Study protocol for SeniorWorkingLife - push and stay mechanisms for labour market participation among older workers

Are the Quality of Organizational Changes Associated with Expected Retirement-Age Among Senior Employees?

OBJECTIVE

Major organizational changes may be associated with both positive and negative uncertainty in working life. This study described the prevalence of organizational changes (reorganizations or round of layoffs) within different job functions in Denmark and investigated whether quality of the implementation process (measured as "information", "involvement" and "consent") was associated with employees' expectations regarding retirement age.

METHODS

A representative sample of older Danish employees ≥ 50 years (n = 12,269) replied to a questionnaire survey in 2020. In cross-sectional analyses, we compared employee's expected retirement age being either not exposed to organizational changes or exposed to implementation processes of high, moderate or low-quality, respectively. Analyses were further stratified for job function: office work, work with people and work in the field of production.

RESULTS

More than half (56%) of the employees had experienced organizational changes within the past 2 years, and 23% of those effected reported that the changes had led to considerations of earlier retirement. Organizational changes were most prevalent within office work, and least prevalent within the job function working with people. The analyses showed significantly lower expected retirement age when the implementation process had been of moderate (mean reduction of 0.45 years) or low quality (mean reduction of 0.71 years) compared to high quality implemented changes.

CONCLUSIONS

Experiences of organizational change processes of moderate or poor quality were associated with expectations of earlier retirement, while well implemented changes were not. This study underscores the importance of good implementation when changes at the organizational level are needed.

A resource-oriented perspective on the aging workforce - exploring job resource profiles and their associations with various health indicators

BACKGROUND

Promoting older workers' health in the context of increasing labor force participation and skill shortages is crucial. Examining job resource profiles offers a promising approach to understanding how to promote and maintain the health of older workers within the workplace. However, it is unclear how different job resources interact within distinct worker subgroups. Thus, this study explores the association between the job resource profiles of distinct subgroups and various health indicators among older workers in Europe.

METHODS

Data from 4,079 older workers (age range: 50-60 years, 57% female) from waves 6 and 8 of the Survey of Health, Ageing and Retirement in Europe (SHARE) were analyzed. Latent profile analysis was employed to identify distinct job resource profiles using social support, recognition, job promotion, autonomy, and development opportunities. Associations between these profiles and various health indicators were examined, alongside the sociodemographic and socioeconomic characteristics associated with each profile.

RESULTS

Four distinct job resource profiles emerged: (I) average job resource workers (n = 2170, 53%), (II) high social job resource workers (n = 983, 24%), (III) low job resource workers (n = 538, 13%), and (IV) autonomous decision-making workers (n = 388, 10%). Workers in the (II) high social job resource profile had the highest socioeconomic status and reported the best self-perceived health, lowest depressive symptoms, and fewest limitations and chronic diseases. Conversely, workers in the (III) low job resource profile had the second-lowest socioeconomic status and reported the poorest health outcomes. Surprisingly, older workers with high autonomy (profile IV) had the lowest socioeconomic status and the second worst self-perceived health. This may be because they perceive themselves as autonomous while lacking support and recognition.

CONCLUSION

There is wide variation in the level and composition of resources available to older workers in the workplace. The most vulnerable subgroups, such as low job resource workers (profile III) and autonomous decision-making workers (profile IV), could benefit from tailored workplace health promotion interventions, such as support from supervisors or peers. Strengthening older workers' job resources, including social support and recognition, can improve their health and contribute to them remaining in the workforce.

The use of individual and collective selection, optimisation and compensation (SOC) strategies and their association with work ability among senior workers

Background Selection, optimisation, and compensation (SOC) can be important strategies for maintaining work ability as we age. This study aimed to explore differences in self-reported individual and collective use of SOC strategies across job functions, as well as their association with self-rated work ability.

METHODS

In the third wave of the SeniorWorkingLife study, 10,798 workers aged 50 + , across the job function categories "Office work", "work with people", and "work in the field of production", replied to questions about collective and individual SOC strategies and work ability. Using multiple regression, we modelled associations between SOC and work ability.

RESULTS

Associations between SOC and work ability were generally weaker among participants working in the field of production. Both individual and collective use of selection had much weaker associations with work ability in the job functions "office work" and "working with people". In the job function "working in the field of production", only collective compensation was positively associated with work ability while individual selection was significantly but negatively associated with work ability.

CONCLUSIONS

The use of SOC may be particularly beneficial for older employees working with people. Optimisation and compensation may be the most important SOC strategies for maintaining the work ability of older employees working with people and doing office work. For older employees working in the field of production, collective optimisation may support the maintenance of work ability while reduced work ability may be associated with the use of individual selection as a "coping strategy".

Work-limiting musculoskeletal pain and its association with loss of paid employment among senior workers: prospective cohort study with register follow-up

BACKGROUND

A growing population of elderly necessitates a sharpened focus on sustainable employment through aging. Physically demanding work can be challenging, especially for senior workers. Establishing determinants of labor market participation could guide policy development and preventive efforts at the workplaces aiming at keeping senior workers longer in the labor market.

METHODS

We used data from SeniorWorkingLife, a comprehensive questionnaire survey among a representative sample of Danish +50-year workers, and investigated the prospective association between self-reported work limitations due to musculoskeletal pain ('work-limiting pain') in 2018 and register-based loss of paid employment before state pension age at 2-year follow-up among +50-year Danish workers with physically demanding work (n = 3050).

RESULTS

Results showed that work-limiting pain increased the risk of loss of paid employment before the state pension age in a progressive manner, i.e. the higher degree of work-limiting pain, the higher risk of loss of paid employment (P < 0.001). Experiencing a low degree of work-limiting pain was associated with an 18% increased risk of loss of paid employment [risk ratio (RR): 1.18, 95% confidence interval (CI): 1.14-1.21], whereas experiencing a very high degree of work-limiting pain increased the risk of loss of paid employment by 155% (RR: 2.55, 95% CI: 2.43-2.69) compared to no work-limiting pain.

CONCLUSION

In conclusion, work-limiting pain constitutes an important risk factor for loss of paid employment among senior workers with physically demanding work, and effective preventive efforts at both policy and workplace levels should be documented and implemented.

Social Networks, New Technologies, and Wellbeing-An Interview Study on Factors Influencing Older Adults' Successful Ageing

Many factors are considered vital in supporting successful ageing and older adults' wellbeing. Whilst evidence exists around facilitating and hindering factors in the general use of various forms of institutional and family support and personal development-oriented education and/or new technologies, evidence is limited with regards to older people's motivations, expectations, and experiences surrounding ageing. Hence, in this study, the author used a qualitative explanatory method to interpret the factors influencing seniors' successful ageing. The author's focus was on how seniors experience ageing. The second issue was how they have been organizing life in old age. The third point concerned their expectations towards ageing now and in the future. Thirteen older adults (60+) were interviewed nationwide using a semi-structured scenario tool. Their objective was to give rich descriptions of their experiences of ageing. The interviews revealed the older adults' own experiences and enabled an understanding of their motivations, perceptions, moderators, and expectations around successful ageing. Based on the analysis of the qualitative data, the author developed three main themes, each with its own sub-themes: 1. Life satisfaction (transitioning to retirement, using coping strategies in adaptation to negative changes, reaching personal goals, leading a meaningful life); 2. Supportive environments (being independent but using temporary assistance from relatives and/or people close to oneself, living with family members (e.g., husband or wife, children, grandchildren), having access to health care system); 3. Social integration (social relations, social engagement, independence in using technological advancements). The main categories that emerged from the three themes were social networks, new technologies, and wellbeing. To analyze these issues, the author used a sociological approach. The theoretic explorations were embedded mainly in two methods: criticism of writing and the analytical and comparative one.

Expected reasons for leaving the labour market and loss of paid employment among older workers: prospective cohort study

BACKGROUND

Surveying expected reasons for retirement may be a useful strategy to maintain labor market affiliation. The aim was to investigate the prospective association between self-reported expected reasons for leaving the labour market and subsequent loss of paid employment before the state pension age among older workers.

METHODS

The prospective risk of loss of paid employment before the official state pension age was estimated from expected reasons for leaving the labour market among 10,320 currently employed older workers (50-63 years) from the SeniorWorkingLife study. In 2018, participants replied to 15 randomly ordered questions about expected reasons for leaving the labour market and were in 2020 followed in a national register containing information on labour market participation.

RESULTS

Loss of paid employment before state pension age was predicted by expected reasons related to 'Health, work demands and occupational well-being': 'Poor physical health' (RR 1.47, 95% CI 1.45-1.49), 'Poor mental health' (RR 1.36, 95% CI 1.32-1.40), 'Not being capable of doing the job' (RR 1.20, 95% CI 1.18-1.22), and 'Not thriving at the workplace' (RR 1.14, 95% CI 1.11-1.17). Expected reasons related to the possibility of receiving voluntary early retirement benefits also increased this risk. Expected reasons related to 'Leisure' ('Wish for more self-determination'; 'Wish for more time for hobbies'), 'Economy' ('Economic considerations'; 'Possibility of receiving pension'), and 'Norms' ('Retirement norms'; 'To make space for younger employees') decreased the risk of loss of paid employment before state pension age. Age-stratified analyses revealed that expected reasons related to the domain of 'Health, work demands and occupational well-being' predicted risk of loss of paid employment to a greater extent among workers aged 50-55 compared to those aged 56-63.

CONCLUSIONS

Expected reasons for leaving the labour market predicted actual labour market participation among older workers in Denmark. Expected reasons related to poor physical and mental health, and not being capable of doing the job seem to be stronger PUSH-factors among workers aged 50-55 compared to those aged 56-63. Preventing early labour market detachment should take the worker's expected reasons for leaving into account.

Barriers and Facilitators of Re-Employment among Senior Workers: Prospective Cohort Study

Re-entering the labour market after a period of unemployment can be challenging for seniors. This study investigates personal as well as circumstantial barriers and facilitators of re-employment. Unemployed seniors in Denmark (≥50 years, n = 1636) from the first wave (mid-2018) of the SeniorWorkingLife study were prospectively followed until March 2020 in national registers on labour market participation. Using weighted logistic-regression-modelled odds ratios (ORs), we estimated the association between personal and circumstantial factors at baseline and re-employment during follow-up. During follow-up, 28% re-entered paid employment. The desire to have a job (reference: not having the desire to have a job) increased the likelihood of re-employment (OR 2.35, 95% CI 1.14-4.85). Contrastingly, a higher age (60-63 vs. 50-54 years; OR 0.36, 95% CI 0.16-0.79) and poor health (OR 0.32, 95% CI 0.16-0.61) decreased the likelihood of re-employment. Sex, education and belief that age constitutes a barrier to re-employment were not associated with the likelihood of re-employment. Unemployed seniors desiring to have a job are more likely to get a job. However, a higher age and poor health are important barriers that should be taken into account, e.g., by ensuring employment opportunities for these groups in society.

Chronic disorders, work-unit leadership quality and long-term sickness absence among 33 025 public hospital employees

OBJECTIVE

This study aimed to examine the association between work-unit level leadership quality and individual-level long-term sickness absence (LTSA) in the hospital sector and effect modification by chronic disorders.

METHODS

This longitudinal analysis included 33 025 Danish public hospital employees who were followed-up for one year after baseline in March 2014. Leadership quality was assessed by questionnaire with mean responses aggregated by work-unit and characterized in tertiles. LTSA during follow-up was determined from employer records. Chronic disorders at baseline was assessed from the Danish hospital and prescription registers. We performed multilevel logistic regression to estimate odds ratios (OR) and 95% confidence intervals (CI) adjusting for potential confounders. We evaluated interaction between chronic illness and low leadership quality on multiplicative and additive scales.

RESULTS

We identified employees as healthy (60.8%) or with somatic (31.6%), mental (3.3%), or both somatic and mental (4.3%) disorders. During follow-up, 6% of employees registered a LTSA. Medium and high leadership quality were associated with lower risk of LTSA with OR of 0.84 (95% CI 0.76-0.94) and 0.73 (95% CI 0.65-0.82) respectively, compared to low leadership quality. Associations were similar for healthy employees and employees with only somatic disorders, whereas no association was observed for employees with mental disorders (in presence or absence of somatic disorders). No statistically significant (α=0.05) interactions between leadership quality and chronic disorders on LTSA were observed.

CONCLUSION

The findings suggest that the quality of leadership in work units is associated with risk of long-term sick leave in the Danish public hospital sector and that strong leadership protects employees against LTSA.

Employee perception of managers' attitudes towards older workers is associated with risk of loss of paid work before state pension age: prospective cohort study with register follow-up

It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees' perceptions of their managers' attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Questionnaire data from 10,320 currently employed workers aged 50 + on perceptions of managers' attitudes towards older workers and perceived age discrimination were collected at baseline in the SeniorWorkingLife study. Data on labour market affiliation were obtained from national registers at baseline and two-year follow-up. Results show that the perception of negative attitudes was prospectively associated with an increased risk of loss of paid work for three of the five negative attitudes "older workers create conflicts, their qualifications are outdated, and they cannot keep up with the pace and development". Perception of positive attitudes was prospectively associated with a reduced risk of loss of paid work. The perception of age discrimination was prospectively associated with an increased risk of loss of paid work. The results strengthen existing evidence on associations between ageism and labour market attachment, by applying a longitudinal design and including actual change in labour market participation. However, some negative attitudes may be more detrimental to the older workers' labour market participation. Employees' positive perceptions of managers' attitudes reduced the risk. Good relations between employees and managers appear to be important for retaining older workers in the labour market.

The Implication of Physically Demanding and Hazardous Work on Retirement Timing

The need to retain individuals longer in the workforce is acknowledged in many high-income countries. The present study therefore aimed to examine the importance of physically demanding work tasks (PDWT) and physically hazardous work environment (PHWE) in relation to retirement timing among pensionable workers (≥61 years). A particular question was whether PDWT and PHWE increased in importance with age. Six waves (2008-2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (n = 5201; 56% women and 44% men; mean age at first survey was 61.0 (SD 2.0) years). Discrete time-event history analysis, stratified by socioeconomic position and gender, showed that among blue-collar workers, PDWT and PHWE were associated with an increased likelihood of retiring within the next two years. With increasing age, high-level PHWE was associated with higher probability of retiring among blue-collar men, whereas heavy PDWT was associated with lower probability of retiring among blue-collar women. Among white-collar workers, having at least some PDWT compared to no PDWT was associated with a lower likelihood of retiring within the next two years. With increasing age, exposure to PHWE was associated with higher probability of retiring among white-collar women. These results suggest that to delay retirements, organizations could offer their older employees, especially blue-collar workers and the oldest white-collar women, alternatives to PDWT and PHWE.

New Technology and Loss of Paid Employment among Older Workers: Prospective Cohort Study

BACKGROUND

This study investigates the association between the implementation of new technology in the workplace and the subsequent loss of paid employment among older workers.

METHODS

We estimated the prospective risk of loss of paid employment (register-based) from questions on new technology among 10,320 older workers (≥50 years). To investigate potential differences between work types, analyses were stratified by job function: (1) work with symbols (office, administration, analysis, IT), (2) work with people (people, service, care), (3) work in the field of production (processing, producing or moving things).

RESULTS

The introduction of new technology at the workplace reduced the risk of losing paid employment among older workers working with symbols (risk ratio [RR] 0.74, 95% CI 0.72-0.76) and in the field of production (RR 0.83, 95% CI 0.80-0.85), whereas new technology increased this risk among those working with people (RR 1.22, 95% CI 1.19-1.26). Being involved in the introduction of new technology and receiving adequate training in its use decreased the risk of loss of paid employment.

CONCLUSIONS

Depending on the context, the introduction of new technology at work associates positively as well as negatively with future labour market participation among older workers. Worker involvement and adequate training in the use of new technology seem to be important for retaining workers in the labour market.

The Interplay between Multimorbidity, Physical Work Demands and Work Ability: Cross-Sectional Study among 12,879 Senior Workers

Background: Aging increases the risk of chronic diseases, which can challenge the ability to work and thereby push senior workers out of the labour market. This study investigates the association between non-communicable diseases (NCDs) and work ability among workers ≥50 years (senior workers) with physically demanding and sedentary work, respectively. Methods: In the SeniorWorkingLife study, 12,879 senior workers replied to a questionnaire survey on work and health in 2018. Associations between the type and number of NCD and work ability (scale 0−10) were modelled using a general linear model adjusting for potential confounders and combined with model-assisted weights from national registers. Results: A higher number of NCD (multimorbidity) was progressively associated with a lower work ability (trend test, p-value < 0.001). Physical work influenced the association between the number of NCDs and work ability. For specific diseases, mental disorders, including burn-out syndrome (least square mean difference (LSMD): −1.46, 95% CI: −1.61 to −1.32) and stress ( LSMD: −1.18, 95% CI: −1.29 to −1.07), demonstrated a stronger association with a lower work ability compared with somatic diseases, such as back diseases (LSMD: −0.72, 95% CI: −0.80 to −0.64). Conclusions: Multimorbidity was progressively associated with a lower work ability in senior workers, especially among those with physical work.

Do good psychosocial working conditions prolong working lives? Findings from a prospective study in Sweden

Due to an ageing population, governments in European countries are striving to keep older workers longer in the workforce. Remarkably few studies have paid attention to the influence of psychosocial working conditions on timing of retirement for older workers in and beyond normative retirement age. The aim of the present study was to examine whether good psychosocial working conditions contribute to prolonged working lives among older workers (59 years and above). A particular question was whether such conditions increase in importance with age. Seven waves (2006–2018) of the Swedish Longitudinal Occupational Survey of Health (SLOSH) were used (N = 6000, observations = 10,632). Discrete-time event history analyses showed that higher levels of job resources (decision authority [OR 1.13, 95% CI 1.06–1.22], skill use [OR 1.17, 95% CI 1.07–1.29], learning opportunities [OR 1.22, 95% CI 1.13–1.31], social support [OR 1.29 (95% CI 1.16–1.42], work-time control [OR 1.07, 95% CI 1.01–1.13], and reward [OR 1.40, 95% CI 1.24–1.57])—but not lower levels of job demands (quantitative and emotional demands or effort)—were associated with working longer (continued work two years later). Also, low effort-reward imbalance (OR 0.84 [95% CI 0.73–0.96]) was associated with working longer. In addition, skill use, work-time control, reward, and low effort-reward imbalance increased in importance with age for continued work. These results suggest that providing older workers with control over their work tasks, giving opportunities for learning and using their skills, as well as rewarding and acknowledging their achievements, may keep them in the workforce longer. Especially, job resources may grow in importance with age.

The Psychosocial Work Environment and Perceived Stress among Seniors with Physically Demanding Jobs: The SeniorWorkingLife Study

Background: Poor psychosocial work conditions are known to foster negative health consequences. While the existing literature on this topic focus mainly on white-collar workers, the influence of different aspects of the psychosocial work environment in physically demanding jobs remain understudied. Likewise, senior workers represent a population of the workforce at increased risk of adverse health outcomes and premature exit from the labour market. This study investigates the association between psychosocial work factors and perceived stress among the senior work force. Methods: Utilizing cross-sectional findings, this study reports associations between psychosocial factors (organizational justice, cooperation and collegial support, decision latitude, clarity of tasks, and quality of leadership) and the outcome of perceived stress quantified by Cohen’s Perceived Stress Scale (CPSS). Currently employed senior workers with physically demanding jobs were included in the analyses (n = 3386). Associations were modeled using general linear models with weights to make the estimates representative. Results: For all individually adjusted psychosocial variables, the category of “good” was consistently associated with lower stress scores compared to the categories of both “moderate” and “poor” (all p < 0.0001). Likewise, in the mutually adjusted analysis, the category of “good” was statistically different from “poor” for all included variables, while the category of “moderate” remained different from “poor” for “clarity of tasks”, “cooperation and collegial support”, and “decision latitude”. Conclusions: Among senior workers with physically demanding jobs, poor ratings of organizational factors related to the psychosocial work environment are consistently associated with high stress scores. Blue-collar occupations focusing primarily on physical risk factors are recommended to increase awareness on psychosocial aspects that may be relevant to the local work environment.

Barriers and opportunities for prolonging working life across different occupational groups: the SeniorWorkingLife study

Background

Increasing retirement age is a pivotal issue in labour market reforms. This study analyses factors conditioning retirement intentions.

Methods

In SeniorWorkingLife, 11 444 employed workers ≥50 years replied to questions in random order about expected reasons for leaving and potential reasons for staying longer at the labour market. Respondents were stratified based on the Danish version of International Standard Classification of Occupations (ISCO). Representative estimates were produced using the SurveyFreq and SurveyLogistic procedures of SAS combined with model-assisted weights based on national registers.

Results

For ISCO groups 1–4 (seated work) main expected reasons for retiring were freedom to choose and desire for more leisure time, but many would consider staying longer if there were better possibilities for additional senior days, longer vacations and flexible working hours. For ISCO groups 5–9 (physical work), poor physical health and not being capable of doing the job were common expected reasons for retiring, but many would consider staying longer if the work were less physically demanding and there were more senior days. Possibility for pension was a general expected reason for retiring. Expected reasons differed to a less extent between genders than between ISCO groups, e.g. economic factors were more important for men and high work demands more important for women.

Conclusion

Different barriers and opportunities for prolonging working life exist across different occupational groups of the labour market—with most consistent differences between those with seated and physical work. Targeting these specifically seems opportune for policy makers and future interventions.

What Do the Managers Think of Us? The Older-Worker-Perspective of Managers' Attitudes

Background: Due to demographic changes, the need to prolong working life has become increasingly salient. Paradoxically, stereotyping and discrimination against workers based on their age can limit possibilities for a long working life. A large body of research has investigated attitudes towards older workers; however, less is known about differences across occupational groups as well gender differences. Aim: To compare perceptions of the managers’ perceptions of older workers between employees from mainly seated work and mainly physical work as well as men and women. Method: Data from 11,444 workers aged 50+ from the baseline questionnaire survey in the SeniorWorkingLife study were analyzed. Results: Across all groups, a larger proportion of the respondents indicated that their managers had more positive than negative perceptions of older workers. Respondents from the International Standard Classification of Occupations (ISCO) group 5–9 (mainly physical work) and women were less likely to point at both positive and negative perceptions than the ISCO group 14 (mainly seated work) and men, respectively. Conclusions: The results indicate that there are differences between those with mainly physical and mainly seated work as well as gender differences. More research is warranted to explore the nature of these differences and, in particular, attitudes towards older female and male workers, respectively.

Psychosocial stress and musculoskeletal pain among senior workers from nine occupational groups: Cross-sectional findings from the SeniorWorkingLife study

INTRODUCTION

Maintaining good health with advancing age is increasingly important as most European countries experience an increase in retirement age. In order to decrease the risk of premature departure from the workforce, identifying groups at increased risk of musculoskeletal pain and psychosocial stress is essential in designing workplace policies. Therefore, the aim of this study was to investigate the relationship between occupational groups differing in terms of physical demands and skill requirement, and the outcomes of stress and pain.

METHODS

This cross-sectional study reports associations of nine different occupational groups with stress and pain among 11 474 senior workers; stratified by occupational group and based on the International Standard Classification of Occupations (ISCO). A large-scale questionnaire survey was dispatched to Danish workers; drawn as a probability sample and merged with national registers. Representative estimates were produced using logistic regression controlling for various confounders, combined with model-assisted weights.

RESULTS

The prevalence of daily pain and high stress among occupational groups ranged between 20.0%-50.5% and 3.9%-10.0%, respectively. Compared with occupations characterised by being mostly sedentary (ISCO group 1-4), those with primarily physical demanding work (ISCO group 5-9) had higher odds of daily pain (OR 1.53, 95% CI 1.37 to 1.70) and a tendency towards higher stress scores (OR 1.20, 95% CI 0.98 to 1.46). Lastly, female workers experience increased odds of daily pain (OR 1.50, 95% CI 1.35 to 1.66) and high stress (OR 1.56, 95% CI 1.29 to 1.89) compared with male workers.

CONCLUSIONS

Occupational settings characterised by mainly physical work and low skill requirements are more likely to experience daily pain compared with those entailing mainly sedentary work. Likewise, in this sample of senior workers, women are more likely to experience pain and stress. These results highlights the need for improving occupation-specific and sex-specific guidelines in the prevention of musculoskeletal pain and psychological stress in workplaces.

TRIAL REGISTRATION NUMBER

ClinicalTrials identifier: NCT03634410.

Is hard physical work in the early working life associated with back pain later in life? A cross-sectional study among 5700 older workers

OBJECTIVES

Physically demanding work increases the risk of developing musculoskeletal disorders during working life, with low back pain (LBP) as the most prevalent and debilitating musculoskeletal disorder worldwide. However, a lack of knowledge exists about the role of early working years on musculoskeletal health later in life. This study investigated whether an exposure-response association exists between physical demands in early working life and risk of LBP in later working life.

DESIGN

Cross-sectional study.

SETTING, PARTICIPANTS AND OUTCOME MEASURE

In the SeniorWorkingLife study, 5909 wage earners aged ≥50 years with currently sedentary work replied to a questionnaire survey in 2018 about physical work demands during their first working years (exposure) and current LBP (outcome). Associations between physical work demands in the early working years and current LBP were modelled using general linear models controlling for various confounders, combined with model-assisted weights based on national registers.

RESULTS

Hard physical work during early working life was associated with more intense LBP later in life among senior workers with currently sedentary jobs. In the fully adjusted model, workers with 'standing/walking work with lifting/carrying' and 'heavy or fast work that is physically strenuous' during the first years of working life reported higher LBP intensity than those with sedentary work during their first working years (0.2 (95% CI, 0.0 to 0.4) and 0.6 (95% CI, 0.4 to 0.9), respectively).

CONCLUSION

Work involving lifting/carrying or work that is physically strenuous in early life is associated with higher intensity of LBP among older workers with currently sedentary employment. These findings suggest that early working life may have an impact on later working years and underscore the necessity for careful introduction and instruction to the working environment for retaining musculoskeletal health and prolonging working life.

TRIAL REGISTRATION NUMBER

NCT03634410.

Joint association of physical work demands and leg pain intensity for work limitations due to pain in senior workers: cross-sectional study

Background

Leg pain, especially of the knees and hips, is common among senior workers and may limit the ability to perform physically demanding work. In light of the aging workforce, this study determined the joint association of physical work demands and leg pain intensity for work-limiting pain in senior workers.

Methods

Currently employed senior workers (≥50 years) participated in the SeniorWorkingLife study in 2018 (n = 12,879). Associations between the combination of physical work demands and leg pain intensity (interaction) with work-limiting pain (outcome) were modeled using binary logistic regression analyses while controlling for potential covariates.

Results

We found a significant interaction (P < 0.001) between physical work demands and leg pain intensity for work-limiting pain. The combination of higher physical work demands and higher leg pain intensity had the worst outcome in terms of the odds of experiencing work-limiting pain. For example, 70% of those with the combination of high physical work demands and leg pain intensity ≥7 (scale 0–10) experienced that the pain limited them to at least some degree in their work.

Conclusions

The combination of high physical work demands and high leg pain intensity are associated with limited ability to perform work among senior workers. These findings highlight the importance of prioritizing the physical work environment in physically demanding occupations, particularly among senior workers, for prolonging working life. Thus, adjusting the work demands, e.g. through use of assistive devices, and lowering the pain, e.g. through physical rehabilitation, may be necessary to sustain work ability to a high age in this group of workers.

Trial registration

This was registered as a cohort study in ClinicalTrials.gov (Identifier: NCT03634410) on the 18th of August 2018 (Retrospectively registered).

Work limitations due to neck-shoulder pain and physical work demands in older workers: cross-sectional study

PURPOSE

Many older workers are working despite having neck-shoulder pain (NSP), which may give rise to work limitations due to pain, especially among those with high physical work demands. This study investigated the joint association of neck-shoulder pain intensity and physical work demands with work limitations among older workers.

METHODS

In SeniorWorkingLife, workers ≥ 50 years (n = 11,800) replied to questions about NSP intensity, work limitations due to pain, and physical activity demands at work. The odds ratio for having a higher level of work limitations due to pain in relation to neck-shoulder pain intensity and physical work demands were modeled using logistic regression controlled for various confounders.

RESULTS

The results showed that the neck-shoulder pain intensity was associated with work limitations in a dose-response fashion (p < 0.0001). Importantly, a significant interaction existed between neck-shoulder pain intensity and physical activity at work (p < 0.0001), e.g., 77% of workers with high pain and high work demands experienced work limitations due to the pain.

CONCLUSION

Higher neck-shoulder pain intensity and higher physical work demands-and particularly in combination-were associated with higher odds of work limitation due to pain among older workers. Thus, it seems especially important to accommodate work demands through a better work environment for these groups of workers.

Is low-back pain a limiting factor for senior workers with high physical work demands? A cross-sectional study

BACKGROUND

Low-back pain (LBP) is highly prevalent among senior workers and may affect work ability, especially among those with hard physical work. This study determined the joint association of LBP intensity and physical work demands with work limitiations due to pain in senior workers.

METHODS

In the SeniorWorkingLife study (2018), 11,738 senior workers (≥50 years) replied to questions about physical work demands, LBP intensity, and work limitations due to pain. Using logistic regression analyses and controlling for potential confounders, associations between the physical work demands and LBP intensity (interaction) with work limitiations due to pain (outcome) was modeled.

RESULTS

Higher LBP intensity, as well as higher physical work demands, significantly increased the odds of experiencing work limitiations due to pain, and these two factors interacted with each other (p < 0.0001). In analyses stratified for LBP intensity, higher physical work demands gradually increased the odds of experiencing work limitiations due to pain.

CONCLUSIONS

Senior workers with a combination of physically demanding work and LBP are more affected by their pain during everyday work tasks compared to workers with similar LBP-intensity in sedentary occupations. Accommodation of work demands seems especially relevant for this group of workers.

Barriers and Willingness to Accept Re-Employment among Unemployed Senior Workers: The SeniorWorkingLife Study

Labor market participation has a positive impact on social inclusion and is linked to financial security. This study identifies barriers and willingness to accept re-employment among unemployed seniors that could highlight opportunities for societal action. From the first wave of SeniorWorkingLife in 2018 combined with the Danish version of the International Standard Classification of Occupations register (ISCO), +50-year-old unemployed senior workers (n = 1682) were stratified into mainly seated work (ISCO 1–4) and mainly physical work (ISCO 5–9), respectively, in their latest employment. We used SurveyFreq and SurveyLogistics of SAS combined with model-assisted weights based on national registers to estimate representative frequencies and odds ratios (OR) for barriers and willingness to accept re-employment. Higher age was perceived as a general barrier for re-employment in both groups. Health was a more pronounced barrier for seniors with mainly physical work compared to seniors with mainly seated work (OR 2.35; CI95 1.31–4.21). Overall, seniors showed a large degree of flexibility and willingness to re-enter the labor market. Different barriers and willingness to accept re-employment exist among currently unemployed seniors. These results highlight the need for different approaches across occupational groups to help unemployed seniors back into the labor market.

Factors Contributing to Retirement Decisions in Denmark: Comparing Employees Who Expect to Retire before, at, and after the State Pension Age

Aim: Analyse factors affecting retirement decisions comparing employees expecting to retire before, at, and after the state pension age. Methods: In the SeniorWorkingLife cohort, 12,269 workers aged +50 replied to questions about expected retirement age, reasons for leaving, and reasons for staying longer. Results: For all groups, poor health, wish for more leisure, and economy were the most salient expected reasons for retiring. Many would stay longer if there were better possibilities for more leisure time, more work flexibility, and economic benefits. Those expecting to retire before state pension age were more likely to point at desire for more leisure time as expected reason for retiring, and less likely to point at economic reasons, and more likely to point at health and work demands as possible reasons for prolonging working life. Those expecting to retire after state pension age were more likely to point at external factors and recognition from the management. Conclusion: Factors influencing retirement decisions are similar across the groups. Initiatives for better work–life balance, healthy lifestyle, and economic incentives to continue working may help prevent early retirement and motivate prolonging work life beyond retirement. Results also indicate that less strenuous work is particularly relevant to prevent early retirement.

Strong Labour Market Inequality of Opportunities at the Workplace for Supporting a Long and Healthy Work-Life: The SeniorWorkingLife Study

Most European countries are gradually increasing the state pension age, but this may run counter to the capabilities and wishes of older workers. The objective of this study is to identify opportunities in the workplace for supporting a prolonged working life in different groups in the labour market. A representative sample of 11,200 employed workers ≥ 50 years responded to 15 questions in random order about opportunities at their workplace for supporting a prolonged working life. Respondents were stratified based on the Danish version of the International Standard Classification of Occupations (ISCO). Using frequency and logistic regression procedures combined with model-assisted weights based on national registers, results showed that the most common opportunities at the workplace were possibilities for more vacation, reduction of working hours, flexible working hours, access to treatment, further education and physical exercise. However, ISCO groups 5–9 (mainly physical work and shorter education) had in general poorer access to these opportunities than ISCO groups 1–4 (mainly seated work and longer education). Women had poorer access than men, and workers with reduced work ability had poorer access than those with full work ability. Thus, in contrast with actual needs, opportunities at the workplace were lower in occupations characterized by physical work and shorter education, among women and among workers with reduced work ability. This inequality poses a threat to prolonging working life in vulnerable groups in the labour market.