Access to Showers and Change Rooms at Work Associated With Active Commuting Among Older Workers: Findings From a National Population Survey

Abstract

Access to workplace showers and change rooms (WS/CR) has been found to be associated with active commuting (AC). Yet it is unclear whether this extends to older workers. We examined the association between WS/CR and AC (walking, cycling) comparing older and younger workers. Data came from 53,294 respondents to the 2007-2008 Canadian Community Health Survey. Associations between WS/CR and walking and cycling were analyzed for main effects and by age and sex using logistic regression. Compared with younger ages, workers 50 to 75 years old were more likely to cycle to work if WS/CR were available (odds ratio [OR] = 1.71, 95% confidence interval [CI] = [1.13, 2.58]), though the overall and sex-related associations between WS/CR and AC were nonsignificant. WS/CR may be a promising strategy to promote AC particularly among older workers. With large numbers of middle- and older-aged adults working longer, the implications of AC for sustaining good health may be considerable.

Keywords

transport physical activity workplace cycling

Introduction

Regular physical activity confers substantial benefits to a person’s health and well-being (Warburton, Nicol, & Bredin, 2006). Yet a third of all adults do not meet recommended physical activity levels (Jefferis et al., 2014; Kohl et al., 2012). Older adults are at particular risk of inactivity. The World Health Organization estimates that 55% of older adults are inactive compared with 19% of the youngest adults (World Health Organization, 2016). Although various settings have been the focus of physical activity promotion strategies for older adults, the workplace holds considerable promise, but has been underresearched. Older adults will continue to represent a large proportion of workers, especially as people live longer and work beyond the typical retirement age (Fields, Uppal, & LaRochelle-Côté, 2017). Workplaces are also increasingly recognized as important settings to promote physical activity as the majority of adults spend a large portion of their day at work (Tudor-Locke, Leonardi, Johnson, & Katzmarzyk, 2011).

Active commuting (AC) to work by walking and cycling presents a practical way for many adults to incorporate more physical activity into their daily life. The health benefits of AC are associated with a reduced risk for cardiovascular disease in working adults (Celis-Morales et al., 2017; Hamer & Chida, 2008). Yet studies show that fewer older workers choose AC than younger workers (Bopp, Der Ananian, & Campbell, 2014; Merom, Miller, van der Ploeg, & Bauman, 2008). Socioecological models posit that these differences may relate to the need for a supportive physical and cultural environment to promote physical activity (Sallis, Floyd, Rodríguez, & Saelens, 2012). One potential environmental barrier to AC is the lack of workplace showers and change room (WS/CR) facilities (Wardman, Tight, & Page, 2007). Limited research exists on the association between access to WS/CR and AC (Buehler, 2012; Kaczynski, Bopp, & Wittman, 2010; Nehme, Pérez, Ranjit, Amick, & Kohl, 2017). Buehler (2012) found that access to WS/CR was associated with workers in Washington being more likely to cycle to work. However, Nehme et al. (2017) found that WS/CR had no relationship to AC in city employees in Texas. One study investigating age differences in AC found no association among employees in Kansas but noted that women were more likely than men to engage in AC when WS/CR were available (Kaczynski et al., 2010). However, these studies were limited in that they sampled 30 individuals or less and recruited within single workplaces.

This study examined whether access to WS/CR was associated with AC by walking and cycling to work in a nationally representative sample of workers with particular attention to similarities and differences between older and younger workers.

Design and Method

Data Sources and Sample

The cross-sectional Canadian Community Health Survey (CCHS) recruited a representative sample of Canadians, collecting information face-to-face and by phone on the status, utilization, and determinants of health (Béland, 2002). We used data from the 2007-2008 CCHS, which included additional questions on facilities at work related to physical activity. One individual per household was selected to participate out of which a response was obtained from 65,946 individuals in 2007 (person-level response rate of 91.7%) and 66,013 individuals in 2008 (person-level response rate of 91.0%). Details about the survey are available elsewhere (Statistics Canada, 2009). Participant consent was obtained by Statistics Canada.

The study sample encompassed adults aged 18 to 75 years, who were employed or self-employed, did not work from home, and had no ongoing long-term condition that limited their participation in physical activities at home or work (N = 68,184).

Variables

The primary exposure was whether respondents had access to WS/CR (yes/no). The primary outcome was whether respondents engaged in AC to work by cycling (yes/no) or walking (yes/no). The secondary outcome was daily AC time to and from work.

Age was examined as a covariate and interaction variable and categorized as 18 to 34 years (youngest age group), 35 to 49 years (middle age group), and 50 to 75 years (older age group), similar to other studies examining physical activity (Kenny, Yardley, Martineau, & Jay, 2008). Covariates with established relationships to physical activity and AC were examined, including seasonality (respondents surveyed in cold or warm weather months), sex, marital status, income, educational attainment, ethnicity, body mass index (BMI), health status, rural or urban residence, access to workplace facilities other than WS/CR, leisure time physical activity, physical work demands, and weekly hours worked. Response keys for variables describing the sample are provided in Table 1.

Table 1.

Sample Characteristics (n = 53,294).

Characteristics	Age (years)			p
Characteristics	18-34	35-49	50-75	p
n (%)	18,546 (34.8)	20,092 (37.7)	14,656 (27.5)	**
Sex, %				†
Male	53.4	52.3	55.1
Female	46.6	47.7	44.9
Marital status, %				**
Married/common law	44.3	76.4	77.5
Single/divorced/separated/widow	55.7	23.6	22.5
Personal income, %				**
<Can$30,000	45.1	23.2	26.1
Can$30,000 to <Can$60,000	39.0	42.0	39.3
≥Can$60,000	15.9	34.7	34.6
Education, %				**
Secondary school graduate or lower	27.2	22.1	30.3
Some postsecondary education	12.6	6.4	6.2
Postsecondary graduate	60.2	71.5	63.5
Ethnicity, %				**
White	77.3	79.0	84.7
Other	22.7	21.0	15.3
Body mass index, M (SE)	26.4 (2.5)	25.5 (2.3)	26.1 (2.3)	.05
Perceived health, %				**
Poor to fair	4.3	6.1	9.8
Good	25.8	27.1	32.0
Very good	43.0	42.2	36.7
Excellent	26.9	24.7	21.5
Hours worked per week, %				**
<30 hr	19.6	11.7	19.2
30 to ≤40 hr	53.0	52.8	49.6
>40 hr	27.4	35.5	31.2
Physical demands of work, %				**
1 (low)	50.6	60.4	59.6
2	23.6	15.7	16.4
3	19.8	18.6	19.6
4 (high)	6.0	5.3	4.4
Active commuting, %				**
Does not walk to work	75.4	85.9	87.5
Walks to work	24.6	14.1	12.5
				**
Does not cycle to work	94.6	96.6	95.7
Cycles to work	5.4	3.4	4.3
Access to WS/CR^a				**
Yes	45.3	46.4	43.6
No or don’t know	54.7	53.6	56.4
Access to other facilities at or near work^b %				†
None	36.4	36.2	38.2
1	12.6	13.0	13.1
>1	51.0	50.8	48.7

Note. Survey-weighted percentages are shown unless otherwise stated. WS/CR = workplace showers and change rooms.

WS/CR, access to showers or change room facilities at work.

Other facilities to promote physical activity include access to a pleasant place to walk or cycle, playing fields, a gym, fitness classes, organized sports teams, and programs to improve health.

†

p < .01. **p < .001.

Statistical Analyses

Percentages and means for sample characteristics were calculated using survey weights to represent the Canadian population. Characteristics were compared using ANOVA and chi-square tests. Logistic regression models examined the relationship between WS/CR and cycling and walking to work, and total daily AC time. Main effects regression models adjusted for all study covariates. Interaction effects of age on outcomes were examined in the adjusted regression models. Differences in outcomes between men and women were explored. We also examined regression estimates for any differences between respondents who completed the survey face-to-face versus by telephone (Holbrook, Green, & Krosnick, 2003). Multicollinearity was assessed, and the variance inflation factor did not exceed 10. Therefore, all variables were retained (Allison, 2012). Estimates were examined using bootstrap methods for complex survey designs and reported as odds ratios (ORs) with 95% confidence intervals (CIs). Statistical analyses were conducted using SAS software v. 9.4 (SAS Institute, Inc.). All tests were two sided, and statistical significance established at p = .05.

Results

Of 68,184 eligible respondents, 53,294 (78%) provided information on all variables. Information on access to physical activity facilities at or near work and cycling to work was most frequently unreported. Respondents with missing information were more likely to be female (54%) and older (35% between 50 and 75 years). There were no differences between those completing the face-to-face or telephone interviews. Table 1 describes the survey characteristics by age group and for those with or without WS/CR. Thirty-five percent were in the youngest age group, 38% in the middle age group, and 28% in the older age group. While some variability was found by age, participants were, on average, mostly male, attained a postsecondary education, White, had a normal BMI, had very good health, worked 30 to 40 hr per week in low physically demanding jobs, did not engage in any AC to work, and had other physical activity facilities at or near work (a pleasant place to walk or cycle, playing fields, a gym, fitness classes, organized sports teams, and health programs). Access to WS/CR was reported by 45% in the youngest age group, 46% in the middle age group, and 44% in the older age group.

Table 2 shows no significant overall association between having access to WS/CR and cycling (OR = 1.10; 95% CI = [0.91, 1.32]) or walking to work (OR = 0.98; 95% CI = [0.89, 1.08]). However, there was a significant interaction effect by age in the association between WS/CR and cycling to work. A strong positive relationship between WS/CR and cycling to work was found among the older age group (OR = 1.71, 95% CI = [1.13, 2.58]). No significant associations were found among the youngest age group (OR = 0.93, 95% CI = [0.71, 1.22]) or among the middle age group (OR = 1.12, 95% CI = [0.86, 1.47]) in the association between having access to WS/CR and cycling to work. No significant differences related to WS/CR were noted by age and walking to work, or between men and women for cycling or walking to work.

Table 2.

The Association Between Having Access to WS/CR and Active Commuting.

Access to WS/CR	Cycle to work		Walk to work
Access to WS/CR	Odds ratio (95% CI)	p	Odds ratio (95% CI)	p
Main effects	1.10 [0.91, 1.32]	—	0.98 [0.89, 1.08]	—
Sex		.47		.10
Men	1.14 [0.91, 1.42]		1.05 [0.93, 1.19]
Women	1.01 [0.76, 1.34]		0.92 [0.81, 1.04]
Age (years)		*		.59
18-34	0.93 [0.71, 1.22]		0.95 [0.84, 1.08]
35-49	1.12 [0.86, 1.47]		0.97 [0.83, 1.14]
50-75	1.71 [1.13, 2.58]		1.06 [0.89, 1.28]

Note. Reference category: does not cycle or walk to work. Unless included as an interaction variable, logistic regression models were adjusted for seasonality, age, sex, marital status, personal income, education, ethnicity, body mass index, perceived health, residential area, access to other physical activity facilities at work, physical demands of work, leisure time physical activity level, and hours worked per week. Main effects model included all covariates. WS/CR = workplace showers and change rooms; CI = confidence interval.

p (interaction): *p < .05. **p < .001.

Table 3 shows a significant association between AC time and cycling to work with greater odds of cycling 60 to 120 min when access to WS/CR was available (OR = 1.62; 95% CI = [1.14, 2.30]). Age modified the association, with access to WS/CR being particularly important for workers in the older age group with shorter (≤30 min; OR = 2.08; 95% CI = [1.08, 4.02]) and longer (60-120 min; OR = 3.17; 95% CI = [1.47, 6.86]) commutes. Sex was not associated with differences in time cycling or walking to work, and age was not associated with walking times.

Table 3.

The Association Between Having Access to Showers and Change Rooms at Work and Total Daily Active Commute Time.

	Total time to cycle to and from work
	≤30 min	>30-60 min	>60-120 min	>120 min
Access to WS/CR	Odds ratio (95% CI)				p
Main effects	1.01 [0.72, 1.43]	0.95 [0.71, 1.27]	1.62 [1.14, 2.30]	1.15 [0.63, 2.10]	—
Sex					.22
Male	1.03 [0.67, 1.58]	1.02 [0.72, 1.46]	1.48 [0.96, 2.28]	1.54 [0.75, 3.15]
Female	0.98 [0.60, 1.61]	0.81 [0.53, 1.23]	1.98 [1.10, 3.55]	0.49 [0.19, 1.25]
Age (years)					*
18-34	0.81 [0.50, 1.30]	0.89 [0.58, 1.39]	1.04 [0.64, 1.69]	1.98 [0.93, 4.22]
35-49	1.11 [0.70, 1.76]	0.89 [0.59, 1.34]	2.17 [1.20, 3.92]	0.77 [0.31, 1.88]
50-75	2.08 [1.08, 4.02]	1.26 [0.57, 2.79]	3.17 [1.47, 6.86]	0.95 [0.37, 2.48]
	Total time to walk to and from work
	≤30 min	>30 to 60 min	>60 to 120 min	>120 min
Access to WS/CR	OR (95% CI)				p
Main effects	0.94 [0.82, 1.09]	1.08 [0.93, 1.26]	0.93 [0.76, 1.14]	0.96 [0.68, 1.36]	—
Sex					.36
Male	1.02 [0.85, 1.23]	1.22 [0.99, 1.50]	0.95 [0.72, 1.25]	0.91 [0.59, 1.40]
Female	0.88 [0.73, 1.06]	0.97 [0.80, 1.18]	0.91 [0.71, 1.16]	1.05 [0.65, 1.70]
Age (years)					.32
18-34	0.93 [0.76, 1.12]	1.00 [0.82, 1.22]	0.93 [0.71, 1.22]	0.97 [0.64, 1.48]
35-49	0.92 [0.73, 1.16]	1.09 [0.85, 1.38]	0.82 [0.61, 1.12]	1.34 [0.75, 2.38]
50-75	0.99 [0.77, 1.28]	1.30 [0.95, 1.79]	1.08 [0.74, 1.57]	0.51 [0.27, 0.98]

Note. Reference category: Does not walk or cycle to work. Unless included as an interaction variable, logistic regression models were adjusted for seasonality, age, sex, marital status, personal income, education, ethnicity, body mass index, perceived health, residential area, access to other physical activity facilities at work, leisure time physical activity level, physical demands of work, and hours worked per week. Main effects model included all covariates. CI = confidence interval.

p (interaction): *p < .05. **p < .001.

Discussion

Few studies have examined the relationship between access to WS/CR and AC. By examining a large sample of workers representative of the Canadian population and across different ages, our findings suggest that providing access to WS/CR was associated with cycling-based AC among workers aged 50 years or more. This group had the strongest association with short (≤30 min) and longer (>60-120 min) cycling-based AC to work than other age groups. These results are promising and suggest greater attention and research is needed examining age and a range of workplace supports for physical activity.

Unlike earlier studies, our findings may be more generalizable as they come from a population-representative sample of workers. The majority of workers in the study did not engage in any AC to work. This was unsurprising as most developed countries have seen a progressive decrease in AC as cars have become widely available, commute distances longer, perceived hazards of urban walking and cycling have increased and, in Canada, winter weather presents a significant obstacle to AC (Shephard, 2008). More individuals walked than cycled to work, which may be due to the built environment making cycling less feasible (e.g., lack of cycle lanes, no storage for bicycles; Buehler, 2012; Heinen, Van, Wee, & Maat, 2010). Although a smaller percentage of older workers walked or cycled to work compared with younger workers, nearly half had access to WS/CR and comparable proportions were found across age groups. This is encouraging and suggests that WS/CR might support AC for some workers, and more research is needed to inform which other facilities and provisions can also help promote AC (Biswas, Smith, & Gignac, forthcoming).

There were no significant age or sex relationships with WS/CR and walking to work. Because cycling is typically more strenuous than walking, WS/CR may be particularly important for cyclists as they allow workers to groom themselves and change into office attire. The paucity of research in this area means that we can only speculate on the factors related to AC differences between older and younger workers with access to WS/CR. It is possible that in some instances, WS/CR were available to workers in physically demanding, strenuous occupations, which are largely represented by younger workers (Sluiter, 2006). Evidence linking physically demanding work with lower participation in non-work-related physical activity (Fransson et al., 2012) suggests that these individuals may be choosing less strenuous modes of transport such as driving. Our finding that older workers with access to WS/CR were more likely to engage in cycling-based AC over a short period (<30 min) is congruent with evidence that short distances to work is a strong predictor of AC in older adults (Panter, Jones, van Sluijs, Griffin, & Wareham, 2011). Conversely, associations with longer cycle-based commute times (>60-120 min) in older adults may be a result of living further away from work and requiring more use of WS/CR, as well as greater perceived behavioral control among some individuals (Panter & Jones, 2010). Further research is needed to further explore the relationships between these and other factors as they relate to differences in associations between WS/CR and AC in younger and older workers.

Our findings substantiate the value of socioecological models of physical activity where the built environment is hypothesized to facilitate or impede physical activity (Sallis et al., 2012). The provision of WS/CR is only one of many ways that workplace physical activity can be encouraged. Greater attention to other workplace facilities should also be examined, such as on-site fitness facilities, health programs, and flexible exercise time (Dodson et al., 2016; Hipp et al., 2017). For example, providing subsidies for health club memberships and paid time for nonwork physical activity in North Carolina was associated with increased physical activity (Lucove, Huston, & Evenson, 2007). Future research should identify ways that workplace health promotion can draw on environmental adaptations to meet the needs and priorities of older workers (Pitt-Catsouphes, James, & Matz-Costa, 2015), particularly as older adults are working longer.

Several study limitations need acknowledgment. Associations were examined in a cross-sectional sample; therefore, it is possible that awareness of WS/CR was more common in individuals who regularly engage in AC and longitudinal studies are need to confirm the direction of the associations. Although our analyses statistically controlled for respondents residing in urban and rural areas, information on the distance from home to work was unavailable in the survey. Examining differences in AC that consider the distance to work could help elucidate our findings. There are also potential limitations like social desirability effects in studies of self-reported physical activity. However, this may have been more likely to inflate time spent in AC and not misreporting whether one cycles or walks to work. Future studies should consider using accurate objective physical activity measures (Lee & Shiroma, 2014). Finally, these findings need to be replicated in other countries.

Built facilities such as WS/CR have been given little focus as a potential strategy to enable older workers to be physically active. This is despite increasing participation of older workers in the labor market. Our findings show that access to WS/CR presents a promising strategy to promote AC and may ultimately increase overall physical activity levels. With the rise in middle-aged and older adults in the workforce, the implications for health care use and cost can be significant. Further investigations are needed to verify these findings in specific workplace settings and to better explain why workers may vary in their use of WS/CR and in engaging in AC.

Footnotes

Declaration of Conflicting Interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

ORCID iD

Aviroop Biswas

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