title: Job strain and unhealthy lifestyle: results from the baseline cohort study, Brazilian Longitudinal Study of Adult Health (ELSA-Brasil).
abstract: BACKGROUND
  Unhealthy lifestyle choices, such as smoking and sedentary behavior, are among the main modifiable risk factors for chronic non-communicable diseases. The workplace is regarded as an important site of potential health risks where preventive strategies can be effective. We investigated independent associations among psychosocial job strain, leisure-time physical inactivity, and smoking in public servants in the largest Brazilian adult cohort.
  
  
  METHODS
  We conducted a cross-sectional analysis of baseline data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil)-a multicenter prospective cohort study of civil servants. Our analytical samples comprised 11,779 and 11,963 current workers for, respectively, analyses of job strain and leisure-time physical activity and analyses of job strain and smoking. Job strain was assessed using the Brazilian version of the Swedish Demand-Control-Support Questionnaire; physical activity was evaluated using a short form of the International Physical Activity Questionnaire. We also examined smoking status and number of cigarettes smoked per day. The association reported in this paper was assessed by means of multinomial and logistic regression, stratified by sex.
  
  
  RESULTS
  Among men, compared with low-strain activities (low demand and high control), job strain showed an association with physical inactivity (odds ratio [OR] = 1.34; 95% confidence interval [CI] = 1.09-1.64) or with the practice of physical activities of less than recommended duration (OR = 1.44; 95% CI = 1.15-1.82). Among women, greater likelihood of physical inactivity was identified among job-strain and passive-job groups (OR = 1.47; 95% CI = 1.22-1.77 and OR = 1.42; 95% CI = 1.20-1.67, respectively). Greater control at work was a protective factor for physical inactivity among both men and women. Social support at work was a protective factor for physical inactivity among women, as was smoking for both genders. We observed no association between demand or control dimensions and smoking.
  
  
  CONCLUSIONS
  Job strain, job control, and social support were associated with physical activity. Social support at work was protective of smoking. Our results are comparable to those found in more developed countries; they provide additional evidence of an association between an adverse psychosocial work environment and health-related behaviors.
authors.affiliation: Laboratory of Health and Environment Education, Oswaldo Cruz Institute, Oswaldo Cruz Foundation, Avenida Brasil, 4365, Manguinhos, Rio de Janeiro, 21040-360, Brazil. rohgriep@ioc.fiocruz.br.|Centre for Health Equity Studies | CHESS, Stockholm University/Karolinska Institutet, Stockholm, Sweden. rohgriep@ioc.fiocruz.br.
authors.forename: Rosane Härter
authors.initials: RH
authors.lastname: Griep
authors.affiliation: Scientific Computing Program (PROCC), Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. aline@fiocruz.br.
authors.forename: Aline Araújo
authors.initials: AA
authors.lastname: Nobre
authors.affiliation: Departamento de Planejamento em Saúde, Instituto de Saúde da Comunidade, Universidade Federal Fluminense, Niterói, RJ, Brazil. marciagma@id.uff.br.
authors.forename: Márcia Guimarães de Mello
authors.initials: MG
authors.lastname: Alves
authors.affiliation: National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. mariajmf@ensp.fiocruz.br.
authors.forename: Maria de Jesus Mendes
authors.initials: Mde J
authors.lastname: da Fonseca
authors.affiliation: National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. leticiaocar@ensp.fiocruz.br.
authors.forename: Letícia de Oliveira
authors.initials: Lde O
authors.lastname: Cardoso
authors.affiliation: School of Nutrition, Universidade Federal de Ouro Preto, Belo Horizonte, MG, Brazil. luana.giatti@gmail.com.
authors.forename: Luana
authors.initials: L
authors.lastname: Giatti
authors.affiliation: National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. enirtes@globo.com.
authors.forename: Enirtes Caetano Prates
authors.initials: EC
authors.lastname: Melo
authors.affiliation: Centre for Health Equity Studies | CHESS, Stockholm University/Karolinska Institutet, Stockholm, Sweden. susanna.toivanen@chess.su.se.
authors.forename: Susanna
authors.initials: S
authors.lastname: Toivanen
authors.affiliation: National School of Public Health, Fundação Oswaldo Cruz, Rio de Janeiro, RJ, Brazil. dorachor@fiocruz.br.
authors.forename: Dóra
authors.initials: D
authors.lastname: Chor
mesh_terms: D000328:Adult; D001938:Brazil; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007899:Leisure Activities; D008019:Life Style; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012309:Risk-Taking; D012907:Smoking / Q000453:epidemiology; D013315:Stress, Psychological / Q000150:complications; D011795:Surveys and Questionnaires; D017132:Workplace / Q000523:psychology