scholarly journals Work participation and working life expectancy after a disabling shoulder lesion

2019 ◽  
Vol 76 (6) ◽  
pp. 363-369 ◽  
Author(s):  
Maria Sirén ◽  
Eira Viikari-Juntura ◽  
Jari Arokoski ◽  
Svetlana Solovieva
Keyword(s):  
Life Expectancy ◽  
Sickness Absence ◽  
Cox Regression ◽  
Musculoskeletal Diseases ◽  
Working Life ◽  
Work Participation ◽  
Disability Retirement ◽  
Musculoskeletal Problems ◽  
Wage Earners ◽  
The Impact

ObjectiveTo examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.MethodsFrom a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.ResultsDuring 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.ConclusionsWorking life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.

scholarly journals High physical work demands and working life expectancy in Denmark

2020 ◽  
Vol 77 (8) ◽  
pp. 576-582 ◽  
Author(s):  
Jacob Pedersen ◽  
Bastian Bygvraa Schultz ◽  
Ida E H Madsen ◽  
Svetlana Solovieva ◽  
Lars L Andersen
Keyword(s):  
Life Expectancy ◽  
Sickness Absence ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Working Life ◽  
Physical Work ◽  
Retirement Age ◽  
Work Demands ◽  
Physical Work Demands ◽  
The Impact

ObjectiveIn most European countries, political reforms gradually increase the statutory retirement age to counter the economic costs of a growing elderly population. However, working to a high age may be difficult for people with hard physical labour. We aim to study the impact of high physical work demands on working life expectancy (WLE).MethodsWe combined physical work demands assessed by job exposure matrix (JEM) and longitudinal high-quality national registers (outcome) in 1.6 million Danish workers to estimate WLE and years of sickness absence, unemployment and disability pension. The JEM value for physical work demand is a summarised score of eight ergonomic exposures for 317 occupations groups, sex and age. The WLE was estimated using a multistate proportional hazards model in a 4-year follow-up period.ResultsIndividuals with high physical work demands had a significantly lower WLE, than those with low physical work demands, with largest differences seen among women. At age 30 years, women with high physical work demands can expect 3.1 years less working, 11 months more of sickness absence and 16 months more of unemployment than low-exposed women. For 30-year-old men, the corresponding results were 2.0 years, 12 months and 8 months, respectively.ConclusionOur findings show that high physical work demands are a marked risk factor for a shortened working life and increased years of sickness absence and unemployment. The results are important when selecting high-risk occupations, and expand the knowledge base for informed political decision making concerning statutory retirement age.

scholarly journals Work participation trajectories in 1098748 Finns: determinants and the incidence of sickness absence

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
T Lallukka ◽  
E Kronholm ◽  
J Pekkala ◽  
S Jäppinen ◽  
J Blomgren ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Sickness Absence ◽  
Cumulative Incidence ◽  
Latent Class ◽  
Musculoskeletal Diseases ◽  
Age Groups ◽  
Work Participation ◽  
Vulnerable Groups ◽  
Paid Employment ◽  
Representative Cohort

Abstract Background Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. Methods Young (25-38 years at baseline, n = 495663) and midlife (39-52 years at baseline, n = 603085) Finnish people, working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for the outcome (work participation) and its determinants and sickness absence. Latent class growth analysis was used to identify trajectories. Results Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. Conclusions Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups. Key messages Distinct trajectories of premature exit from paid employment can be identified in a nationally representative cohort of initially employed people from Finland. Focusing on the determinants and reasons of premature long-term labor market exit may help promote work participation particularly in the most vulnerable groups.

scholarly journals Doubled mortality rate in irradiated patients reoperated for regrowth of a macroadenoma of the pituitary gland

2004 ◽  
pp. 497-502 ◽  
Author(s):  
EM Erfurth ◽  
B Bulow ◽  
CH Nordstrom ◽  
Z Mikoczy ◽  
L Hagmar ◽  
...  
Keyword(s):  
Mortality Rate ◽  
Life Expectancy ◽  
Cushing’S Disease ◽  
Pituitary Adenomas ◽  
Cox Regression ◽  
Cushing's Disease ◽  
Calendar Time ◽  
Cox Regression Analysis ◽  
Risk Increase ◽  
The Impact

BACKGROUND: Reduced life expectancy has been shown in patients with hypopituitarism, mainly caused by cardiovascular diseases. A major cause of hypopituitarism is pituitary adenomas, and radiotherapy may be employed as a treatment modality to reduce the post-operative regrowth rate of these tumours. Recently, we showed that in patients with craniopharyngiomas, tumour regrowth foreshadowed a fourfold risk increase for death. For patients with pituitary adenomas, the impact of regrowth on life expectancy is, however, not known. OBJECTIVE: To assess the impact of a reoperation due to a regrowth of a pituitary macroadenoma on mortality, taking into account other candidate prognostic factors. DESIGN AND PATIENTS: In 281 patients with operated and irradiated macroadenomas, excluding acromegaly and Cushing's disease, 35 patients had a regrowth (median follow-up 16.6 years). Possible risk factors for tumour regrowth were investigated by Cox regression models. RESULTS: For tumour regrowth, age, calendar time at primary surgery, gender and extension of tumour growth had no statistically significant impact. For younger patients, the proportion of regrowths was higher, but after age-stratified Cox regression analysis only regrowth was shown to have a significant impact on mortality, with a more than doubled mortality risk for patients with tumour regrowth as compared with the non-regrowing tumour patients (hazard ratio=2.24, P<0.001). This finding was corroborated by cohort analyses using the general population as an external comparison group. CONCLUSION: Among patients with irradiated pituitary macroadenomas, excluding acromegaly and Cushing's disease, a doubled mortality rate was observed for those reoperated for tumour regrowth as compared with patients with non-regrowing tumours.

P1505COMORBIDITY AND AGE OF DIALYSIS PATIENTS OUTPERFORMS FRAILTY BURDEN AS A PREDICTOR FOR MORTALITY

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Mimoza Milenkova ◽  
Adrijana Spasovska Vasilova ◽  
Aleksandra Canevska ◽  
Vladimir Pushevski ◽  
GJULSEN SELIM ◽  
...  
Keyword(s):  
Life Expectancy ◽  
Cox Regression ◽  
Absolute Number ◽  
Chronic Hemodialysis ◽  
Rank Test ◽  
Dialysis Patients ◽  
Kaplan Meier ◽  
Dialysis Vintage ◽  
Comorbidity Index ◽  
The Impact

Abstract Background and Aims The life expectancy in dialysis patients depends on patients’ age and comorbidities. Frailty in elderly patients is a state of impaired homeostasis with loss of physiologic reserve and a consequent impaired responses to dialysis burden. In this study we assessed the impact of age, comorbidities and frailty on dialysis patients’ survival. Method The study enrolled 162 prevalent patients on chronic hemodialysis with mean dialysis vintage of 100 months, 55% were women and 21 % had diabetes. Patients were divided into three groups by the Khan Comorbidity index score, highest score was considered worse. Frailty was assessed by presence of 3 or more symptoms (unintentional weight loss, feeling exhausted, weak grip strength, slow walking speed and low physical activity) and expressed as absolute number. Estimates of five years life expectancy were assessed by Kaplan Meier survival log-rank test and Cox regression hazard model. Results There were 26 (16%) with lowest score, 85 (52%) with medium score and worst highest score in 51 (31%). During the 5 years of follow up 69(43%) patients died of all-cause mortality. There were no deaths in the group with lowest score and mortality rates in the intermediate and worse score group increased by double (0; 30%; 69%, respectively). Significantly higher mean life expectancy was found in lower Khan Score groups: 60mo; 48.40 ± 18.51; 32.44 ± 22.06, log-rank: p &lt; 0.012. Patients that scored worse had four folds higher risk for death HR 4.2 (95% CI: 2.72 – 6.36), p=0.0001. In the multivariate model Khan Score was a more powerful predictor of mortality than frailty in elderly, with HR 3.2 (95% CI: 2.88 – 5.41), p=0.0001. Conclusion Comorbidities and age outperforms frailty burden as a predictor of mortality in dialysis patients.

Labour market marginalisation in obsessive–compulsive disorder: a nationwide register-based sibling control study

2018 ◽  
Vol 49 (6) ◽  
pp. 1015-1024 ◽  
Author(s):  
Ana Pérez-Vigil ◽  
Ellenor Mittendorfer-Rutz ◽  
Magnus Helgesson ◽  
Lorena Fernández de la Cruz ◽  
David Mataix-Cols
Keyword(s):  
Labour Market ◽  
Obsessive Compulsive Disorder ◽  
Sickness Absence ◽  
Disability Pension ◽  
Cox Regression ◽  
Specialist Care ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
The Impact

AbstractBackgroundThe impact of obsessive–compulsive disorder (OCD) on objective indicators of labour market marginalisation has not been quantified.MethodsLinking various Swedish national registers, we estimated the risk of three labour market marginalisation outcomes (receipt of newly granted disability pension, long-term sickness absence and long-term unemployment) in individuals diagnosed with OCD between 2001 and 2013 who were between 16 and 64 years old at the date of the first OCD diagnosis (n = 16 267), compared with matched general population controls (n = 157 176). Hazard ratios (HR) with 95% confidence intervals (CI) were calculated using Cox regression models, adjusting for a number of covariates (e.g. somatic disorders) and stratifying by sex. To adjust for potential familial confounders, we further analysed data from 7905 families that included full siblings discordant for OCD.ResultsPatients were more likely to receive at least one outcome of interest [adjusted HR = 3.63 (95% CI 3.53–3.74)], including disability pension [adjusted HR = 16.36 (95% CI 15.34–17.45)], being on long-term sickness absence [adjusted HR = 3.07 (95% CI 2.95–3.19)] and being on long-term unemployment [adjusted HR = 1.72 (95% CI 1.63–1.82)]. Results remained similar in the adjusted sibling comparison models. Exclusion of comorbid psychiatric disorders had a minimal impact on the results.ConclusionsHelp-seeking individuals with OCD diagnosed in specialist care experience marked difficulties to participate in the labour market. The findings emphasise the need for cooperation between policy-makers, vocational rehabilitation and mental health services in order to design and implement specific strategies aimed at improving the patients’ participation in the labour market.

scholarly journals 0213 The impact of the norwegian cooperation agreement on a more inclusive working life (ia agreement) on sickness absence and disability pensioning

2017 ◽  
Author(s):  
Therese Nordberg Hanvold ◽  
Karina Corbett ◽  
Rune Hoff ◽  
Petter Kristensen ◽  
Ingrid Sivesind Mehlum
Keyword(s):  
Sickness Absence ◽  
Working Life ◽  
Cooperation Agreement ◽  
The Impact

scholarly journals Work participation trajectories among 1,098,748 Finns: reasons for premature labour market exit and the incidence of sickness absence due to mental disorders and musculoskeletal diseases

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Tea Lallukka ◽  
Erkki Kronholm ◽  
Johanna Pekkala ◽  
Sauli Jäppinen ◽  
Jenni Blomgren ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Sickness Absence ◽  
Cumulative Incidence ◽  
Social Insurance ◽  
Latent Class ◽  
Musculoskeletal Diseases ◽  
Age Groups ◽  
Distinct Group ◽  
Work Participation ◽  
Vulnerable Groups

Abstract Background Early exit from paid employment is a notable public health and societal challenge. Previous research has largely focused on the relationships among variables instead of the relationships among individuals with different work participation history. Person-oriented methods enable to identify latent groups of individuals who are likely to follow similar development in their work participation over time. We thus aimed to identify work participation trajectories during early and midlife careers and their social determinants using large nationally representative data comprising over 1 million initially employed individuals and a 10-year follow-up for their work participation. A further aim was to determine the cumulative incidence of sickness absence due to key diagnostic groups, mental disorders and musculoskeletal diseases within the trajectories. Methods Young (25–38 years at baseline, n = 495,663) and midlife (39–52 years at baseline, n = 603,085) Finnish people, all working in 2004, were followed up through 2013, with registers of the Social Insurance Institution, and the Statistics Finland. The registers provided data for work participation and its determinants, as well as for computing the cumulative incidence of sickness absence. Latent class growth analysis was used to identify trajectories. Results Three distinctive trajectories were identified: temporary exit, permanent exit, and continuously employed people. As compared to the other trajectories, those belonging to the permanent exit trajectory were more likely men, manual workers and had a lower income. The cumulative incidence of sickness absence due to mental disorders was highest in the permanent exit trajectory group. For musculoskeletal diseases, the cumulative incidence of sickness absence increased in the permanent exit trajectory mainly in the older age groups. Conclusion Distinct group-based trajectories of early work exit can be identified in a representative cohort of initially employed people. Focusing on the determinants of premature exit and early intervention to tackle increasing sickness absence may promote work participation particularly in the most vulnerable groups.

Sign in / Sign up

Export Citation Format

Share Document