Physical Work Environment Factors Affecting Risk for Disability Pension Due to Mental or Musculoskeletal Diagnoses Among Nursing Professionals, Care Assistants and Other Occupations: a Prospective, Population-based Cohort Study

Overview

Journal BMJ Open

Specialty General Medicine

Date 2019 Oct 18

PMID 31619414

Citations 10

Authors

Klas Gustafsson

Staffan Marklund

Gunnar Aronsson

Constanze Leineweber

Affiliations

Soon will be listed here.

Abstract

Objective: To study the influence of physical work factors on the risks of future disability pension (DP) due to mental or musculoskeletal diagnoses among nursing professionals, care assistants and all other occupations in the general working population in Sweden.

Methods: The prospective population study was based on representative samples of working individuals (n=79 004) aged 16-64, interviewed in the Swedish Work Environment Survey between 1993 and 2013. Information on diagnosed DP in 1994-2014 was gathered from the Social Insurance Agency's database. The focus was on nursing professionals (registered nurses and midwives) and care assistants, for example, assistant nurses and hospital ward assistants. The outcome was DP, classified into two diagnostic groups. Associations between physical work factors and risk of DP were calculated using Cox regression with HR and 95% CI.

Results: Physical work factors were associated with future DP after adjusting for sociodemographic conditions and psychosocial work factors among care assistants (n=10 175) and among all other occupations (n=66 253), but not among nursing professionals (n=2576). The increased risk among care assistants (n=197) exposed to heavy physical work was 66% (HR 1.66, 95% CI 1.39 to 1.97), and for those exposed to strenuous work postures (n=420) it was 56% (HR 1.56, 95% CI 1.35 to 1.80). Physical work indicators were mainly associated with musculoskeletal DP diagnoses among care assistants, but two indicators were significant also for mental diagnoses. An increased risk of DP was found among nursing professionals (n=102) exposed to detergents or disinfectants (HR 1.48, 95% CI 1.06 to 2.05), but not among care assistants.

Conclusions: Heavy physical work and strenuous postures are predictors of future DP, particularly among care assistants and in the general working population. In order to reduce early exit from the workforce, efforts should be made to improve physical and ergonomic working conditions.

Citing Articles

Jakobsen M, Vinstrup J, Andersen L J Occup Rehabil. 2024; .

PMID: 39103730 DOI: 10.1007/s10926-024-10221-y.

Individual and organizational interventions to promote staff health and well-being in residential long-term care: a systematic review of randomized controlled trials over the past 20 years.

Herz M, Bosl S, Gebhard D BMC Nurs. 2024; 23(1):195.

PMID: 38519896 PMC: 10958844. DOI: 10.1186/s12912-024-01855-7.

Biomechanical evaluation of midwifery tasks and its relationship with the prevalence of musculoskeletal disorders.

Hasheminejad N, Amirmahani M, Tahernejad S Heliyon. 2023; 9(9):e19442.

PMID: 37809434 PMC: 10558586. DOI: 10.1016/j.heliyon.2023.e19442.

Nagel C, Nilsson K Int J Environ Res Public Health. 2022; 19(23).

PMID: 36497643 PMC: 9738150. DOI: 10.3390/ijerph192315569.

[The Employment Perspective in the Health Care Sector - Until What Age do Older Employees Want to, Can and Plan to Work?].

Garthe N, Hasselhorn H Gesundheitswesen. 2022; 85(6):514-521.

PMID: 36195109 PMC: 11248691. DOI: 10.1055/a-1915-4324.

References

Lahelma E, Laaksonen M, Lallukka T, Martikainen P, Pietilainen O, Saastamoinen P . Working conditions as risk factors for disability retirement: a longitudinal register linkage study. BMC Public Health. 2012; 12:309. PMC: 3438015. DOI: 10.1186/1471-2458-12-309. View

Nygaard Jensen J, Holtermann A, Clausen T, Mortensen O, Carneiro I, Andersen L . The greatest risk for low-back pain among newly educated female health care workers; body weight or physical work load?. BMC Musculoskelet Disord. 2012; 13:87. PMC: 3404961. DOI: 10.1186/1471-2474-13-87. View

Karasek R, Brisson C, Kawakami N, Houtman I, Bongers P, Amick B . The Job Content Questionnaire (JCQ): an instrument for internationally comparative assessments of psychosocial job characteristics. J Occup Health Psychol. 1998; 3(4):322-55. DOI: 10.1037//1076-8998.3.4.322. View

Ando S, Ono Y, Shimaoka M, Hiruta S, Hattori Y, Hori F . Associations of self estimated workloads with musculoskeletal symptoms among hospital nurses. Occup Environ Med. 2000; 57(3):211-6. PMC: 1739924. DOI: 10.1136/oem.57.3.211. View

Eriksen W, Bruusgaard D, Knardahl S . Work factors as predictors of intense or disabling low back pain; a prospective study of nurses' aides. Occup Environ Med. 2004; 61(5):398-404. PMC: 1740782. DOI: 10.1136/oem.2003.008482. View

Albertsen K, Lund T, Christensen K, Kristensen T, Villadsen E . Predictors of disability pension over a 10-year period for men and women. Scand J Public Health. 2007; 35(1):78-85. DOI: 10.1080/14034940600858474. View

Hannerz H, Tuchsen F . Hospitalizations among female home-helpers in Denmark, 1981-1997. Am J Ind Med. 2002; 41(1):1-10. DOI: 10.1002/ajim.10028. View

Eriksen W . The prevalence of musculoskeletal pain in Norwegian nurses' aides. Int Arch Occup Environ Health. 2003; 76(8):625-30. DOI: 10.1007/s00420-003-0453-6. View

Ervasti J, Pietilainen O, Rahkonen O, Lahelma E, Kouvonen A, Lallukka T . Long-term exposure to heavy physical work, disability pension due to musculoskeletal disorders and all-cause mortality: 20-year follow-up-introducing Helsinki Health Study job exposure matrix. Int Arch Occup Environ Health. 2018; 92(3):337-345. PMC: 6420465. DOI: 10.1007/s00420-018-1393-5. View

10.

Hagen K, Tambs K, Bjerkedal T . A prospective cohort study of risk factors for disability retirement because of back pain in the general working population. Spine (Phila Pa 1976). 2002; 27(16):1790-6. DOI: 10.1097/00007632-200208150-00019. View

11.

Ervasti J, Pietilainen O, Rahkonen O, Lahelma E, Kouvonen A, Lallukka T . Joint contribution of rotation of the back and repetitive movements to disability pension using job exposure matrix data. Eur J Public Health. 2019; 29(6):1079-1084. DOI: 10.1093/eurpub/ckz108. View

12.

Dulon M, Kromark K, Skudlik C, Nienhaus A . Prevalence of skin and back diseases in geriatric care nurses. Int Arch Occup Environ Health. 2007; 81(8):983-92. DOI: 10.1007/s00420-007-0292-y. View

13.

Bernal D, Campos-Serna J, Tobias A, Vargas-Prada S, Benavides F, Serra C . Work-related psychosocial risk factors and musculoskeletal disorders in hospital nurses and nursing aides: a systematic review and meta-analysis. Int J Nurs Stud. 2014; 52(2):635-48. DOI: 10.1016/j.ijnurstu.2014.11.003. View

14.

Jensen L, Ryom P, Christensen M, Andersen J . Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides. BMJ Open. 2012; 2(6). PMC: 3533112. DOI: 10.1136/bmjopen-2012-000991. View

15.

Li C, Sung F . A review of the healthy worker effect in occupational epidemiology. Occup Med (Lond). 1999; 49(4):225-9. DOI: 10.1093/occmed/49.4.225. View

16.

Stapelfeldt C, Nielsen C, Andersen N, Krane L, Borg V, Fleten N . Sick leave patterns as predictors of disability pension or long-term sick leave: a 6.75-year follow-up study in municipal eldercare workers. BMJ Open. 2014; 4(2):e003941. PMC: 3918999. DOI: 10.1136/bmjopen-2013-003941. View

17.

Kjellberg K, Lundin A, Falkstedt D, Allebeck P, Hemmingsson T . Long-term physical workload in middle age and disability pension in men and women: a follow-up study of Swedish cohorts. Int Arch Occup Environ Health. 2016; 89(8):1239-1250. PMC: 5052305. DOI: 10.1007/s00420-016-1156-0. View

18.

van der Meer E, Boot C, van der Gulden J, Jungbauer F, Coenraads P, Anema J . Hand eczema among healthcare professionals in the Netherlands: prevalence, absenteeism, and presenteeism. Contact Dermatitis. 2013; 69(3):164-71. DOI: 10.1111/cod.12099. View

19.

Stover M, Pape K, Johnsen R, Fleten N, Sund E, Ose S . Work environment and disability pension-- an 18-year follow-up study in a Norwegian working population. Scand J Public Health. 2013; 41(6):587-96. DOI: 10.1177/1403494813486965. View

20.

Lagerstrom M, Hansson T, Hagberg M . Work-related low-back problems in nursing. Scand J Work Environ Health. 1999; 24(6):449-64. DOI: 10.5271/sjweh.369. View