Background: High levels of occupational physical activity (OPA) may be related to pain and sickness absence in the eldercare sector, which is dependent on foreign-born workforce. However, no study has investigated the closeness of OPA in eldercare to the recommendations proposed by EU-OSHA and compared workers born in different countries, which is important to address inequalities in occupational health.

Aim: To determine how close the physical activity compositions of Swedish-born and foreign-born eldercare workers are to EU-OSHA's recommended composition (60% sitting, 30% standing, and 10% moving) during work hours. 

Methods: We analyzed data from 222 eldercare workers in three Swedish municipalities. Physical activity was assessed with a thigh-worn accelerometer for seven days.  Time spent sitting, standing, and moving at work (diary based) was analyzed using the Actipass software. The Aitchison distance between each observed OPA composition and the composition recommended by EU-OSHA was calculated and expressed as a closeness index ranging from 0 (‘worst possible’ composition [1:1:98]) to 100 (EU-OSHA composition [60:30:10]). The closeness indices for Swedish-born and foreign-born workers were compared using linear mixed models.

Results: The Swedish-born group (n=160, 72.1%) had an average composition of 49:39:12, which led to a closeness index of 88.3 [SD 7.1], while the foreign-born had a composition of 44:40:15 and closeness index of 84.9 [SD 7.6]. The two groups were significantly different (β=3.34; CI=[1.19:5.48]; p<0.01), even after adjustments for age, gender and sector (nursing home or homecare) (β=3.98; CI=[1.74:6.22]; p<0.01).

Conclusions: Compositions of OPA among foreign-born workers were further from the EU-OSHA recommendation compared to their Swedish peers. Task-related differences in patient care may explain our findings. Future studies should consider alternations between sitting, standing and moving, and develop interventions to promote a more balanced OPA between Swedish-born and foreign-born workers, and thus address potential inequalities in the eldercare sector.