Work participation and working life expectancy after a disabling shoulder lesion

Objective T o examine the impact of a disabling nontraumatic shoulder lesion on work participation and working life expectancy. Methods From 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. Results During 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. Conclusions Working 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.Peer reviewe

Occupational differences in disability retirement due to a shoulder lesion : do work-related factors matter?

Objective To identify occupations with a high risk of disability retirement due to a shoulder lesion and to examine the effect of physical and psychosocial work-related factors on occupational differences in disability retirement. Methods We followed Finnish wage earners aged 30-59 years (n = 1,135,654) from 2005 to 2014 for full disability retirement due to a shoulder lesion. The work-related exposures were assessed with job exposure matrices. We calculated age-adjusted incidence rates and hazard ratios to test for the association between occupation and disability retirement due to a shoulder lesion. We also examined the contribution of work-related exposures to the excess risk of disability retirement. Results As compared to professionals, the age-adjusted risk of disability retirement was increased among men in all occupational groups except managers and customer service clerks and among women in several occupational groups. Adjustment for education attenuated the occupational differences considerably, particularly among women. The physical work-related factors fully explained the excess risk of disability retirement due to a shoulder lesion among male finance and sales associate professionals and administrative secretaries as well as among agricultural and fishery workers. In women, the physical work-related factors fully explained the excess risk among construction workers, electricians and plumbers. For both genders, the contribution of psychosocial factors to excess risk of disability retirement was modest and seen for monotonous work only. Conclusions A reduction of the level of physical work load factors as well as monotonousness of work has a potential to prevent work disability due to a shoulder lesion.Peer reviewe

Occupational and non-occupational risk factors of sickness absence due to a shoulder lesion

Objectives To determine the associations of lifestyle factors and cumulative physical workload exposures with sickness absence (SA) due to a shoulder lesion and to calculate their population attributable fractions (PAF). Methods Our nationally representative cohort consisted of 4344 individuals aged 30-62 years who participated in the Finnish Health 2000 Survey. Education, smoking, chronic diseases and work exposures were assessed during interviews and leisure time physical activity with a questionnaire. Weight and height were measured. We followed the individuals for 15 years for the first SA due to a shoulder lesion. We used competing risk regression models. We calculated PAFs to assess the proportion of SA that was attributed to modifiable risk factors. Results In the entire study population, risk factors of SA were age, daily smoking, being exposed for more than 10 years to physically heavy work and being exposed for more than 10 years to at least two specific physical workload factors. The overall PAF for the modifiable risk factors was 49%. In men, number of specific cumulative exposures, obesity and daily smoking predicted SA with PAF values of 34%, 30% and 14%, respectively. Among women, being exposed for more than 10 years to physically heavy work, number of specific cumulative exposures and daily smoking accounted for 23%, 22% and 15% of SA, respectively. Conclusions Reducing significantly prolonged exposure to physical workload factors, avoiding regular smoking in both genders and obesity in men has a high potential to prevent SA due to a shoulder lesion.Peer reviewe

Physical and psychosocial work exposures as risk factors for disability retirement due to a shoulder lesion

Objective To assess the longitudinal associations of physical and psychosocial exposures with disability retirement due to a shoulder lesion. Methods In a nationwide register-based study, we followed 1 135 654 wage earners aged 30-59 years for the occurrence of disability retirement due to a shoulder lesion. The occupational exposures were assessed with job exposure matrices. We used a competing risk regression model to estimate HRs and their 95% CIs and to test for the association between the exposures and the outcome. We also calculated the attributable fraction of disability retirement due to occupational exposures. Results A total of 2472 persons had full disability retirement due to a shoulder lesion during the follow-up. Physically heavy work showed the strongest association with the outcome in both genders, in men with an HR of 2.90 (95% CI 2.37 to 3.55) and in women with an HR of 3.21 (95% CI 2.80 to 3.90). Of the specific physical exposures, working with hands above shoulder level was statistically significantly associated with disability retirement in men. When all physical exposures were taken into consideration, 46% and 41% of disability retirement due to a shoulder lesion were attributed to physical work load factors in men and women, respectively. In addition, 49% (men) and 35% (women) of disability retirement were attributed to psychosocial work-related factors. Conclusions Our findings suggest that a considerable proportion of disability retirement due to a shoulder lesion could be prevented by reducing physical and psychosocial exposures at work to a low level.Peer reviewe

Change in body mass index during transition to statutory retirement : an occupational cohort study

Background: Retirement is a major life transition affecting health behaviors. The aim of this study was to examine within-individual changes in body mass index (BMI) during transition from full-time work to statutory retirement by sex and physical work characteristics. Methods: A multiwave cohort study repeated every 4 years and data linkage to records from retirement registers. Participants were 5426 Finnish public-sector employees who retired on a statutory basis in 2000-2011 and who reported their body weight one to three times prior to (w(-3), w(-2), w(-1)), and one to three times after (w(+1), w(+2), w(+3)) retirement. Results: During the 4-year retirement transition (w(+1), vs. w(-1)) men showed decline in BMI, which was most marked among men with sedentary work (-0.18 kg/m(2), 95% CI -.30 to -0.05). In contrast, BMI increased during retirement transition in women and was most marked among women with diverse (0.14 kg/m(2), 95% CI 0.08 to 0.20) or physically heavy work (0.31 kg/m(2), 95% CI 0.16 to 0.45). Physical activity during leisure time or commuting to work, alcohol consumption or smoking did not explain the observed changes during retirement transition. Conclusions: In this study statutory retirement was associated with small changes in BMI. Weight loss was most visible in men retiring from sedentary jobs and weight gain in women retiring from diverse and physically heavy jobs.Peer reviewe

Associations of cardiovascular risk factors, carotid intima-media thickness and manifest atherosclerotic vascular disease with carpal tunnel syndrome

Peer reviewe

Osatyökyvyttömyys ja työurien pituus yksityisellä ja julkisella sektorilla

Tutkimushankkeessa tarkasteltiin osasairauspäivärahan ja osatyökyvyttömyyseläkkeen käyttöön vaikuttavia tekijöitä sekä osatyökyvyttömyysetuuksien käytön yhteyksiä työurien pituuteen. Keskityimme erityisesti yksityisen ja julkisen sektorin välisiin eroihin, sillä työnantajasektorien välillä on järjestelmäeroja, jotka todennäköisesti vaikuttavat sekä osatyökyvyttömyysetuuksien käyttöön että sen jälkeiseen työmarkkinoille osallistumiseen

Role of overweight and obesity in low back disorders among men : a longitudinal study with a life course approach

Objectives: To assess the association between being overweight or obese with low back pain (LBP) and clinically defined low back disorders across the life course. Design: A longitudinal and cross-sectional study. Setting: A nationwide health survey supplemented with data from records of prior compulsory military service. Participants: Premilitary health records (baseline) were searched for men aged 30–50 years (n=1385) who participated in a national health examination survey (follow-up). Methods and outcome measures: Height and weight were measured at baseline and follow-up, and waist circumference at follow-up. Weight at the ages of 20, 30, 40 and 50 years were ascertained, when applicable. Repeated measures of weight were used to calculate age-standardised mean body mass index (BMI) across the life course. The symptom-based outcome measures at follow-up included prevalence of non-specific and radiating LBP during the previous 30 days. The clinically defined outcome measures included chronic low back syndrome and sciatica. Results: Baseline BMI (20 years) predicted radiating LBP in adulthood, with the prevalence ratio (PR) being 1.26 (95% CI 1.08 to 1.46) for one SD (3.0 kg/m2) increase in BMI. Life course BMI was associated with radiating LBP (PR=1.23; 95% CI 1.03 to 1.48 per 1 unit increment in Z score, corresponding to 2.9 kg/m2). The development of obesity during follow-up increased the risk of radiating LBP (PR=1.91, 95% CI 1.03 to 3.53). Both general and abdominal obesity (defined as waist-to-height ratio) were associated with radiating LBP (OR=1.64, 95% CI 1.02 to 2.65 and 1.44, 95% CI 1.02 to 2.04). No associations were seen for non-specific LBP. Conclusions: Our findings imply that being overweight or obese in early adulthood as well as during the life course increases the risk of radiating but not non-specific LBP among men. Taking into account the current global obesity epidemic, emphasis should be placed on preventive measures starting at youth and, also, measures for preventing further weight gain during the life course should be implemented

Työpolitiikka ja työllisyysaste : tutkimukseen perustuvia johtopäätöksiä

Tässä raportissa luodaan katsaus ulkomaiseen ja kotimaiseen kirjallisuuteen työpolitiikan työllisyysvaikutuksista ja muotoillaan politiikkajohtopäätöksiä tämän tutkimustiedon perusteella. Tarkasteltavat politiikka-alueet ovat aktiivinen työvoimapolitiikka, työttömyysturvajärjestelmä, työkyvyttömyyteen ja osatyökyvyttömyyteen liittyvät etuusjärjestelmät ja työn verotus. Aktiivisen työvoimapolitiikan, työn verotuksen ja työttömyysturvan osalta tukeudutaan kansainvälisiin meta-analyyseihin ja katsauksiin, joita täydennetään tuoreimmalla ulkomaisella ja kotimaisella tutkimuksella. Työkyvyttömyyteen ja osatyökyvyttömyyteen liittyvien etuusjärjestelmien osalta pääpaino on pohjoismaisissa arviointitutkimuksissa. Kaikkien osioiden kohdalla kiinnitetään erityistä huomiota tutkimusten laatuun, tulosten uskottavuuteen ja soveltuvuuteen Suomeen. Työpolitiikan toimenpiteiden kokonaisvaikutuksia käsitellään aiempaan kirjallisuuteen nähden laajasti. Katsauksen mukaan työpolitiikalla voidaan vaikuttaa työllisyyteen, mutta sen vaikutukset ovat rajalliset. Käsiteltyjä osa-alueita koskevien yksityiskohtaisten politiikkajohtopäätösten lisäksi esitämme yleisiä johtopäätöksiä. Näihin liittyviä läpileikkaavia teemoja ovat toimenpiteiden sivuvaikutukset, keskinäinen vaihtoehtoisuus, kohdentaminen, suhdanneriippuvaisuus, osa-aikaisten ratkaisujen hyödyntäminen, kustannusvaikuttavuus ja monialaisuus.Tämä julkaisu on toteutettu osana valtioneuvoston selvitys- ja tutkimussuunnitelman toimeenpanoa. (tietokayttoon.fi). Julkaisun sisällöstä vastaavat tiedon tuottajat, eikä tekstisisältö välttämättä edusta valtioneuvoston näkemystä