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

Abstract

Objective This study aimed to examine if a change to an occupation with a lower physical workload reduces the risk of all-cause disability pension (DP) and musculoskeletal DP (MDP). MethodsThis study used a sample of 359 453 workers who were registered as living in Sweden in 2005 and aged 44-63 in 2010. Exposure to physical workload was measured from 2005-2010 by linking a mean value from a job exposure matrix to occupational codes. The mean values were then split into quartiles. All included participants had high exposure to physical workload (top quartile) from 2005-2007. A change in physical workload was measured as a change to (i) any lower quartile or (ii) medium-high or low quartiles from 2008-2010. DP cases were taken from register data from 2011-2016. Crude and multivariate Cox proportional-hazards regression models estimated sex-specific hazard ratios (HR) with 95% confidence intervals (CI). ResultsCompared to workers with consistently high physical workload, a change to any lower quartile of physical workload was associated with a decreased risk of all-cause DP (men: HR 0.59, 95% CI 0.46-0.77, women: HR 0.63, 95% CI 0.52-0.76) and MDP (men: HR 0.52, 95% CI 0.31-0.89, women: HR 0.61, 95% CI 0.44-0.84). Older workers had the largest decreased risk for MDP. Generally, changing from high to low physical workload was associated with a greater reduced risk of DP than changing from high to medium-high physical workload. ConclusionChanging to an occupation with lower exposure to physical workload was associated with reduced risks of DP and MDP among both sexes.

Within-individual changes in physical work demands associated with self-reported health and musculoskeletal symptoms: a cohort study among Dutch workers

“…In line with previous studies investigating the association between an increase in physical work demands and self-rated health (van de Ven et al 2022 ) and sickness absence (Saastamoinen et al 2014 ), we found associations between an increase in physical work demands and poor health and musculoskeletal symptoms, especially among female. However, our study did not find a beneficial health effect of a decrease in physical work demands, which is contrary to the findings of these two studies and to a study among workers with heavy physical workloads conducted in Sweden (Badarin et al 2022 ). It is important to note that there are differences in follow-up period, study sample, and methods between our study and previous studies.…”

“…To get a better understanding of the impact of physical work demands, the role of changes in exposure level on worker’s health needs to be investigated. To date, only a few studies have investigated the association of changes in physical work demands on health and work participation (Badarin et al 2022 ; Saastamoinen et al 2014 ; van de Ven et al 2022 ). Van de Ven et al ( 2022 ) showed that in a sample of Dutch workers aged 45 and older, a decrease in physical work demands was associated with an improved work ability and self-rated health in the same year.…”

“…Similarly, a study among municipal employees in Helsinki aged 40–60 years found that reducing physical working conditions was followed by a lowered risk for sickness absence one year later, while an increase in this exposure was followed by an increased risk (Saastamoinen et al 2014 ). Another study, in which over 300,000 workers were surveyed in Sweden with physically demanding jobs, showed that a change into lower physical work demands was associated with a reduced risk of all-cause and musculoskeletal disability pension for both genders (Badarin et al 2022 ).…”

“…Firstly, we will examine the topic among a broad sample of workers, rather than focusing solely on older workers or those in specific sectors. Secondly, given the gender-specific associations between physical work demands and health outcomes (Badarin et al 2022 ; Cillekens et al 2022 ; Guettler 2023 ; Serna Arnau et al 2023 ), we will also investigate potential gender differences in the association of changes in physical work demands on health. Thirdly, we will assess the association of changes in physical work demands on health within a relatively short time period (6 months) as we hypothesize that changes in physical work demands will result in acute changes in health.…”

The impact of cardiorespiratory fitness and physical workload on disability pension–a cohort study of Swedish men

“…However, recovery time during working hours is also essential for physically demanding jobs (Korshøj et al 2015 ). Furthermore, we have recently found that DP could be prevented by changing from a job with heavy physical workload to a job with lower physical workload (Badarin et al 2022 ).…”