The Impact of Cardiorespiratory Fitness and Physical Workload on Disability Pension-a Cohort Study of Swedish Men

Overview

Journal Int Arch Occup Environ Health

Specialty Environmental Health

Date 2023 Nov 16

PMID 37971680

Authors

Karin Berglund

Melody Almroth

Daniel Falkstedt

Tomas Hemmingsson

Katarina Kjellberg

Affiliations

Soon will be listed here.

Abstract

Objective: Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD).

Methods: A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP.

Results: Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures.

Conclusion: Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).

References

Andersen L . A maximal cycle exercise protocol to predict maximal oxygen uptake. Scand J Med Sci Sports. 1995; 5(3):143-6. DOI: 10.1111/j.1600-0838.1995.tb00027.x. View

Karlqvist L, Leijon O, Harenstam A . Physical demands in working life and individual physical capacity. Eur J Appl Physiol. 2003; 89(6):536-47. DOI: 10.1007/s00421-003-0832-4. View

Karlsson N, Carstensen J, Gjesdal S, Alexanderson K . Risk factors for disability pension in a population-based cohort of men and women on long-term sick leave in Sweden. Eur J Public Health. 2008; 18(3):224-31. DOI: 10.1093/eurpub/ckm128. View

Falkstedt D, Hemmingsson T, Albin M, Bodin T, Ahlbom A, Selander J . Disability pensions related to heavy physical workload: a cohort study of middle-aged and older workers in Sweden. Int Arch Occup Environ Health. 2021; 94(8):1851-1861. PMC: 8490214. DOI: 10.1007/s00420-021-01697-9. View

Karnehed N, Rasmussen F, Kark M . Obesity in young adulthood and later disability pension: a population-based cohort study of 366,929 Swedish men. Scand J Public Health. 2007; 35(1):48-54. DOI: 10.1080/14034940600858524. View

Obling K, Hansen A, Overgaard K, Normann K, Sandbaek A, Maindal H . Association between self-reported and objectively measured physical fitness level in a middle-aged population in primary care. Prev Med Rep. 2016; 2:462-6. PMC: 4721415. DOI: 10.1016/j.pmedr.2015.05.010. View

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

Amick B, McLeod C, Bultmann U . Labor markets and health: an integrated life course perspective. Scand J Work Environ Health. 2016; 42(4):346-53. DOI: 10.5271/sjweh.3567. View

Badarin K, Hemmingsson T, Almroth M, Falkstedt D, Hillert L, Kjellberg K . Does a change to an occupation with a lower physical workload reduce the risk of disability pension? A cohort study of employed men and women in Sweden. Scand J Work Environ Health. 2022; 48(8):662-671. PMC: 10546609. DOI: 10.5271/sjweh.4053. View

10.

Lie S, Tveito T, Reme S, Eriksen H . IQ and mental health are vital predictors of work drop out and early mortality. Multi-state analyses of Norwegian male conscripts. PLoS One. 2017; 12(7):e0180737. PMC: 5500358. DOI: 10.1371/journal.pone.0180737. View

11.

Karpansalo M, Lakka T, Manninen P, Kauhanen J, Rauramaa R, Salonen J . Cardiorespiratory fitness and risk of disability pension: a prospective population based study in Finnish men. Occup Environ Med. 2003; 60(10):765-9. PMC: 1740405. DOI: 10.1136/oem.60.10.765. View

12.

Rijs K, van der Pas S, Geuskens G, Cozijnsen R, Koppes L, van der Beek A . Development and validation of a physical and psychosocial job-exposure matrix in older and retired workers. Ann Occup Hyg. 2013; 58(2):152-70. DOI: 10.1093/annhyg/met052. View

13.

Aberg M, Pedersen N, Toren K, Svartengren M, Backstrand B, Johnsson T . Cardiovascular fitness is associated with cognition in young adulthood. Proc Natl Acad Sci U S A. 2009; 106(49):20906-11. PMC: 2785721. DOI: 10.1073/pnas.0905307106. View

14.

Karpansalo M, Manninen P, Lakka T, Kauhanen J, Rauramaa R, Salonen J . Physical workload and risk of early retirement: prospective population-based study among middle-aged men. J Occup Environ Med. 2002; 44(10):930-9. DOI: 10.1097/00043764-200210000-00012. View

15.

Solovieva S, Pehkonen I, Kausto J, Miranda H, Shiri R, Kauppinen T . Development and validation of a job exposure matrix for physical risk factors in low back pain. PLoS One. 2012; 7(11):e48680. PMC: 3495969. DOI: 10.1371/journal.pone.0048680. View

16.

Badarin K, Hemmingsson T, Hillert L, Kjellberg K . Physical workload and increased frequency of musculoskeletal pain: a cohort study of employed men and women with baseline occasional pain. Occup Environ Med. 2021; . PMC: 8292582. DOI: 10.1136/oemed-2020-107094. View

17.

Gravseth H, Bjerkedal T, Irgens L, Aalen O, Selmer R, Kristensen P . Life course determinants for early disability pension: a follow-up of Norwegian men and women born 1967-1976. Eur J Epidemiol. 2007; 22(8):533-43. DOI: 10.1007/s10654-007-9139-9. View

18.

Holtermann A, Marott J, Gyntelberg F, Sogaard K, Mortensen O, Prescott E . Self-reported occupational physical activity and cardiorespiratory fitness: Importance for cardiovascular disease and all-cause mortality. Scand J Work Environ Health. 2016; 42(4):291-8. DOI: 10.5271/sjweh.3563. View

19.

Gupta N, Heiden M, Mathiassen S, Holtermann A . Is self-reported time spent sedentary and in physical activity differentially biased by age, gender, body mass index, and low-back pain?. Scand J Work Environ Health. 2017; 44(2):163-170. DOI: 10.5271/sjweh.3693. View

20.

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