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International Archives of Occupational and Environmental Health

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Open Access 01-05-2020 | Original Article

Life events as predictors for disability pension due to musculoskeletal diagnoses: a cohort study of Finnish twins

Authors: Sanna Kärkkäinen, Karri Silventoinen, Pia Svedberg, Annina Ropponen

Published in: International Archives of Occupational and Environmental Health | Issue 4/2020

Abstract

Purpose

Musculoskeletal diagnoses (MSD) are one of the largest diagnostic groups for disability pensions (DP). This study investigated the associations between life events and DP due to MSD, considering sociodemographic, health, and familial factors.

Methods

The study sample included 18,530 Finnish twins, 24–64 years old at baseline, who responded to a questionnaire in 1981 including a 21-item life event inventory. Information on DP with diagnosis codes (ICD codes: M00–M99) were obtained from the official national pension registers. Life events were divided into family- and work-related events. “Positive change in life” was analyzed separately. Cox proportional hazards models were used to calculate hazard ratios (HR) with 95% confidence intervals (CI).

Results

During the follow-up of 23 years, 1273 (7%) individuals were granted DP due to MSD. In discordant pair analysis, family-related events (≥ 4 events) increased (HR 1.63, 95% CI 1.31, 2.03) and the absence of such events decreased (HR 0.68, 95% CI 0.48, 0.95) the risk of DP due to MSD. For work-related events (≥ 3 events), the risk estimates were non-significant when controlling for familial factors. Having had a positive change in life decreased the risk of DP due to MSD (HR 0.79, 95% CI 0.65, 0.96) while controlling for familial confounding, but were non-significant in the full model controlling for various covariates (HR 0.91, 95% CI 0.75, 1.12).

Conclusions

The associations between life events and the risk of DP due to MSD are complex and potentially affected by familial and other confounding factors including sociodemographics and health.

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Appelberg K, Romanov K, Heikkilä K, Honkasalo ML, Koskenvuo M (1996) Interpersonal conflict as a predictor of work disability: a follow-up study of 15,348 Finnish employees. J Psychosom Res 40(2):157–167

Bergh H, Baigi A, Månsson J, Mattsson B, Marklund B (2007) Predictive factors for long-term sick leave and disability pension among frequent and normal attenders in primary health care over 5 years. Public Health 121(1):25–33

Bruusgaard D, Smeby L, Claussen B (2010) Education and disability pension: a stronger association than previously found. Scand J Public Health 38(7):686–690

Cleland C, Kearns A, Tannahill C, Ellaway A (2016) The impact of life events on adult physical and mental health and well-being: longitudinal analysis using the GoWell health and well-being survey. BMC Res Notes 9(1):470

Engberg E, Alen M, Kukkonen-Harjula K, Peltonen JE, Tikkanen HO, Pekkarinen H (2012) Life events and change in leisure time physical activity: a systematic review. Sports Med 42(5):433–447

Finnish Centre for Pensions (2016) Statistical yearbook of pensioners in Finland 2015.8. Finnish Centre for Pensions. The Social Insurance Institution of Finland, Helsinki

Folkman S (2008) The case for positive emotions in the stress process. Anxiety Stress Coping 21(1):3–14

Hammen C (2016) Depression and stressful environments: identifying gaps in conceptualization and measurement. Anxiety Stress Coping 29(4):335–351

Harkonmäki K, Silventoinen K, Levälahti E, Pitkäniemi J, Huunan-Seppälä A, Klaukka T, Koskenvuo M, Kaprio J (2008) The genetic liability to disability retirement: a 30-year follow-up study of 24,000 Finnish twins. PLoS One 3(10):e3402

Heikkinen S, Miettinen J, Pukkala E, Koskenvuo M, Malila N, Pitkäniemi J (2017) Impact of major life events on breast-cancer-specific mortality: a case fatality study on 8000 breast cancer patients. Cancer Epidemiol 48:62–69

Holmes TH, Rahe RH (1967) The social readjustment rating scale. J Psychosom Res 11(2):213–218

Hur YM, Macgregor AJ, Cherkas L, Williams FM, Spector TD (2012) Age differences in genetic and environmental variations in stress-coping during adulthood: a study of female twins. Behav Genet 42(4):541–548

Järvenpää T, Rinne JO, Koskenvuo M, Räihä I, Kaprio J (2005) Binge drinking in midlife and dementia risk. Epidemiology 16(6):766–771

Juvani A, Oksanen T, Virtanen M, Elovainio M, Salo P, Pentti J, Kivimäki M, Vahtera J (2016) Organizational justice and disability pension from all-causes, depression and musculoskeletal diseases: a Finnish cohort study of public sector employees. Scand J Work Environ Health 42(5):395–404

Kaprio J, Koskenvuo M (2002) Genetic and environmental factors in complex diseases: the older Finnish Twin Cohort. Twin Res Hum Genet 5(5):358–365

Kärkkäinen S, Pitkäniemi J, Silventoinen K, Svedberg P, Huunan-Seppälä A, Koskenvuo K, Koskenvuo M, Alexanderson K, Kaprio J, Ropponen A (2013) Disability pension due to musculoskeletal diagnoses: importance of work-related factors in a prospective cohort study of Finnish twins. Scand J Work Environ Health 39(4):343–350

Kendler KS (2001) Twin studies of psychiatric illness: an update. Arch Gen Psychiatry 58(11):1005–1014

Kendler KS, Baker JH (2007) Genetic influences on measures of the environment: a systematic review. Psychol Med 37(5):615–626

Kivimäki M, Vahtera J, Elovainio M, Lillrank B, Kevin MV (2002) Death or illness of a family member, violence, interpersonal conflict, and financial difficulties as predictors of sickness absence: longitudinal cohort study on psychological and behavioral links. Psychosom Med 64(5):817–825

Korkeila M, Kaprio J, Rissanen A, Koskenvuo M, Sørensen TI (1998) Predictors of major weight gain in adult Finns: stress, life satisfaction and personality traits. Int J Obes Relat Metab Disord 22(10):949–957

Kujala UM, Kaprio J, Sarna S, Koskenvuo M (1998) Relationship of leisure-time physical activity and mortality: the Finnish twin cohort. JAMA 279(6):440–444

Lazarus RS (1984) Stress, appraisal, and coping. Springer Publishing Company, New York

Lillberg K, Verkasalo PK, Kaprio J, Teppo L, Helenius H, Koskenvuo M (2003) Stressful life events and risk of breast cancer in 10,808 women: a cohort study. Am J Epidemiol 157(5):415–423

Lin Y, Wang C, Zhong Y, Huang X, Peng L, Shan G, Wang K, Sun Q (2013) Striking life events associated with primary breast cancer susceptibility in women: a meta-analysis study. J Exp Clin Cancer Res 32(1):53–9966

McGue M, Osler M, Christensen K (2010) Causal inference and observational research: the utility of twins. Perspect Psychol Sci 5(5):546–556

Messing K, Sr Stock, Tissot F (2009) Should studies of risk factors for musculoskeletal disorders be stratified by gender? Lessons from the 1998 Quebec Health and Social Survey. Scand J Work Environ Health 35(2):96–112

Narusyte J, Ropponen A, Silventoinen K, Alexanderson K, Kaprio J, Samuelsson A, Svedberg P (2011) Genetic liability to disability pension in women and men: a prospective population-based twin study. PLoS One 6(8):e23143

OECD (2010) Sickness, disability and work: breaking the barriers: a synthesis of findings across OECD countries. OECD Publishing, France

Osler M, Mcgue M, Lund R, Christensen K (2008) Marital status and twins’ health and behavior: an analysis of middle-aged Danish twins. Psychosom Med 70(4):482–487

Park CI, Iacocca MO (2014) A stress and coping perspective on health behaviors: theoretical and methodological considerations. Anxiety Stress Coping 27(2):123–137

Peled R, Carmil D, Siboni-Samocha O, Shoham-Vardi I (2008) Breast cancer, psychological distress and life events among young women. BMC Cancer 8:245–2407

Reitzes D, Mutran E (2002) Self-concept as the organization of roles: importance, centrality, and balance. Sociol Q 43(4):647–667

Romanov K, Rose RJ, Kaprio J, Koskenvuo M, Langinvainio H, Sarna S (1987) Self-reported alcohol use: a longitudinal study of 12,994 adults. Alcohol Alcohol Suppl 1:619–623

Ropponen A, Silventoinen K, Svedberg P, Alexanderson K, Koskenvuo K, Huunan-Seppälä A, Koskenvuo M, Kaprio J (2011) Health-related risk factors for disability pensions due to musculoskeletal diagnoses: a 30-year Finnish twin cohort study. Scand J Public Health 39(8):839–848

Ropponen A, Svedberg P, Kalso E, Koskenvuo M, Silventoinen K, Kaprio J (2013) A prospective twin cohort study of disability pensions due to musculoskeletal diagnoses in relation to stability and change in pain. Pain 154(10):1966–1972

Ropponen A, Silventoinen K, Koskenvuo M, Svedberg P, Kaprio J (2016) Stability and change of body mass index as a predictor of disability pension. Scand J Public Health 44(4):369–376

Rose G, Kumlin L, Dimberg L, Bengtsson C, Orth-Gomer K, Cai X (2006) Work-related life events, psychological well-being and cardiovascular risk factors in male Swedish automotive workers. Occup Med 56(6):386–392

Sarna S, Kaprio J, Sistonen P, Koskenvuo M (1978) Diagnosis of twin zygosity by mailed questionnaire. Hum Hered 28(4):241–254

Statistics Finland (1974) Population census 1970: occupation and social position: official statistics of Finland VI C:104. Central statistical office of Finland, Helsinki

Williams Rl (2000) A note on robust variance estimation for cluster-correlated data. Biometrics 56(2):645–664

Zhang H, Gao T, Gao J, Kong Y, Hu Y, Wang R, Mei S (2017) A comparative study of negative life events and depressive symptoms among healthy older adults and older adults with chronic disease. Int J Soc Psychiatry 63(8):699–707

Title: Life events as predictors for disability pension due to musculoskeletal diagnoses: a cohort study of Finnish twins
Authors: Sanna Kärkkäinen
Karri Silventoinen
Pia Svedberg
Annina Ropponen
Publication date: 01-05-2020
Publisher: Springer Berlin Heidelberg
Published in: International Archives of Occupational and Environmental Health / Issue 4/2020
Print ISSN: 0340-0131
Electronic ISSN: 1432-1246
DOI: https://doi.org/10.1007/s00420-019-01505-5

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Life events as predictors for disability pension due to musculoskeletal diagnoses: a cohort study of Finnish twins

Abstract

Purpose

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Purpose

Methods

Results

Conclusions

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