BackgroundEarly retirement due to disability is a public health and work environment problem that shortens working careers. Transition to disability retirement is based on ill-health, but working conditions are also of relevance. We examined the contributions of work arrangements, physical working conditions and psychosocial working conditions to subsequent disability retirement.MethodsThe data were derived from the Helsinki Health Study cohort on employees of the City of Helsinki, Finland. Information on working conditions was obtained from the baseline surveys conducted in 2000, 2001 and 2002. These data were linked with register data on disability retirement and their main diagnoses obtained from the Finnish Centre for Pensions. Follow up by the end of 2008 yielded 525 disability retirement events. The analysed data included 6525 participants and 525 disability retirement events. Hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated from Cox regression analysis.ResultsSeveral working conditions showed own associations with disability retirement before adjustment. After adjustment for all working conditions, the primary risk factors for all-cause disability retirement were physical workload among women (HR 2.02, 95% CI 1.57-2.59) and men (HR 2.00, 95% CI 1.18-3.38), and low job control among women (HR 1.60, 95% CI 1.29-1.99). In addition, for disability retirement due to musculoskeletal causes, the risk factors were physical workload and low job control. For disability retirement due to mental causes the risk factors were computer work and low job control. Furthermore, occupational class was a risk factor for disability retirement due to all causes and musculoskeletal diseases.ConclusionsAmong various working conditions, those that are physically demanding and those that imply low job control are potential risk factors for disability retirement. Improving the physical working environment and enhancing control over one’s job is likely to help prevent early retirement due to disability.

The Helsinki Health Study cohort was set up to enable longitudinal studies on the social and work related determinants of health and well-being, making use of self-reported as well as objective register data. The target population is the staff of the City of Helsinki, Finland. Baseline data for the cohort were derived from questionnaire surveys conducted in 2000, 2001 and 2002 among employees reaching 40, 45, 50, 55 or 60 years of age in each year. The number of responders at baseline was 8960 (80% women, response rate 67%). Additional age-based health examination data were available. A follow up survey was conducted in 2007 yielding 7332 responders (response rate 83%). Measures of health include health behaviours, self-rated health, common mental disorders, functioning, pain, sleep problems, angina symptoms and major diseases. Social determinants include socio-demographics, socio-economic circumstances, working conditions, social support, and work-family interface. Further register linkages include sickness absence, hospital discharge, prescribed drugs, and retirement updated at the end of 2010. The cohort allows comparisons with the Whitehall II study, London, UK, and the Japanese Civil Servants Study from western Japan. The cohort data are available for collaborative research at Hjelt Institute, Department of Public Health, University of Helsinki, Finland.

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Expected occupational class inequalities in health among both women and men were found for global and physical health but not for mental health. The observed inequalities could not be attributed to physical or mental workload.

Pain is a strong predictor of reduced work ability and well-being, but there is little information on the prevalence of and socio-economic differences in acute, chronic and disabling chronic pain among employees. A questionnaire survey conducted in 2000-2002 among employees aged 40, 45, 50, 55 and 60 of the City of Helsinki (N=8970, response rate 67%) included socio-demographic and socio-economic factors and measures of current pain, pain duration and pain-related disability. Pain was acute when lasting a maximum of 3 months and chronic when persisting for more than 3 months. Disabling chronic pain was determined using the disability subscale of Von Korff's Chronic Pain Grade questionnaire. Acute pain was reported by 15% of women, chronic pain by 29% and disabling chronic pain by 7%. The corresponding figures for men were 12, 24 and 5%. Chronic and disabling chronic pain were more common in older age groups among both genders. Among women, those with secondary or basic education were more likely to report chronic or disabling chronic pain than those with higher education, and semi-professionals, routine non-manual employees and manual workers were more likely to report disabling chronic pain than managers. Among men, separated/divorced or widowed men were more likely to report acute pain than married men, and manual workers were more likely to report chronic pain than managers. Chronic pain was relatively common in this population, and those with older age, lower education and occupational class appear to be at excess risk for chronic pain, especially for disabling chronic pain.