RESUMEN

BACKGROUND: We aimed to evaluate the impact of a workplace senior program intervention on early exit from labor market and on the disability retirement among older employees and work-related physical factors associated with it. METHODS: A total of 259 individuals aged 55 + years participated in the study (107 in intervention and 152 were controls). A questionnaire survey was conducted among Finnish food industry employees between 2003 and 2009 and the intervention "senior program" was provided between 2004 and 2009. The type of pension for the respondents who had retired by 2019 was obtained and dichotomized as statutory vs. early labor market exit. Disability pension was investigated as a separate outcome. Information on work-related factors was obtained from the survey. Cox regression analysis was used to estimate hazard ratios (HR) with their 95% confidence intervals. RESULTS: Fifty-one employees had early labor market exit. Of them, 70% (n = 36) were control participants. Employees in the senior program worked for longer years (mean years 7.4, 95% CI 6.4-8.1) compared to the control (6.6, 95% CI 6.3-7.5). Sixty percent lower risk of early labor market exit (HR 0.40, 95% CI 0.19-0.84) and disability pension was found among employees in the senior program compared to the control group. Good work ability had a 94% lower risk (0.06, 95% CI 0.01-0.29) of early labor market exit and 85% lower risk (0.15, 95% CI 0.03-0.73) of disability pension compared to poor work ability. Employees with musculoskeletal pain had 4 times higher risk of disability pension compared to those without musculoskeletal pain. CONCLUSIONS: A workplace senior program intervention prolonged work life and had positive effect on reducing disability pension among older industrial workers.

Asunto(s)

RESUMEN

AIMS: This study aimed to investigate occupational health (OH) primary-care patients' use of other health-care services and whether parallel use affects their likelihood to have sickness absences (SA) or disability pensions (DP). METHODS: Primary-care services in Finland are provided through three parallel health-care sectors, all available to the working population: public, private and OH sectors. Patients may also be referred to secondary care. This follow-up study combines real-world medical record data containing SA data from a nationwide OH provider with health-care attendance data from public and private primary-care sectors and public secondary care, sociodemographic data and DP decisions. Patients between 18 and 68 years of age who used OH primary care at least once during the study years 2014-2016 were included. The total study population comprised 59,650 patients. Odds ratios were used to analyse association between parallel service use and SA or DP. RESULTS: Females and patients with a lower educational level were more likely to use services in other health-care sectors in addition to OH than others. Those patients who used any other health-care sector in addition to OH primary care had an increased likelihood of having long SA or receiving DP. CONCLUSIONS: OH primary-care patients using the services of several health-care sectors in parallel have an increased likelihood of receiving disability benefits - either SA or DP. There is need for care coordination to ensure adequate measures for work-ability support.

RESUMEN

Work disability creates significant expenses for nations and causes human suffering by limiting patients' lives. International studies show that to enhance recognition of and support for work disability, cooperation, mutual trust, and information exchange between public primary health care and occupational health care must be strengthened. However, little is known of how health care professionals experience this cooperation. The aim of this study was to understand how professionals experience the cooperation between public primary health care and occupational health services regarding patients' work ability. Semi-structured interviews were conducted with 29 health care professionals working in five small cities (<10,000 inhabitants) in Finland. Interviews were audio and video recorded, transcribed verbatim, and analyzed through inductive thematic analysis. Three key themes were identified from the interviews: attitudes toward the other health care sector, the exchange of information, and resources for cooperation. Professionals seem to have poor knowledge about the services available and how care is given in the other sector, appearing to lead to weak mutual trust. The public primary health care professionals especially emphasized the benefits of cooperation, but several issues were mentioned as barriers to cooperation. These results can be used when planning effective patient paths and service provisioning models.

Asunto(s)

RESUMEN

OBJECTIVES: To investigate occupational health frequent attenders' (FAs) use of other healthcare sector services and whether parallel use affects their likelihood to receive a disability pension. DESIGN: Longitudinal study combining routine medical record data with register data. SETTING: Primary care in Finland is provided through three parallel healthcare sectors, all available to the working population. Additionally, patients can be referred to secondary care. This study combines medical record data from a nationwide occupational healthcare provider, with healthcare attendance data from private care and from public primary and secondary care attendance, sociodemographic data and disability pension decisions. PARTICIPANTS: Patients between 18 and 68 years of age who used occupational health primary care at least once during the study years 2014-2016 were included. The total study population was 59 650 patients. They were divided into three groups (occasional and persistent FAs and non-FAs) for analysis. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was FAs parallel use of private care and public primary and secondary care. The secondary outcome was work disability pension granted to FAs who used several healthcare sectors. RESULTS: Both FA groups were more likely to use other healthcare service sectors more than non-FAs did. Persistent FAs were likely to use public secondary care services in particular (OR 4.31 95% CI 3.46 to 5.36). FAs using all healthcare sectors were also more likely to receive a disability pension than those FAs using only occupational health services (OR 4.53 (95% CI 1.54 to 13.34). This association was strengthened by attendance in public secondary care. CONCLUSIONS: FAs using several healthcare sectors in parallel have an increased likelihood to receive a disability pension. There is need for care coordination to ensure adequate measures for work ability support.

Asunto(s)

RESUMEN

PURPOSE: To study the workers' perception of the quality of work community and its association with intention to retire early, separately among women and men working in Finnish postal service. METHODS: A questionnaire survey was sent to all Finnish postal services employees aged ≥ 50 years in 2016 and 44% (n = 2096) replied to the survey (mean age 56.3, 40% women). Employee's intention to retire before statutory retirement was measured on a scale of 1-5 and dichotomized. The quality of work community was defined by four composite variables: equality at work, flexibility at work, supportive work environment and health or other reason and trichotomized by their tercile values. Odds ratio (ORs) and their 95% confidence intervals (CIs) for associations of quality of work community with intention to retire were calculated separately for men and women using log binomial regression models adjusted for potential confounders. RESULTS: About one-third of respondents intended to retire early with no significant gender difference in retirement intention. Low equality at work (women OR 2.77, 95% CI 1.60-4.81; men 2.84, 1.80-4.48) and low flexibility at work (women 3.30, 1.94-5.60; men 2.91, 1.88-4.50) was associated with higher likelihood of intention to retire. Among women intention to retire was found less likely due to low supportive work environment (0.52, 0.31-0.89) and among men due to intermediate health or other reason (0.65, 043-0.98). CONCLUSION: The results highlight the importance of the quality of work community as well as the promotion of work-related health in order to encourage employees to remain at workforce for longer.

Asunto(s)

RESUMEN

BACKGROUND: Work disability is a complex issue that requires preventive efforts from healthcare systems and individuals, and that too often results in disability pensions (DP). While many studies have attempted to characterize risk factors of work disability, many showing for example a link between socioeconomic positions, working conditions and frequent attendance to OH primary care it is not known if frequent attendance is associated with DP despite the sociodemographic factors. This study aims to address this gap and examine the association between frequent attendance to OH primary care and DP, when adjusted by sociodemographic factors. METHODS: This study combines routine medical record data of an occupational health service provider with comprehensive national registers. Medical record data were used to define groups of frequent attenders to OH primary care (FA) (1-year-FA, 2-year-FA, persistent-FA and non-FA) from 2014 to 2016. The sociodemographic factors (including i.e. educational level, occupational class, unemployment periods) were derived from Statistic Finland and DP decisions were derived from Finnish Centre for Pensions. Association of frequent attendance to OH primary care with DP decisions were analyzed and adjusted by sociodemographic factors. RESULTS: In total, 66,381 patients were included. Basic and intermediate education along with manual and lower non-manual work predicted frequent attendance to OH primary care. Unemployment in 2013 did not predict frequent attendance to OH primary care. Frequent attendance to OH primary care was associated with DP within next two years, even when adjusted for sociodemographic factors. The association of frequent attendance to OH primary care with DP grew stronger as high service use persisted over time. CONCLUSIONS: Frequent attendance to OH primary care is associated with DP risk in the near future despite the underlying sociodemographic differences. Patients using OH primary care services extensively should be identified and rehabilitative needs and measures necessary to continue in the work force should be explored. Sociodemographic issues that co-exist should be explored and considered when planning interventions.

Asunto(s)

RESUMEN

BACKGROUND: We investigated work ability and trajectories of work life satisfaction (WLS) as predictors of intention to retire (ITR) before the statutory age. METHODS: Participants were Finnish postal service employees, who responded to surveys in 2016 and 2018 (n = 1466). Survey measures included ITR, work ability and WLS. Mixture modelling was used to identify trajectories of WLS. A generalized linear model was used to determine the measures of association (Risk Ratios, RR; 95% Confidence Intervals, CI) between exposures (work ability and WLS) and ITR. RESULTS: Approximately 40% of respondents indicated ITR. Four distinct trajectories of WLS were identified: high (33%), moderate (35%), decreasing (23%) and low (9%). Participants with poor work ability (RR 1.79, 95% CI 1.40-2.29) and decreasing WLS (1.29, 1.13-1.46) were more likely to indicate an ITR early compared to the participants with excellent/good work ability and high WLS. Job control mediated the relationship between ITR and work ability (9.3%) and WLS (14.7%). Job support also played a similar role (14% and 20.6%). CONCLUSIONS: Work ability and WLS are important contributors to the retirement intentions of employees. Ensuring workers have appropriate support and control over their work are mechanisms through which organisations may encourage employees to remain at work for longer.

Asunto(s)

RESUMEN

AIM: To investigate single-site and multi-site musculoskeletal pain as predictors of future sickness absence due to musculoskeletal disorders (MSD) among blue-collar employees in food industry, and to study to what extent this relationship depends on physical loading at work. METHODS: Survey responses of 901 employees on working conditions and musculoskeletal pain during the past week were linked to their future sickness absence records obtained from the personnel register of a food industry company. Negative binomial regression models were computed to determine associations of pain in one and in multi-site with the number of sickness absence days due to MSD during a four-year follow-up. Analyses were made in the whole cohort and stratified by the occurrence of repetitive movements and awkward postures (low/high). RESULTS: Multi-site pain occurred among 59 % in the total cohort and predicted sickness absence with a rate ratio of 1.48 [95 % confidence interval (CI) 1.21-1.80], adjusted for age, gender, biomechanical and psychosocial working conditions, body mass index and physical exercise. Similar associations were seen in the sub-cohorts with a low occurrence of repetitive movements (RR 2.18, CI 1.69-2.80) and awkward postures (RR 1.78, CI 1.39-2.28), but not in the sub-cohorts with a high occurrence of these exposure. Single-site pain was not predictive of sickness absence. CONCLUSIONS: A very high level of sickness absence in biomechanically strenuous work was found. Multi-site pain predicted sickness absence due to MSD among the employees with low exposure, but not among those with high exposure.

Asunto(s)

RESUMEN

This study hypothesized that in a longitudinal setting deteriorating physical working conditions increases the perceived physical and mental strain among food processing employees. The study was conducted in 2003 and 2007. It examined 248 blue-collar workers, all of whom were in the same occupation throughout the entire follow-up period. The data were obtained through a structural questionnaire distributed to the employees at the workplace. Mental strain had increased (7%) significantly among younger employees during the follow-up. The changes in mental strain for the younger employees were positively associated with the changes in physical strain. The changes in physical strain were also significantly associated with the changes in physical working conditions among both younger and the older workers. The results of this study partly support the study hypothesis, namely that deteriorating physical working condition increases physical strain and also increases mental strain, especially among younger employees.

Asunto(s)

RESUMEN

PURPOSE: Musculoskeletal pain at multiple sites is common among working-age people and greatly increases work disability risk. Little is known of the work-related physical and psychosocial factors contributing to multi-site pain. METHODS: Survey responses from 734 employees (518 blue- and 216 white-collar; 65 % female) of a food processing company were collected twice, in 2005 and 2009. Information on musculoskeletal pain during the preceding week, and on environmental, biomechanical and psychosocial work exposures were obtained through a structured questionnaire. The association of multi-site pain with work exposures was estimated with logistic regression by gender and age group. RESULTS: At baseline, 54 % of informants reported pain in more than one area, and 50 % at 4-year follow-up. Forty percent of all employees had multi-site pain both at baseline and at follow-up. Among those with multi-site pain at baseline, 69 % had multi-site pain at follow-up. Both repetitive work and awkward work postures at baseline were associated with multi-site pain at follow-up. Psychosocial factors (low job satisfaction, low team spirit, and little opportunity to exert influence at work) also strongly predicted multi-site pain at follow-up, especially among younger workers and men. CONCLUSION: This prospective study provides new evidence of the high occurrence and persistence of musculoskeletal pain at multiple body sites in an industrial population with a strong association between biomechanical and psychosocial exposures at work and multi-site pain. Prevention of multi-site pain with many-sided modification of work exposures is likely to reduce work disability.

Asunto(s)

RESUMEN

OBJECTIVES: To analyze the association between changes in perceived physical and psychosocial working conditions and change of sickness absence days in younger and older (< 50 and ≥ 50 years) food industry employees. METHODS: This was a follow up study of 679 employees, who completed working conditions survey questionnaires in 2005 and 2009 and for whom the requisite sickness absence data were available for the years 2004 and 2008. RESULTS: Sickness absence increased and working conditions improved during follow-up. However, the change of increased sickness absence days were associated with the change of increased poor working postures and the change of deteriorated team spirit and reactivity (especially among < 50 years). No other changes in working conditions were associated with the changes in sickness absence. CONCLUSION: Sickness absence is affected by many factors other than working conditions. Nevertheless, according to this study improving team spirit and reactivity and preventing poor working postures are important in decreasing sickness absence.

RESUMEN

OBJECTIVES: The study explored whether differences in sickness absence between four factories of a food industry company were explained by common determinants of sickness absence, such as employee health, sociodemographic characteristics, and physical and psychosocial work conditions. METHODS: Survey responses of 582 employees were linked to the records of short-term (1-3 days) and long-term (>3 days) absence, as well as to records of absences due to musculoskeletal diagnoses. Multilevel models were applied in assessing the between-factory absence differences. RESULTS: Compared with the levels in the factory with the lowest sickness absence, in one factory the levels of short-term [rate ratio (RR) 1.72], long-term (RR 1.96), and musculoskeletal (rate ratio 2.93) absence were significantly higher. Another factory also had higher levels of long-term and musculoskeletal absence (RR 2.17 and 2.52, respectively). Adjustment for the background factors explained 35% of the difference in short-term absence, 3-9% of the differences in long-term absence, and 18-12% of the differences in musculoskeletal absence, but the between-factory differences were still highly significant. CONCLUSIONS: This study showed large differences in sickness absence between factories that were only partly explained by common determinants. Moreover, economic factors and formal control were unlikely explanatory factors, as the study was conducted within a single company. These results justify further research on local absence practices and cultures, including those of health service organizations and professionals.

Asunto(s)