Physical workload and increased frequency of musculoskeletal pain: a cohort study of employed men and women with baseline occasional pain

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Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement. Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix. Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure. Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors.

Section: Methodsmentioning

confidence: 99%

Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers

d’Errico

Falkstedt

Almroth

et al. 2022

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“…The study participants' degree of overall occupational physical workload was classified using a recently developed jobexposure matrix (JEM) for physical workload applicable to up to 355 occupations in Sweden. This JEM is based on data from the Swedish Work Environment Surveys 1997-2013, which in turn derives from eight questions regarding physical loads that involve heavy lifting, uncomfortable working postures, repetitive work and physically demanding work (Badarin et al 2021). A gender-specific index mean value for the overall physical exposure, based on the eight questions, was obtained from the matrix and linked to individuals through yearly data on their occupations in 2005.…”

Section: Physical Workload (Exposure)mentioning

confidence: 99%

Disability pensions related to heavy physical workload: a cohort study of middle-aged and older workers in Sweden

Falkstedt

Hemmingsson

Albin

et al. 2021

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Objectives The aim of the study was to examine the associations between heavy physical workload among middle-aged and older workers and disability pension due to any diagnosis, as well as musculoskeletal, psychiatric, cardiovascular or respiratory diagnoses. The population-based design made it possible to examine dose–response and potential gender differences in the associations. Methods About 1.8 million men and women aged 44–63 years and registered as living in Sweden in 2005 were followed regarding disability pension during 2006–2016, until ages 55–65 years. Mean values of physical workload and job control, estimated through gender-specific job-exposure matrices (JEMs), were assigned to individuals through their occupational titles in 2005. Exposure values were ranked separately for women and men and divided into quintiles. Associations were analyzed with Cox proportional-hazards regression. Results The analyses showed robust, dose–response associations between physical workload and disability pension with a musculoskeletal diagnosis in both genders: the adjusted hazard ratio and 95% confidence interval for those with the heaviest exposure was 2.58 (2.37–2.81) in women and 3.34 (2.83–3.94) in men. Dose–response associations were also seen in relation to disability pension with a cardiovascular or a respiratory diagnosis, though the hazard ratios were smaller. Physical workload was not associated with disability pension with a psychiatric diagnosis after adjustment for job control. Conclusion This study of the entire Swedish population of middle-aged and older workers suggests that higher degrees of physical workload may increase the risk of disability pension overall, and specifically with musculoskeletal, cardiovascular or respiratory diagnosis, in both women and men.

“…Baseline exposure to PWL was estimated using a Swedish JEM. The construction of the JEM has been described previously (Badarin et al 2021). The JEM was developed using responses to eight questions on physical strenuous work from the biennial Swedish Work Environment Surveys (SWES) between 1997 and 2013.…”

Section: Physical Workload (Exposure)mentioning

confidence: 99%

“…Another strength is the application of the JEMs. The Swedish JEMs have shown good external validity when predicting worsening MSP (Badarin et al 2021), disability pension (Falkstedt et al 2021) or diagnosed depression (Almroth et al 2021). Studies that examine the use of existing JEMs, constructed using similar methods, suggest that the exposure estimates provided by the JEMs can be used to identify occupations with higher risks of MSP and other health outcomes (Rijs et al 2014, Hanvold et al 2018Solovieva et al 2012).…”

Section: Strengths and Limitationsmentioning

confidence: 99%

The impact of musculoskeletal pain and strenuous work on self-reported physical work ability: a cohort study of Swedish men and women

Badarin

Hemmingsson

Hillert

et al. 2021

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Objective We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA). Methods This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: “moderate”, “rather poor” and “very poor” indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27. Results MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00–8.15, women: AOR: 3.25 95% CI 1.81–5.83). The SI was non-significant for both sexes. Conclusion Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces.