Joint Association of Overweight and Common Mental Disorders With Diagnosis-Specific Disability Retirement: A Follow-Up Study Among Female and Male Employees

[Occupational and Health Strains of Pensioners with Reduced Earning Capacity Due to Mental or Physical Illnesses - Implications for the Health Care System]

OBJECTIVE

Demographic changes with an increasing number of people receiving pensions and a decreasing number of working people paying into the pension system represent major challenges for the German social security system. In particular, it is important to support people to continue working so that there is no (premature) reduction in their earning capacity and pensioners with reduced earning capacity (disability pensioners) should be helped to return to gainful employment. The aim of this study was to investigate the differing needs of two kinds of disability pensioners, namely those with mental illness and those who were physically ill.

METHODS

A total of 453 persons receiving disability pension because of temporararily reduced earning capacity were interviewed over the telephone. Differences in demographic variables, occupational characteristics before applying for disability pension, and general resources were examined in descriptive analyses and multivariate analyses of variance with post-hoc tests.

RESULTS

A third of the sample (33.1%) suffered from mental illness and the rest from somatic disorders. Those with mental illness reported higher perceived mental age, lower work-related self-efficacy, and lower quality of life concerning their mental health. Moreover, they reported higher levels of mental stressors at work.

CONCLUSION

Mentally ill disability pensioners differ considerably from those with somatic illnesses. Accordingly, to promote a return to work, interventions need to target different factors in these two groups.

Physical working conditions and subsequent sickness absence: a record linkage follow-up study among 19-39-year-old municipal employees

Purpose

Physical work exposures are associated with sickness absence among older employees. We aimed to examine if they similarly contribute to all-cause sickness absence during early and mid-careers.

Methods

We used questionnaire data on physical work exposures linked to register data on sickness absence from 3542 municipal employees aged 19–39 years. Follow-up for the number of sickness absence days was 12 months. Exposures to physical workload, occupational environmental hazards, and sedentary work were divided into quartiles. In addition, duration of daily exposure to heavy work was included. Negative binomial regression models were used.

Results

Higher exposure to physical workload or hazardous exposures was associated with a higher number of sickness absence days. The age and gender adjusted rate ratios for sickness absence days among the participants whose exposure to physical workload was in the highest exposure quartile were 2.1 (95% CI 1.8‒2.5) compared with those whose exposure was in the lowest quartile. In addition, rate ratios for sickness absence days among participants who reported that they do heavy physical work 1.1‒2.0 h, 2.1‒4.0 h or over 4 h daily were 1.6 (1.3‒1.9), 1.5 (1.3‒1.8) and 1.7 (1.5‒2.1), respectively, compared with those who reported not doing physical work. Further adjustment for lifestyle factors or health characteristics attenuated the associations only slightly.

Conclusion

Exposure to physically demanding work is associated with a higher number of sickness absence days among municipal employees below 40 years of age. Physical working conditions should be considered when aiming to support later work ability.

Supplementary Information

The online version contains supplementary material available at 10.1007/s00420-021-01791-y.

Physical working conditions and subsequent disability retirement due to any cause, mental disorders and musculoskeletal diseases: does the risk vary by common mental disorders?

PURPOSE

Physical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined.

METHODS

The data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000-2002, 2007 and 2012. We used 12,458 observations from 6159 employees, who were 40-60 years old at baseline. CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+). Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as "neither", "work exposure only", "CMD only", and "both". Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up. Additionally, synergy indices were calculated for the combined effects.

RESULTS

Those reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60-5.03), mental disorders (HR 5.41, 95% CI 3.87-7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49-5.71) when compared to those with neither. Synergy indices indicated that these associations were synergistic. Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work.

CONCLUSIONS

Identification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.