Advertisement

Can high psychological job demands, low decision latitude, and high job strain predict disability pensions? A 12-year follow-up of middle-aged Swedish workers

  • Catarina CanivetEmail author
  • BongKyoo Choi
  • Robert Karasek
  • Mahnaz Moghaddassi
  • Carin Staland-Nyman
  • Per-Olof Östergren
Original Article

Abstract

Objectives

The aim of this study was to investigate whether job strain, psychological demands, and decision latitude are independent determinants of disability pension rates over a 12-year follow-up period.

Methods

We studied 3,181 men and 3,359 women, all middle-aged and working at least 30 h per week, recruited from the general population of Malmö, Sweden, in 1992. The participation rate was 41 %. Baseline data include sociodemographics, the Job Content Questionnaire, lifestyle, and health-related variables. Disability pension information was obtained through record linkage from the National Health Insurance Register.

Results

Nearly 20 % of the women and 15 % of the men were granted a disability pension during the follow-up period. The highest quartile of psychological job demands and the lowest quartile of decision latitude were associated with disability pensions when controlling for age, socioeconomic position, and health risk behaviours. In the final model, with adjustment also for health indicators and stress from outside the workplace, the hazard ratios for high strain jobs (i.e. high psychological demands in combination with low decision latitude) were 1.5 in men (95 % CI, 1.04–2.0) and 1.7 in women (95 % CI, 1.3–2.2). Stratifying for health at baseline showed that high strain tended to affect healthy but not unhealthy men, while this pattern was reversed in women.

Conclusions

High psychological demands, low decision latitude, and job strain were all confirmed as independent risk factors for subsequent disability pensions. In order to increase chances of individuals remaining in the work force, interventions against these adverse psychosocial factors appear worthwhile.

Keywords

Disability leave Stress, physiological Stress, psychological Gender Longitudinal studies 

Notes

Acknowledgments

This study was supported by grants from the Swedish Medical Research Council, the Swedish Council for Social Research, the Medical Faculty at Lund University, the National Institute of Public Health, and the Swedish Work Environment Fund.

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Alexanderson K, Norlund A (2004) Swedish Council on Technology Assessment in Health Care (SBU). Chapter 1. Aim, background, key concepts, regulations, and current statistics. Scand J Public Health Suppl 63:12–30CrossRefGoogle Scholar
  2. Ali SM, Lindström M (2008) Psychosocial work conditions, unemployment and health locus of control: a population-based study. Scand J Public Health 36:429–435CrossRefGoogle Scholar
  3. Allebeck P, Mastekaasa A (2004) Swedish Council on Technology Assessment in Health Care (SBU). Chapter 5. Risk factors for sick leave—general studies. Scand J Public Health Suppl 63:49–108CrossRefGoogle Scholar
  4. Armor D, Polich J (1982) Measurement of alcohol consumption. In: Pattison EM, Kaufman E (eds) Encyclopedic handbook of alcoholism. Gardner Press, New York, pp 72–80Google Scholar
  5. Belkic KL, Landsbergis PA, Schnall PL, Baker D (2004) Is job strain a major source of cardiovascular disease risk? Scand J Work Environ Health 30:85–128CrossRefGoogle Scholar
  6. Bellingrath S, Weigl T, Kudielka BM (2009) Chronic work stress and exhaustion is associated with higher allostastic load in female school teachers. Stress 12:37–48CrossRefGoogle Scholar
  7. Bonde JP (2008) Psychosocial factors at work and risk of depression: a systematic review of the epidemiological evidence. Occup Environ Med 65:438–445CrossRefGoogle Scholar
  8. Bongers PM, de Winter CR, Kompier MA, Hildebrandt VH (1993) Psychosocial factors at work and musculoskeletal disease. Scand J Work Environ Health 19:297–312CrossRefGoogle Scholar
  9. Börsch-Supan A, Brugiavini A, Croda E (2009) The role of institutions and health in European patterns of work and retirement. J Eur Soc Policy 19:341–358CrossRefGoogle Scholar
  10. Chandola T, Brunner E, Marmot M (2006) Chronic stress at work and the metabolic syndrome: prospective study. BMJ 332:521–525CrossRefGoogle Scholar
  11. Chandola T, Heraclides A, Kumari M (2010) Psychophysiological biomarkers of workplace stressors. Neurosci Biobehav Rev 35:51–57CrossRefGoogle Scholar
  12. Choi B, Ostergren PO, Canivet C, Moghadassi M, Lindeberg S, Karasek R et al (2011) Synergistic interaction effect between job control and social support at work on general psychological distress. Int Arch Occup Environ Health 84:77–89CrossRefGoogle Scholar
  13. Christensen KB, Feveile H, Labriola M, Lund T (2008) The impact of psychosocial work environment factors on the risk of disability pension in Denmark. Eur J Public Health 18:235–237CrossRefGoogle Scholar
  14. Claussen B (1998) Restricting the influx of disability beneficiaries by means of law: experiences in Norway. Scand J Soc Med 26:1–7Google Scholar
  15. Claussen B, Dalgard OS (2009) Disability pensioning: the gender divide can be explained by occupation, income, mental distress and health. Scand J Public Health 37:590–597CrossRefGoogle Scholar
  16. de Lange AH, Kompier MA, Taris TW, Geurts SA, Beckers DG, Houtman IL et al (2009) A hard day’s night: a longitudinal study on the relationships among job demands and job control, sleep quality and fatigue. J Sleep Res 18:374–383CrossRefGoogle Scholar
  17. Emslie C, Ridge D, Ziebland S, Hunt K (2006) Men’s accounts of depression: reconstructing or resisting hegemonic masculinity? Soc Sci Med 62:2246–2257CrossRefGoogle Scholar
  18. Friis K, Ekholm O, Hundrup YA (2008) The relationship between lifestyle, working environment, socio-demographic factors and expulsion from the labour market due to disability pension among nurses. Scand J Caring Sci 22:241–248CrossRefGoogle Scholar
  19. Fukuoka Y, Dracup K, Takeshima M, Ishii N, Makaya M, Groah L et al (2009) Effect of job strain and depressive symptoms upon returning to work after acute coronary syndrome. Soc Sci Med 68:1875–1881CrossRefGoogle Scholar
  20. Gallo LC, Jimenez JA, Shivpuri S, Espinosa de Los Monteros K, Mills PJ (2011) Domains of chronic stress, lifestyle factors, and allostatic load in middle-aged Mexican-American women. Ann Behav Med 41:21–31CrossRefGoogle Scholar
  21. Geurts SA, Sonnentag S (2006) Recovery as an explanatory mechanism in the relation between acute stress reactions and chronic health impairment. Scand J Work Environ Health 32:482–492CrossRefGoogle Scholar
  22. Gjesdal S, Ringdal PR, Haug K, Maeland JG (2004) Predictors of disability pension in long-term sickness absence: results from a population-based and prospective study in Norway 1994–1999. Eur J Public Health 14:398–405CrossRefGoogle Scholar
  23. Gjesdal S, Haug K, Ringdal P, Maeland JG, Hagberg J, Roraas T et al (2009) Sickness absence with musculoskeletal or mental diagnoses, transition into disability pension and all-cause mortality: a 9-year prospective cohort study. Scand J Public Health 37:387–394CrossRefGoogle Scholar
  24. Government Offices of Sweden (2010) Sickness insurance in Sweden 2009. http://www.sweden.gov.se/. Accessed 25 April 2011
  25. Hult C, Stattin M, Janlert U, Järvholm B (2010) Timing of retirement and mortality—a cohort study of Swedish construction workers. Soc Sci Med 70:1480–1486CrossRefGoogle Scholar
  26. Isacsson SO, Hanson BS, Janzon L, Lindell SE, Steen B (1987) Methods to assess alcohol consumption in 68-year-old men: results from the population study ‘Men born in 1914’ Malmo, Sweden. Br J Addict 82:1235–1244CrossRefGoogle Scholar
  27. Kaplan GA, Camacho T (1983) Perceived health and mortality: a nine-year follow-up of the human population laboratory cohort. Am J Epidemiol 117:292–304Google Scholar
  28. Karasek R (1979) Job demands, job decision latitude, and mental strain: implications for job redesign. Adm Sci Q 24:285–307CrossRefGoogle Scholar
  29. Karasek R, Choi B, Östergren PO, Ferrario M, De Smet P (2007) Testing two methods to create comparable scale scores between the Job Content Questionnaire (JCQ) and JCQ-Like Questionnaires in the European JACE study. Int J Behav Med 14:189–201CrossRefGoogle Scholar
  30. Kivimäki M, Virtanen M, Elovainio M, Kouvonen A, Vaananen A, Vahtera J (2006) Work stress in the etiology of coronary heart disease—a meta-analysis. Scand J Work Environ Health 32:431–442CrossRefGoogle Scholar
  31. Krause N, Lynch J, Kaplan GA, Cohen RD, Goldberg DE, Salonen JT (1997) Predictors of disability retirement. Scand J Work Environ Health 23:403–413CrossRefGoogle Scholar
  32. Krokstad S, Johnsen R, Westin S (2002) Social determinants of disability pension: a 10-year follow-up of 62,000 people in a Norwegian county population. Int J Epidemiol 31:1183–1191CrossRefGoogle Scholar
  33. Kuorinka I, Jonsson B, Kilbom A, Vinterberg H, Biering-Sorensen F, Andersson G et al (1987) Standardised Nordic questionnaires for the analysis of musculoskeletal symptoms. Appl Ergon 18:233–237CrossRefGoogle Scholar
  34. Laine S, Gimeno D, Virtanen M, Oksanen T, Vahtera J, Elovainio M et al (2009) Job strain as a predictor of disability pension: the Finnish public sector study. J Epidemiol Commun Health 63(1):24–30CrossRefGoogle Scholar
  35. Manjer J, Carlsson S, Elmstahl S, Gullberg B, Janzon L, Lindström M et al (2001) The Malmo diet and cancer study: representativity, cancer incidence and mortality in participants and non-participants. Eur J Cancer Prev 10:489–499CrossRefGoogle Scholar
  36. Melchior M, Caspi A, Milne BJ, Danese A, Poulton R, Moffitt TE (2007) Work stress precipitates depression and anxiety in young, working women and men. Psychol Med 37:1119–1129CrossRefGoogle Scholar
  37. OECD (2003) Transforming disability into ability: policies to promote work and income security for disabled people. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2860194/?tool=pubmed. Accessed 25 April 2011
  38. Östergren PO, Hanson BS, Balogh I, Ektor-Andersen J, Isacsson A, Orbaek P et al (2005) Incidence of shoulder and neck pain in a working population: effect modification between mechanical and psychosocial exposures at work? Results from a one year follow up of the Malmö shoulder and neck study cohort. J Epidemiol Commun Health 59:721–728CrossRefGoogle Scholar
  39. Punnett L, Cherniack M, Henning R, Morse T, Faghri P, CPH-NEW Research Team (2009) A conceptual framework for integrating workplace health promotion and occupational ergonomics programs. Public Health Rep Suppl 1:16–25Google Scholar
  40. Rai D, Kosidou K, Lundberg M, Araya R, Lewis G, Magnusson C (2011) Psychological distress and risk of long-term disability: population-based longitudinal study. J Epidemiol Commun Health. doi: 10.1136/jech.2010.1196442011 Google Scholar
  41. SHARE (2009) Tackling the demographic challenge: the survey of health, ageing, and retirement in Europe. http://www.share-project.org/t3/share/fileadmin/SHARE_Brochure/share_broschuere_web_final.pdf. Accessed 25 April 2011
  42. Smith PM, Frank JW, Mustard CA, Bondy SJ (2008) Examining the relationships between job control and health status: a path analysis approach. J Epidemiol Commun Health 62:54–61CrossRefGoogle Scholar
  43. Stansfeld S, Candy B (2006) Psychosocial work environment and mental health—a meta-analytic review. Scand J Work Environ Health 32:443–462CrossRefGoogle Scholar
  44. Statistics Sweden (1982) Swedish socioeconomic classification. (in Swedish). http://www.scb.se/Pages/PublishingCalendarViewInfo____259924.aspx?PublObjId=6607
  45. Stattin M (2005) Retirement on grounds of ill health. Occup Environ Med 62:135–140CrossRefGoogle Scholar
  46. Stattin M, Järvholm B (2005) Occupation, work environment, and disability pension: a prospective study of construction workers. Scand J Public Health 33:84–90CrossRefGoogle Scholar
  47. Straface E, Lista P, Gambardella L, Franconi F, Malorni W (2010) Gender-specific features of plasmatic and circulating cell alterations as risk factors in cardiovascular disease. Fundam Clin Pharmacol 24:665–674CrossRefGoogle Scholar
  48. Sundquist J, Al-Windi A, Johansson SE, Sundquist K (2007) Sickness absence poses a threat to the Swedish welfare state: a cross-sectional study of sickness absence and self-reported illness. BMC Public Health 7:45. http://www.biomedcentral.com/1471-2458/7/45. Accessed 6 May 2011
  49. Theorell T, Harms-Ringdahl K, Ahlberg-Hulten G, Westin B (1991) Psychosocial job factors and symptoms from the locomotor system—a multicausal analysis. Scand J Rehabil Med 23:165–173Google Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • Catarina Canivet
    • 1
    Email author
  • BongKyoo Choi
    • 2
  • Robert Karasek
    • 3
  • Mahnaz Moghaddassi
    • 1
  • Carin Staland-Nyman
    • 4
  • Per-Olof Östergren
    • 1
  1. 1.Division of Social Medicine and Global Health, Department of Clinical Sciences Malmö, Malmö University HospitalLund UniversityMalmöSweden
  2. 2.Center for Occupational and Environment HealthUniversity of CaliforniaIrvineUSA
  3. 3.Department of Work EnvironmentUniversity of MassachusettsLowellUSA
  4. 4.Unit of Social Medicine, Department of Public Health and Community MedicineUniversity of GothenburgGothenburgSweden

Personalised recommendations