Risk Of Disability Retirement Research Articles

\u2018Return to Work\u2019 Coordinator Model and Work Participation of Employees: A Natural Intervention Study in Finland

Purpose Employers increasingly use ‘return to work’ (RTW) coordinators to support work ability and extend working careers, particularly among employees with reduced work ability. We examined whether applying this model was associated with changes in employee sickness absence and disability retirements. Methods We used data from the Finnish Public Sector study from 2009 until 2015. Employees where the model was introduced in 2012 constituted the cases (n = 4120, one municipality) and employees where the model was not in use during the follow-up, represented the controls (n = 5600, two municipalities). We analysed risk of disability retirement in 2013–2015 and risk of sickness absence after (2013–2015) vs. before (2009–2011) intervention by case–control status. Results The incidence of disability retirement after the intervention was lower in cases compared to controls both in the total population (hazard ratio HR = 0.49, 95% CI 0.30–0.79) and in the subgroup of participants with reduced work ability (HR = 0.34, 95% CI 0.12–0.99). The risk of sickness absence increased from pre-intervention to post-intervention period both among cases and controls although the relative increase was greater among cases (RRpost- vs. pre-intervention = 1.26, 95% CI 1.14–1.40) than controls (RRpost- vs. pre-intervention = 1.03, 95% CI 0.97–1.08). In the group of employees with reduced work ability, no difference in sickness absence trends between cases and controls was observed. Conclusions These findings suggest that RTW-coordinator model may increase employee sickness absence, but decrease the risk of disability retirement, i.e., permanent exclusion from the labour market.

Occupational differences in disability retirement due to a shoulder lesion: do work-related factors matter?

ObjectiveTo identify occupations with a high risk of disability retirement due to a shoulder lesion and to examine the effect of physical and psychosocial work-related factors on occupational differences in disability retirement.MethodsWe followed Finnish wage earners aged 30–59 years (n = 1,135,654) from 2005 to 2014 for full disability retirement due to a shoulder lesion. The work-related exposures were assessed with job exposure matrices. We calculated age-adjusted incidence rates and hazard ratios to test for the association between occupation and disability retirement due to a shoulder lesion. We also examined the contribution of work-related exposures to the excess risk of disability retirement.ResultsAs compared to professionals, the age-adjusted risk of disability retirement was increased among men in all occupational groups except managers and customer service clerks and among women in several occupational groups. Adjustment for education attenuated the occupational differences considerably, particularly among women. The physical work-related factors fully explained the excess risk of disability retirement due to a shoulder lesion among male finance and sales associate professionals and administrative secretaries as well as among agricultural and fishery workers. In women, the physical work-related factors fully explained the excess risk among construction workers, electricians and plumbers. For both genders, the contribution of psychosocial factors to excess risk of disability retirement was modest and seen for monotonous work only.ConclusionsA reduction of the level of physical work load factors as well as monotonousness of work has a potential to prevent work disability due to a shoulder lesion.

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

PurposePhysical work exposures and common mental disorders (CMD) have been linked to increased risk of work disability, but their joint associations with disability retirement due to any cause, mental disorders or musculoskeletal diseases have not been examined.MethodsThe data for exposures and covariates were from the Finnish Helsinki Health Study occupational cohort surveys in 2000–2002, 2007 and 2012. We used 12,458 observations from 6159 employees, who were 40–60 years old at baseline. CMD were measured by the General Health Questionnaire (GHQ-12, cut-off point 3+). Four self-reported work exposures (hazardous exposures, physical workload, computer and shift work) were combined with CMD and categorized as “neither”, “work exposure only”, “CMD only”, and “both”. Associations with register-based disability retirement were assessed with Cox proportional hazards models for sample survey data adjusting for confounders over 5-year follow-up. Additionally, synergy indices were calculated for the combined effects.ResultsThose reporting CMD and high physical workload had a greater risk of disability retirement due to any cause (HR 4.26, 95% CI 3.60–5.03), mental disorders (HR 5.41, 95% CI 3.87–7.56), and musculoskeletal diseases (HR 4.46, 95% CI 3.49–5.71) when compared to those with neither. Synergy indices indicated that these associations were synergistic. Similar associations were observed for CMD and hazardous exposures, but not for combined exposures to CMD and computer or shift work.ConclusionsIdentification of mental health problems among employees in physically demanding jobs is important to support work ability and reduce the risk of premature exit from work due to disability.

Company-level determinants of disability retirement: a multilevel study of Finnish private sector workplaces.

We examined whether the risk for disability retirement varies between companies over and above the individual-level characteristics of their employees and which company-level characteristics are associated with the risk for any, full or partial disability retirement. A 30% random sample of Finnish private sector companies with at least 10 employees was used (5567 companies and 301 313 employees). The risk for disability retirement over 6 years was analyzed using multilevel logistic regression. Company size and industry, as well as gender, age, education and social class measured both at the individual- and the company-level were used as explanatory variables. 3.8% of the variance in the risk for disability retirement was attributed to the company level after controlling for individual-level characteristics of the employees. Company-level variance was much larger in partial (11.7%) than in full (4.2%) disability retirement. After controlling for all individual- and company-level characteristics, those working in health and social work activities had increased risk for both full and partial disability retirement. The risk for full disability retirement increased by decreasing educational level of the company. The risk for partial disability retirement increased by increasing company size and was elevated in companies with the highest proportion of women. After controlling for the individual-level characteristics, variation in the risk for disability retirement between companies was modest. The more substantial variation in partial disability pension suggests that companies have a marked role in advancing working with partial disabilities.

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

We examined the joint association of overweight and CMDs (common mental disorders) with diagnosis-specific disability retirement among midlife employees. Baseline surveys (n = 8960, response rate 67%) were linked with registers of the Finnish Centre of Pensions. We calculated the hazard ratios (HRs) for disability retirement due to any, musculoskeletal, and mental diagnoses according to the International Classification of Diseases (ICD-10) with Cox regression analysis (mean follow-up 8.3 years) among normal-weight (body mass index 18.5 to 25 kg/m) and overweight (≥25 kg/m) participants with or without CMD (General Health Questionnaire-12 score ≥3). Overweight was associated with disability retirement due to any and musculoskeletal diagnoses and CMD with any and mental diagnoses. The risk for disability retirement was additively higher for those with both overweight and CMD. Preventing overweight and CMD, and especially considering those with both conditions simultaneously, likely helps maintain work ability.

Does dispositional optimism moderate the relationship between role conflict and risk of disability retirement?

This study determines whether dispositional optimism moderates the relationship between role conflict and the risk of disability retirement. The study was based on a combination of self-report survey questionnaire data on role conflict and dispositional optimism with official register data on disability benefits from the Norwegian Labour and Welfare Administration. The sample comprised 14,501 Norwegian employees from various occupations and industries. Role conflict was significantly related to higher risk (HR 1.35, 95% CI 1.19–1.53), whereas optimism was associated with decreased risk (HR 0.75, 95% CI 0.64–0.88), of disability retirement. Optimism did not modify the effect on role conflict on disability retirement. Having an optimistic life orientation decreases the risk of disability retirement in general, but does not protect against the detrimental effects of role conflict at the workplace. As optimism is a malleable personality characteristic, organizations may benefit from interventions that help employees experience daily events more positively.

Workplace level differences in the risk of disability retirement

Workplace level differences in the risk of disability retirement

Occupational class inequalities in disability retirement after hospitalisation.

This study aimed to investigate whether hospitalisation is associated with increased risk of disability retirement differently across four occupational classes. 170,510 employees of the City of Helsinki, Finland were followed from 1990 to 2013 using national registers for hospitalisations and disability retirement. Increases in the risk of disability retirement after hospitalisation for any cause, cardiovascular diseases, musculoskeletal disorders, mental disorders, malignant neoplasms, respiratory diseases and injuries were assessed across four occupational classes: professional, semi-professional, routine non-manual and manual, using competing risks models. In general, hospitalisation showed a slightly more increased risk of disability retirement in the lower ranking occupational classes. Hospitalisation among women for mental disorders showed a more increased risk in the professional class (hazard ratio 14.73, 95% confidence interval 12.67 to 17.12) compared to the routine manual class (hazard ratio 7.27, 95% confidence interval 6.60 to 8.02). Occupational class differences were similar for men and women. The risk of disability retirement among women increased most in the routine non-manual class after hospitalisation for musculoskeletal disorders and injuries, and most in the professional class after hospitalisation for cardiovascular diseases. The corresponding risks among men increased most in the two lowest ranking classes after hospitalisation for injuries. Ill-health as measured by hospitalisation affected disability retirement in four occupational classes differently, and the effects also varied by the diagnostic group of hospitalisation. Interventions that tackle work disability should consider the impact of ill-health on functioning while taking into account working conditions in each occupational class.

Does human resource primacy moderate the impact of psychological distress on subsequent risk for disability retirement?

Objective Human resource primacy (HRP) refers to employees' perceptions of how the organization shows interests in its employees' welfare, happiness, and health. The aims of this study were to determine whether (i) perceptions of HRP are related to the risk for disability retirement and (ii) HRP moderates the impact of psychological distress on later risk for disability retirement. Methods The study relied on a combination of self-report survey questionnaire data on HRP and psychological distress supplemented with official register data on disability benefits from the Norwegian Labor and Welfare Administration. The sample comprised 14 501 Norwegian employees from various occupations and industries. Results HRP was significantly associated with reduced risk of disability retirement [hazard ratio (HR) in bivariate analysis 0.84, 95% confidence interval (95% CI) 0.77-0.93] and after adjusting for gender and educational level. However, HRP (HR 0.97, 95% CI 0.87-1.07) was not associated with later risk for disability retirement after adjusting for psychological distress and did not moderate the association between psychological distress and disability retirement. Conclusions A positive impression of HRP may reduce the risk of disability retirement in general but not in cases following psychological distress. Upcoming research should identify other factors that may be more beneficial with regard to reducing the risk for disability retirement following distress.

Psychological, social, and mechanical work exposures and disability retirement: a prospective registry study

BackgroundRelations between several occupational psychological and social factors and disability retirement remain largely unexplored. Knowledge of which specific aspects of the work environment that affect risk of disability is a prerequisite for the success of organizational interventions aiming to prevent premature work force exit. The objective of the present study was to determine contributions to registered disability retirement by a broad range of psychological and social work exposures while taking into account effects of mechanical exposure.MethodsWritten consent was obtained from 13 012 employees (96 organizations) representing a wide range of occupations, to link their survey responses to data from the Norwegian national registry of disability compensation. Median follow-up time was 5.8 years. To determine effects of self-reported work exposures on risk of disability retirement hazard ratios (HR) and 99% confidence intervals (99% CI) were calculated with Cox regression analysis. Effects of sex, age group, skill level, sickness absence in the last three years, and work exposures estimated to be confounders were accounted for. Post hoc stratification by sex was conducted to explore if identified predictors affected risk of disability retirement differently in men compared to women.ResultsContributors to higher risk of disability retirement were “role conflict” (high level HR 1.55 99% CI 1.07 to 2.24) and “physical workload” (high level HR 1.93 99% CI 1.39 to 2.68). Contributors to lower risk of disability retirement were “positive challenge” (high level HR 0.56 99% CI 0.34 to 0.93), “fair leadership” (high level HR 0.56 99% CI 0.39 to 0.81), and “control over work intensity” (high level HR 0.62, 99% CI 0.47 to 0.82). Direction of effects was not dependent on sex in any of the five identified predictors.ConclusionsSeveral specific psychological and social work factors are independent contributors to risk of disability retirement. In order to prevent premature work force exit workplace interventions should consider targeting the predictors identified by the present study.

Do debts lead to disability pension? Evidence from a 15-year follow-up of 54,000 Finnish men and women

While over-indebtedness has emerged as a new social risk among Europeans as a consequence of economic recessions, its associations with health and disability are poorly understood. This study utilises longitudinal, register-based data to assess the associations of over-indebtedness with disability retirement. Severely over-indebted people were identified from the Finnish credit information register. For each over-indebted person, one matched control was retrieved from the population register (total N: 54,494). Register data on socio-demographics, health-related factors and pensions were used to analyse the incidence of disability pensions due to different diagnoses among over-indebted people and their controls during the period 1995–2009 using Cox regression analysis. The analyses showed that over-indebtedness was strongly associated with the risk of disability retirement in all diagnostic groups. The associations were stronger among women than among men. The adverse effects of over-indebtedness on health and disability should be acknowledged. In addition to standard socio-demographic indicators, debtor status may add to our knowledge of the predictors of poor health. Policymakers should adopt measures to prevent over-indebtedness and to overcome its harmful effects.

Educational differences in disability retirement among young employees in Helsinki, Finland.

Disability retirement (DR) among young employees is an increasing problem affecting work life and public health, given the potential major loss of working time. Little is known about educational differences in the risk of DR among young employees, despite the need for such knowledge in targeting preventive measures. We examined the association between education and DR due to any cause and to mental and non-mental causes among young employees. Personnel register data of the City of Helsinki from the years 2002-2013 for 25-to-34-year-old employees (n= 41225) were linked to register data from the Finnish Centre for Pensions on DR (n= 381), and from Statistics Finland on education. Education was categorised into four hierarchical groups. The mean follow-up time was 5.7 years. Cox regression analysis was used. There were 381 DR events and of the events, over 70% were due to mental disorders and 72% were temporary. A consistent educational gradient was found. Those with a basic education were at the highest risk of DR due to any cause (HR 4.64, 95% CI 3.07, 7.02), and to mental (HR 4.79, 95% CI 2.89, 7.94) and non-mental causes (HR 4.32, 95% CI 2.10, 8.91). DR due to any cause, and to mental and non-mental causes, followed a clear educational gradient. Early intervention, treatment and rehabilitation with a view to maintaining work ability are needed among young employees, especially those with low education. Adapting working conditions to their health and work ability may also help to avoid premature exit from work.

A prospective study of occupational status and disability retirement among employees with diabetes in Denmark.

The aim of this study was to examine the extent and distribution of disability retirement among people with diabetes in the workforce. Using four population registries, the study examined the relative rates of disability retirement among employees in Denmark over a 10-year period. The findings highlight that the risk of disability retirement increases as occupational status decreases. With an ageing workforce and increasing prevalence of diabetes, it is important to target primary, secondary and tertiary prevention to the groups that need it most in attempts to prolong the working lives of individuals.

Economic difficulties and subsequent disability retirement.

This study examined whether economic difficulties are associated with subsequent disability retirement while controlling for covariates. Survey data among middle-aged employees of the City of Helsinki in 2000-2002 were linked with the Finnish Centre for Pensions register data on all-cause disability retirement among women (n=4816) and men (n=1354) until the end of 2010. Additionally, disability retirement due to musculoskeletal diseases and mental disorders (ICD-10) was examined among women. Frequency in difficulties paying pills and buying food and clothes, and covariates (occupational class, income, housing tenure, and work- and health-related covariates) were self-reported at baseline. Hazard ratios (HR) and their 95% confidence intervals (95% CI) were calculated from Cox regression analysis. Frequent economic difficulties were associated with all-cause disability retirement after adjusting for age among both women (HR=2.11; 95% CI 1.63-2.73) and men (HR=2.69; 95% CI 1.65-4.41). Adjustment for covariates somewhat attenuated the associations, but they remained. Economic difficulties were also associated with disability retirement due to both mental disorders (HR=3.29; 95% CI 1.98-5.46) and musculoskeletal diseases (HR=1.85; 95% CI 1.24-2.75) among women. Adjustments made a minor contribution to the risk of disability retirement due to mental disorders, whereas the risk of disability retirement due to musculoskeletal diseases reduced after considering socioeconomic circumstances. Conclusions: economic difficulties are independently associated with disability retirement. Thus, they should be considered in attempts to tackle early exit from the labour market due to disability.

Military Occupation and Deployment: Descriptive Epidemiology of Active Duty U.S. Army Men Evaluated for a Disability Discharge

Physically demanding jobs and history of deployment put Soldiers at increased risk for injury, hospitalizations, and disability. Characterizing differences in disability outcomes by occupation and deployment history may identify specific military populations for targeted prevention and intervention programs as well as potential areas of future research. A cross-sectional analysis was conducted on U.S. Army enlisted men evaluated in the Department of Defense's Disability Evaluation System (DES) between fiscal years 2005 and 2011, comparing those assigned a Combat Arms military occupational specialty (MOS) to individuals with any other MOS (Other). Among deployed Soldiers, those with Combat Arms MOS were substantially and significantly more likely to receive medical disability retirement than Other MOS and were more likely to be evaluated for conditions compatible with combat exposures, including post-traumatic stress disorder, residuals of traumatic brain injury, and paralysis. Among nondeployed Soldiers, Combat Arms MOS were only slightly more likely to receive medical disability than Other MOS, and no substantial differences in medical conditions were noted between the two MOS groups. Combat Arms MOS is a significant risk factor for disability retirement primarily among deployed men. Further research is needed to identify specific military occupations most at risk for disability retirement.

Life tables of disability beneficiaries by morbidity cause. Brazil, 1999-2002

The main goal of this paper is to estimate a Disability Beneficiaries Life Table from the General Social Security Regime for Private Sector Workers (rgps) by sex, age and disability cause in Brazil using multiple-decrement models. We used administrative records from Technological Enterprises and Social Security Information (dataprev 1999- 2002), and the information of social beneficiaries given by National Records of Social Information (cnis 1999-2002).The results show that –in contradiction with the disability life tables used in the private sector– the male disability retirement hazard increases steadily until age 65 and decreases afterwards. However, for females, these risks increase continuously up to the oldest age. More sex differentials show that, among women, the risk of disability retirement is larger due to circulatory diseases, musculoskeletal diseases and neoplasms. Among males, mental disorders are the most responsible for an overweight in the number of pensioners, especially among the young and adult age groups. This paper contributes to a better understanding of work and disability, especially in the field of social security and retirement.

Prospective Analysis of Disability Retirement as a Consequence of Injuries in a Labour Force Population

The aim of the present work was to investigate the influence of different types of injury on the risk for disability retirement among economically active people in Denmark. In this prospective study, all people in the Danish labour force aged 21-54 years 1 January 1997 (N = 2 211 057) were followed for disability retirement during 1997-2001. Age and gender standardised incidence ratios (SIR) were calculated to compare retirement rates among those who received treatment for an injury during 1996 (N = 252 468, including both work-related and non-work related types) with the rates in the total labour force. Life-table methodology was used to calculate years of lost economically active life (YLEAL) by injury type. Among the injured people we observed a total number of 5580 cases of subsequent disability retirement and 45% of these could be statistically attributed to the injury. The SIR for disability retirement by injury type ranged from 1.38 to 7.00. The least severe types, superficial injuries and dislocations, sprains, and strains, were most prevalent and generated the highest numbers of YLEALs. The high frequency of injuries and their influence on retirement rates suggest that injury prevention is a highly relevant approach to reduce future costs from disability retirement. YLEAL calculations can be used to set priorities.