Physical work demands and expected labor market affiliation (ELMA): Prospective cohort with register-follow-up among 46 169 employees

Abstract

Objective This study aimed to estimate the impact of high physical work demands on expected labor market affiliation (ELMA) among men and women of different ages in the general working population. Methods After participating in the Danish Work Environment and Health study (2012, 2014, and/or 2016), 46 169 employees were followed for two years in national registers. Using multi-state modeling, taking all day-to-day transition probabilities of labor market affiliation into account (work, unemployment, sickness absence, temporary out, and permanently out), and performing multilevel adjustment, we estimated the prospective association between physical work demands (ergonomic index including 7 factors) and ELMA. Results During 104 896 person-years of follow-up, we identified of 439 045 transitions. Using low physical work demands as reference, higher physical work demands were associated with fewer days of active work (2–35 days) during 730 days of follow-up, and more days of sickness absence (4–26 days) and unemployment (ranging 1-9 days) among men and women of aged 40–49 and 50–64 years. Among men and women aged 18–39 years, high physical work demands only had minor and inconsistent impact on ELMA. Conclusions Analyzing multiple and highly detailed patterns of transition probabilities concerning labor market affiliation, we showed that reducing physical work demands is likely to increase the active working time and prevent high societal cost of sickness absence and unemployment, especially among middle-aged and older workers.

The labor market costs of work-related stress: A longitudinal study of 52 763 Danish employees using multi-state modeling

“…The ELMA uses Cox proportional hazard regression for establishing time-dependent transition probabilities for each covariate while incorporating modern survival terms such as left and right censoring, time truncation, recurrent events, and competing events management while fulfilling a Markov assumption ( 28 ). Using numerical integration, ELMA converts complex patterns of state-conditioned transition probabilities into overall state duration estimates ( 29 , 30 ) before conducting variance analysis on the duration estimates to find the variable-specific contributions ( 8 , 13 , 31 ).…”

“…However, since we can only estimate the actual production value lost while employees were absent from work, we use the term ‘costs of work absenteeism’ to describe the costs of any negative difference between the number of working days deduced from the analysis and the expected number of working days. The ELMA method has shown to be a well-founded analytical tool for analyzing multiple labor market outcomes while including the interconnectivity between multiple outcomes ( 8 , 13 , 20 ).…”

Labour market trajectories after part-time sickness absence: a nationwide cohort study from Finland

“…25 26 We chose to examine these two exposures as previous studies have provided consistent evidence on the associations of physical workload and job control with work participation. [27][28][29] The JEM for physical heaviness of work and job control have also shown good validity. 25 26 The JEM information was linked to occupational codes in the register data using a classification by Statistics Finland (Classification of Occupations 2010), based on the International Standard Classification of Occupations (ISCO-88).…”

A Rapid Review on the Effectiveness and Use of Wearable Biofeedback Motion Capture Systems in Ergonomics to Mitigate Adverse Postures and Movements of the Upper Body

“…Close to half are exposed to tiring and painful work postures at least one-quarter of the worktime, and 14% are exposed to such postures all or most of the time. In addition to causing years without disability and imposing high costs on both individuals and society, WMSDs can impair work capacity and increase the risk of short- and long-term absenteeism and premature exit from the labor market [ 26 , 27 , 28 ]. Given the widespread occurrence of WMSDs, proactive measures are necessary to prevent ill health conditions.…”