Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers

Abstract

Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement. Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix. Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure. Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors.

Gender Differences in Associations between Biomechanical and Psychosocial Work Exposures and Age of Withdrawal from Paid Employment among Older Workers

“…In line with previous studies that reported gender-specific outcomes among older workers [ 14 , 18 , 20 ], the results from the present study indicate that biomechanical and psychosocial work exposures are associated with age of withdrawal from paid employment among both men and women and that some gender differences in the associations exist.…”

“…Thus, knowledge of how work exposures are associated with early withdrawal from work among older workers is vital to extend working life successfully. Previous studies have examined biomechanical and psychosocial work exposures among older workers with respect to early retirement [ 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 ], disability retirement [ 8 , 14 , 16 , 18 , 19 , 20 ], long-term sickness absence [ 16 , 19 ] and unemployment [ 8 , 16 , 19 ].…”

“…However, men and women may have different push and pull factors [ 21 ], and there is a lack of studies focusing on gender differences in the relationship between work exposures and withdrawal from work among older workers. First, only a few studies have reported gender-specific results [ 14 , 18 , 20 ], although some report that stratified or interaction analysis did not reveal substantial gender differences [ 13 , 19 ]. Second, among the studies that reported gender-specific results, the findings have been inconsistent for psychosocial exposures.…”

“…Second, among the studies that reported gender-specific results, the findings have been inconsistent for psychosocial exposures. High job demands have been found to be a risk factor for disability pension and early retirement pension among women, but both a risk factor and a protective factor among men [ 14 , 18 ]. Inconsistent results with regard to disability pension and early retirement have also been found for low job control, with a mix of positive, negative and no association for men and women [ 14 , 18 , 20 ].…”

“…High job demands have been found to be a risk factor for disability pension and early retirement pension among women, but both a risk factor and a protective factor among men [ 14 , 18 ]. Inconsistent results with regard to disability pension and early retirement have also been found for low job control, with a mix of positive, negative and no association for men and women [ 14 , 18 , 20 ]. Third, there is a lack of studies examining multiple independent work exposures, particularly among biomechanical exposures.…”