Occupational Health Professionals Research Articles

Support needs for return to work among self-employed workers: A focus group study.

The aim of this study is to gain insight into the facilitators, barriers, and support needs of Dutch self-employed workers when returning to work (RTW) after sick leave. Three focus groups were conducted, involving 15 Dutch self-employed workers who were on sick leave due to health problems. The transcripts were analysed through thematic content analysis. Five main themes regarding barriers, facilitators and needs of self-employed workers to RTW were identified: autonomy, social support, client management, financial security and information on sick leave. Having autonomy was considered a facilitator for RTW. However, the participants expressed a need for more financial support, additional guidance from occupational health professionals, and tailored information regarding RTW. The results of this study emphasize a need for optimizing national policy and support for self-employed workers regarding sick leave and RTW.

Characteristics of Multiprofessional and Client-Oriented Approach in Occupational Health Services: A Cross-Sectional Survey Among Occupational Health Professionals.

Multiprofessional and client-oriented approaches are considered key factors for successful occupational health services, and for impressive occupational health cooperation between a client organisation and occupational health service provider. The purpose of this study was to find out the views of occupational health physicians, occupational health nurses, occupational physiotherapists, and occupational health psychologists about multiprofessional and client-oriented working methods. These working methods describe the guidelines for good occupational health practice in Finland, also serving the framework of the present study. The survey was conducted in May and June 2022. The data consisted of answers to open-ended questions of a larger questionnaire. The data was analysed with the method of theory-related thematic analysis. Seven occupational health service providers committed to the study. Altogether 121 professionals responded to the question surveying the multiprofessional approach, and 119 professionals responded to the question of client-oriented approach. The results showed that both the multiprofessional and client-oriented approaches are closely related to each other, and the views of these approaches are in line with the good occupational health practice. Multiprofessional approach was most commonly described with the theme of sharing expertise. Respectively, the theme of smooth cooperation most commonly described the client-oriented approach. At its best, the answers showed that a multiprofessional working strategy takes into account the expertise of different professionals so that the client can be offered high-quality, accurate content and timely occupational health services. The results provide up-to-date information on working strategies of occupational health services in Finland. The results can be used in further development of multiprofessional and client-oriented work in occupational health services.

Development and psychometric evaluation of a Total Worker Health® practice scale.

Occupational Safety and Health (OSH) professionals increasingly need to assess and mitigate a broad scope of worker safety, health, and well-being concerns that extend beyond traditional OSH training curricula. Work-related and non-work-related psychosocial hazards, chronic physical and mental health conditions, and changing work arrangements call for an integrative, public health approach to occupational risk management; this approach has been called, "Total Worker Health®" by United States public health authorities (Schulte et al. 2019). OSH professionals need education to ensure that Total Worker Health (TWH) practice approaches are consistently and effectively applied. This study sought to develop a valid, reliable scale that could be used to assess TWH skills gaps that can be addressed with tailored, competency-based curricula. We developed a survey scale to assess professional competency for specific TWH practice approaches described in prior literature (Lee et al. 2016; Punnett et al. 2020). The scale contained 11 statements and used a 5-point scale (not skilled to highly skilled) to rate the level of competency. We pre-tested and refined the statements for face validity then administered the scale with a convenience sample of 258 professionals from mixed OSH disciplines. A total of 210 OSH professionals (31% safety, 17% industrial hygiene, 12% occupational nurses, 11% occupational physicians, 29% other) who completed 50% or more of the questions were included in the analysis. Scale reliability was assessed with a Cronbach's alpha test. Scale validity and structure were assessed with exploratory factor analysis (EFA). The 11-item scale had high internal consistency (Cronbach's α = 0.92). The initial EFA solution suggested 2 factors that explained 65.3% of variance, with one cross-loaded question. A final 10-item, 2-factor scale was developed that accounted for 66.0% of variance with no cross-loaded items (Cronbach's alpha α = 0.91). Factor 1 (6 items) contributed to 55.5% of the variance and captured skills related to TWH program leadership (e.g. leader commitment, integrating program systems, engaging with other program leaders and workers). Factor 2 (4 items) contributed to 10.5% of the variance and captured technical skills related to hazard identification and control (e.g. identifying hazards, designing work to reduce hazards). Internal consistency was very good for both TWH program leadership (Cronbach α = 0.89) and TWH risk assessment and control (Cronbach α = 0.80) subscales. A novel 10-item TWH skill scale to assess specific TWH practice approaches was developed with very good reliability. Factor analysis revealed 2 latent constructs: TWH leadership skills and TWH risk assessment and control skills. This study offers an evidence-based tool to assess competency for specific TWH practices among OSH professionals. The results of this study contribute to the broader research base needed to formalize a TWH competency framework, as advocated by other scholars interested in TWH workforce education (Newman et al. 2020).

Causal Effects of High Stress Assessed via Interviews on Mental and Physical Health: Toward Computer Agent-Driven Stress Assessment.

This study investigated the causal effect of high stress assessment via an interview on the mental and physical health of workers one month later. Stress assessment interviews and feedback were conducted with 50 Japanese workers. In addition to the interviewer, two occupational health professionals assessed participants' stress based on recordings. The average treatment effect was estimated by propensity score matching. High stress, according to the interview-based assessment, had a significant negative causal effect on self-reported well-being one month later (95% confidence interval: -3.02, -1.10). In addition, no effect of high stress on stress load, mental and physical symptoms, or burnout was observed. This study provides important insights into the prognosis of individuals who were assessed through interviews to have high stress. The findings are expected to help automate stress assessments using computer agents.

Prévenir les consommations de substances psychoactives par l’intervention en milieu de travail

<p>In a society where workers are using psychoactive substances in their workplace, what type of prevention can we propose in order to limit the risks? The aim of this research is to contribute to the improvement of current prevention systems. This work is grounded within an Inter-company Occupational Health and Prevention Service (IOHPS). Data were collected during four prevention interventions in companies affiliated with the service. These interventions were documented to assist in the development of new collective and primary prevention approaches for substance use in the workplace. Developing preventive actions in the workplace requires collective and multidisciplinary collaboration between occupational health professionals and company stakeholders. Based on studies conducted on the analysis of mental health interventions in the workplace, our results confirmed the importance of the five essential conditions that facilitate the development of actions highlighted by Rouat (Rouat, 2010; Rouat et al., 2021). They also identified two additional conditions: the establishment of a common set of representations and the preexistence of a framework that facilitates prevention. We have identified a set of factors that can constrain these interventions. Thus, performance-driven approaches to occupational health, lack of support in implementing interdisciplinary projects, or the digitalization of relationships between occupational health stakeholders can influence the success of substance use prevention projects. Given that addictive behaviours intersect personal and professional spheres, we emphasize the importance of applying occupational and organizational psychology principles in this area of intervention.</p>

Falta de conhecimento sobre os fatores de risco não ocupacionais da dor lombar entre profissionais de saúde ocupacional brasileiros: um estudo observacional transversal

INTRODUCTION: Low back pain (LBP) is highly prevalent and is one of the main causes of disability in Brazil and around the world. LBP presents a multifactorial etiology, being extremely common in workers. OBJECTIVE: This study aimed to verify the knowledge about the LBP risk factors, beliefs and attitudes about the management of LBP among health professionals (physiotherapists and ergonomists) working in the occupational area. MATERIALS AND METHODS: A cross-sectional observational study was conducted with 81 Brazilian occupational health professionals. Participants completed an electronic questionnaire comprising professional data, sociodemographics, items about LBP risk factors, and the Brazilian version of the Pain Attitudes and Beliefs Scale for Physiotherapists. Knowledge, beliefs and attitudes were analyzed using the chi-square test for LBP risk factors and the linear regression model for health professionals' beliefs and attitudes. RESULTS: Obesity (7.4%), sitting for more than 2 hours (8.6%), physical activity (9.9%), lack of psychosocial support at work (11.1%) and consuming alcohol (37.0%) presented the lowest rate of knowledge about LBP risk factors by professionals. Items about general health showed the lowest knowledge. A balanced biomedical and psychosocial orientation of beliefs and attitudes about managing LBP was observed. CONCLUSION: Brazilian occupational health professionals lack knowledge about non-occupational LBP risk factors, especially general health status. These professionals also have balanced biomedical and psychosocial concepts in managing LBP.

Worker's Compensation Injury and Illness Care: A Global Round Table.

Work-related injuries and diseases have a significant impact on workers and their families, society, and the economy. There is a gap in the literature regarding the structures, content, quality, and outcomes of international occupational health systems serving injured and ill workers. This global round table was an attempt to elucidate, evaluate, and identify areas needing improvement. International occupational health professionals were identified via chain/snowball sampling and asked to answer five questions designed to evaluate the structures, processes, and outcomes of the workers' compensation systems in each country. Areas for improvement identified during this round table included timely access, reducing the impact of liability and eligibility determinations on access to medical care, equitable access to care, and the accuracy of reporting. Canada had successfully utilized a virtual approach to care for the geographically remote worker. International workers' compensation structures are designed to ensure timely access to quality care and services. Financial incentives optimize the safety of the working environment. There remain areas for improvement. Resources are limited, especially within the public health systems, which may delay care and affect quality. Informal and remote workers often do not have the same access to care. Occupational Health Services (OHS) and national reporting databases exist throughout the world but may not accurately capture data on informal, self-employed, small business, migrant, and remote workers.

Integration of Total Worker Health ® Training for Occupational Health and Safety Professionals With Efforts to Promote Worker Health, Safety, and Well-being in Mexico.

We sought to test whether a 2-week Total Worker Health (TWH) training mapped to TWH education competencies could be administered to a Mexican audience of occupational safety and health professionals and could lead to positive changes to knowledge and behaviors. This study used robust program evaluation methods collected before and after each of the nine training days and at the end of the course. Overall course quality received a mean score of 4.6 (SD = 0.6) and 98.8% of participants agreed that their TWH knowledge increased. All participants intended to make at least one change to their professional practice, most frequently helping companies assess their organizational culture to support health, safety, and well-being. This TWH training was well received and led to positive self-reported increase in knowledge and abilities to influence workers' health, safety, and well-being.

The Role of Community Health Nurses in Promoting Occupational Health and Safety Awareness within Facilities by Embracing Modern Distance Learning Techniques

Overall, accessibility, engagement, and cost-effectiveness can all be significantly impacted by the use of remote learning for occupational health and safety training. In order to make significant progress toward raising occupational health and safety awareness within facilities, it is critical to deal with any potential roadblocks and implement plans that will optimize its effectiveness. Using remote learning for occupational health and safety training of facility staff presents both potential benefits and challenges with regard to raising safety awareness and improving occupational health. Community health nurses play a critical role in improving health and wellness in local communities (CHNs). Workplace health and safety is another area where this is pertinent, particularly for smaller businesses located in impoverished areas where access to occupational health professionals may be limited. By utilizing contemporary remote learning technology, CHNs can serve as effective advocates for and teachers of personnel on critical safety procedures. Thus, the purpose of this study was to examine the role of community health nurses in promoting occupational health and safety awareness within facilities by embracing modern distance learning techniques.

Creating shared perspectives for worker well-being: A community health-focused certificate in Total Worker Health®.

To highlight the utility of a new certificate program in Total Worker Health® designed for health professionals in other (i.e. non-occupational) community health settings (OCHS). Stakeholder needs assessment, priority-setting, and comparison to existing core competencies in Total Worker Health (TWH) approaches to identify learning objectives and curricular threads in alignment with adult learning principles. Faculty-student pairings for content and assessment development. A free six-module training course that prepares OCHS professionals to collaborate with occupational safety and health (OSH) professionals. TWH can be advanced through collaboration between OSH and OCHS professionals. In service of shared ground, OCHS professionals should articulate the influence of work on health, TWH principles, and OSH vocabulary and concepts. Such training is a necessary step towards facilitating groups for the benefit of all work and workers.

Validation of the Return-to-Work Obstacles and Self-Efficacy Scale for Women on Sick Leave Due to Breast Cancer (ROSES-BC).

Breast cancer (BC) is the most frequently diagnosed cancer among women. Approximately 40% of BC survivors are diagnosed during the peak years of their professional career. Women face numerous obstacles when returning to work (RTW) after BC. Their decision-making process and self-efficacy to overcome these barriers may undergo alterations. The objective of this study was to validate the Return-to-work Obstacles and Self-Efficacy Scale (ROSES) for BC survivors, with a focus on three psychometric properties: construct validity, test-retest reliability, and predictive validity. This prospective study consists of three phases: Phase 1 (baseline, during sick leave) was conducted to evaluate construct validity, Phase 2 (2 weeks later) assessed test-retest reliability, and Phase 3 (6-month follow-up, RTW or not) aimed to evaluate predictive validity. A total of 153 BC survivors participated in Phase 1 of the study, where they completed the 10 dimensions of the ROSES (e.g., fear of relapse, cognitive difficulties). Confirmatory factor analyses (CFA), Pearson correlations, and Cox regressions were performed, with respect to each phase. The mean duration for RTW with the same employer was 62.7 weeks. CFAs confirmed the ROSES structure, which had previously been established for other health conditions, showing satisfactory coefficients. Significant Pearson correlation coefficients were observed between the ROSES dimensions from Phase 1 to Phase 2, ranging from 0.66 to 0.88. When considering various confounding variables, chemotherapy treatment and cognitive difficulties (ROSES dimension) emerged as the only significant predictors of RTW. These findings support the utilization of the ROSES in clinical and research settings for BC survivors to improve their successful RTW. After an initial screening using the ROSES, occupational health professionals can further conduct a focused and thorough evaluation of specific dimensions, such as cognitive difficulties. Additional research and information are required to assist BC survivors in dealing with cognitive impairments induced by chemotherapy when they return to work.

Predicting physical and mental health status through interview-based evaluation of work stress: initial attempts to standardize the interviewing method.

This study conducted an interview-based stress evaluation that considered the psychosocial models of work stress and verified the evaluation's predictive validity. A four-stage assessment comprising a pre-survey, pre-interview questionnaire, stress assessment interview, and post-survey after one month was conducted with 50 Japanese workers. Additionally, 16 occupational health professionals provided stress evaluations based on recorded interview videos. Variables based on intraclass correlation coefficients (ICCs) were computed in multiple ways to compare the agreement among the evaluators. The generalized estimating equation (GEE) was conducted to evaluate the prediction models. The overall ICC among the evaluators was 0.58. The GEE revealed that the mean score of the evaluators in the interview-based stress evaluation significantly predicted psychological symptoms (β=2.02, p=0.019), burnout (β=0.77, p<0.001), and well-being (β=-0.64, p=0.007) one month later, even after adjusting for the self-reported stress levels measured in the pre-survey. The predictive validity of the proposed interview-based stress evaluation was confirmed. Although there are several challenges in standardizing this evaluation, semi-structured interviews are an effective tool for understanding work stress.

Comprehensive evaluation of the impact of workplace exposures on physician-certified sick leave in the general working population

BackgroundOur objective was to quantify the prospective associations between work factors across chemical, physical, mechanical, and psychosocial domains and the onset of medically certified sick leave.MethodsEligible respondents were interviewed in 2009, 2013, or 2016 and were registered in the national sick leave register with an employee relationship lasting more than 50 working days during the year of the survey interviews and the following year (n = 15,294 observations). To focus on the onset of high-level sick leave (HLSL; >16 days a year), we excluded individuals with HLSL during the survey year (baseline). We then used mixed-effect logistic regression models to assess prospective associations between self-reported work conditions and the occurrence of doctor-certified HLSL in the following year.ResultsThe average occurrence of HLSL was 13.1%. After adjusting for sex, age, level of education, chronic health problems, and smoking, we observed an exposure-response relationship between cumulative exposure to work factors within all domains and the occurrence of HLSL. When evaluating the impact of combined exposures, predicted odds ratios (OR) for employees exposed to 1, 2, and 3 or more work factors within all domains were 1.60 (95%CI 1.32 − 1.94), 2.56 (95%CI 1.73 − 3.74) and 4.09 (95%CI 2.28 − 7.25), compared to those not exposed.ConclusionsThe results support the notion that exposure to multiple work factors in various domains, including psychosocial, mechanical, chemical, and physical work conditions, is associated with an increased risk of high-level sick leave. Employers and occupational health professionals should consider the joint impact of these domains when designing interventions.

2023 Sylvia Docker lecture: Ignite your passion, and connect, to make a difference.

Together, we grow our profession of occupational therapy as we engage in understanding and addressing the issues that challenge the people we work with. In this Sylvia Docker Lecture, I will share the collective journeys of myself and other occupational therapists and health professionals who have undertaken (or are currently undertaking) their PhDs and are actively involved in research, to address these challenges. Together, we will explore three themes: understanding the WHY that ignites one's passion; living the journey-the EXPERIENCE; and making a difference-the IMPACT. Stories will be told through the lived experience of those engaged in research as currently enrolled PhD students, emerging researchers, and experienced researchers. These stories will capture the lived experience across individuals, and at different times in the research journey. Stories are summarised and captured using natural language processing. Topics are identified, concept maps visualised, and outputs interpreted in context of related theoretical models. Key topics identified include: the clinical and personal motivators that have ignited the passion in individuals; the value of connecting with others and growing networks; and how one's research has made a difference. The impact of discoveries and outcomes are highlighted, together with the importance of people and networks. Analysis of connections and synthesis over time revealed frequent and strong connections across themes, concepts and topics; with synthesising concepts of passion, networks, knowledge translation, opportunities, supervision and communication emerging and being shaped over time. These collective journeys provide inspiration and pathways to creative careers that have future potential in the growth of the profession of occupational therapy. It is recommended that each occupational therapist take the time to reflect on the 'why' that ignites your passion, your journey and how you can make a difference!

Occupational health nursing: realities and challenges.

Designing and enhancing resilient occupational health and safety systems is a challenge. This fact makes it clear that occupational health professionals must be able to develop their full range of competencies. From this premise, it is appropriate to define and deepen the strengths and weaknesses of occupational health nursing (OHN), as well as to point out the opportunities and realities that address its performance. In the history of the professionalization of this speciality, different circumstances have conditioned its projection: the absence of its own body of doctrine, the lack of professional recognition, limited autonomy, and the definition of a clear regulatory framework. In addition to an epistemological limitation and the absence of clear leadership. In the consolidation of this speciality, there is a limited capacity to implement its own competencies, the invisibility of nursing care, the absence of leadership that incorporates research findings and difficulties in the application of scientific evidence, in addition to the influence of regulatory provisions and the idiosyncrasies of the company. The analysis of classical models with a transformative approach invites a more fluid and coordinated communication between occupational health, occupational risk prevention, primary care and public health, a proposal that induces collaboration and a more holistic approach to care for workers.

Let's Learn Together! A Mixed-Methods Study to Assess Readiness for Interprofessional Education on Total Worker Health® Practice.

Occupational safety and health (OSH) professionals increasingly need interdisciplinary collaborative practice competencies to respond to complex worker safety, health, and well-being risks. Effective collaboration with non-OSH-trained professionals (e.g., health promotion, human resources) is critical for planning integrated interventions that address work and non-work risks, consistent with a "Total Worker Health" (TWH) approach. Interprofessional education (IPE) pedagogy offers skill-building for interdisciplinary collaboration, but little attention has been given to IPE in OSH education and training literature. The goal of this study was to assess OSH professionals' perceptions about IPE to guide application in postgraduate TWH education. The mixed-methods study involved 210 U.S. professionals in safety (31%), industrial hygiene (16%), occupational nursing (12%) and medicine (11%), and related disciplines (30%). Participants completed a 12-item Readiness for Interprofessional Education Scale (RIPLS) adapted for TWH. Nineteen survey-takers also participated in virtual focus groups to share opinions about IPE benefits, barriers, and desirable course features. Occupational safety and health professionals reported high overall readiness for IPE (RIPLS, 4.45 ± 0.47), endorsing IPE for interdisciplinary skill-building. Salient IPE motivators were learning new perspectives from diverse disciplines and industries; gaining new subject expertise; developing common ground across disciplines; and learning TWH best practices. Participants recommended case studies to practice interdisciplinary problem-solving through group work. Interprofessional education is a promising pedagogy for OSH continuing education to promote interdisciplinary collaboration skills needed for TWH practice in the workplace. Occupational safety and health educators need to build competency in IPE pedagogical theory and practice to ensure effective training design and evaluation.

Collaboration between occupational health professionals in smoking cessation treatment and support.

Promoting health is an important part of occupational health (OH) professionals' daily practice. Occupational health services (OHS) support work ability and prevent both work-related diseases and lifestyle-related illnesses. We focused on how interprofessional collaboration (IPC), regardless of whether the OHS provider is public, private or in-house, influences the implementation of smoking cessation treatment and support (SCTS). We studied IPC of OH professionals in SCTS and whether they differ depending on OHS providers. We collected data through an online survey of a cross-sectional sample of OH professionals of physicians (n = 182), nurses (n = 296) and physiotherapists (n = 96) at two different time-points, in 2013 and 2017. The questionnaire contained questions on interprofessional SCTS practices, so that we could assess how the professionals' experiences differed from each other. We used explanatory factor analysis to study the collaboration, and the Kruskall-Wallis test to detect the differences between the OH professional groups as a post-hoc data analysis. OH physicians (mean 3.4, SD 1.2) and OH nurses (mean 3.2, SD 1.1) experienced smooth collaboration in SCTS whereas OH physiotherapists (mean 2.5, SD 1.1) felt excluded from IPC. In-house OH centres (mean 3.5, SD 1.0) seemed to offer the best opportunities for implementing IPC in SCTS comparing to public (mean 3.1, SD 0.9) or private (mean 2.9, SD 0.9) OHS. The IPC of OH professionals in SCTS interventions need to be rearranged. This requires boundary-crossing SCTS practices involving all professionals. All OH professionals should implement IPC in SCTS and share their specific competence.

METABOLIC SYNDROME AND POOR SELF-RATED HEALTH AS RISK FACTORS FOR PREMATURE EMPLOYMENT EXIT

Abstract Poor self-rated health (SRH) is a well-established risk factor for premature employment exit through unemployment, work disability, and early retirement. However, it is not clear whether the premature employment exit risk associated with underlying cardio-metabolic health conditions is fully captured by poor SRH. This study examines the metabolic syndrome (MetS), an early-stage risk factor for cardiovascular disease and type two diabetes mellitus, as a risk factor for premature employment exit while controlling for poor SRH. We analyzed data from N=54,108 middle-aged and older Dutch workers (40-64 years) from five waves of the Lifelines Cohort Study and Biobank. MetS components were based on physical measures, blood markers, and medication use. SRH and employment states were self-reported. The associations between MetS, SRH, and premature employment exit types were analyzed using competing risk regression analysis. During follow-up (4.3 years), MetS was identified as an independent risk factor for unemployment (adjusted subdistribution hazard ratio (SHR): 1.13, 95% CI: 1.03, 1.25) and work disability (adjusted SHR: 1.35, 95% CI: 1.13, 1.61) when adjusted for poor SRH, chronic diseases, and sociodemographic factors. MetS was not associated with early retirement. To conclude, poor SRH did not fully capture the risk for unemployment and work disability associated with MetS. Workers with MetS might thus not be aware of their cardio- metabolic health related risks for premature employment exit. More awareness about MetS as a risk factor for premature employment exit is needed among workers, employers, and occupational health professionals. Further, MetS prevention might help to prolong working lives.

IMPACTS OF INDUSTRIAL PAINTINGS ON WORKERS’ HEALTH

Objective: to describe the impacts of industrial paintings on workers’ health. Methods: an integrative literature review study was conducted. Articles recovered through secondary databases Virtual Health Library (VHL), Latin American and Caribbean Literature on Health Sciences (LILACS), Scientific Electronic Library Online (Scielo) and Online Medical Literature Search and Analysis System (MEDLINE) were analyzed from the descriptors paintings, worker’s health and occupational medicine. Studies published in Portuguese, English or Spanish were considered and dealt directly with the theme object of study. Results: the main impacts of industrial paintings on workers’ health are skin diseases, allergic reactions, eye irritation and respiratory problems, neoplasms, myelodysplastic syndromes, neuropathies, olfactory disorders, saturnism and acute and chronic effects on the central nervous system. Conclusion: industrial paintings can cause real risks to the health of workers in this service sector, which requires the performance of occupational health professionals for timely prevention and care.

Metabolic syndrome and poor self-rated health as risk factors for premature employment exit: a longitudinal study among 55 016 middle-aged and older workers from the Lifelines Cohort Study and Biobank.

Poor self-rated health (SRH) is a well-established risk factor for premature employment exit through unemployment, work disability, and early retirement. However, it is unclear whether the premature employment exit risk associated with underlying cardio-metabolic health conditions is fully captured by poor SRH. This study examines the metabolic syndrome (MetS), an early-stage risk factor for cardiovascular disease and type two diabetes mellitus, as a risk factor for premature employment exit while controlling for poor SRH. We analyzed data from N = 55016 Dutch workers (40-64 years) from five waves of the Lifelines Cohort Study and Biobank. MetS components were based on physical measures, blood markers, and medication use. SRH and employment states were self-reported. The associations between MetS, SRH, and premature employment exit types were analyzed using competing risk regression analysis. During 4.3 years of follow-up, MetS remained an independent risk factor for unemployment [adjusted subdistribution hazard ratio (SHR): 1.14, 95% CI: 1.03, 1.25] and work disability (adjusted SHR: 1.33, 95% CI: 1.11, 1.58) when adjusted for poor SRH, common chronic diseases related to labor market participation (i.e., cancer, musculoskeletal-, pulmonary-, and psychiatric diseases), and sociodemographic factors. MetS was not associated with early retirement. Poor SRH did not fully capture the risk for unemployment and work disability associated with MetS. More awareness about MetS as a 'hidden' cardio-metabolic risk factor for premature employment exit is needed among workers, employers, and occupational health professionals. Regular health check-ups including MetS assessment and MetS prevention might help to prolong healthy working lives.