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

Abstract

ObjectiveTo 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.MethodsThe 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.ResultsPhysical 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.ConclusionsHeavy 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.

Musculoskeletal pain intensity in different body regions and risk of disability pension among female eldercare workers: prospective cohort study with 11-year register follow-up

“…The present study's findings that musculoskeletal pain intensity in different body regions function as a predictor for future disability pension among eldercare workers supplements previous findings that high physical work demands [21,22], pain duration [23], and multi-site pain [15] predict disability pension. As a novel finding, the present study found high/very high pain intensity to predict disability pension among both younger and older workers.…”

“…Certain job groups report particularly high physical work demands and prevalence of musculoskeletal disorders. One of these job groups are healthcare workers who are at increased risk of musculoskeletal pain [17][18][19], sickness absence [9,20], and disability pension [21][22][23]. In the latest (2018) round of the Work Environment and Health study in Denmark, 46% of healthcare workers reported having musculoskeletal pain several times per week, consequently representing the job group with the highest prevalence of weekly bodily pain [24].…”

“…The high prevalence of pain among healthcare workers may be explained by the high mental and physical demands they are confronted with in their daily work, comprising lifting and manually assisting personsoftentimes with sustained and awkward postures [17,18]. For instance, high physical exertion during eldercare work increased the odds of persistent low-back and knee pain (> 30 days during the past year) at 1-year follow-up [18], while heavy physical work and strenuous work postures increased the risk of disability pension among healthcare workers (including nurses) [21][22][23]. Additionally, musculoskeletal pain may also origin from chronic diseases such as osteoarthritis and cancer [26,27].…”

“…In addition, work ability (proxy for disability pension) among nurses declined with higher intensity of musculoskeletal pain [30], while pain intensity in the low-back, neck/shoulders, and legs associated with increased work limitation (also a proxy for disability pension) in a dose-response manner among workers ≥50 years from the general working population [28,29,31]. Thus, while pain intensity is associated with poorer ability to work [28][29][30][31], and physical work demands and musculoskeletal pain (single-and multi-site pain) increase the risk of disability pension [15,16,[21][22][23], no studies to date have investigated the dose-response association between pain intensity in different body regions and risk of disability pension among eldercare workers.…”

Health problems and violence experiences of nurses working in acute care hospitals, long-term care facilities, and home-based long-term care in Germany: A systematic review

“…In this respect, the available studies of our review are in line with current research showing high prevalences of burnout risk [ 39 , 44 , 46 , 51 , 53 , 63 ] and musculoskeletal disorders [ 34 , 40 , 42 , 52 ], independently from the setting nurses work in. This indicates that nurses do not only show an increased risk of long-term absence from work, but also are at risk in terms of occupational disability [ 13 , 58 , 64 ] and early retirement [ 8 ]. Thus, it is not surprising that in Germany almost every second employee in this field thinks about leaving the profession several times a year [ 9 ].…”