title: Work, household, and leisure-time physical activity and risk of mortality in the EPIC-Spain cohort.
abstract: OBJECTIVE
  Large-scale longitudinal data on the association of domain-specific physical activity (PA) and mortality is limited. Our objective was to evaluate the association of work, household (HPA), and leisure time PA (LTPA) with overall and cause-specific mortality in the EPIC-Spain study.
  
  
  METHODS
  38,379 participants (62.4% women), 30-65years old, and free of chronic disease at baseline were followed-up from recruitment (1992 - 1996) to December 31st, 2008 to ascertain vital status and cause of death. PA was evaluated at baseline and at a 3-year follow-up with a validated questionnaire (EPIC-PAQ) and combined variables were used to classify the participants by sub-domains of PA. Associations with overall, cancer, and cardiovascular mortality risks were assessed using competing risk Cox regression models adjusted by potential confounders.
  
  
  RESULTS
  After 13.6years of mean follow-up, 1371 deaths were available for analyses. HPA was strongly associated to reduced overall (hazard ratio (HR) for Q4 vs. Q1=0.47 (0.34, 0.64)) and cause-specific mortalities in women and to lower cancer mortality in men (P for trend=0.004), irrespective of age, education, and lifestyle and morbidity variables. LTPA was associated with lower mortality in women (HR for Q4 vs. Q1=0.71 (0.52, 0.98)), but not men. No relationships were found between sedentariness at work and overall mortality.
  
  
  CONCLUSIONS
  HPA was associated to lower mortality risk in men and women from the EPIC-Spain cohort, whereas LTPA also contributed to reduce risk of death in women. Considering the large proportion of total daily PA that HPA represents in some population groups, these results are of public health importance.
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain. Electronic address: jmhuerta.carm@gmail.com.
authors: José Mª
authors: JM
authors: Huerta
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Department of Health and Social Sciences, University of Murcia, Campus Universitario de Espinardo, 30100, Murcia, Spain. Electronic address: mdolores.chirlaque@carm.es.
authors: María Dolores
authors: MD
authors: Chirlaque
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain. Electronic address: mjose.tormo@carm.es.
authors: María José
authors: MJ
authors: Tormo
authors: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: gbuckland@iconcologia.net.
authors: Genevieve
authors: G
authors: Buckland
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Navarre Public Health Institute, Leyre, 15, 31003 Pamplona, Spain. Electronic address: me.ardanaz.aicua@cfnavarra.es.
authors: Eva
authors: E
authors: Ardanaz
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Public Health Division of Gipuzkoa, Health Research Institute BIO-Donostia, Basque Government, Avenida de Navarra, 4, 20013 Donostia-San Sebastián, Spain. Electronic address: l-arriola@ej-gv.es.
authors: Larraitz
authors: L
authors: Arriola
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain. Electronic address: diana.gavrila@carm.es.
authors: Diana
authors: D
authors: Gavrila
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Department of Health and Social Sciences, University of Murcia, Campus Universitario de Espinardo, 30100, Murcia, Spain. Electronic address: diego.salmeron@carm.es.
authors: Diego
authors: D
authors: Salmerón
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Department of Health and Social Sciences, University of Murcia, Campus Universitario de Espinardo, 30100, Murcia, Spain. Electronic address: lluis.cirera@carm.es.
authors: Lluís
authors: L
authors: Cirera
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain. Electronic address: bienvenida.carpe@carm.es.
authors: Bienvenida
authors: B
authors: Carpe
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Andalusian School of Public Health, Cuesta del Observatorio, 4, 18011, Granada, Spain. Electronic address: memolina@cnio.es.
authors: Esther
authors: E
authors: Molina-Montes
authors: Public Health Division of Gipuzkoa, Health Research Institute BIO-Donostia, Basque Government, Avenida de Navarra, 4, 20013 Donostia-San Sebastián, Spain. Electronic address: s-chamosa@ej-gv.es.
authors: Saioa
authors: S
authors: Chamosa
authors: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: ntravier@iconcologia.net.
authors: Noemie
authors: N
authors: Travier
authors: Public Health Directorate, Ciriaco Miguel Vigil, 9, 33006 Oviedo, Spain. Electronic address: joseramon.quirosgarcia@asturias.org.
authors: José R
authors: JR
authors: Quirós
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Navarre Public Health Institute, Leyre, 15, 31003 Pamplona, Spain. Electronic address: aurelio.barricarte.gurrea@cfnavarra.es.
authors: Aurelio
authors: A
authors: Barricarte
authors: Unit of Nutrition, Environment and Cancer, Cancer Epidemiology Research Programme, Catalan Institute of Oncology (ICO), Gran Via de l'Hospitalet, 199-203, 08908 L'Hospitalet de Llobregat, Barcelona, Spain. Electronic address: aagudo@iconcologia.net.
authors: Antonio
authors: A
authors: Agudo
authors: CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Andalusian School of Public Health, Cuesta del Observatorio, 4, 18011, Granada, Spain. Electronic address: mariajose.sanchez.easp@juntadeandalucia.es.
authors: María José
authors: MJ
authors: Sánchez
authors: Department of Epidemiology, Murcia Regional Health Council, IMIB-Arrixaca, Ronda de Levante, 11, 30008, Murcia, Spain; CIBER Epidemiología y Salud Pública (CIBERESP), Melchor Fernández Almagro, 3-5, 28029, Madrid, Spain; Department of Health and Social Sciences, University of Murcia, Campus Universitario de Espinardo, 30100, Murcia, Spain. Electronic address: carmen.navarro@carm.es.
authors: Carmen
authors: C
authors: Navarro
mesh_terms: D000328:Adult; D000368:Aged; D002423:Cause of Death / Q000639:trends; D015444:Exercise; D005260:Female; D015438:Health Behavior / Q000502:physiology*; D006796:Household Work / Q000379:methods / Q000706:statistics & numerical data*; D006801:Humans; D007899:Leisure Activities; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D061213:Mortality, Premature / Q000639:trends*; D015999:Multivariate Analysis; D009790:Occupations / Q000145:classification / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D057185:Sedentary Behavior; D017678:Sex Distribution; D013030:Spain / Q000453:epidemiology; D013997:Time Factors
keywords: EPIC-Spain; Household physical activity; Mortality; Physical activity; Recreational physical activity