Leisure-time physical activity and perceived occupational stress: a cross-sectional study of workers in Japan

Leisure-time physical activity and perceived occupational stress: a cross-sectional study of workers in Japan | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Leisure-time physical activity and perceived occupational stress: a cross-sectional study of workers in Japan Sakura Koriyama, Susumu S. Sawada, Xiangyu Zhai, Serena A. Dimitroff, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-4505591/v1 This work is licensed under a CC BY 4.0 License Status: Published Journal Publication published 26 Apr, 2025 Read the published version in Sport Sciences for Health → Version 1 posted 8 You are reading this latest preprint version Abstract Purpose: We conducted a large cross-sectional study to investigate the relationship between leisure-time physical activity and perceived stress among workers in Japan. Methods: 7192 workers in Japan were surveyed about their lifestyle habits, frequency of leisure-time physical activity (never, only specific seasons, once or twice a month, once a week, more than twice a week), and perceived occupational stress. According to the frequency of leisure-time physical activity, participants were classified into five groups. Logistic regression models were used to explore the relationship between leisure-time physical activity and perceived stress after adjustment for several confounding factors. Multivariable-adjusted odds ratios and 95% confidence intervals for the prevalence of perceived occupational stress were calculated. Results: A total of 848 participants reported perceived occupational stress. Using the low leisure-time physical activity group (never) as reference, multivariable-adjusted odds ratios and 95% confidence intervals were 0.79 (0.59−1.07) for “only specific seasons,” 0.84 (0.66−1.08) for “once or twice a month,” 0.80 (0.63−1.03) for “once a week,” and 0.60 (0.46−0.79) for “more than twice a week” ( p for trend 0 < 0.001). Conclusion: In this large cross-sectional study, there was a negative association between leisure-time physical activity frequency and perceived occupational stress was observed among workers in Japan. Exercise Life style Anxiety Depression Epidemiology Introduction Occupational stress can be harmful to health, leading to high blood pressure, heart problems, weakened immune systems, deterioration, anxiety, unrest, and depression [ 1 , 2 ]. It causes debilitation in addition to reducing workers’ motivation and enthusiasm. As a result, worker productivity decreases, absenteeism and presenteeism occur [ 3 , 4 ]. According to the "2018 Basic Survey on Industrial Safety and Health" conducted by Japan's Ministry of Health, Labor and Welfare (MHLW), 58.0% of Japanese workers have matters that they feel are causing substantial high-stress levels related to their current work or professional life [ 5 ]. In the National Health Survey conducted by the MHLW, among who answered "yes" to the question of whether they have worries or stressors in their daily lives, "work" was the number one cause among men in their 20s to 50s [ 6 ]. For this reason, high perceived occupational stress is a major public health problem. Therefore, it is important to identify ways to reduce high perceived occupational stress. Physical activity is recommended because of its beneficial effects on physical as well as mental health [ 7 ]. Physical activity releases hormones such as serotonin and endorphins, which have a stabilizing effect on the mind. Continued physical activity on a daily basis provides a steady supply of serotonin and endorphins, which have positive effect on stress [ 8 ]. It has been shown that exercise-based physical activity is associated with lower occupational psychological and physical stress responses in cross-sectional studies [ 9 ]. A cross-sectional study also reported a negative relationship between leisure-time physical activity (LTPA) and occupational stress among women in Spain [ 10 ]. However, there are limited studies that have examined various types of occupational stress and the frequency of LTPA. To investigate the relationship between the frequency of LTPA and occupational stress and high-stress components would be significant evidence to improve the mental health of Japanese workers. In light of the above concerns, the objectives of this study were: 1) to investigate the relationship between the frequency of LTPA and high perceived occupational stress among workers; 2) to investigate the relationship between the frequency of LTPA and other six high-stress components (vigor, fatigue, depression, physical complaints, anger-irritability, anxiety) among large numbers of workers. Methods Participants This study was conducted as a part of the “Lifestyle Research Survey to Reduce Workers’ Stress Responses” in the Project for Industrial Accident Prevention Measures supported by the MHLW. Participants who were willing to join the Japan Industrial Safety and Health Association Health Advice Service were required to provide a self-reported questionnaire [ 11 ]. The number of participants was 7832 in 2017. Participants with missing information in any of the questionnaire items (n = 594) and who selected the option “unspecified” for frequency of LTPA (n = 133) were excluded from this study. Missing values were excluded for ages 5 and under and 100 and over. Regarding medical history, only those with medical history were ascertained without processing missing values. Ultimately, a total of 7105 participants (5702 men aged 18–78 years, 1403 women aged 18–78 years) from 41 workplaces in 27 industries in 24 of the 47 prefectures in Japan (Japan Standard Industrial Classification, middle category [ 12 ] ) were included in the analysis. All demographic information and survey items discussed were dealt with anonymously. Perceived Occupational Stress and high-stress components This study examined perceived occupational stress among workers using the Brief Job Stress Questionnaire (BJSQ) [ 13 , 14 ]. The BJSQ is a self-reported questionnaire, consists of 57 questions to assess “job stressor” (17 items), “psychological and physical stress response” (29 items), “buffering factor” (9 items), and “satisfaction” (2 items). All items are rated on a 4-point Likert scale, with higher scores indicating higher stress response levels. Whether or not a person is high-stress was determined using the example of evaluation criteria (Part 1) described in the “Stress check implementation manual based on the Japanese Industrial Safety and Health Act” [ 15 ]. The total score (4 points for high stress response and 1 point for low stress response) for “psychological and physical stress response” was calculated, and those with a total score of 77 points or higher were classified as high-stress worker. Alternatively, the total score of “job stressor” and “buffering factor”was calculated, and those with a total score of 76 points or higher and a total score of 63 points or higher for "psychological and physical stress response" were classified as high-stress worker. The BJSQ was developed in Japan to assess occupational stress response and is widely used for industrial health assessment and research fields [ 16 ]. Previous studies have reported the reliability and validity of the BJSQ in Japanese workers [ 17 , 18 ]. Previous study has shown that most subscales in the BJSQ showed acceptable levels of test-retest reliability and internal consistency [ 18 ]. Vigor by a total of No. 1–3, anger-irritability by a total of No. 4–6, fatigue by a total of No. 7–9, anxiety by a total of No. 10–12, depression by a total of No. 13–18, and physical complaints by a total of No. 19–29, was classified into 5 levels according to the Stress Check Manual [ 15 ]. Each of the five levels, 3–5, was judged as having a stress reaction. Leisure-time physical activity Participants responded to a self-report questionnaire in the Japan Industrial Safety and Health Association Health Advice Service on the frequency of LTPA. Participants answered the question, “How much physical activity or sports do you do other than walking?" Participants were asked to choose from “never”, “only specific seasons”, “once or twice a month”, “once a week”, “more than twice a week”, or “unspecified”. In order to improve the response quality and rate, a single-item physical activity question was used to reduce respondent burden instead of a lengthy questionnaire. The validity and reliability of the single-item physical activity question have been shown in previous studies [ 19 ]. Moreover, the absolute physical activity question (k = 0.75) has been reported to be more reliable than the relative physical activity question (k = 0.56) [ 20 ]. Confounding factors A self-report questionnaire was used to determine sex, age, smoking habits (non-smoker, previous smoker, smoker, and other), drinking habits (never, less than 3 times/week, 3–5 times/week, minimum 6 or more times/week, and other), physical work (very much so, moderately so, somewhat, not at all), and sleep duration (≥ 6 hours/day, < 6 hours/day, and other). Medical histories such as heart disease, hypertension, and diabetes were also investigated. A participant was considered to have a current medical history if they had any of these diseases. The “other” in the response limb is selected by those whose situation is not an option. Statistical analysis To determine participant’s characteristics, they were divided into two groups according to the presence or absence of high-stress. Data were expressed as means and standard deviation (SD) for continuous variables and percentages (number of persons) for categorical variables. Logistic regression models were used to examine the association between the frequency of LTPA and the presence or absence of high perceived occupational stress, with the group without high occupational stress as the reference for the objective variable. The “never” group for LTPA was used as the reference group to obtain the odds ratios (OR) and 95% confidence intervals (95% Cl) for high-stress in the other groups. Model 1 adjusted for age and sex. Model 2 further adjusted for smoking habits, drinking habits, sleep duration, physical work, and medical history. Since the participants were nested in their industries, a multilevel model analysis (with individuals at level 1 and industries at level 2) was conducted using a random intercept model designated Model 3. Trend tests were also conducted to determine if there was a dose-response relationship between the LTPA frequency and high-stress. In addition, we calculated ORs and 95% CIs for the possession of each of the perceived occupational stress response components—vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. All data analysis was performed using IBM SPSS Statistics 27 (IBM, Japan). The significance level was determined as a p value of less than 0.05, and the results were deemed statistically significant if the p value was less than 0.05 on a two-tailed test. Trend tests were calculated by putting each category of LTPA as a continuous variable into the explanatory variables of the logistic regression model. Results As shown in Table 1 , 5702 men (age: 44.3, SD: 13.2) and 1403 women (age: 41.6, SD: 11.5) were included in this study. 687 men (12.0%) and 161 women (11.5%) were identified as high perceived occupational stress. [INSERT Table 1 HERE] Table 2 shows the relationship between LTPA frequency and high occupational stress response. In terms of LTPA, the “never” group was used as the reference group. Compared to Crude Model with the unadjusted OR, Models 1 and 2 with adjustment items did not show notable changes. In Model 3, which used a multilevel analysis, the intraclass correlation coefficient for industry was as low as 0.174, which did not result in a notable change compared to the OR for Model 2. The results of the trend tests were significant (all p for trend < 0.001) in all models, with more frequent physical activity indicating lower ORs of high-stress. [INSERT Table 2 HERE] Table 3 shows the relationship between LTPA frequency and the high-stress components: vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. In terms of LTPA, the “never” group was used as the reference group. For all items, the other groups all had significantly lower ORs than the reference group. Compared to Crude Model with unadjusted ORs, there were no significant changes in Model 1 or 2 with the adjusted several confounding factors. Similarly, no notable changes were observed for Model 3 using multilevel analysis. The ORs for the “more than twice a week” group in Model 3 for vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety were 0.51, 0.55, 0.59, 0.51, 0.84, and 0.69 respectively, indicating similar OR levels for all high perceived occupational stress components. As in Table 3 , the results of all trend tests were significant ( p for trend < 0.001). [INSERT Table 3 HERE] The more frequent the LTPA, the lower the OR for all high-stress components. Table 1 Characteristics of participants by perceived occupational stress response levels Total High-stress Not high-stress Number of participants, n (%) 7105 (100.0) 848 (11.9) 6257 (88.1) Men, n (%) 5702 (100.0) 687 (12.0) 5015 (88.0) Women, n (%) 1403 (100.0) 161 (11.5) 1242 (88.5) Age, mean ± SD 43.7 ± 12.9 41.8 ± 11.3 44.0 ± 13.1 Smoking, n (%) Non-smoker Previous smoker Smoker Other 3491 (49.1) 1325 (18.6) 2273 (32.0) 16 (0.2) 413 (48.7) 123 (14.5) 310 (36.6) 2 (0.2) 3078 (49.2) 1202 (19.2) 1963 (31.4) 14 (0.2) Drinking, n (%) Never Less than 3 times/week 3–5 times/week 6 times or more/week Other 3134 (44.1) 995 (14.0) 1185 (16.7) 1685 (23.7) 106 (1.5) 426 (50.2) 106 (12.5) 114 (13.4) 189 (22.3) 13 (1.5) 2708 (43.3) 889 (14.2) 1071 (17.1) 1496 (23.7) 93 (1.5) Sleeping, n (%) ≥ 6 hours/day < 6 hours/day Other 4331 (61.0) 2650 (37.3) 124 (1.7) 337 (39.7) 491 (57.9) 20 (2.4) 3994 (63.8) 2159 (34.5) 104 (1.7) Physical work, n (%) Very much so Moderately so Somewhat Not at all 885 (12.5) 2027 (28.5) 2400 (33.8) 1793 (25.2) 217 (25.6) 262 (30.9) 226 (26.7) 143 (16.9) 668 (10.7) 1765 (28.2) 2174 (34.7) 1650 (26.4) Medical history, n (%) 1439 (20.3) 168 (19.8) 1271 (20.3) Leisure-time physical activity, n (%) Never Only specific season 1 − 2 times/month Once a week More than twice a week 3985 (56.1) 507 (7.1) 856 (12.0) 887 (12.5) 870 (12.3) 536 (63.2) 57 (6.7) 93 (11.0) 89 (10.5) 73 (8.6) 3449 (55.1) 450 (7.2) 763 (12.2) 798 (12.8) 797 (12.7) Stress response components Vigor, n (%) Fatigue, n (%) Depression, n (%) Physical complaints, n (%) Anger-irritability, n (%) Anxiety, n (%) 2016 (28.4) 2094 (29.5) 1694 (23.8) 1948 (27.4) 1881 (26.5) 1669 (23.5) 622 (73.3) 721 (85.0) 740 (87.3) 698 (82.3) 632 (74.5) 671 (79.1) 1394 (22.3) 1373 (21.9) 954 (15.2) 1250 (20.0) 1249 (20.0) 998 (16.0) Table 2 Association between frequency of leisure-time physical activity and high-stress among workers inJapan n Cases Cases / 1000 Crude Model OR (95% CI) Model 1 a OR (95% CI) Model 2 b OR (95% CI) Model 3 c OR (95% CI) Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 536 57 93 89 73 135 112 109 100 84 1.00 (Reference) 0.82 (0.61 − 1.09) 0.78 (0.62 − 0.99) 0.72 (0.57 − 0.91) 0.59 (0.46 − 0.76) p for trend < 0.001 1.00 (Reference) 0.77 (0.58 − 1.04) 0.74 (0.59 − 0.94) 0.70 (0.55 − 0.89) 0.58 (0.45 − 0.75) p for trend < 0.001 1.00 (Reference) 0.80 (0.60 − 1.09) 0.83 (0.65 − 1.06) 0.79 (0.62 − 1.01) 0.62 (0.48 − 0.81) p for trend < 0.001 1.00 (Reference) 0.79 (0.59 − 1.07) 0.84 (0.66 − 1.08) 0.80 (0.63 − 1.03) 0.60 (0.46 − 0.79) p for trend < 0.001 a Model 1: Crude Model + age (continuous, year) and sex (men, women). b Model 2: Model 1 + smoking habits (non-smoker, previous smoker, smoker, other), drinking habits (never, less than 3 times/week, 3–5 times/week, 6 or more times/week, other), sleeping (≥ 6 hours/day, < 6 hours/day, other), physical work (very much so, moderately so, somewhat, not at all), medical history (yes, no). c Model 3: Model 2 + multilevel regression analyses. Table 3 Association between some frequency of leisure-time physical activity and high-stress components among workers in Japan n Cases Cases / 1000 Crude Model OR (95% CI) Model 1 a OR (95% CI) Model 2 b OR (95% CI) Model 3 c OR (95% CI) Vigor Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 1318 106 202 219 171 331 209 236 247 197 1.00 (Reference) 0.54 (0.43 − 0.67) 0.63 (0.53 − 0.74) 0.66 (0.56 − 0.78) 0.50 (0.41 − 0.59) p for trend < 0.001 1.00 (Reference) 0.54 (0.43 − 0.67) 0.63 (0.53 − 0.74) 0.67 (0.56 − 0.79) 0.50 (0.41 − 0.59) p for trend < 0.001 1.00 (Reference) 0.55 (0.44 − 0.69) 0.65 (0.55 − 0.77) 0.70 (0.59 − 0.83) 0.51 (0.43 − 0.62) p for trend < 0.001 1.00 (Reference) 0.55 (0.43 − 0.68) 0.65 (0.55 − 0.77) 0.71 (0.60 − 0.84) 0.51 (0.42 − 0.61) p for trend < 0.001 Fatigue Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 1290 148 240 230 186 324 291 280 259 214 1.00 (Reference) 0.86 (0.70 − 1.06) 0.81 (0.69 − 0.96) 0.73 (0.62 − 0.86) 0.57 (0.48 − 0.68) p for trend < 0.001 1.00 (Reference) 0.77 (0.62 − 0.94) 0.73 (0.62 − 0.86) 0.69 (0.58 − 0.81) 0.54 (0.45 − 0.64) p for trend < 0.001 1.00 (Reference) 0.78 (0.63 − 0.97) 0.79 (0.67 − 0.94) 0.75 (0.63 − 0.90) 0.55 (0.46 − 0.67) p for trend < 0.001 1.00 (Reference) 0.78 (0.63 − 0.97) 0.79 (0.67 − 0.94) 0.76 (0.64 − 0.90) 0.55 (0.46 − 0.67) p for trend < 0.001 Depression Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 1040 111 213 181 149 261 219 249 204 171 1.00 (Reference) 0.79 (0.64 − 0.99) 0.94 (0.79 − 1.11) 0.73 (0.61 − 0.87) 0.59 (0.48 − 0.71) p for trend < 0.001 1.00 (Reference) 0.72 (0.58 − 0.90) 0.86 (0.72 − 1.02) 0.69 (0.58 − 0.83) 0.56 (0.46 − 0.68) p for trend < 0.001 1.00 (Reference) 0.74 (0.59 − 0.93) 0.91 (0.76 − 1.08) 0.75 (0.62 − 0.90) 0.59 (0.49 − 0.72) p for trend < 0.001 1.00 (Reference) 0.74 (0.58 − 0.92) 0.91 (0.76 − 1.08) 0.75 (0.63 − 0.90) 0.59 (0.48 − 0.72) p for trend < 0.001 Physical complaints Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 1217 150 221 207 153 305 296 258 233 176 1.00 (Reference) 0.96 (0.78 − 1.17) 0.79 (0.67 − 0.94) 0.69 (0.58 − 0.82) 0.49 (0.40 − 0.59) p for trend < 0.001 1.00 (Reference) 0.94 (0.76 − 1.15) 0.78 (0.66 − 0.92) 0.69 (0.58 − 0.81) 0.48 (0.40 − 0.58) p for trend < 0.001 1.00 (Reference) 0.97 (0.79 − 1.20) 0.85 (0.71 − 1.01) 0.76 (0.64 − 0.91) 0.51 (0.42 − 0.62) p for trend < 0.001 1.00 (Reference) 0.97 (0.79 − 1.20) 0.85 (0.71 − 1.01) 0.76 (0.64 − 0.91) 0.51 (0.42 − 0.62) p for trend < 0.001 Anger-irritability Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 1092 138 220 228 203 274 272 257 290 233 1.00 (Reference) 0.99 (0.81 − 1.22) 0.92 (0.77 − 1.08) 0.92 (0.78 − 1.08) 0.81 (0.68 − 0.96) p for trend = 0.013 1.00 (Reference) 0.90 (0.73 − 1.11) 0.84 (0.71 − 0.99) 0.88 (0.74 − 1.04) 0.78 (0.65 − 0.92) p for trend = 0.001 1.00 (Reference) 0.92 (0.74 − 1.13) 0.88 (0.74 − 1.05) 0.95 (0.80 − 1.13) 0.83 (0.70 − 0.99) p for trend = 0.043 1.00 (Reference) 0.92 (0.74 − 1.13) 0.89 (0.75 − 1.06) 0.96 (0.81 − 1.14) 0.84 (0.70 − 1.00) p for trend = 0.062 Anxiety Never Only specific seasons 1–2 times per month Once a week More than twice a week 3985 507 856 887 870 991 115 207 190 166 248 226 242 214 191 1.00 (Reference) 0.89 (0.71 − 1.10) 0.96 (0.81 − 1.15) 0.82 (0.69 − 0.98) 0.71 (0.59 − 0.86) p for trend < 0.001 1.00 (Reference) 0.81 (0.65 − 1.01) 0.88 (0.74 − 1.05) 0.79 (0.66 − 0.94) 0.68 (0.57 − 0.82) p for trend < 0.001 1.00 (Reference) 0.82 (0.65 − 1.03) 0.93 (0.78 − 1.11) 0.84 (0.70 − 0.85) 0.70 (0.58 − 0.85) p for trend < 0.001 1.00 (Reference) 0.82 (0.65 − 1.03) 0.93 (0.77 − 1.11) 0.85 (0.71 − 1.02) 0.69 (0.57 − 0.84) p for trend < 0.001 a Model 1: Crude Model + age (continuous, year) and sex (men, women). b Model 2: Model 1 + smoking habits (non-smoker, previous smoker, smoker, other), drinking habits (never, less than 3 times/week, 3–5 times/week, 6 or more times/week, other), sleeping (≥ 6 hours/day, < 6 hours/day, other), physical work (very much so, moderately so, somewhat, not at all), medical history (yes, no). c Model 3: Model 2 + multilevel regression analyses. Discussion This cross-sectional study investigated the relationship between LTPA frequency and perceived occupational stress among 7105 workers. The study results revealed a negative association between LTPA frequency and perceived occupational stress. The findings of this study are consistent with several studies [ 9 , 10 , 21 , 22 ]. In this study, we also investigated the association between LTPA frequency and components of perceived occupational stress, such as vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. We found a negative association between all components and LTPA frequency. A meta-analysis of studies of children and adolescents reported that greater participation in physical activity was associated with lower vigor, anxiety, depression, and fatigue [ 23 ]. However, no such studies have been reported in workers, and the present study is the first to show that physical activity is associated with multiple components of occupational stress in workers. Regarding the components of perceived occupational stress, this study suggests a negative association between LTPA and the lack of vigor. Several studies found that similar to the results of this study, PA improved the levels of vigor, and spending time doing PA had a positive effect on more energy in workers [ 24 ] [ 25 ]. However, Daniel et al. [ 26 ] found that doing high levels of weekly PA increases the negative effect of stress on the levels of vigor, the result of the present study differs. A previous study analyzing mediation effects shows that weekly PA negatively affects vigor. Consistent with previous studies, this study showed a negative association between LTPA and depressive symptoms among Japanese workers [ 21 , 22 ]. Additionally, there was a negative association between LTPA and physical complaints. However, in a previous study, the prevalence of musculoskeletal disorders was higher in the group with high moderate-to-vigorous intensity physical activity (MVPA) and high sedentary behavior, while there was no increased prevalence in the group with high MVPA and low sedentary behavior [ 27 ]. Considering the results of the previous study, the negative association between LTPA and physical complaints in the present study might be because of the low sedentary behavior of this study's participants. Sedentary behavior is also a risk factor for musculoskeletal disorders, and physical complaints and musculoskeletal disorders need to be examined in terms of sedentary behavior during work and MVPA. In terms of mechanisms, Esch and Stefano found that physical activity can affect the reward and motivation circuits of the nervous system, resulting in self-regulatory and endogenous stress relief [ 28 ]. Also, physical activity affects proliferation indirectly through effects on the vascular system, inflammation and the stress system, has considerable relevance for brain disorders like depression [ 8 ]. Strengths and limitations A strength of this study is that it uses the results of an extensive survey of over 7000 individuals to determine the relationship between LPTA frequency and perceived occupational stress. There are some limitations to our study. First, it is cross-sectional, which is not a research design that can identify causal relationships. Secondly, this study used a self-reported questionnaire survey and did not objectively examine stress response levels or LTPA frequency. However, this study assessed stress response levels using the BJSQ, which has been validated [ 17 , 18 ]. Thirdly, this study did not adjust for the type of work. However, we adjusted for the industrial classification and, to some extent, deducted confounding of type of work. In addition, it should be noted that the LTPA frequency was based on a simple questionnaire survey and is not a question that has been examined for reliability and validity. Therefore, it is possible that some bias such as recall bias may have influenced the results. Although this study adjusts for potential confounders through multivariable analysis, some factors have not been investigated, such as income and the presence of children. These factors may be residual confounders. The number of missing values (n = 727) represents approximately 9% of the study participants (n = 7832) and is not expected to affect the results significantly. In addition, the sample representativeness of this study is challenged by the fact that the target population is not a random sample of workers in Japan. However, since the survey was conducted on workers in various industries located in various parts of Japan, the results of this study are generalizable to other workers in Japan to some extent since the surveys were conducted in various industries across Japan. These issues should be addressed in the future, and prospective studies should properly investigate the effect of LTPA in reducing perceived occupational stress. Conclusions This study showed a negative association between the frequency of LTPA and perceived occupational stress response and other six high-stress components among workers in Japan. Although the cross-sectional study makes it difficult to make a definitive assessment of causality, workers may lower their perceived occupational stress responses by engaging in more frequent LTPA. Abbreviations LTPA: leisure-time physical activity; MHLW: Ministry of Health, Labor and Welfare; BJSQ: Brief Job Stress Questionnaire; SD: standard deviation; OR: odds ratio; CI: confidence interval; MVPA: moderate-to-vigorous intensity physical activity Declarations Conflict of Interest Keizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Ethical approval This study has been conducted in accordance with the Declaration of Helsinki and the Ethical Guidelines for Epidemiological Research by the Japanese Government. This study was conducted with the approval of the Research Ethics Committee of the Japan Industrial Safety and Health Association and Waseda University (approval numbers: 201902 and 2020 − 222), the committee explicitly approved the written consent implied upon return of a completed questionnaire. Informed consent The questionnaire included a cover page explaining the purposes and procedures of the study. On this cover page, respondents were told that participation in the survey was voluntary and returning the questionnaires represented informed consent. Competing Interests Keizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Funding This study received research funding from the Japan Industrial Safety and Health Association and JST SPRING (JPMJSP2128). Author Contribution Susumu S. Sawada conceptualized the study design. Sakura Koriyama, Susumu S. Sawada, Xiangyu Zhai, and Serena A. Dimitroff contributed to the drafting of the study. Sakura Koriyam and Susumu S. Sawada substantially contributed to the analysis of the data. Susumu S. Sawada was responsible for the overall concept and design of this manuscript. Also, Sakura Koriyam, Susumu S. Sawada, Masaki Nishida, Kumpei Tanisawa, and Ryoko Kawakami contributed to the interpretation of the data. All authors approved the final version of the manuscript. Acknowledgement The authors are grateful to all participating in this study and the Japan Industrial Safety and Health Association. Special thanks to Benjamin How for contributions to English language editing. Data Availability The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request. References Sarafis P, Rousaki E, Tsounis A, et al. (2016) The impact of occupational stress on nurses’ caring behaviors and their health related quality of life. BMC Nursing. 15(1)doi: 10.1186/s12912-016-0178-y . Gu B, Tan Q, Zhao S. (2019) The association between occupational stress and psychosomatic wellbeing among Chinese nurses. Medicine (Baltimore). 98(22):e15836. doi: 10.1097/MD.0000000000015836 . Hoboubi N CA, Kamari Ghanavati F, Keshavarzi S, Akbar Hosseini A. (2017) The Impact of Job Stress and Job Satisfaction on Workforce Productivity in an Iranian Petrochemical Industry. Saf Health Work. 8(1):67–71. doi: 10.1016/j.shaw.2016.07.002 . Nawata K. (2024) Evaluation of physical and mental health conditions related to employees’ absenteeism. Front Public Health. 11:1326334. doi: 10.3389/fpubh.2023.1326334 . Ministry of Health, Labour and Welfare. (2018) Basic Survey on Industrial Safety and Health in 2018. https://www.mhlw.go.jp/toukei/list/dl/h30-46-50_kekka-gaiyo02.pdf . Accessed 22 April 2024. Ministry of Health, Labour and Welfare. (2010) National Health Survey in 2010. National Health Survey in 2010. https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/dl/gaikyou.pdf . Accessed 22 April 2024. World Health Organization. (2018) Global action plan on physical activity 2018–2030: more active people for a healthier world. Accessed 22 April 2024. Bolijn S, Lucassen PJ. (2015) How the Body Talks to the Brain; Peripheral Mediators of Physical Activity-Induced Proliferation in the Adult Hippocampus. Brain Plast. 1(1):5–27. doi: 10.3233/bpl-150020 . Abe T, Okuyama K, Motohiro et al. (2024) Association between different types of physical activity and occupational stress in Japanese workers: a cross-sectional study. Ind Health. doi: 10.2486/indhealth.2023-0092 . De-Pedro-Jiménez D, Meneses-Monroy A, De Diego-Cordero R et al. (2021) Occupational and Leisure-Time Physical Activity Related to Job Stress and Job Satisfaction: Correspondence Analysis on a Population-Based Study. Int J Environ Res Public Health. 18(21):11220. doi: 10.3390/ijerph182111220 . Japan Industrial Safety and Health Association. (2019) Health advice service check sheet comprehensive version. Ministry of Internal Affairs and Communications. Japan Standard Industrial Classification. (2013) https://www.soumu.go.jp/toukei_toukatsu/index/seido/sangyo/02toukatsu01_03000044.html . Accessed 22 April 2024. Japan Industrial Safety and Health Association. (2014) The Brief Job Stress Questionnaire English version https://www.mhlw.go.jp/bunya/roudoukijun/anzeneisei12/dl/stress-check_e.pdf . Accessed 22 April 2024. Shimomitsu T, Haratani T, Nakamura K et al. (2000) Final development of the Brief Job Stress Questionnaire mainly used for assessment of the individuals. The Ministry of Labor sponsored grant for the prevention of work-related illness: The 1999 report. (in Japanese). 126–164.. Ministry of Health, Labour and Welfare. (2021) Stress check implementation manual based on the Japanese Industrial Safety and Health Act. https://www.mhlw.go.jp/content/000533925.pdf Accessed 22 April 2024. Shimura A, Sugiura K, Inoue M, et al. (2020) Which sleep hygiene factors are important? comprehensive assessment of lifestyle habits and job environment on sleep among office workers. Sleep Health. 6(3):288–298. doi: 10.1016/j.sleh.2020.02.001 . Tsutsumi A, Inoue A, Eguchi H. (2017) How accurately does the Brief Job Stress Questionnaire identify workers with or without potential psychological distress? J Occup Health. 59(4):356–360. doi: 10.1539/joh.17-0011-br . Inoue A, Kawakami N, Shimomitsu T, et al. (2014) Development of a Short Version of the New Brief Job Stress Questionnaire. Ind Health. 52(6):535–540. doi: 10.2486/indhealth.2014-0114 . Milton K, Clemes S, Bull F. (2013) Can a single question provide an accurate measure of physical activity? Br J Sports Med. 47(1):44–48. doi: 10.1136/bjsports-2011-090899 . Gill DP, Jones GR, Zou G, Speechley M. (2012) Using a single question to assess physical activity in older adults: a reliability and validity study. BMC Med Res Methodol. 12(1):20. doi: 10.1186/1471-2288-12-20 . Kuwahara K, Honda T, Nakagawa T et al. (2018) Intensity of Leisure-Time Exercise and Risk of Depressive Symptoms Among Japanese Workers: A Cohort Study. J Epidemiol. 28(2):94–98. doi: 10.2188/jea.je20170009 . Fukai K, Kuwahara K, Chen S, et al. (2020) The association of leisure-time physical activity and walking during commuting to work with depressive symptoms among Japanese workers: A cross‐sectional study. J Occup Health. 62(1)doi: 10.1002/1348-9585.12120 . Li B, Ng K, Tong X et al. (2023) Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health. 17(1)doi: 10.1186/s13034-023-00629-4 . Ginoux C, Isoard-Gautheur S, Sarrazin P. “Workplace Physical Activity Program” (WOPAP) study protocol: a four-arm randomized controlled trial on preventing burnout and promoting vigor. BMC Public Health. 2019. 19(1). doi: 10.1186/s12889-019-6598-3 . Hansen AM, Blangsted AK, Hansen EA et al. Physical activity, job demand-control, perceived stress-energy, and salivary cortisol in white-collar workers. Int Arch Occup Environ Health. 2010. 83(2): p. 143–53. doi: 10.1007/s00420-009-0440-7 . Cortés-Denia D, Isoard-Gautheur S, Lopez-Zafra E, Pulido-Martos M. Effects of vigor at work and weekly physical activity on job stress and mental health. Sci Rep. 2022. 12(1): p. 16025. doi: 10.1038/s41598-022-19966-z . Putsa B, Jalayondeja W, Mekhora K, Bhuanantanondh P, Jalayondeja C. (2022) Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020. BMC Public Health. 22(1)doi: 10.1186/s12889-022-13940-0 . Esch T, Stefano GB. (2010) Endogenous reward mechanisms and their importance in stress reduction, exercise and the brain. Arch Med Sci. 3:447–455. doi: 10.5114/aoms.2010.14269 . Additional Declarations Competing interest reported. Keizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article. Cite Share Download PDF Status: Published Journal Publication published 26 Apr, 2025 Read the published version in Sport Sciences for Health → Version 1 posted Editorial decision: Revision requested 11 Mar, 2025 Reviews received at journal 09 Mar, 2025 Reviewers agreed at journal 06 Mar, 2025 Reviewers agreed at journal 26 Feb, 2025 Reviewers invited by journal 24 Jan, 2025 Submission checks completed at journal 31 May, 2024 Editor assigned by journal 31 May, 2024 First submitted to journal 30 May, 2024 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-4505591","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":312112129,"identity":"5c1d0568-5b3b-4081-bf64-33e50979b8ea","order_by":0,"name":"Sakura Koriyama","email":"","orcid":"","institution":"Waseda University","correspondingAuthor":false,"prefix":"","firstName":"Sakura","middleName":"","lastName":"Koriyama","suffix":""},{"id":312112135,"identity":"40f94224-a929-43e3-a2a0-fb6a18e7e927","order_by":1,"name":"Susumu S. Sawada","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA0ElEQVRIiWNgGAWjYPACZgZ+MM3GwMDYQKwWyQaStRgcgGohCOQb2B9+5qmxlje+kfz4w4cyOwbm2QSsMTjAYyzNcyzdcNuNNDPJGeeSGRjnHCCgRf4Ng3QO22HGbbcTzJh525gZGGckEHTY4985/w7bb56d/vnz37Z6wloYDjCYSee2HU7cIJ1jIM3YdpiwFqBfzKz/9qUnz7j/pkyy59xxHoJ+ATns5oxv1rb9Pcc3f/hRVi1nSCjEMACP4QwSdQDtlSBZyygYBaNgFAxzAAARCUN0RVWvDAAAAABJRU5ErkJggg==","orcid":"","institution":"Waseda University","correspondingAuthor":true,"prefix":"","firstName":"Susumu","middleName":"S.","lastName":"Sawada","suffix":""},{"id":312112137,"identity":"acc5450e-86b0-4ea3-b130-14f1ccc4cbf5","order_by":2,"name":"Xiangyu Zhai","email":"","orcid":"","institution":"Waseda University","correspondingAuthor":false,"prefix":"","firstName":"Xiangyu","middleName":"","lastName":"Zhai","suffix":""},{"id":312112138,"identity":"ea5ee23c-b4e9-4b4e-b284-701176d056f2","order_by":3,"name":"Serena A. Dimitroff","email":"","orcid":"","institution":"Waseda University","correspondingAuthor":false,"prefix":"","firstName":"Serena","middleName":"A.","lastName":"Dimitroff","suffix":""},{"id":312112139,"identity":"22a10c26-3c80-41d2-b254-5d11de2477b7","order_by":4,"name":"Masaki Nishida","email":"","orcid":"","institution":"Waseda University","correspondingAuthor":false,"prefix":"","firstName":"Masaki","middleName":"","lastName":"Nishida","suffix":""},{"id":312112140,"identity":"4fa06313-3523-4653-b798-bb0e9b0f6819","order_by":5,"name":"Kumpei Tanisawa","email":"","orcid":"","institution":"Waseda University","correspondingAuthor":false,"prefix":"","firstName":"Kumpei","middleName":"","lastName":"Tanisawa","suffix":""},{"id":312112142,"identity":"3b7ef19a-3b29-42c7-a4b1-2c4f3dcafb05","order_by":6,"name":"Ryoko Kawakami","email":"","orcid":"","institution":"Meiji Yasuda Life Foundation of Health and Welfare","correspondingAuthor":false,"prefix":"","firstName":"Ryoko","middleName":"","lastName":"Kawakami","suffix":""},{"id":312112143,"identity":"c6f8750e-977e-48a8-8882-9381b71915f6","order_by":7,"name":"Keizo Hamaya","email":"","orcid":"","institution":"Japan Industrial Safety and Health Association","correspondingAuthor":false,"prefix":"","firstName":"Keizo","middleName":"","lastName":"Hamaya","suffix":""},{"id":312112145,"identity":"fa67fde7-0202-4ce4-b372-2bfcc1cafcf0","order_by":8,"name":"Teruichi Shimomitsu","email":"","orcid":"","institution":"Japan Health Promotion and Fitness Foundation","correspondingAuthor":false,"prefix":"","firstName":"Teruichi","middleName":"","lastName":"Shimomitsu","suffix":""}],"badges":[],"createdAt":"2024-05-31 01:59:12","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-4505591/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-4505591/v1","draftVersion":[],"editorialEvents":[{"content":"https://doi.org/10.1007/s11332-025-01394-x","type":"published","date":"2025-04-26T15:57:21+00:00"}],"editorialNote":"","failedWorkflow":false,"files":[{"id":81570200,"identity":"5d7302f4-fd1a-4363-a219-08d294ec46a7","added_by":"auto","created_at":"2025-04-28 16:12:53","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":941598,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-4505591/v1/fdf2d735-3c3b-43a5-9c80-524f4541900c.pdf"}],"financialInterests":"Competing interest reported. Keizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.","formattedTitle":"Leisure-time physical activity and perceived occupational stress: a cross-sectional study of workers in Japan","fulltext":[{"header":"Introduction","content":"\u003cp\u003eOccupational stress can be harmful to health, leading to high blood pressure, heart problems, weakened immune systems, deterioration, anxiety, unrest, and depression [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e]. It causes debilitation in addition to reducing workers\u0026rsquo; motivation and enthusiasm. As a result, worker productivity decreases, absenteeism and presenteeism occur [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e]. According to the \"2018 Basic Survey on Industrial Safety and Health\" conducted by Japan's Ministry of Health, Labor and Welfare (MHLW), 58.0% of Japanese workers have matters that they feel are causing substantial high-stress levels related to their current work or professional life [\u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e5\u003c/span\u003e]. In the National Health Survey conducted by the MHLW, among who answered \"yes\" to the question of whether they have worries or stressors in their daily lives, \"work\" was the number one cause among men in their 20s to 50s [\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e]. For this reason, high perceived occupational stress is a major public health problem. Therefore, it is important to identify ways to reduce high perceived occupational stress.\u003c/p\u003e \u003cp\u003ePhysical activity is recommended because of its beneficial effects on physical as well as mental health [\u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e]. Physical activity releases hormones such as serotonin and endorphins, which have a stabilizing effect on the mind. Continued physical activity on a daily basis provides a steady supply of serotonin and endorphins, which have positive effect on stress [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e]. It has been shown that exercise-based physical activity is associated with lower occupational psychological and physical stress responses in cross-sectional studies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e]. A cross-sectional study also reported a negative relationship between leisure-time physical activity (LTPA) and occupational stress among women in Spain [\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, there are limited studies that have examined various types of occupational stress and the frequency of LTPA. To investigate the relationship between the frequency of LTPA and occupational stress and high-stress components would be significant evidence to improve the mental health of Japanese workers. In light of the above concerns, the objectives of this study were: 1) to investigate the relationship between the frequency of LTPA and high perceived occupational stress among workers; 2) to investigate the relationship between the frequency of LTPA and other six high-stress components (vigor, fatigue, depression, physical complaints, anger-irritability, anxiety) among large numbers of workers.\u003c/p\u003e"},{"header":"Methods","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003eParticipants\u003c/h2\u003e \u003cp\u003eThis study was conducted as a part of the \u0026ldquo;Lifestyle Research Survey to Reduce Workers\u0026rsquo; Stress Responses\u0026rdquo; in the Project for Industrial Accident Prevention Measures supported by the MHLW. Participants who were willing to join the Japan Industrial Safety and Health Association Health Advice Service were required to provide a self-reported questionnaire [\u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e]. The number of participants was 7832 in 2017. Participants with missing information in any of the questionnaire items (n\u0026thinsp;=\u0026thinsp;594) and who selected the option \u0026ldquo;unspecified\u0026rdquo; for frequency of LTPA (n\u0026thinsp;=\u0026thinsp;133) were excluded from this study. Missing values were excluded for ages 5 and under and 100 and over. Regarding medical history, only those with medical history were ascertained without processing missing values. Ultimately, a total of 7105 participants (5702 men aged 18\u0026ndash;78 years, 1403 women aged 18\u0026ndash;78 years) from 41 workplaces in 27 industries in 24 of the 47 prefectures in Japan (Japan Standard Industrial Classification, middle category [\u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e12\u003c/span\u003e] ) were included in the analysis. All demographic information and survey items discussed were dealt with anonymously.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003ePerceived Occupational Stress and high-stress components\u003c/h2\u003e \u003cp\u003eThis study examined perceived occupational stress among workers using the Brief Job Stress Questionnaire (BJSQ) [\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e, \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The BJSQ is a self-reported questionnaire, consists of 57 questions to assess \u0026ldquo;job stressor\u0026rdquo; (17 items), \u0026ldquo;psychological and physical stress response\u0026rdquo; (29 items), \u0026ldquo;buffering factor\u0026rdquo; (9 items), and \u0026ldquo;satisfaction\u0026rdquo; (2 items). All items are rated on a 4-point Likert scale, with higher scores indicating higher stress response levels. Whether or not a person is high-stress was determined using the example of evaluation criteria (Part 1) described in the \u0026ldquo;Stress check implementation manual based on the Japanese Industrial Safety and Health Act\u0026rdquo; [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. The total score (4 points for high stress response and 1 point for low stress response) for \u0026ldquo;psychological and physical stress response\u0026rdquo; was calculated, and those with a total score of 77 points or higher were classified as high-stress worker. Alternatively, the total score of \u0026ldquo;job stressor\u0026rdquo; and \u0026ldquo;buffering factor\u0026rdquo;was calculated, and those with a total score of 76 points or higher and a total score of 63 points or higher for \"psychological and physical stress response\" were classified as high-stress worker. The BJSQ was developed in Japan to assess occupational stress response and is widely used for industrial health assessment and research fields [\u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e]. Previous studies have reported the reliability and validity of the BJSQ in Japanese workers [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Previous study has shown that most subscales in the BJSQ showed acceptable levels of test-retest reliability and internal consistency [\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eVigor by a total of No. 1\u0026ndash;3, anger-irritability by a total of No. 4\u0026ndash;6, fatigue by a total of No. 7\u0026ndash;9, anxiety by a total of No. 10\u0026ndash;12, depression by a total of No. 13\u0026ndash;18, and physical complaints by a total of No. 19\u0026ndash;29, was classified into 5 levels according to the Stress Check Manual [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e]. Each of the five levels, 3\u0026ndash;5, was judged as having a stress reaction.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003eLeisure-time physical activity\u003c/h2\u003e \u003cp\u003e Participants responded to a self-report questionnaire in the Japan Industrial Safety and Health Association Health Advice Service on the frequency of LTPA. Participants answered the question, \u0026ldquo;How much physical activity or sports do you do other than walking?\" Participants were asked to choose from \u0026ldquo;never\u0026rdquo;, \u0026ldquo;only specific seasons\u0026rdquo;, \u0026ldquo;once or twice a month\u0026rdquo;, \u0026ldquo;once a week\u0026rdquo;, \u0026ldquo;more than twice a week\u0026rdquo;, or \u0026ldquo;unspecified\u0026rdquo;. In order to improve the response quality and rate, a single-item physical activity question was used to reduce respondent burden instead of a lengthy questionnaire. The validity and reliability of the single-item physical activity question have been shown in previous studies [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Moreover, the absolute physical activity question (k\u0026thinsp;=\u0026thinsp;0.75) has been reported to be more reliable than the relative physical activity question (k\u0026thinsp;=\u0026thinsp;0.56) [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e].\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003eConfounding factors\u003c/h2\u003e \u003cp\u003eA self-report questionnaire was used to determine sex, age, smoking habits (non-smoker, previous smoker, smoker, and other), drinking habits (never, less than 3 times/week, 3\u0026ndash;5 times/week, minimum 6 or more times/week, and other), physical work (very much so, moderately so, somewhat, not at all), and sleep duration (\u0026ge;\u0026thinsp;6 hours/day, \u0026lt;\u0026thinsp;6 hours/day, and other). Medical histories such as heart disease, hypertension, and diabetes were also investigated. A participant was considered to have a current medical history if they had any of these diseases. The \u0026ldquo;other\u0026rdquo; in the response limb is selected by those whose situation is not an option.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003eStatistical analysis\u003c/h2\u003e \u003cp\u003eTo determine participant\u0026rsquo;s characteristics, they were divided into two groups according to the presence or absence of high-stress. Data were expressed as means and standard deviation (SD) for continuous variables and percentages (number of persons) for categorical variables.\u003c/p\u003e \u003cp\u003eLogistic regression models were used to examine the association between the frequency of LTPA and the presence or absence of high perceived occupational stress, with the group without high occupational stress as the reference for the objective variable. The \u0026ldquo;never\u0026rdquo; group for LTPA was used as the reference group to obtain the odds ratios (OR) and 95% confidence intervals (95% Cl) for high-stress in the other groups. Model 1 adjusted for age and sex. Model 2 further adjusted for smoking habits, drinking habits, sleep duration, physical work, and medical history. Since the participants were nested in their industries, a multilevel model analysis (with individuals at level 1 and industries at level 2) was conducted using a random intercept model designated Model 3. Trend tests were also conducted to determine if there was a dose-response relationship between the LTPA frequency and high-stress. In addition, we calculated ORs and 95% CIs for the possession of each of the perceived occupational stress response components\u0026mdash;vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. All data analysis was performed using IBM SPSS Statistics 27 (IBM, Japan). The significance level was determined as a \u003cem\u003ep\u003c/em\u003e value of less than 0.05, and the results were deemed statistically significant if the \u003cem\u003ep\u003c/em\u003e value was less than 0.05 on a two-tailed test. Trend tests were calculated by putting each category of LTPA as a continuous variable into the explanatory variables of the logistic regression model.\u003c/p\u003e \u003c/div\u003e"},{"header":"Results","content":"\u003cp\u003eAs shown in Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e, 5702 men (age: 44.3, SD: 13.2) and 1403 women (age: 41.6, SD: 11.5) were included in this study. 687 men (12.0%) and 161 women (11.5%) were identified as high perceived occupational stress. [INSERT Table \u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e HERE] Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e shows the relationship between LTPA frequency and high occupational stress response. In terms of LTPA, the \u0026ldquo;never\u0026rdquo; group was used as the reference group. Compared to Crude Model with the unadjusted OR, Models 1 and 2 with adjustment items did not show notable changes. In Model 3, which used a multilevel analysis, the intraclass correlation coefficient for industry was as low as 0.174, which did not result in a notable change compared to the OR for Model 2. The results of the trend tests were significant (all \u003cem\u003ep for trend\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;0.001) in all models, with more frequent physical activity indicating lower ORs of high-stress. [INSERT Table \u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e HERE] Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e shows the relationship between LTPA frequency and the high-stress components: vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. In terms of LTPA, the \u0026ldquo;never\u0026rdquo; group was used as the reference group. For all items, the other groups all had significantly lower ORs than the reference group. Compared to Crude Model with unadjusted ORs, there were no significant changes in Model 1 or 2 with the adjusted several confounding factors. Similarly, no notable changes were observed for Model 3 using multilevel analysis. The ORs for the \u0026ldquo;more than twice a week\u0026rdquo; group in Model 3 for vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety were 0.51, 0.55, 0.59, 0.51, 0.84, and 0.69 respectively, indicating similar OR levels for all high perceived occupational stress components. As in Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e, the results of all trend tests were significant (\u003cem\u003ep\u003c/em\u003e for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001). [INSERT Table \u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e HERE] The more frequent the LTPA, the lower the OR for all high-stress components.\u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eCharacteristics of participants by perceived occupational stress response levels\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTotal\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eHigh-stress\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eNot high-stress\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNumber of participants, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e7105 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e848 (11.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e6257 (88.1)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMen, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e5702 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e687 (12.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e5015 (88.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWomen, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1403 (100.0)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e161 (11.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1242 (88.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge, mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e43.7\u0026thinsp;\u0026plusmn;\u0026thinsp;12.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e41.8\u0026thinsp;\u0026plusmn;\u0026thinsp;11.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e44.0\u0026thinsp;\u0026plusmn;\u0026thinsp;13.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSmoking, n (%)\u003c/p\u003e \u003cp\u003eNon-smoker\u003c/p\u003e \u003cp\u003ePrevious smoker\u003c/p\u003e \u003cp\u003eSmoker\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3491 (49.1)\u003c/p\u003e \u003cp\u003e1325 (18.6)\u003c/p\u003e \u003cp\u003e2273 (32.0)\u003c/p\u003e \u003cp\u003e16 (0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e413 (48.7)\u003c/p\u003e \u003cp\u003e123 (14.5)\u003c/p\u003e \u003cp\u003e310 (36.6)\u003c/p\u003e \u003cp\u003e2 (0.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3078 (49.2)\u003c/p\u003e \u003cp\u003e1202 (19.2)\u003c/p\u003e \u003cp\u003e1963 (31.4)\u003c/p\u003e \u003cp\u003e14 (0.2)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDrinking, n (%)\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eLess than 3 times/week\u003c/p\u003e \u003cp\u003e3\u0026ndash;5 times/week\u003c/p\u003e \u003cp\u003e6 times or more/week\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3134 (44.1)\u003c/p\u003e \u003cp\u003e995 (14.0)\u003c/p\u003e \u003cp\u003e1185 (16.7)\u003c/p\u003e \u003cp\u003e1685 (23.7)\u003c/p\u003e \u003cp\u003e106 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e426 (50.2)\u003c/p\u003e \u003cp\u003e106 (12.5)\u003c/p\u003e \u003cp\u003e114 (13.4)\u003c/p\u003e \u003cp\u003e189 (22.3)\u003c/p\u003e \u003cp\u003e13 (1.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2708 (43.3)\u003c/p\u003e \u003cp\u003e889 (14.2)\u003c/p\u003e \u003cp\u003e1071 (17.1)\u003c/p\u003e \u003cp\u003e1496 (23.7)\u003c/p\u003e \u003cp\u003e93 (1.5)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleeping, n (%)\u003c/p\u003e \u003cp\u003e\u0026ge; 6 hours/day\u003c/p\u003e \u003cp\u003e\u0026lt; 6 hours/day\u003c/p\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e4331 (61.0)\u003c/p\u003e \u003cp\u003e2650 (37.3)\u003c/p\u003e \u003cp\u003e124 (1.7)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e337 (39.7)\u003c/p\u003e \u003cp\u003e491 (57.9)\u003c/p\u003e \u003cp\u003e20 (2.4)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3994 (63.8)\u003c/p\u003e \u003cp\u003e2159 (34.5)\u003c/p\u003e \u003cp\u003e104 (1.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical work, n (%)\u003c/p\u003e \u003cp\u003eVery much so\u003c/p\u003e \u003cp\u003eModerately so\u003c/p\u003e \u003cp\u003eSomewhat\u003c/p\u003e \u003cp\u003eNot at all\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e885 (12.5)\u003c/p\u003e \u003cp\u003e2027 (28.5)\u003c/p\u003e \u003cp\u003e2400 (33.8)\u003c/p\u003e \u003cp\u003e1793 (25.2)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e217 (25.6)\u003c/p\u003e \u003cp\u003e262 (30.9)\u003c/p\u003e \u003cp\u003e226 (26.7)\u003c/p\u003e \u003cp\u003e143 (16.9)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e668 (10.7)\u003c/p\u003e \u003cp\u003e1765 (28.2)\u003c/p\u003e \u003cp\u003e2174 (34.7)\u003c/p\u003e \u003cp\u003e1650 (26.4)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMedical history, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c2\"\u003e \u003cp\u003e1439 (20.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c3\"\u003e \u003cp\u003e168 (19.8)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e \u003cp\u003e1271 (20.3)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLeisure-time physical activity, n (%)\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific season\u003c/p\u003e \u003cp\u003e1\u0026thinsp;\u0026minus;\u0026thinsp;2 times/month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985 (56.1)\u003c/p\u003e \u003cp\u003e507 (7.1)\u003c/p\u003e \u003cp\u003e856 (12.0)\u003c/p\u003e \u003cp\u003e887 (12.5)\u003c/p\u003e \u003cp\u003e870 (12.3)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e536 (63.2)\u003c/p\u003e \u003cp\u003e57 (6.7)\u003c/p\u003e \u003cp\u003e93 (11.0)\u003c/p\u003e \u003cp\u003e89 (10.5)\u003c/p\u003e \u003cp\u003e73 (8.6)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3449 (55.1)\u003c/p\u003e \u003cp\u003e450 (7.2)\u003c/p\u003e \u003cp\u003e763 (12.2)\u003c/p\u003e \u003cp\u003e798 (12.8)\u003c/p\u003e \u003cp\u003e797 (12.7)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eStress response components\u003c/p\u003e \u003cp\u003eVigor, n (%)\u003c/p\u003e \u003cp\u003eFatigue, n (%)\u003c/p\u003e \u003cp\u003eDepression, n (%)\u003c/p\u003e \u003cp\u003ePhysical complaints, n (%)\u003c/p\u003e \u003cp\u003eAnger-irritability, n (%)\u003c/p\u003e \u003cp\u003eAnxiety, n (%)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e2016 (28.4)\u003c/p\u003e \u003cp\u003e2094 (29.5)\u003c/p\u003e \u003cp\u003e1694 (23.8)\u003c/p\u003e \u003cp\u003e1948 (27.4)\u003c/p\u003e \u003cp\u003e1881 (26.5)\u003c/p\u003e \u003cp\u003e1669 (23.5)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e622 (73.3)\u003c/p\u003e \u003cp\u003e721 (85.0)\u003c/p\u003e \u003cp\u003e740 (87.3)\u003c/p\u003e \u003cp\u003e698 (82.3)\u003c/p\u003e \u003cp\u003e632 (74.5)\u003c/p\u003e \u003cp\u003e671 (79.1)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1394 (22.3)\u003c/p\u003e \u003cp\u003e1373 (21.9)\u003c/p\u003e \u003cp\u003e954 (15.2)\u003c/p\u003e \u003cp\u003e1250 (20.0)\u003c/p\u003e \u003cp\u003e1249 (20.0)\u003c/p\u003e \u003cp\u003e998 (16.0)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between frequency of leisure-time physical activity and high-stress among workers inJapan\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003cp\u003e/ 1000\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCrude Model\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eModel 1 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eModel 2 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eModel 3 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e536\u003c/p\u003e \u003cp\u003e57\u003c/p\u003e \u003cp\u003e93\u003c/p\u003e \u003cp\u003e89\u003c/p\u003e \u003cp\u003e73\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e135\u003c/p\u003e \u003cp\u003e112\u003c/p\u003e \u003cp\u003e109\u003c/p\u003e \u003cp\u003e100\u003c/p\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.82 (0.61\u0026thinsp;\u0026minus;\u0026thinsp;1.09)\u003c/p\u003e \u003cp\u003e0.78 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;0.99)\u003c/p\u003e \u003cp\u003e0.72 (0.57\u0026thinsp;\u0026minus;\u0026thinsp;0.91)\u003c/p\u003e \u003cp\u003e0.59 (0.46\u0026thinsp;\u0026minus;\u0026thinsp;0.76)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.77 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;1.04)\u003c/p\u003e \u003cp\u003e0.74 (0.59\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.70 (0.55\u0026thinsp;\u0026minus;\u0026thinsp;0.89)\u003c/p\u003e \u003cp\u003e0.58 (0.45\u0026thinsp;\u0026minus;\u0026thinsp;0.75)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.80 (0.60\u0026thinsp;\u0026minus;\u0026thinsp;1.09)\u003c/p\u003e \u003cp\u003e0.83 (0.65\u0026thinsp;\u0026minus;\u0026thinsp;1.06)\u003c/p\u003e \u003cp\u003e0.79 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;1.01)\u003c/p\u003e \u003cp\u003e0.62 (0.48\u0026thinsp;\u0026minus;\u0026thinsp;0.81)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend \u0026lt; 0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.79 (0.59\u0026thinsp;\u0026minus;\u0026thinsp;1.07)\u003c/p\u003e \u003cp\u003e0.84 (0.66\u0026thinsp;\u0026minus;\u0026thinsp;1.08)\u003c/p\u003e \u003cp\u003e0.80 (0.63\u0026thinsp;\u0026minus;\u0026thinsp;1.03)\u003c/p\u003e \u003cp\u003e0.60 (0.46\u0026thinsp;\u0026minus;\u0026thinsp;0.79)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003csup\u003ea\u003c/sup\u003e Model 1: Crude Model\u0026thinsp;+\u0026thinsp;age (continuous, year) and sex (men, women). \u003csup\u003eb\u003c/sup\u003e Model 2: Model 1\u0026thinsp;+\u0026thinsp;smoking habits (non-smoker, previous smoker, smoker, other), drinking habits (never, less than 3 times/week, 3\u0026ndash;5 times/week, 6 or more times/week, other), sleeping (\u0026ge;\u0026thinsp;6 hours/day, \u0026lt; 6 hours/day, other), physical work (very much so, moderately so, somewhat, not at all), medical history (yes, no). \u003csup\u003ec\u003c/sup\u003e Model 3: Model 2\u0026thinsp;+\u0026thinsp;multilevel regression analyses.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003eAssociation between some frequency of leisure-time physical activity and high-stress components among workers in Japan\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"8\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e \u003cp\u003en\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eCases\u003c/p\u003e \u003cp\u003e/ 1000\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c5\"\u003e \u003cp\u003eCrude Model\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eModel 1 \u003csup\u003ea\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eModel 2 \u003csup\u003eb\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c8\"\u003e \u003cp\u003eModel 3 \u003csup\u003ec\u003c/sup\u003e\u003c/p\u003e \u003cp\u003eOR (95% CI)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eVigor\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1318\u003c/p\u003e \u003cp\u003e106\u003c/p\u003e \u003cp\u003e202\u003c/p\u003e \u003cp\u003e219\u003c/p\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e331\u003c/p\u003e \u003cp\u003e209\u003c/p\u003e \u003cp\u003e236\u003c/p\u003e \u003cp\u003e247\u003c/p\u003e \u003cp\u003e197\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.54 (0.43\u0026thinsp;\u0026minus;\u0026thinsp;0.67)\u003c/p\u003e \u003cp\u003e0.63 (0.53\u0026thinsp;\u0026minus;\u0026thinsp;0.74)\u003c/p\u003e \u003cp\u003e0.66 (0.56\u0026thinsp;\u0026minus;\u0026thinsp;0.78)\u003c/p\u003e \u003cp\u003e0.50 (0.41\u0026thinsp;\u0026minus;\u0026thinsp;0.59)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.54 (0.43\u0026thinsp;\u0026minus;\u0026thinsp;0.67)\u003c/p\u003e \u003cp\u003e0.63 (0.53\u0026thinsp;\u0026minus;\u0026thinsp;0.74)\u003c/p\u003e \u003cp\u003e0.67 (0.56\u0026thinsp;\u0026minus;\u0026thinsp;0.79)\u003c/p\u003e \u003cp\u003e0.50 (0.41\u0026thinsp;\u0026minus;\u0026thinsp;0.59)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.55 (0.44\u0026thinsp;\u0026minus;\u0026thinsp;0.69)\u003c/p\u003e \u003cp\u003e0.65 (0.55\u0026thinsp;\u0026minus;\u0026thinsp;0.77)\u003c/p\u003e \u003cp\u003e0.70 (0.59\u0026thinsp;\u0026minus;\u0026thinsp;0.83)\u003c/p\u003e \u003cp\u003e0.51 (0.43\u0026thinsp;\u0026minus;\u0026thinsp;0.62)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.55 (0.43\u0026thinsp;\u0026minus;\u0026thinsp;0.68)\u003c/p\u003e \u003cp\u003e0.65 (0.55\u0026thinsp;\u0026minus;\u0026thinsp;0.77)\u003c/p\u003e \u003cp\u003e0.71 (0.60\u0026thinsp;\u0026minus;\u0026thinsp;0.84)\u003c/p\u003e \u003cp\u003e0.51 (0.42\u0026thinsp;\u0026minus;\u0026thinsp;0.61)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eFatigue\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1290\u003c/p\u003e \u003cp\u003e148\u003c/p\u003e \u003cp\u003e240\u003c/p\u003e \u003cp\u003e230\u003c/p\u003e \u003cp\u003e186\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e324\u003c/p\u003e \u003cp\u003e291\u003c/p\u003e \u003cp\u003e280\u003c/p\u003e \u003cp\u003e259\u003c/p\u003e \u003cp\u003e214\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.86 (0.70\u0026thinsp;\u0026minus;\u0026thinsp;1.06)\u003c/p\u003e \u003cp\u003e0.81 (0.69\u0026thinsp;\u0026minus;\u0026thinsp;0.96)\u003c/p\u003e \u003cp\u003e0.73 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;0.86)\u003c/p\u003e \u003cp\u003e0.57 (0.48\u0026thinsp;\u0026minus;\u0026thinsp;0.68)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.77 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.73 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;0.86)\u003c/p\u003e \u003cp\u003e0.69 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.81)\u003c/p\u003e \u003cp\u003e0.54 (0.45\u0026thinsp;\u0026minus;\u0026thinsp;0.64)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.78 (0.63\u0026thinsp;\u0026minus;\u0026thinsp;0.97)\u003c/p\u003e \u003cp\u003e0.79 (0.67\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.75 (0.63\u0026thinsp;\u0026minus;\u0026thinsp;0.90)\u003c/p\u003e \u003cp\u003e0.55 (0.46\u0026thinsp;\u0026minus;\u0026thinsp;0.67)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.78 (0.63\u0026thinsp;\u0026minus;\u0026thinsp;0.97)\u003c/p\u003e \u003cp\u003e0.79 (0.67\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.76 (0.64\u0026thinsp;\u0026minus;\u0026thinsp;0.90)\u003c/p\u003e \u003cp\u003e0.55 (0.46\u0026thinsp;\u0026minus;\u0026thinsp;0.67)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1040\u003c/p\u003e \u003cp\u003e111\u003c/p\u003e \u003cp\u003e213\u003c/p\u003e \u003cp\u003e181\u003c/p\u003e \u003cp\u003e149\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e261\u003c/p\u003e \u003cp\u003e219\u003c/p\u003e \u003cp\u003e249\u003c/p\u003e \u003cp\u003e204\u003c/p\u003e \u003cp\u003e171\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.79 (0.64\u0026thinsp;\u0026minus;\u0026thinsp;0.99)\u003c/p\u003e \u003cp\u003e0.94 (0.79\u0026thinsp;\u0026minus;\u0026thinsp;1.11)\u003c/p\u003e \u003cp\u003e0.73 (0.61\u0026thinsp;\u0026minus;\u0026thinsp;0.87)\u003c/p\u003e \u003cp\u003e0.59 (0.48\u0026thinsp;\u0026minus;\u0026thinsp;0.71)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.72 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.90)\u003c/p\u003e \u003cp\u003e0.86 (0.72\u0026thinsp;\u0026minus;\u0026thinsp;1.02)\u003c/p\u003e \u003cp\u003e0.69 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.83)\u003c/p\u003e \u003cp\u003e0.56 (0.46\u0026thinsp;\u0026minus;\u0026thinsp;0.68)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.74 (0.59\u0026thinsp;\u0026minus;\u0026thinsp;0.93)\u003c/p\u003e \u003cp\u003e0.91 (0.76\u0026thinsp;\u0026minus;\u0026thinsp;1.08)\u003c/p\u003e \u003cp\u003e0.75 (0.62\u0026thinsp;\u0026minus;\u0026thinsp;0.90)\u003c/p\u003e \u003cp\u003e0.59 (0.49\u0026thinsp;\u0026minus;\u0026thinsp;0.72)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.74 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.92)\u003c/p\u003e \u003cp\u003e0.91 (0.76\u0026thinsp;\u0026minus;\u0026thinsp;1.08)\u003c/p\u003e \u003cp\u003e0.75 (0.63\u0026thinsp;\u0026minus;\u0026thinsp;0.90)\u003c/p\u003e \u003cp\u003e0.59 (0.48\u0026thinsp;\u0026minus;\u0026thinsp;0.72)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePhysical complaints\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1217\u003c/p\u003e \u003cp\u003e150\u003c/p\u003e \u003cp\u003e221\u003c/p\u003e \u003cp\u003e207\u003c/p\u003e \u003cp\u003e153\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e305\u003c/p\u003e \u003cp\u003e296\u003c/p\u003e \u003cp\u003e258\u003c/p\u003e \u003cp\u003e233\u003c/p\u003e \u003cp\u003e176\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.96 (0.78\u0026thinsp;\u0026minus;\u0026thinsp;1.17)\u003c/p\u003e \u003cp\u003e0.79 (0.67\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.69 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.82)\u003c/p\u003e \u003cp\u003e0.49 (0.40\u0026thinsp;\u0026minus;\u0026thinsp;0.59)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.94 (0.76\u0026thinsp;\u0026minus;\u0026thinsp;1.15)\u003c/p\u003e \u003cp\u003e0.78 (0.66\u0026thinsp;\u0026minus;\u0026thinsp;0.92)\u003c/p\u003e \u003cp\u003e0.69 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.81)\u003c/p\u003e \u003cp\u003e0.48 (0.40\u0026thinsp;\u0026minus;\u0026thinsp;0.58)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.97 (0.79\u0026thinsp;\u0026minus;\u0026thinsp;1.20)\u003c/p\u003e \u003cp\u003e0.85 (0.71\u0026thinsp;\u0026minus;\u0026thinsp;1.01)\u003c/p\u003e \u003cp\u003e0.76 (0.64\u0026thinsp;\u0026minus;\u0026thinsp;0.91)\u003c/p\u003e \u003cp\u003e0.51 (0.42\u0026thinsp;\u0026minus;\u0026thinsp;0.62)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.97 (0.79\u0026thinsp;\u0026minus;\u0026thinsp;1.20)\u003c/p\u003e \u003cp\u003e0.85 (0.71\u0026thinsp;\u0026minus;\u0026thinsp;1.01)\u003c/p\u003e \u003cp\u003e0.76 (0.64\u0026thinsp;\u0026minus;\u0026thinsp;0.91)\u003c/p\u003e \u003cp\u003e0.51 (0.42\u0026thinsp;\u0026minus;\u0026thinsp;0.62)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnger-irritability\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1092\u003c/p\u003e \u003cp\u003e138\u003c/p\u003e \u003cp\u003e220\u003c/p\u003e \u003cp\u003e228\u003c/p\u003e \u003cp\u003e203\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e274\u003c/p\u003e \u003cp\u003e272\u003c/p\u003e \u003cp\u003e257\u003c/p\u003e \u003cp\u003e290\u003c/p\u003e \u003cp\u003e233\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.99 (0.81\u0026thinsp;\u0026minus;\u0026thinsp;1.22)\u003c/p\u003e \u003cp\u003e0.92 (0.77\u0026thinsp;\u0026minus;\u0026thinsp;1.08)\u003c/p\u003e \u003cp\u003e0.92 (0.78\u0026thinsp;\u0026minus;\u0026thinsp;1.08)\u003c/p\u003e \u003cp\u003e0.81 (0.68\u0026thinsp;\u0026minus;\u0026thinsp;0.96)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;=\u0026thinsp;0.013\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.90 (0.73\u0026thinsp;\u0026minus;\u0026thinsp;1.11)\u003c/p\u003e \u003cp\u003e0.84 (0.71\u0026thinsp;\u0026minus;\u0026thinsp;0.99)\u003c/p\u003e \u003cp\u003e0.88 (0.74\u0026thinsp;\u0026minus;\u0026thinsp;1.04)\u003c/p\u003e \u003cp\u003e0.78 (0.65\u0026thinsp;\u0026minus;\u0026thinsp;0.92)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;=\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.92 (0.74\u0026thinsp;\u0026minus;\u0026thinsp;1.13)\u003c/p\u003e \u003cp\u003e0.88 (0.74\u0026thinsp;\u0026minus;\u0026thinsp;1.05)\u003c/p\u003e \u003cp\u003e0.95 (0.80\u0026thinsp;\u0026minus;\u0026thinsp;1.13)\u003c/p\u003e \u003cp\u003e0.83 (0.70\u0026thinsp;\u0026minus;\u0026thinsp;0.99)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;=\u0026thinsp;0.043\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.92 (0.74\u0026thinsp;\u0026minus;\u0026thinsp;1.13)\u003c/p\u003e \u003cp\u003e0.89 (0.75\u0026thinsp;\u0026minus;\u0026thinsp;1.06)\u003c/p\u003e \u003cp\u003e0.96 (0.81\u0026thinsp;\u0026minus;\u0026thinsp;1.14)\u003c/p\u003e \u003cp\u003e0.84 (0.70\u0026thinsp;\u0026minus;\u0026thinsp;1.00)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;=\u0026thinsp;0.062\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003cp\u003eNever\u003c/p\u003e \u003cp\u003eOnly specific seasons\u003c/p\u003e \u003cp\u003e1\u0026ndash;2 times per month\u003c/p\u003e \u003cp\u003eOnce a week\u003c/p\u003e \u003cp\u003eMore than twice a week\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e3985\u003c/p\u003e \u003cp\u003e507\u003c/p\u003e \u003cp\u003e856\u003c/p\u003e \u003cp\u003e887\u003c/p\u003e \u003cp\u003e870\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e991\u003c/p\u003e \u003cp\u003e115\u003c/p\u003e \u003cp\u003e207\u003c/p\u003e \u003cp\u003e190\u003c/p\u003e \u003cp\u003e166\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e248\u003c/p\u003e \u003cp\u003e226\u003c/p\u003e \u003cp\u003e242\u003c/p\u003e \u003cp\u003e214\u003c/p\u003e \u003cp\u003e191\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.89 (0.71\u0026thinsp;\u0026minus;\u0026thinsp;1.10)\u003c/p\u003e \u003cp\u003e0.96 (0.81\u0026thinsp;\u0026minus;\u0026thinsp;1.15)\u003c/p\u003e \u003cp\u003e0.82 (0.69\u0026thinsp;\u0026minus;\u0026thinsp;0.98)\u003c/p\u003e \u003cp\u003e0.71 (0.59\u0026thinsp;\u0026minus;\u0026thinsp;0.86)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.81 (0.65\u0026thinsp;\u0026minus;\u0026thinsp;1.01)\u003c/p\u003e \u003cp\u003e0.88 (0.74\u0026thinsp;\u0026minus;\u0026thinsp;1.05)\u003c/p\u003e \u003cp\u003e0.79 (0.66\u0026thinsp;\u0026minus;\u0026thinsp;0.94)\u003c/p\u003e \u003cp\u003e0.68 (0.57\u0026thinsp;\u0026minus;\u0026thinsp;0.82)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.82 (0.65\u0026thinsp;\u0026minus;\u0026thinsp;1.03)\u003c/p\u003e \u003cp\u003e0.93 (0.78\u0026thinsp;\u0026minus;\u0026thinsp;1.11)\u003c/p\u003e \u003cp\u003e0.84 (0.70\u0026thinsp;\u0026minus;\u0026thinsp;0.85)\u003c/p\u003e \u003cp\u003e0.70 (0.58\u0026thinsp;\u0026minus;\u0026thinsp;0.85)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c8\"\u003e \u003cp\u003e1.00 (Reference)\u003c/p\u003e \u003cp\u003e0.82 (0.65\u0026thinsp;\u0026minus;\u0026thinsp;1.03)\u003c/p\u003e \u003cp\u003e0.93 (0.77\u0026thinsp;\u0026minus;\u0026thinsp;1.11)\u003c/p\u003e \u003cp\u003e0.85 (0.71\u0026thinsp;\u0026minus;\u0026thinsp;1.02)\u003c/p\u003e \u003cp\u003e0.69 (0.57\u0026thinsp;\u0026minus;\u0026thinsp;0.84)\u003c/p\u003e \u003cp\u003e\u003cem\u003ep for trend\u0026thinsp;\u0026lt;\u0026thinsp;0.001\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"8\"\u003e\u003csup\u003ea\u003c/sup\u003e Model 1: Crude Model\u0026thinsp;+\u0026thinsp;age (continuous, year) and sex (men, women). \u003csup\u003eb\u003c/sup\u003e Model 2: Model 1\u0026thinsp;+\u0026thinsp;smoking habits (non-smoker, previous smoker, smoker, other), drinking habits (never, less than 3 times/week, 3\u0026ndash;5 times/week, 6 or more times/week, other), sleeping (\u0026ge;\u0026thinsp;6 hours/day, \u0026lt; 6 hours/day, other), physical work (very much so, moderately so, somewhat, not at all), medical history (yes, no). \u003csup\u003ec\u003c/sup\u003e Model 3: Model 2\u0026thinsp;+\u0026thinsp;multilevel regression analyses.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThis cross-sectional study investigated the relationship between LTPA frequency and perceived occupational stress among 7105 workers. The study results revealed a negative association between LTPA frequency and perceived occupational stress. The findings of this study are consistent with several studies [\u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e9\u003c/span\u003e, \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. In this study, we also investigated the association between LTPA frequency and components of perceived occupational stress, such as vigor, fatigue, depression, physical complaints, anger-irritability, and anxiety. We found a negative association between all components and LTPA frequency. A meta-analysis of studies of children and adolescents reported that greater participation in physical activity was associated with lower vigor, anxiety, depression, and fatigue [\u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e]. However, no such studies have been reported in workers, and the present study is the first to show that physical activity is associated with multiple components of occupational stress in workers.\u003c/p\u003e \u003cp\u003eRegarding the components of perceived occupational stress, this study suggests a negative association between LTPA and the lack of vigor. Several studies found that similar to the results of this study, PA improved the levels of vigor, and spending time doing PA had a positive effect on more energy in workers [\u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e24\u003c/span\u003e] [\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e]. However, Daniel et al. [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e] found that doing high levels of weekly PA increases the negative effect of stress on the levels of vigor, the result of the present study differs. A previous study analyzing mediation effects shows that weekly PA negatively affects vigor. Consistent with previous studies, this study showed a negative association between LTPA and depressive symptoms among Japanese workers [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. Additionally, there was a negative association between LTPA and physical complaints. However, in a previous study, the prevalence of musculoskeletal disorders was higher in the group with high moderate-to-vigorous intensity physical activity (MVPA) and high sedentary behavior, while there was no increased prevalence in the group with high MVPA and low sedentary behavior [\u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e27\u003c/span\u003e]. Considering the results of the previous study, the negative association between LTPA and physical complaints in the present study might be because of the low sedentary behavior of this study's participants. Sedentary behavior is also a risk factor for musculoskeletal disorders, and physical complaints and musculoskeletal disorders need to be examined in terms of sedentary behavior during work and MVPA.\u003c/p\u003e \u003cp\u003eIn terms of mechanisms, Esch and Stefano found that physical activity can affect the reward and motivation circuits of the nervous system, resulting in self-regulatory and endogenous stress relief [\u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e28\u003c/span\u003e]. Also, physical activity affects proliferation indirectly through effects on the vascular system, inflammation and the stress system, has considerable relevance for brain disorders like depression [\u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e8\u003c/span\u003e].\u003c/p\u003e \u003cdiv id=\"Sec10\" class=\"Section2\"\u003e \u003ch2\u003eStrengths and limitations\u003c/h2\u003e \u003cp\u003eA strength of this study is that it uses the results of an extensive survey of over 7000 individuals to determine the relationship between LPTA frequency and perceived occupational stress. There are some limitations to our study. First, it is cross-sectional, which is not a research design that can identify causal relationships. Secondly, this study used a self-reported questionnaire survey and did not objectively examine stress response levels or LTPA frequency. However, this study assessed stress response levels using the BJSQ, which has been validated [\u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e17\u003c/span\u003e, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. Thirdly, this study did not adjust for the type of work. However, we adjusted for the industrial classification and, to some extent, deducted confounding of type of work. In addition, it should be noted that the LTPA frequency was based on a simple questionnaire survey and is not a question that has been examined for reliability and validity. Therefore, it is possible that some bias such as recall bias may have influenced the results. Although this study adjusts for potential confounders through multivariable analysis, some factors have not been investigated, such as income and the presence of children. These factors may be residual confounders. The number of missing values (n\u0026thinsp;=\u0026thinsp;727) represents approximately 9% of the study participants (n\u0026thinsp;=\u0026thinsp;7832) and is not expected to affect the results significantly. In addition, the sample representativeness of this study is challenged by the fact that the target population is not a random sample of workers in Japan. However, since the survey was conducted on workers in various industries located in various parts of Japan, the results of this study are generalizable to other workers in Japan to some extent since the surveys were conducted in various industries across Japan. These issues should be addressed in the future, and prospective studies should properly investigate the effect of LTPA in reducing perceived occupational stress.\u003c/p\u003e \u003c/div\u003e"},{"header":"Conclusions","content":"\u003cp\u003eThis study showed a negative association between the frequency of LTPA and perceived occupational stress response and other six high-stress components among workers in Japan. Although the cross-sectional study makes it difficult to make a definitive assessment of causality, workers may lower their perceived occupational stress responses by engaging in more frequent LTPA.\u003c/p\u003e"},{"header":"Abbreviations","content":"\u003cp\u003eLTPA: leisure-time physical activity; MHLW: Ministry of Health, Labor and Welfare; BJSQ: Brief Job Stress Questionnaire; SD: standard deviation; OR: odds ratio; CI: confidence interval; MVPA: moderate-to-vigorous intensity physical activity\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch2\u003e\u003cstrong\u003eConflict of Interest\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eKeizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eEthical approval\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study has been conducted in accordance with the Declaration of Helsinki and the Ethical Guidelines for Epidemiological Research by the Japanese Government. This study was conducted with the approval of the Research Ethics Committee of the Japan Industrial Safety and Health Association and Waseda University (approval numbers: 201902 and 2020\u0026thinsp;\u0026minus;\u0026thinsp;222), the committee explicitly approved the written consent implied upon return of a completed questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eInformed consent\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe questionnaire included a cover page explaining the purposes and procedures of the study. On this cover page, respondents were told that participation in the survey was voluntary and returning the questionnaires represented informed consent.\u003c/p\u003e\n\u003ch2\u003e\u003cstrong\u003eCompeting Interests\u003c/strong\u003e\u003c/h2\u003e\n\u003cp\u003eKeizo Hamaya is employee of the Japan Industrial Safety and Health Association. The other authors declare no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003ch2\u003eFunding\u003c/h2\u003e\n\u003cp\u003eThis study received research funding from the Japan Industrial Safety and Health Association and JST SPRING (JPMJSP2128).\u003c/p\u003e\n\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\n\u003cp\u003eSusumu S. Sawada conceptualized the study design. Sakura Koriyama, Susumu S. Sawada, Xiangyu Zhai, and Serena A. Dimitroff contributed to the drafting of the study. Sakura Koriyam and Susumu S. Sawada substantially contributed to the analysis of the data. Susumu S. Sawada was responsible for the overall concept and design of this manuscript. Also, Sakura Koriyam, Susumu S. Sawada, Masaki Nishida, Kumpei Tanisawa, and Ryoko Kawakami contributed to the interpretation of the data. All authors approved the final version of the manuscript.\u003c/p\u003e\n\u003ch2\u003eAcknowledgement\u003c/h2\u003e\n\u003cp\u003eThe authors are grateful to all participating in this study and the Japan Industrial Safety and Health Association. Special thanks to Benjamin How for contributions to English language editing.\u003c/p\u003e\n\u003ch2\u003eData Availability\u003c/h2\u003e\n\u003cp\u003eThe datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eSarafis P, Rousaki E, Tsounis A, et al. (2016) The impact of occupational stress on nurses\u0026rsquo; caring behaviors and their health related quality of life. BMC Nursing. 15(1)doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12912-016-0178-y\u003c/span\u003e\u003cspan address=\"10.1186/s12912-016-0178-y\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGu B, Tan Q, Zhao S. (2019) The association between occupational stress and psychosomatic wellbeing among Chinese nurses. Medicine (Baltimore). 98(22):e15836. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1097/MD.0000000000015836\u003c/span\u003e\u003cspan address=\"10.1097/MD.0000000000015836\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHoboubi N CA, Kamari Ghanavati F, Keshavarzi S, Akbar Hosseini A. (2017) The Impact of Job Stress and Job Satisfaction on Workforce Productivity in an Iranian Petrochemical Industry. Saf Health Work. 8(1):67\u0026ndash;71. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.shaw.2016.07.002\u003c/span\u003e\u003cspan address=\"10.1016/j.shaw.2016.07.002\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eNawata K. (2024) Evaluation of physical and mental health conditions related to employees\u0026rsquo; absenteeism. Front Public Health. 11:1326334. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3389/fpubh.2023.1326334\u003c/span\u003e\u003cspan address=\"10.3389/fpubh.2023.1326334\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health, Labour and Welfare. (2018) Basic Survey on Industrial Safety and Health in 2018. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mhlw.go.jp/toukei/list/dl/h30-46-50_kekka-gaiyo02.pdf\u003c/span\u003e\u003cspan address=\"https://www.mhlw.go.jp/toukei/list/dl/h30-46-50_kekka-gaiyo02.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health, Labour and Welfare. (2010) National Health Survey in 2010. National Health Survey in 2010. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/dl/gaikyou.pdf\u003c/span\u003e\u003cspan address=\"https://www.mhlw.go.jp/toukei/saikin/hw/k-tyosa/k-tyosa10/dl/gaikyou.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. (2018) Global action plan on physical activity 2018\u0026ndash;2030: more active people for a healthier world. Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eBolijn S, Lucassen PJ. (2015) How the Body Talks to the Brain; Peripheral Mediators of Physical Activity-Induced Proliferation in the Adult Hippocampus. Brain Plast. 1(1):5\u0026ndash;27. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3233/bpl-150020\u003c/span\u003e\u003cspan address=\"10.3233/bpl-150020\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eAbe T, Okuyama K, Motohiro et al. (2024) Association between different types of physical activity and occupational stress in Japanese workers: a cross-sectional study. Ind Health. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2486/indhealth.2023-0092\u003c/span\u003e\u003cspan address=\"10.2486/indhealth.2023-0092\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eDe-Pedro-Jim\u0026eacute;nez D, Meneses-Monroy A, De Diego-Cordero R et al. (2021) Occupational and Leisure-Time Physical Activity Related to Job Stress and Job Satisfaction: Correspondence Analysis on a Population-Based Study. Int J Environ Res Public Health. 18(21):11220. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.3390/ijerph182111220\u003c/span\u003e\u003cspan address=\"10.3390/ijerph182111220\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJapan Industrial Safety and Health Association. (2019) Health advice service check sheet comprehensive version.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Internal Affairs and Communications. Japan Standard Industrial Classification. (2013) \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.soumu.go.jp/toukei_toukatsu/index/seido/sangyo/02toukatsu01_03000044.html\u003c/span\u003e\u003cspan address=\"https://www.soumu.go.jp/toukei_toukatsu/index/seido/sangyo/02toukatsu01_03000044.html\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eJapan Industrial Safety and Health Association. (2014) The Brief Job Stress Questionnaire English version \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mhlw.go.jp/bunya/roudoukijun/anzeneisei12/dl/stress-check_e.pdf\u003c/span\u003e\u003cspan address=\"https://www.mhlw.go.jp/bunya/roudoukijun/anzeneisei12/dl/stress-check_e.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e. Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShimomitsu T, Haratani T, Nakamura K et al. (2000) Final development of the Brief Job Stress Questionnaire mainly used for assessment of the individuals. The Ministry of Labor sponsored grant for the prevention of work-related illness: The 1999 report. (in Japanese). 126\u0026ndash;164..\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMinistry of Health, Labour and Welfare. (2021) Stress check implementation manual based on the Japanese Industrial Safety and Health Act. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.mhlw.go.jp/content/000533925.pdf\u003c/span\u003e\u003cspan address=\"https://www.mhlw.go.jp/content/000533925.pdf\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e Accessed 22 April 2024.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eShimura A, Sugiura K, Inoue M, et al. (2020) Which sleep hygiene factors are important? comprehensive assessment of lifestyle habits and job environment on sleep among office workers. Sleep Health. 6(3):288\u0026ndash;298. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1016/j.sleh.2020.02.001\u003c/span\u003e\u003cspan address=\"10.1016/j.sleh.2020.02.001\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eTsutsumi A, Inoue A, Eguchi H. (2017) How accurately does the Brief Job Stress Questionnaire identify workers with or without potential psychological distress? J Occup Health. 59(4):356\u0026ndash;360. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1539/joh.17-0011-br\u003c/span\u003e\u003cspan address=\"10.1539/joh.17-0011-br\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eInoue A, Kawakami N, Shimomitsu T, et al. (2014) Development of a Short Version of the New Brief Job Stress Questionnaire. Ind Health. 52(6):535\u0026ndash;540. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2486/indhealth.2014-0114\u003c/span\u003e\u003cspan address=\"10.2486/indhealth.2014-0114\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eMilton K, Clemes S, Bull F. (2013) Can a single question provide an accurate measure of physical activity? Br J Sports Med. 47(1):44\u0026ndash;48. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1136/bjsports-2011-090899\u003c/span\u003e\u003cspan address=\"10.1136/bjsports-2011-090899\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGill DP, Jones GR, Zou G, Speechley M. (2012) Using a single question to assess physical activity in older adults: a reliability and validity study. BMC Med Res Methodol. 12(1):20. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/1471-2288-12-20\u003c/span\u003e\u003cspan address=\"10.1186/1471-2288-12-20\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eKuwahara K, Honda T, Nakagawa T et al. (2018) Intensity of Leisure-Time Exercise and Risk of Depressive Symptoms Among Japanese Workers: A Cohort Study. J Epidemiol. 28(2):94\u0026ndash;98. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.2188/jea.je20170009\u003c/span\u003e\u003cspan address=\"10.2188/jea.je20170009\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eFukai K, Kuwahara K, Chen S, et al. (2020) The association of leisure-time physical activity and walking during commuting to work with depressive symptoms among Japanese workers: A cross‐sectional study. J Occup Health. 62(1)doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1002/1348-9585.12120\u003c/span\u003e\u003cspan address=\"10.1002/1348-9585.12120\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eLi B, Ng K, Tong X et al. (2023) Physical activity and mental health in children and youth during COVID-19: a systematic review and meta-analysis. Child Adolesc Psychiatry Ment Health. 17(1)doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s13034-023-00629-4\u003c/span\u003e\u003cspan address=\"10.1186/s13034-023-00629-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eGinoux C, Isoard-Gautheur S, Sarrazin P. \u0026ldquo;Workplace Physical Activity Program\u0026rdquo; (WOPAP) study protocol: a four-arm randomized controlled trial on preventing burnout and promoting vigor. BMC Public Health. 2019. 19(1). doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12889-019-6598-3\u003c/span\u003e\u003cspan address=\"10.1186/s12889-019-6598-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eHansen AM, Blangsted AK, Hansen EA et al. Physical activity, job demand-control, perceived stress-energy, and salivary cortisol in white-collar workers. Int Arch Occup Environ Health. 2010. 83(2): p. 143\u0026ndash;53. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1007/s00420-009-0440-7\u003c/span\u003e\u003cspan address=\"10.1007/s00420-009-0440-7\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eCort\u0026eacute;s-Denia D, Isoard-Gautheur S, Lopez-Zafra E, Pulido-Martos M. Effects of vigor at work and weekly physical activity on job stress and mental health. Sci Rep. 2022. 12(1): p. 16025. doi: \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1038/s41598-022-19966-z\u003c/span\u003e\u003cspan address=\"10.1038/s41598-022-19966-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003ePutsa B, Jalayondeja W, Mekhora K, Bhuanantanondh P, Jalayondeja C. (2022) Factors associated with reduced risk of musculoskeletal disorders among office workers: a cross-sectional study 2017 to 2020. BMC Public Health. 22(1)doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.1186/s12889-022-13940-0\u003c/span\u003e\u003cspan address=\"10.1186/s12889-022-13940-0\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eEsch T, Stefano GB. (2010) Endogenous reward mechanisms and their importance in stress reduction, exercise and the brain. Arch Med Sci. 3:447\u0026ndash;455. doi:\u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003e10.5114/aoms.2010.14269\u003c/span\u003e\u003cspan address=\"10.5114/aoms.2010.14269\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e.\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":true,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false},"keywords":"Exercise, Life style, Anxiety, Depression, Epidemiology","lastPublishedDoi":"10.21203/rs.3.rs-4505591/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-4505591/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003ePurpose:\u003c/strong\u003e We conducted a large cross-sectional study to investigate the relationship between leisure-time physical activity and perceived stress among workers in Japan.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 7192 workers in Japan were surveyed about their lifestyle habits, frequency of leisure-time physical activity (never, only specific seasons, once or twice a month, once a week, more than twice a week), and perceived occupational stress. According to the frequency of leisure-time physical activity, participants were classified into five groups. Logistic regression models were used to explore the relationship between leisure-time physical activity and perceived stress after adjustment for several confounding factors. Multivariable-adjusted odds ratios and 95% confidence intervals for the prevalence of perceived occupational stress were calculated.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e A total of 848 participants reported perceived occupational stress. Using the low leisure-time physical activity group (never) as reference, multivariable-adjusted odds ratios and 95% confidence intervals were 0.79 (0.59−1.07) for “only specific seasons,” 0.84 (0.66−1.08) for “once or twice a month,” 0.80 (0.63−1.03) for “once a week,” and 0.60 (0.46−0.79) for “more than twice a week” (\u003cem\u003ep\u003c/em\u003e for trend 0 \u0026lt; 0.001).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion:\u003c/strong\u003e In this large cross-sectional study, there was a negative association between leisure-time physical activity frequency and perceived occupational stress was observed among workers in Japan.\u003c/p\u003e","manuscriptTitle":"Leisure-time physical activity and perceived occupational stress: a cross-sectional study of workers in Japan","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2024-06-13 14:56:26","doi":"10.21203/rs.3.rs-4505591/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"decision","content":"Revision requested","date":"2025-03-11T09:59:19+00:00","index":"","fulltext":""},{"type":"editorInvitedReview","content":"","date":"2025-03-10T03:20:45+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"63117107862714751890768337677695281671","date":"2025-03-06T23:44:06+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"330568708615709942777875543716854894490","date":"2025-02-27T00:54:28+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-01-24T17:05:14+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2024-05-31T15:00:31+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2024-05-31T15:00:31+00:00","index":"","fulltext":""},{"type":"submitted","content":"Sport Sciences for Health","date":"2024-05-31T01:56:59+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"sport-sciences-for-health","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"ssfh","sideBox":"Learn more about [Sport Sciences for Health](http://link.springer.com/journal/11332)","snPcode":"11332","submissionUrl":"https://submission.nature.com/new-submission/11332/3","title":"Sport Sciences for Health","twitterHandle":"","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"em","reportingPortfolio":"Springer Hybrid","inReviewEnabled":true,"inReviewRevisionsEnabled":false}}],"origin":"","ownerIdentity":"b55d1570-c81c-4e10-a6f8-785790be25d3","owner":[],"postedDate":"June 13th, 2024","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"published-in-journal","subjectAreas":[],"tags":[],"updatedAt":"2025-04-28T16:08:18+00:00","versionOfRecord":{"articleIdentity":"rs-4505591","link":"https://doi.org/10.1007/s11332-025-01394-x","journal":{"identity":"sport-sciences-for-health","isVorOnly":false,"title":"Sport Sciences for Health"},"publishedOn":"2025-04-26 15:57:21","publishedOnDateReadable":"April 26th, 2025"},"versionCreatedAt":"2024-06-13 14:56:26","video":"","vorDoi":"10.1007/s11332-025-01394-x","vorDoiUrl":"https://doi.org/10.1007/s11332-025-01394-x","workflowStages":[]},"version":"v1","identity":"rs-4505591","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-4505591","identity":"rs-4505591","version":["v1"]},"buildId":"qtupq5eGEP_6zYnWcrvyt","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}