O11-2 Associations between physical workload and early exits from labour market due to long-term sickness absence, disability pension and long-term unemployment during a 7-year follow-up in a general working population

BackgroundThe aim was to elucidate if the risk of labour market marginalisation (LMM), measured as long-term unemployment, long-term sickness absence, disability pension and a combined measure of these three measures, differed between refugees and non-refugee migrants with different regions of birth compared with native Swedes.MethodsAll non-pensioned individuals aged 19–60 years who were resident in Sweden on 31 December 2009 were included (n=4 441 813, whereof 216 930 refugees). HRs with 95% CIs were computed by Cox regression models with competing risks and time-dependent covariates with a follow-up period of 2010–2013.ResultsRefugees had in general a doubled risk (HR: 2.0, 95% CI 1.9 to 2.0) and non-refugee migrants had 70% increased risk (HR: 1.7, 95% CI 1.7 to 1.7) of the combined measure of LMM compared with native Swedes. Refugees from Somalia (HR: 2.7, 95% CI 2.6 to 2.8) and Syria (HR: 2.5, 95% CI 2.5 to 2.6) had especially high risk estimates of LMM, mostly due to high risk estimates of long-term unemployment (HR: 3.4, 95% CI 3.3 to 3.5 and HR: 3.2, 95% CI 3.1 to 3.2). African (HR: 0.7, 95% CI 0.6 to 0.7) and Asian (HR: 1.0, 95% CI 1.0 to 1.1) refugees had relatively low risk estimates of long-term sickness absence compared with other refugee groups. Refugees from Europe had the highest risk estimates of disability pension (HR: 1.9, 95% CI 1.8 to 2.0) compared with native Swedes.ConclusionRefugees had in general a higher risk of all measures of LMM compared with native Swedes. There were, however, large differences in risk estimates of LMM between subgroups of refugees and with regard to type of LMM. Actions addressing differences between subgroups of refugees is therefore crucial in order to ensure that refugees can obtain as well as retain a position on the labour market.

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Physical workload and risk of long-term sickness absence in the general working population and among blue-collar workers: prospective cohort study with register follow-up

Occupational and Environmental Medicine ◽

10.1136/oemed-2015-103314 ◽

2016 ◽

Vol 73 (4) ◽

pp. 246-253 ◽

Cited By ~ 65

Author(s):

Lars Louis Andersen ◽

Nils Fallentin ◽

Sannie Vester Thorsen ◽

Andreas Holtermann

Keyword(s):

Cohort Study ◽

Sickness Absence ◽

Prospective Cohort Study ◽

Prospective Cohort ◽

Blue Collar ◽

Physical Workload ◽

Working Population ◽

Blue Collar Workers

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Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study

Scandinavian Journal of Public Health ◽

10.1177/1403494817745190 ◽

2017 ◽

Vol 46 (3) ◽

pp. 321-330 ◽

Cited By ~ 20

Author(s):

Ulla Kinnunen ◽

Jouko Nätti

Keyword(s):

Sickness Absence ◽

Work Ability ◽

Disability Pension ◽

Negative Binomial ◽

Work Ability Index ◽

Rate Ratios ◽

Future Work ◽

Work Ability Score

Aims: We investigated two single items of the Work Ability Index – work ability score, and future work ability – as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up. Methods: Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0–5), moderate (6–7) and good/excellent (8–10) and future work ability into poor (1–2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates. Results: Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68–14.49) for poor and 2.25 (CI 95% 1.51–3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71–14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19–4.32) and 1.59 (95% CI 1.32–1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97–2.36) for poor future work ability. Conclusions: The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

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Gender segregation of occupations and sustainable employment: A prospective population-based cohort study

Scandinavian Journal of Public Health ◽

10.1177/1403494818785255 ◽

2018 ◽

Vol 47 (3) ◽

pp. 348-356 ◽

Cited By ~ 3

Author(s):

Lena Gonäs ◽

Anders Wikman ◽

Marjan Vaez ◽

Kristina Alexanderson ◽

Klas Gustafsson

Keyword(s):

Cohort Study ◽

Labour Market ◽

Sickness Absence ◽

Disability Pension ◽

Population Based ◽

Gender Segregation ◽

Labour Market Situation ◽

Market Situation ◽

Male Dominated

Background: Although the labour market is characterized by a strong numerical gender segregation of occupations, there is little knowledge about the associations of this with the future labour market situation for an individual person. Objectives: This study aimed to elucidate whether working in a gender-segregated or gender-integrated occupation is associated with future labour market attachment and sickness absence or disability pensions among women and men. Methods: We used a population-based prospective cohort study with univariate and multiple logistic regression analyses stratified by gender, including all people living in Sweden aged 20–56 years and in paid work in 2003 ( n=3,239,989). They were followed up eight years later with regard to employment status, sickness absence and disability pension. Results: Women and men employed in extremely female-dominated occupations in 2003 had the highest employment levels and the lowest unemployment levels at follow up in 2011. When adjusting for age, level of education and sector of employment, the highest odds ratios (ORs) for not being employed in 2011 were found for women working in extremely male-dominated occupations in 2003 (OR 1.27; 95% CI 1.21–1.33) and for men in female-dominated occupations (OR 1.42; 95% CI 1.39–1.45) relative to those in gender-integrated occupations. Women in extremely male-dominated occupations had the highest ORs for sickness absence or the receipt of a disability pension at follow up (OR 1.26; 95% CI 1.17–1.36) and men in female-dominated occupations had the highest OR 1.15 (95% CI 1.11–1.20). Conclusions: For both women and men, the gender composition of the occupation they work in seems to be of importance for their future labour market attachment and sickness absence or receipt of a disability pension.

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M131. RETURN TO LABOUR MARKET IN SCHIZOPHRENIA AND OTHER PSYCHOSES – THE NORTHERN FINLAND BIRTH COHORT 1966

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa030.443 ◽

2020 ◽

Vol 46 (Supplement_1) ◽

pp. S185-S185

Author(s):

Tuomas Majuri ◽

Hanna Huovinen ◽

Tanja Nordström ◽

Leena Ala-Mursula ◽

Jouko Miettunen ◽

...

Keyword(s):

General Population ◽

Psychiatric Disorder ◽

Return To Work ◽

Labour Market ◽

Disability Pension ◽

Occupational Outcomes ◽

Occupational Outcome ◽

Schizophrenia Group

Abstract Background People with psychotic disorders typically have the poorest rate of employment compared to other mental disorders. However, the chances of returning back to labour market and work after long-term work disability is unclear. Aim of this study was to study proportion of persons who can return to labour market after they have received disability pension. We also aim to study potential predictors for return to work. Methods The study was based on the Northern Finland Birth Cohort 1966 (NFBC1966) (N=12 058) which is an unselected, general population-based sample. NFBC1966 offers us a unique way to examine return to labour market and its predictors in general population sample with true prospectively collected data with 50-years follow-up. Different national registers were utilized in the study (information about psychiatric diagnoses and occupational outcomes). Occupational outcomes until end of the 2016 were measured by information about disability pension, disability benefits and employment contracts. The sample included 232 schizophrenia patients, 208 persons with other psychosis and 1927 persons with non-psychotic psychiatric disorder diagnosed until the end of 2016. There is also large amount of predictor data (for occupational outcomes) collected since birth until recent years. Results Of the 141 (61%) persons with schizophrenia who had been on disability pension due to psychiatric reason, disability pensions of 16 (11%) persons had ended due to return to labour market. Of the 74 (32%) persons in the other psychosis subgroup and 180 (9%) in the non-psychotic psychiatric disorder subgroup who had been on disability pension due to psychiatric reason, corresponding numbers of pension’s ending due to return to labour market were 18 (24%) and 56 (31%), respectively. Disability pensions of 14 (10%) persons in schizophrenia group, 3 (4%) persons in other psychosis subgroup and 4 (2%) persons in non-psychotic psychiatric disorder subgroup had ended due to death. Disability pensions of 111 (79%) persons in schizophrenia group, 53 (72%) persons in other psychosis subgroup and 120 (67%) persons in non-psychotic psychiatric disorder subgroup were still running. Later, also sociodemographic information, psychiatric and somatic comorbidity and age at the onset of disease as predictors for the good occupational outcome (i.e. return to work) will be analysed and presented. Discussion Our results indicate that having schizophrenia diagnosis often means relatively poor occupational outcome compared to other psychiatric disorders and ending up on disability pension. Besides of that some people with psychosis manage to maintain their working ability, some people also manage to return to labour market after being on disability pension. Finding the predictors for returning back to labour force in long-time follow-up can help us to cut off the long-term disability periods and support people back to work in the future.

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Favourable changes in physical working conditions and the risk of all-cause sickness absence: a pseudo-experiment

European Journal of Public Health ◽

10.1093/eurpub/ckz175 ◽

2019 ◽

Vol 30 (2) ◽

pp. 253-259

Author(s):

Rahman Shiri ◽

Aapo Hiilamo ◽

Olli Pietiläinen ◽

Minna Mänty ◽

Ossi Rahkonen ◽

...

Keyword(s):

Environmental Factors ◽

Sickness Absence ◽

Working Conditions ◽

Negative Binomial ◽

Physical Workload ◽

Health Study ◽

Baseline Survey ◽

Short Term

Abstract Background We determined whether favourable changes in physical workload and environmental factors reduce sickness absence (SA) days using observational cohort data as a pseudo-experiment. Methods The data from the Finnish Helsinki Health Study included three cohorts of employees of the City of Helsinki [2000/2002–07 (N = 2927), 2007–12 (N = 1686) and 2012–17 (N = 1118), altogether 5731 observations]. First, we estimated the propensity score of favourable changes (reduction in exposures) in physical workload and environmental factors during each 5-year follow-up period on the baseline survey characteristics using logistic regression. Second, we created and stabilized inverse probability of treatment weights for each participant using the propensity scores. Lastly, we used generalized linear model and fitted negative binomial regression models for over-dispersed count data to estimate whether the favourable changes decrease the risk of short-term (1–3 days), intermediate-term (4–14 days) and long-term (>14 days) SA using employer’s register data. Results During a 5-year follow-up, 11% of the participants had favourable changes in physical workload factors, 13% in environmental factors and 8% in both factors. The incidence of short-term, intermediate-term and long-term SA were lower in employees with favourable workplace changes compared with those without such changes. The reductions were largest for long-term SA. Reporting favourable changes in both workload and environmental factors reduced the number of SA days by 41% within 1 year after the changes and by 32% within 2 years after the changes. Conclusion This pseudo-experimental study suggests that improving physical working conditions reduces SA.

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Sickness Absence and Disability Pension in the Very Long Term: A Finnish Register-Based Study With 20 Years Follow-Up

Frontiers in Public Health ◽

10.3389/fpubh.2021.556648 ◽

2021 ◽

Vol 9 ◽

Author(s):

Julia Klein ◽

Kaarina Reini ◽

Jan Saarela

Keyword(s):

Sickness Absence ◽

Disability Pension ◽

Event History Analysis ◽

Finnish Population ◽

Short Term ◽

Distant Future ◽

History Analysis ◽

Disability Pensioner

Sickness allowance is paid for short-term sickness absence and is thus an indicator of temporary ill health, but it is also associated with a heightened risk of receiving disability pension. Using event history analysis, we examined the long-term risk for disability pension receipt after first observed receipt of medically certified sickness allowance in each single year after sickness allowance was first recorded. Utilizing longitudinal data from the Finnish population register, covering the period 1989–2010, we observed 110,675 individuals aged 16–40 years at baseline. Using discrete-time hazard models, we estimated how the first observed receipt of sickness allowance was related to the risk of receiving disability pension, with an average follow-up time of 20.6 years. In this population, about 40 percent received sickness allowance and 10 percent received disability pension. In the first years after sickness allowance receipt, there was a substantial difference between long-term and short-term sickness allowance recipients in the hazard of becoming a disability pensioner. This difference levelled out over time, but even 20 years after the first observed sickness allowance receipt, the hazard of disability retirement was more than 15 times higher than that of non-recipients of sickness allowance. Patterns were similar for men and women. First observed receipt of sickness allowance is a powerful predictor for disability pension receipt, also in the very distant future. Thus, it can be used to monitor people with heightened risk of becoming more permanently ill and falling outside the labour market.

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Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers

Occupational and Environmental Medicine ◽

10.1136/oemed-2016-104279 ◽

2017 ◽

Vol 75 (2) ◽

pp. 114-123 ◽

Cited By ~ 23

Author(s):

Emil Sundstrup ◽

Åse Marie Hansen ◽

Erik Lykke Mortensen ◽

Otto Melchior Poulsen ◽

Thomas Clausen ◽

...

Keyword(s):

Labour Market ◽

Work Environment ◽

Sickness Absence ◽

Older Workers ◽

Disability Pension ◽

Working Life ◽

Physical Work ◽

Market Exit ◽

Physical Work Environment

ObjectiveTo determine the prospective association between retrospectively assessed physical work environment during working life and prospectively assessed sickness absence and labour market exit among older workers.MethodsUsing Cox regression analyses we estimated the 4-year to 6-year prospective risk of register-based long-term sickness absence (LTSA), disability pension, early retirement and unemployment from exposure to different physical work environmental factors during working life among 5076 older workers (age 49–63 at baseline) from the Copenhagen Aging and Midlife Biobank cohort.ResultsVery hard physical work throughout working life was a risk factor for LTSA (HR 1.66,95% CI 1.32 to 2.07), disability pension (HR 2.21,95% CI 1.04 to 4.72) and early retirement (HR 1.57,95% CI 1.13 to 2.17). Both short-term (<10 years) and long-term (≥20 years) exposures to lifting or carrying of heavy burdens predicted the risk of LTSA (HRs 1.49–1.56) and disability pension (HRs 2.26–3.29). In contrast, exposure to dust was associated with LTSA and disability pension only following 20 or more exposure years.ConclusionsRetrospectively assessed hard physical work during working life and exposure to several factors in the physical work environment, especially heavy lifting, were important for labour market exit and sickness absence. This study underscores the importance of reducing physical work exposures throughout the working life course for preventing sickness absence and premature exit from the labour market.

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