317 (20.2) 0.87 (0.76–1.00)
Mostly walking 1417 840 (59.3) 0.95 (0.89–1.02) 340 (24.0) 0.98 (0.83–1.15)
Mostly heavy labor 1006 635 (63.1) 0.95 (0.89–1.01) 244 (24.3) 0.96 (0.81–1.14)
Occupational activity trend – – 0.98 (0.96–1.00) – 0.99 (0.94–1.04)
a
Sufficiently active was defined as ≥150 min/week of leisure-time physical activity and walking for transport combined.
 J.Y. Chau et al. / Preventive Medicine 54 (2012) 195–200
associations for the development of overweight or obesity in adults,
independent of physical activity. We also found that having a mostly
sitting job was associated with higher obesity risk compared to hav-
ing a mostly standing job independent of physical activity; however,
there was no significant trend of obesity risk across occupational ac-
tivity categories. Overall, the results indicate that there is no clear as-
sociation between occupational activity and obesity risk. This is partly
consistent with a systematic review of occupational sitting and health
risks which found evidence of a positive association between occupa-
tional sitting and BMI in five out of ten cross-sectional studies (van
Uffelen et al., 2010).
Thus, while the association between occupational sitting/activity
and obesity needs further investigation, it seems that there is rela-
tively stronger evidence that leisure-time sitting is associated with
obesity risk. Developing strategies for reducing sitting in leisure-
time may have stronger justification than targeting occupational sit-
ting based on the current albeit cross-sectional evidence; nonethe-
less, efforts towards decreasing sitting in both leisure and
occupational settings are warranted (Chau et al., 2010; Hamilton et
al., 2007; King et al., 2010).
We found that workers with mostly sitting jobs were more likely
to be sufficiently active in leisure-time compared to workers with
mostly standing, walking or heavy labor jobs. These findings differ
from those of an Australian study of full-time workers living in re-
gional communities, which found no relationship between the
amount of sitting time at work and leisure-time physical activity
levels (Mummery et al., 2005), possibly because the NHS involved a
nationally representative sample of Australian adults.
Additionally, our results show that workers across occupational
activity categories on average sat for similar durations in their
leisure-time (3.3–3.5 h/day) and that workers with jobs involving
mostly sitting were more likely than workers with mostly heavy
labor jobs to have high leisure-time sitting. These data support previ-
ous findings from Dutch and Scottish studies that workers with
higher occupational sitting time did not sit less in their leisure-time
(Jans et al., 2007; Tigbe et al., 2011).
Based on these results, it is possible that workers are compensat-
ing for their occupational sitting or activity with more physical activ-
ity but not less sitting in their leisure-time, especially when
occupational activity is generally determined by job requirements. If
workers are compensating for their sitting over the workday with
more physical activity in their leisure-time, it would be important
to examine the factors which influence this compensation through
physical activity. It would also be important to explore why workers
may not offset their occupational sitting by sitting less in leisure-time.
Research has shown that blue-collar workers (e.g., tradespersons,
intermediate production, and transport workers, laborers) compared
with their white-collar and professional counterparts have higher oc-
cupational activity levels (Schofield et al., 2005; Steele and
Mummery, 2003) and are more likely to engage in active transport
and meet physical activity recommendations (Duncan et al., 2010).
We found that workers in higher occupational activity categories
(mostly walking or heavy labor) were likely to be walking more for
transport, but were likely to do less leisure-time physical activity,
compared with workers with mostly sitting jobs. This is similar to
findings from the US whereby laborers were more likely to be regu-
larly active when questions included lifestyle (non-work)
moderate-intensity physical activity (Kruger et al., 2006). These find-
ings highlight that physical activity in the occupational, transport and
leisure-time domains contribute to workers’ daily physical activity
participation differently. Workers with jobs in different activity cate-
gories may accrue their daily physical activity in different domains.
Only using leisure-time physical activity to define sufficient activity
may not be appropriate and it would be important to consider
transport-related walking and other active transport modes like
cycling.
199
Strengths and limitations
The main strength of this study is the large sample size that in-
cluded a nationally representative sample of the Australian work-
force. This provided sufficient statistical power to examine
associations between occupational activity categories and leisure-
time sitting and risk of overweight or obesity in workers.
Another strength of this study was that BMI was derived from ob-
jectively measured height and weight, as opposed to self-reported
which is known to be less accurate. At the same time, the use of
self-reported sitting and physical activity measures is a limitation as
they are susceptible to possible respondent biases. It would be desir-
able to collect objective data on sitting and physical activity, as has
been done in some population studies (Matthews et al., 2008;
Troiano et al., 2008). However, this is relatively complicated and ex-
pensive to orchestrate at a population level.
This study's cross-sectional design prevents conclusions of causal-
ity. We cannot be certain that higher amounts of occupational or
leisure-time sitting cause higher BMI. It may be that high amounts
of sitting in leisure-time lead to higher BMI or it may be that individ-
uals with higher BMI sit more during leisure-time. More work is re-
quired using prospective designs and longitudinal data to examine
the possible causal relationship between sitting and overweight and
obesity (Proper et al., 2011; van Uffelen et al., 2010). Similarly, we
cannot establish causally that workers compensate for occupational
sitting/activity in their leisure-time.
Conclusion
This study showed that substantial proportions of Australian
workers have occupations that involve mostly sitting. Our results sug-
gest that leisure-time sitting is associated with increased obesity risk,
while occupational sitting has a less clear relationship with obesity.
These findings contribute to the increasing evidence base about the
potential health benefits of reducing sitting time during work and in
leisure-time. Interventions for preventing overweight or obesity
may consider reducing leisure-time sitting and occupational sitting
as potential strategies, although we emphasize that these are cross-
sectional data and causality is still to be established in prospective
studies.
Conflict of interest statement
None.
Acknowledgments
This study was supported by funding from the Australian National
Health and Medical Research Council Program Grant #301200. JYC
was supported by a University of Sydney Postgraduate Award.
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