Associations of vacation time with lifestyle, long-term mortality and health-related quality of life in old age: The Helsinki Businessmen Study

Empirical Study on the Relationship Between Vacation Schedule and Seafarers' Fatigue in Chinese Seafarer Population

Background

Fatigue is an important factor for the safety of ships. In order to alleviate fatigue of the seafarers, the STCW Convention (International Convention on Standards of Training, Certification, and Watchkeeping for Seafarers) has made many regulations on the working time of seafarers. At present, if a crew member takes only one day off at home before returning to work on the ship, the working time on the ship must be re-calculated again. If the time spent at home is not sufficient to allow the crew to recover, the regulations of only stipulating the working time, not stipulating the home vacation time, cannot guarantee the crew's fatigue been well controlled. The aim of present study is to explore the relationship between vacation schedule and fatigue of the seafarers.

Methods

In present study, a simplified stress scale developed by the Ministry of Labor of Japan has been used as a measurement tool. The method of stratified sampling was adopted. Data collection mainly came from domestic ocean-going seafarers (n = 165). Analysis was conducted using the Cross (chi-square) analysis and hierarchical multiple regression analysis methods.

Results

We found that there was no difference between crew members of different positions in terms of average vacation time and on-board service time (p > 0.05). The length of last vacation time and this service time for seafarers of different positions showed obvious differences (p < 0.01). The rank has a significant effect on the length of the last vacation (χ2 = 101.560, p = 0.000 < 0.01) and the length of this service time (χ2 = 75.624, p = 0.000 < 0.01). Also, the results showed that there was a significant negative correlation between the duration of vacation and overall fatigue (t = -7.160, p = 0.000 < 0.01), while there was a significant positive correlation between the length of service time on board and overall fatigue (t = 3.474, p = 0.001 < 0.01).

Conclusion

The results indicated that a reasonable vacation schedule was crucial for the relief of the seafarers' fatigue, and also played a positive role in the state of working on the ship again.

Vacation frequency is associated with metabolic syndrome and symptoms

Objective: To examine the extent to which vacationing behavior is associated with metabolic outcomes. Specifically, we consider how total vacation episodes and total vacation days from the past 12 months relate to metabolic syndrome and metabolic symptoms.Design: Sixty-three workers eligible for paid vacation attended a lab visit during which their blood was drawn and they completed an interview assessing vacationing behavior in the past 12 months.Main outcome measures: Metabolic syndrome and metabolic symptoms are the main outcome measures.Results: Over the past 12 months, participants took approximately five vacations (M = 5.44, SD = 3.16) and used about 2 weeks of their paid vacation days (M = 13.80, SD = 7.25). Participants rated vacations positively, expressing low levels of travel-, childcare- and financial burden-related stress. As vacation episodes increased, metabolic syndrome incidence (OR = 0.76, p = 0.051) and number of metabolic symptoms met (IRR = 0.92, p = 0.035) decreased. Notably, risk for metabolic syndrome decreased by nearly a quarter with each additional vacation taken by participants.Conclusions: Overall, vacations are experienced as positive events. This positive subjective experience may translate into physical health benefits given that vacation frequency may protect against metabolic syndrome and symptoms.

Increased Mortality Despite Successful Multifactorial Cardiovascular Risk Reduction in Healthy Men: 40-Year Follow-Up of the Helsinki Businessmen Study Intervention Trial

OBJECTIVES

In a 5-year multifactorial risk reduction intervention for healthy men with at least one cardiovascular disease (CVD) risk factor, mortality was unexpectedly higher in the intervention than the control group during the first 15-year follow-up. In order to find explanations for the adverse outcome, we have extended mortality follow-up and examined in greater detail baseline characteristics that contributed to total mortality.

DESIGN

Long-term follow-up of a controlled intervention trial.

SETTING

The Helsinki Businessmen Study Intervention Trial.

PARTICIPANTS AND INTERVENTION

The prevention trial between 1974-1980 included 1,222 initially healthy men (born 1919-1934) at high CVD risk, who were randomly allocated into intervention (n=612) and control groups (n=610). The 5-year multifactorial intervention consisted of personal health education and contemporary drug treatments for dyslipidemia and hypertension. In the present analysis we used previously unpublished data on baseline risk factors and lifestyle characteristics.

MAIN OUTCOME MEASURES

40-year total and cause-specific mortality through linkage to nation-wide death registers.

RESULTS

The study groups were practically identical at baseline in 1974, and the 5-year intervention significantly improved risk factors (body mass index, blood pressure, serum lipids and glucose), and total CVD risk by 46% in the intervention group. Despite this, total mortality has been consistently higher up to 25 years post-trial in the intervention group than the control group, and converging thereafter. Increased mortality risk was driven by CVD and accidental deaths. Of the newly-analysed baseline factors, there was a significant interaction for mortality between intervention group and yearly vacation time (P=0.027): shorter vacation was associated with excess 30-year mortality in the intervention (hazard ratio 1.37, 95% CI 1.03-1.83, P=0.03), but not in the control group (P=0.5). This finding was robust to multivariable adjustments.

CONCLUSION

After a multifactorial intervention for healthy men with at least one CVD risk factor, there has been an unexpectedly increased mortality in the intervention group. This increase was especially observed in a subgroup characterised by shorter vacation time at baseline. Although this adverse response to personal preventive measures in vulnerable individuals may be characteristic to men of high social status with subclinical CVD, it clearly deserves further investigation.