Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders?

Abstract

Purpose Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined. Methods The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012. We used 12,458 observations from 6159 employees, who were 40-60 years old at baseline. CMD were measured by the General Health Questionnaire (GHQ-12, cutoff point 3+). Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as "neither", "work exposure only", "CMD only", and "both". Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up. Additionally, synergy indices were calculated for the combined effects. Results Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither. Synergy indices indicated that these associations were synergistic. Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work. Conclusions Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.

Disability pensions related to heavy physical workload: a cohort study of middle-aged and older workers in Sweden

“…Conversely, occupations without physical strain are often non-manual occupations which allow more flexibility for the workers in terms of how and when tasks are to be performed (Johansson and Lundberg 2009). A hindering effect in physically strenuous jobs could give rise to the more general association with poor self-rated health (Burr et al 2017), long-term sick leave (Andersen et al 2016;Sommer et al 2016;Sundstrup et al 2018), all-cause disability pension (Emberland et al 2017;Friis et al 2008;Halonen et al 2019;Jarvholm et al 2014;Karpansalo et al 2002;Labriola et al 2009;Lahelma et al 2012;Sommer et al 2016) and, consequently, loss of work-life expectancy (Schram et al 2020) demonstrated in previous studies. However, low education and a history of unemployment also seem to contribute to the explanation.…”

“…Heavy physical workload, including heavy manual handling, awkward body postures, repetitive and circulatory demanding work, seems to decrease the possibility of continuing to work up until an older age. Several studies have shown that disability pension is much more frequent among workers with heavy physical workload than in those without (Emberland et al 2017;Ervasti et al 2019;Friis et al 2008;Halonen et al 2019;Jarvholm et al 2014;Karkkainen et al 2013;Karpansalo et al 2002;Kjellberg et al 2016;Labriola et al 2009;Lahelma et al 2012;Prakash et al 2017;Ropponen et al 2014;Sommer et al 2016). Other studies have shown that long-term sickness absence, which usually precedes disability pension, is also more common (Andersen et al 2016;Sommer et al 2016;Sundstrup et al 2018).…”

Precarious work increases depression-based disability among male employees

“…The covariates characterizing working conditions included adverse physical factors, job demands/control and shiftwork, as these job characteristics have been linked to disability. 18 , 21 , 22 Physical work exposures were based on an 18-item inventory. Following prior studies, 18 we used a factor analysis that divided the items into three factors: hazardous, physical workload and ‘office work’ exposures.…”

“… 18 , 21 , 22 Physical work exposures were based on an 18-item inventory. Following prior studies, 18 we used a factor analysis that divided the items into three factors: hazardous, physical workload and ‘office work’ exposures.…”

“… 16 We focus on depression-based disability because it is the leading cause for granting DP in Finland. Earlier studies on cause-specific DP have paid little attention to gender, the focus being on physical work exposures, 18 job strain, 19 relational justice 20 and worktime. 21 Among these studies, only Vahtera et al 21 addressed the gender aspect: Self-assessed worktime control decreased the risk of receiving DP based on mental disorders among women.…”