The COVID-19 pandemic has become a public health emergency of international concern, which may have affected lifestyle habits and mental health. Based on national health profile assessments, this study investigated perceived changes of lifestyle habits in response to the COVID-19 pandemic and associations between perceived lifestyle changes and mental health in Swedish working adults. Among 5599 individuals (50% women, 46.3 years), the majority reported no change (sitting 77%, daily physical activity 71%, exercise 69%, diet 87%, alcohol 90%, and smoking 97%) due to the pandemic. Changes were more pronounced during the first wave (April–June) compared to the second (October–December). Women, individuals <60 years, those with a university degree, white-collar workers, and those with unhealthy lifestyle habits at baseline had higher odds of changing lifestyle habits compared to their counterparts. Negative changes in lifestyle habits and more time in a mentally passive state sitting at home were associated with higher odds of mental ill-health (including health anxiety regarding one’s own and relatives’ health, generalized anxiety and depression symptoms, and concerns regarding employment and economy). The results emphasize the need to support healthy lifestyle habits to strengthen the resilience in vulnerable groups of individuals to future viral pandemics and prevent health inequalities in society.

Background: Identify and compare health risk indicators for common chronic diseases between different occupational groups.Methods: A total of 72,855 participants (41% women) participating in an occupational health service screening in 2014–2019 were included. Occupation was defined by the Swedish Standard Classification of Occupation, and divided into nine major and additionally eight sub-major groups. These were analysed separately, as white- and blue-collar occupations and as low- and high-skilled occupations. Seven health risk indicators were self-reported: exercise, physical work situation, sitting at work and leisure, smoking, diet, and perceived health, whereas cardiorespiratory fitness, BMI and blood pressure were measured. These were further dichotomized (yes/no) and as clustering of risk indicators (≥3 vs. <3).Results: The greatest variation in OR across sub-major and major occupational groups were seen for daily smoking (OR = 0.68 to OR = 5.12), physically demanding work (OR = 0.55 to OR = 45.74) and high sitting at work (OR = 0.04 to OR = 1.86). For clustering of health risk indicators, blue-collar workers had significantly higher clustering of health risks (OR: 1.80; 95% CI 1.71–1.90) compared to white-collar workers (reference). Compared to high-skilled white-collar workers, low-skilled white-collar workers had similar OR (2.00; 1.88–2.13) as high-skilled blue-collar workers (1.98; 1.86–2.12), with low-skilled blue-collar workers having the highest clustered risk (2.32; 2.17–2.48).Conclusion: There were large differences in health risk indicators across occupational groups, mainly between high-skilled white-collar occupations and the other occupations, with important variations also between major and sub-major occupational groups. Future health interventions should target the occupational groups identified with the highest risk for effective disease prevention.

Background: Reports have indicated a negative trend in cardiorespiratory fitness (CRF) in the general population. However, trends in relation to different occupational groups are missing. Therefore, the aim of our study was to examine the trends in CRF during the last 20 years, and to provide a prognosis of future trends in CRF, in different occupational groups of Swedish workers. Methods: Data from 516,122 health profile assessments performed between 2001 to 2020 were included. CRF was assessed as maximal oxygen consumption and was estimated from a submaximal cycling test. Analyses include CRF as a weighted average, standardized proportions with low CRF (<32 mL/min/kg), adjusted annual change in CRF, and forecasting of future trends in CRF. Results: There was a decrease in CRF over the study period, with the largest decrease in both absolute and relative CRF seen for individuals working in administrative and customer service (−10.1% and −9.4%) and mechanical manufacturing (−6.5% and −7.8%) occupations. The greatest annual decrease was seen in transport occupations (−1.62 mL/min/kg, 95% CI −0.190 to −0.134). Men and younger individuals had in generally a more pronounced decrease in CRF. The proportion with a low CRF increased, with the greatest increase noted for blue-collar and low-skilled occupations (range: +19% to +27% relative change). The forecast analyses predicted a continuing downward trend of CRF. Conclusion: CRF has declined in most occupational groups in Sweden over the last two decades, with a more pronounced decline in blue-collar and low-skilled occupational groups.

Aims: Submaximal tests estimating VO₂max have inherent biases; hence, using VO₂max estimations from the same test is essential for reducing this bias. This study aimed to establish sex- and age-specific reference values for estimated VO₂max using the Åstrand-test (Å-test) and the Ekblom-Bak test (EB-test). We also assessed the effects of age, exercise level, and BMI on VO₂max estimations. Methods: We included men and women (20–69 years) from the Swedish working population participating in Health Profile Assessments between 2010 and 2020. Excluding those on heart rate-affecting medicines and smokers, n = 263,374 for the Å-test and n = 95,043 for the EB-test were included. VO₂max reference values were based on percentiles 10, 25, 40, 60, 75, and 90 for both sexes across 5-year age groups. Results: Estimated absolute and relative VO₂max were for men 3.11 L/min and 36.9 mL/min/kg using the Å-test, and 3.58 L/min and 42.4 mL/min/kg using the EB-test. For women, estimated absolute and relative VO₂max were 2.48 L/min and 36.6 mL/min/kg using the Å-test, and 2.41 L/min and 35.5 mL/min/kg using the EB-test. Higher age (negative), higher exercise level (positive), and higher BMI (negative) were associated with estimated VO₂max using both tests. However, explained variance by exercise on estimated VO₂max was low, 10% for the Å-test and 8% for the EB-test, and moderate for BMI, 23% and 29%. Conclusion: We present reference values for estimated VO₂max from two submaximal cycle tests. Age, exercise, and BMI influenced estimated VO₂max. These references can be valuable in clinical evaluations using the same submaximal tests.

The main aim was to examine the association between occupational groups and incident cardiovascular disease (CVD), and to which extent associations are mediated by lifestyle-associated variables (cardiorespiratory fitness, smoking, BMI, exercise, and diet). A total of 304,702 participants (mean age 42.5 yrs., 47% women), who performed a health profile assessment in Sweden between 1982 and 2019, were included in the analyses. CVD incidence was obtained from national registers. All participants were free from CVD prior to the health profile assessment. Occupational group was defined using the Swedish Standard Classification of Occupations and analyzed separately (13 different occupational groups) as well as after aggregation into four occupational groups (white-collar high-skilled, white-collar low-skilled, blue-collar high-skilled and blue-collar low-skilled). Cardiorespiratory fitness, BMI, exercise, smoking, and diet were included as mediators and analyzed separately in single models and simultaneously in one multiple mediation model. All mediation analyses were adjusted for sex, age, length of education and calendar time. White-collar high-skilled was set as reference in all analyses. Blue-collar and low-skilled occupation had a higher risk of incident CVD compared to the reference. Cardiorespiratory fitness, BMI, exercise, smoking, and diet mediated 48% to 54% of the associations between reference and the other aggregated occupational groups. In the single model, the strongest mediators were cardiorespiratory fitness, smoking and BMI. In conclusion, blue-collar and low-skilled occupations had a significantly higher risk for incident CVD compared to white-collar high-skilled workers, with the association mediated to a large extent by variation in lifestyle-associated variables.

Purpose: The aim of this study was to validate the submaximal Ekblom-Bak test (EB-test) and the Åstrand test (Å-test) for an elderly population.Methods: Participants (n = 104), aged 65–75 years, completed a submaximal aerobic test on a cycle ergometer followed by an individually adjusted indirect calorimetry VO₂max test on a treadmill. The HR from the submaximal test was used to estimate VO₂max using both the EB-test and Å-test equations.Results: The correlation between measured and estimated VO₂max using the EB method and Å method in women wasr = 0.64 andr = 0.58, respectively and in menr = 0.44 andr = 0.44, respectively. In women, the mean difference between estimated and measured VO₂max was − 0.02 L min⁻¹(95% CI − 0.08 to 0.04) for the EB method and − 0.12 L min⁻¹(95% CI − 0.22 to − 0.02) for the Å method. Corresponding values for men were 0.05 L min⁻¹(95% CI − 0.04 to 0.14) and − 0.28 L min⁻¹(95% CI − 0.42 to − 0.14), respectively. However, the EB method was found to overestimate VO₂max in men with low fitness and the Å method was found to underestimate VO₂max in both women and men. For women, the coefficient of variance was 11.1%, when using the EB method and 19.8% when using the Å method. Corresponding values for men were 11.6% and 18.9%, respectively.Conclusion: The submaximal EB-test is valid for estimating VO₂max in elderly women, but not in all elderly men. The Å-test is not valid for estimating VO₂max in the elderly.