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International Archives of Occupational and Environmental Health

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Open Access 29-05-2023 | Original Article

Combined exposure to heavy physical workload and low job control and the risk of disability pension: A cohort study of employed men and women in Sweden

Authors: Kathryn Badarin, Tomas Hemmingsson, Melody Almroth, Daniel Falkstedt, Lena Hillert, Katarina Kjellberg

Published in: International Archives of Occupational and Environmental Health | Issue 7/2023

Abstract

Objective

To investigate the separate and combined effects of overall heavy physical workload (PWL) and low decision authority on all-cause disability pension (DP) or musculoskeletal DP.

Methods

This study uses a sample of 1,804,242 Swedish workers aged 44–63 at the 2009 baseline. Job Exposure Matrices (JEMs) estimated exposure to PWL and decision authority. Mean JEM values were linked to occupational codes, then split into tertiles and combined. DP cases were taken from register data from 2010 to 2019. Cox regression models estimated sex-specific Hazard Ratios (HR) with 95% confidence intervals (95% CI). The Synergy Index (SI) estimated interaction effects.

Results

Heavy physical workload and low decision authority were associated with an increased risk of DP. Workers with combined exposure to heavy PWL and low decision authority often had greater risks of all-cause DP or musculoskeletal DP than when adding the effects of the single exposures. The results for the SI were above 1 for all-cause DP (men: SI 1.35 95%CI 1.18–1.55, women: SI 1.19 95%CI 1.05–1.35) and musculoskeletal disorder DP (men: SI 1.35 95%CI 1.08–1.69, women: 1.13 95%CI 0.85–1.49). After adjustment, the estimates for SI remained above 1 but were not statistically significant.

Conclusion

Heavy physical workload and low decision authority were separately associated with DP. The combination of heavy PWL and low decision authority was often associated with higher risks of DP than would be expected from adding the effects of the single exposures. Increasing decision authority among workers with heavy PWL could help reduce the risk of DP.

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Almroth M, Hemmingsson T, Sörberg Wallin A, Kjellberg K, Burström B, Falkstedt D (2021) Psychosocial working conditions and the risk of diagnosed depression: a Swedish register-based study. Psychol Med 22:1–9

Andersen LL, Villadsen E, Clausen T (2020) Influence of physical and psychosocial working conditions for the risk of disability pension among healthy female eldercare workers: Prospective cohort. Scand J Public Health 48:460–467CrossRef

Andersson T, Alfredsson L, Källberg H, Zdravkovic S, Ahlbom A (2005) Calculating measures of biological interaction. Eur J Epidemiol 20:575–579CrossRef

Badarin K, Hemmingsson T, Hillert L, Kjellberg K (2021) Physical workload and increased frequency of musculoskeletal pain: a cohort study of employed men and women with baseline occasional pain. Occupat Environm Med. 78:556

Christensen KB, Feveile H, Labriola M, Lund T (2008) The impact of psychosocial work environment factors on the risk of disability pension in Denmark. Eur J Pub Health 18:235–237CrossRef

Devereux JJ, Vlachonikolis IG, Buckle PW (2002) Epidemiological study to investigate potential interaction between physical and psychosocial factors at work that may increase the risk of symptoms of musculoskeletal disorder of the neck and upper limb. Occupat Environm Med 59:269–277CrossRef

Ervasti J, Pietiläinen O, Rahkonen O, Lahelma E, Kouvonen A, Lallukka T, Mänty M (2019) Long-term exposure to heavy physical work, disability pension due to musculoskeletal disorders and all-cause mortality: 20-year follow-up-introducing Helsinki Health Study job exposure matrix. Int Arch Occup Environ Health 92:337–345CrossRef

Falkstedt D, Hemmingsson T, Albin M, Bodin T, Ahlbom A, Selander J, Gustavsson P, Andersson T, Almroth M, Kjellberg K (2021) Disability pensions related to heavy physical workload: a cohort study of middle-aged and older workers in Sweden. Int Arch Occup Environ Health 94:1851–1861CrossRef

FORSAKRINGSKASSAN (2021) Sickness Compensation [Online]. The Swedish Social Insurance Agency. Available: https://www.forsakringskassan.se/ Accessed 11 Oct 2021

Försäkringskassan (2022) Social Insurance in Figures 2022 Stockholm

Gustafsson K, Marklund S, Aronsson G, Leineweber C (2020) Interaction effects of physical and psychosocial working conditions on the risk of disability pension among nursing professionals and care assistants in Sweden: A prospective study. Int J Nurs Stud 102:103484–103484CrossRef

Halonen JI, Mänty M, Pietiläinen O, Kujanpää T, Kanerva N, Lahti J, Lahelma E, Rahkonen O, Lallukka T (2020) Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders? Soc Psychiatry Psychiatr Epidemiol 55:1021–1029CrossRef

Helgesson M, Marklund S, Gustafsson K, Aronsson G, Leineweber C (2020) Interaction effects of physical and psychosocial working conditions on risk for sickness absence: a prospective study of nurses and care assistants in sweden. Int J Environ Res Public Health 17:7427CrossRef

Kadefors R, Nilsson K, Rylander L, Г-Stergren PO, Albin M (2018) Occupation, gender and work-life exits: a Swedish population study. Ageing and Society 38:1332–1349CrossRef

Karasek RA (1979) Job demands job decision latitude, and mental strain: implications for job redesign. Admin Sci Quart 22:285–308CrossRef

Karasek RA (1997) Demand/Control Model: a social, emotional, and physiological approach to stress risk and active behaviour development. In: International Labour Office (ILO) Encyclopaedia of Occupational Health and Safety

Kjellberg K, Lundin A, Falkstedt D, Allebeck P, Hemmingsson T (2016) Long-term physical workload in middle age and disability pension in men and women: a follow-up study of Swedish cohorts. Int Arch Occup Environ Health 89:1239–1250CrossRef

Knardahl S, Johannessen HA, Sterud T, Härmä M, Rugulies R, Seitsamo J, Borg V (2017) The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses. BMC Public Health 17:176–176CrossRef

Leineweber C, Marklund S, Aronsson G, Gustafsson K (2019) Work-related psychosocial risk factors and risk of disability pension among employees in health and personal care: A prospective cohort study. Int J Nurs Stud 93:12–20CrossRef

Macdonald LA, Karasek RA, Punnett L, Scharf T (2001) Covariation between workplace physical and psychosocial stressors: evidence and implications for occupational health research and prevention. Ergonomics 44:696–718CrossRef

Mäki NE, Martikainen PT, Eikemo T, Menvielle G, Lundberg O, Östergren O, Mackenbach JP (2014) The potential for reducing differences in life expectancy between educational groups in five European countries: the effects of obesity, physical inactivity and smoking. J Epidemiol Comm Health 68:635–640CrossRef

Punnett L, Wegman DH (2004) Work-related musculoskeletal disorders: the epidemiologic evidence and the debate. J Electromyogr Kinesiol 14:13–23CrossRef

Sabbath EL, Glymour MM, Descatha A, Leclerc A, Zins M, Goldberg M, Berkman LF (2013) Biomechanical and psychosocial occupational exposures: joint predictors of post-retirement functional health in the French GAZEL cohort. Adv Life Course Res 18:235–243CrossRef

SCB, S. S. (2001) SSYK 1996 Standard for svensk yrkesklassificering 1996 (Swedish Standard Classification of Occupations 1996) [Online]. SCB statistics Sweden. Available: https://www.scb.se/contentassets/50bf86d2c66149d696f515a9481bc9e2/ov9999_1998a01_br_x70op9803.pdf Accessed

Sundstrup E, Andersen LL (2021) Joint association of physical and psychosocial working conditions with risk of long-term sickness absence: prospective cohort study with register follow-up. Scand J Public Health 49:132–140CrossRef

Sundstrup E, Hansen AM, Mortensen EL, Poulsen OM, Clausen T, Rugulies R, Maller A, Andersen LL (2018) Retrospectively assessed psychosocial working conditions as predictors of prospectively assessed sickness absence and disability pension among older workers. BMC Public Health 18:332CrossRef

Theorell T (2005) Chapter Four Possible mechanisms behind the relationship between the demand-control-support model and disorders of the locomotor system. Beyond Biomechanic Psychosocial Aspects Of Musculoskeletal Disorders In Office Work. London: Taylor snd Francis

Thorbjörnsson CB, Alfredsson L, Fredriksson K, Michélsen H, Punnett L, Vingård E, Torgén M, Kilbom Å (2000) Physical and psychosocial factors related to low back pain during a 24-year period a nested case-control analysis. Spine 25:369–375CrossRef

Vanderweele TJ, Knol MJ (2014) A Tutorial on Interaction. Epidemiol Meth 3:33–72CrossRef

Wells R, Norman R, Neumann P, Andrews D, Frank J, Shannon H, Kerr M (1997) Assessment of physical work load in epidemiologic studies: common measurement metrics for exposure assessment. Ergonomics 40:51–61CrossRef

Widanarko B, Legg S, Devereux J, Stevenson M (2014) The combined effect of physical, psychosocial/organisational and/or environmental risk factors on the presence of work-related musculoskeletal symptoms and its consequences. Appl Ergon 45:1610–1621CrossRef

Widanarko B, Legg S, Devereux J, Stevenson M (2015) Interaction between physical and psychosocial work risk factors for low back symptoms and its consequences amongst Indonesian coal mining workers. Appl Ergon 46:158–167CrossRef

Title: Combined exposure to heavy physical workload and low job control and the risk of disability pension: A cohort study of employed men and women in Sweden
Authors: Kathryn Badarin
Tomas Hemmingsson
Melody Almroth
Daniel Falkstedt
Lena Hillert
Katarina Kjellberg
Publication date: 29-05-2023
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 7/2023
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-023-01983-8

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Combined exposure to heavy physical workload and low job control and the risk of disability pension: A cohort study of employed men and women in Sweden

Abstract

Objective

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Objective

Methods

Results

Conclusion

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