Job strain as a predictor of disability pension: the Finnish Public Sector Study

• Published in: Journal of epidemiology and community health (1979) 2009-01, Vol.63 (1), p.24-30
• Main Authors: Laine, S, Gimeno, D, Virtanen, M, Oksanen, T, Vahtera, J, Elovainio, M, Koskinen, A, Pentti, J, Kivimäki, M
• Format: Article
• Language: English
• Subjects: Absenteeism; Adult; Biological and medical sciences; Community health; Disabilities; Disability pensions; Disease risk; Employees; Employment - psychology; Female; Finland - epidemiology; General aspects; Health risks; Humans; Job design; Labor demand; Male; Medical sciences; Middle Aged; Miscellaneous; Occupational Diseases - epidemiology; Occupational Diseases - psychology; Occupational health; Pensions - statistics & numerical data; Predisposing factors; Prospective Studies; Psychological stress; Public health. Hygiene; Public health. Hygiene-occupational medicine; Public sector; Public Sector - statistics & numerical data; Regression analysis; Research reports; Retirement - statistics & numerical data; Risk Factors; Risk taking; Sick Leave - statistics & numerical data; Socioeconomics; Sprains and strains; Stress, Psychological - epidemiology; Stress, Psychological - psychology; Studies; Work environment; Work Schedule Tolerance; Workload - psychology
• ISSN: 0143-005X; 1470-2738
• DOI: 10.1136/jech.2007.071407

Objective:To examine whether high job strain (a combination of high job demands and low job control) is a risk factor for disability pension.Setting:Ten municipalities and 21 hospitals in Finland.Design and participants:A prospective cohort study of 20 386 female and 4 764 male Finnish public sector employees aged 19–50 using data from two surveys (baseline in 2000–2 and follow-up in 2005) and employers’ registers. In addition to self-reported job strain, we computed work unit-aggregated job strain for each participant (the average of scores of all workers of participant’s work unit except the participant him/herself).Main results:93 employees (0.4%) retired because of disability during the follow-up. In multilevel logistic regression analysis adjusted for demographic characteristics and health risk behaviour, odds for disability pension was 2.60 (95% CI 1.26 to 5.34) times higher for employees with high self-assessed job strain than for those with low self-assessed job strain at baseline. The corresponding OR for passive job versus low job strain was 2.82 (95% CI 1.34 to 5.96). Analysis of work unit-aggregated scores replicated the association for high job strain, OR 2.25 (95% CI 1.17 to 4.35), but not that for passive job. The association between work unit job strain and disability pension remained significant after further adjustment for prevalent diseases, psychological distress and perceived health status.Conclusions:Job strain is associated with risk of subsequent disability pension. If causal, this association suggests that organisational interventions to reduce job strain may also reduce early exit from work.