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

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          Abstract

          Objective

          To 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.

          Methods

          Using 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.

          Results

          Very 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.

          Conclusions

          Retrospectively 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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          Most cited references30

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          Physical work environment risk factors for long term sickness absence: prospective findings among a cohort of 5357 employees in Denmark.

          To examine the effects of physical work environment on long term sickness absence and to investigate interaction between physical and psychosocial risk factors. Prospective cohort study of long term sickness absence among employees in Denmark. 5357 employees interviewed in 2000 about their physical work environment, and various covariates were followed for 18 months in a national sickness absence register. Outcome measurements Cox regression analysis was performed to assess risk estimates for physical risk factors in the work environment and onset of long term sickness absence, defined as receiving sickness absence compensation for eight consecutive weeks or more. 348 participants (6.9%) developed long term sickness absence during follow-up. Of these, 194 (55.7%) were women and 154 (44.3%) were men. For both female and male employees, risk of onset of long term sickness absence was increased by extreme bending or twisting of the neck or back, working mainly standing or squatting, lifting or carrying loads, and pushing or pulling loads. Significant interactions were found for three combinations of physical and psychosocial work environment risk factors among female employees (P<0.05). Uncomfortable working positions, lifting or carrying loads, and pushing or pulling loads increased the risk of onset of long term sickness absence. The study shows a potential for reducing long term sickness absence through modifying work postures straining the neck and back, reducing the risk of work done standing or walking, and reducing the risk associated with handling loads. Dealing with psychosocial stressors simultaneously may improve physical intervention efforts further for female employees.
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            Biological dust exposure in the workplace is a risk factor for chronic obstructive pulmonary disease.

            Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Although the main risk factor is smoking, 15-19% of COPD even in smokers has been attributed to occupational exposures. The aim of this study was to investigate the association between occupational exposure and risk of COPD. Participants were part of a cross sectional study of risk factors for COPD. A total of 1232 completed a detailed respiratory questionnaire, spirometric testing and measurement of gas transfer. Job histories were coded according to the International Standard Classification of Occupations. These codes were then used to establish occupational exposures using the ALOHA job exposure matrix. The prevalence of emphysema was 2.4%, chronic obstructive bronchitis 1.8%, and COPD 3.4%. Subjects ever exposed to biological dusts had an increased risk of chronic obstructive bronchitis (OR 3.19; 95% CI 1.27 to 7.97), emphysema (OR 3.18; 95% CI 1.41 to 7.13), and COPD (OR 2.70, 95% CI 1.39 to 5.23). These risks were higher in women than in men. For biological dust, the risk of emphysema and COPD was also significantly increased in both the duration of exposure categories, again in women but not in men. No significant increased risks for COPD were found for mineral dust (OR 1.13; 95% CI 0.57 to 2.27) or gases/fumes (OR 1.63; 95% CI 0.83 to 3.22). In this general population sample of adults, occupational exposures to biological dusts were associated with an increased risk of COPD which was higher in women. Preventive strategies should be aimed at reducing exposure to these agents in the workplace.
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              Influence of health and work on early retirement.

              The influence of health and work on early retirement and incentives for longer working were determined. A systematic review was conducted of longitudinal studies on factors for nondisability early retirement. Besides, seven focus group interviews (n = 32) were conducted about reasons for planning retirement early and incentives to stay longer in work among workers with poor and excellent work ability. Eight longitudinal studies showed that important factors for early retirement were poor health, being single, high physical work demands, high work pressure, low job satisfaction, and lack of physical activity in leisure time. In addition, focus group participants reported shift work, social support, and appreciative leadership style also as factors. Poor health and poor work circumstances are important factors in decisions to retire early. Social support and appreciative leadership style may be buffers in this process.
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                Author and article information

                Journal
                Occup Environ Med
                Occup Environ Med
                oemed
                oem
                Occupational and Environmental Medicine
                BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                1351-0711
                1470-7926
                February 2018
                17 August 2017
                : 75
                : 2
                : 114-123
                Affiliations
                [1 ] National Research Centre for the Working Environment , Copenhagen, Denmark
                [2 ] departmentDepartment of Public Health , University of Copenhagen , Copenhagen, Denmark
                [3 ] departmentCenter for Healthy Aging , University of Copenhagen , Copenhagen, Denmark
                [4 ] departmentDepartment of Psychology , University of Copenhagen , Copenhagen, Denmark
                [5 ] departmentDepartment of Occupational Medicine , Holbæk Hospital , Copenhagen, Denmark
                [6 ] departmentDepartment of Public Health, The Research Unit for General Practice and Section of General Practice , University of Copenhagen , Copenhagen, Denmark
                [7 ] departmentDepartment of Health Science and Technology, Physical Activity and Human Performance group, SMI , Aalborg University , Copenhagen, Denmark
                Author notes
                [Correspondence to ] Emil Sundstrup, National Research Centre for the Working Environment, Lersø Parkallé 105 2100 Copenhage, Denmark; esu@ 123456nrcwe.dk
                Article
                oemed-2016-104279
                10.1136/oemed-2016-104279
                5800344
                28819019
                f663258d-bb3a-436c-bbcc-c112816bc357
                © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

                This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

                History
                : 28 December 2016
                : 07 July 2017
                : 27 July 2017
                Funding
                Funded by: Danish Working Environment Research Fund;
                Categories
                Workplace
                1506
                Original article
                Custom metadata
                unlocked

                Occupational & Environmental medicine
                disability pension,sickness absence,physical workloads

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