| 1. |
- Almroth, Melody, 1989-, et al.
(författare)
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Labour market exit routes in high- and low-educated older workers before and after social insurance and retirement policy reforms in Sweden
- 2024
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Ingår i: Ageing & Society. - 0144-686X .- 1469-1779.
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Tidskriftsartikel (refereegranskat)abstract
- Few previous studies have investigated how socioeconomic differences in labour market exit have changed after restrictions in social insurance policies. The aim of this register-based study is to investigate how early labour market exit pathways among older men and women with different levels of education changed after major restrictive social insurance and retirement policy reforms in Sweden. Cohort 1 (pre-reform) consisted of individuals who were 60 or 61 years old in 2005 (N = 186,145) and Cohort 2 (post-reform) consisted of individuals who were 60 or 61 years old in 2012 (N = 176,216). Educational differences in four labour market exit pathways were investigated using Cox proportional hazards regression; the exit pathways were disability pension, early old-age pension with and without income respectively, and no income for two consecutive years. As expected, exits through disability pension were rarer in Cohort 2. Lower education was also more strongly associated with disability pension in Cohort 2. Parallel to this, lower education showed a stronger association with both early old-age pension types in Cohort 2. Additionally, a tendency towards a relatively higher likelihood of earning no income was seen among the less educated. Increases in inequalities tended to be greater for women. Our results indicate that educational inequalities in labour market exit have grown significantly after restrictions in social insurance and changes in retirement policies, which can have negative financial repercussions for those already in a vulnerable position. These results indicate that careful analyses of effects on disparities are needed before making major changes in welfare systems.
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| 2. |
- Badarin, Kathryn, et al.
(författare)
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Combined exposure to heavy physical workload and low job control and the risk of disability pension : A cohort study of employed men and women in Sweden
- 2023
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Ingår i: International Archives of Occupational and Environmental Health. - 0340-0131 .- 1432-1246. ; 96:7, s. 973-984
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Tidskriftsartikel (refereegranskat)abstract
- Objective To investigate the separate and combined effects of overall heavy physical workload (PWL) and low decision authority on all-cause disability pension (DP) or musculoskeletal DP.Methods This study uses a sample of 1,804,242 Swedish workers aged 44–63 at the 2009 baseline. Job Exposure Matrices (JEMs) estimated exposure to PWL and decision authority. Mean JEM values were linked to occupational codes, then split into tertiles and combined. DP cases were taken from register data from 2010 to 2019. Cox regression models estimated sex-specific Hazard Ratios (HR) with 95% confidence intervals (95% CI). The Synergy Index (SI) estimated interaction effects.Results Heavy physical workload and low decision authority were associated with an increased risk of DP. Workers with combined exposure to heavy PWL and low decision authority often had greater risks of all-cause DP or musculoskeletal DP than when adding the effects of the single exposures. The results for the SI were above 1 for all-cause DP (men: SI 1.35 95%CI 1.18–1.55, women: SI 1.19 95%CI 1.05–1.35) and musculoskeletal disorder DP (men: SI 1.35 95%CI 1.08–1.69, women: 1.13 95%CI 0.85–1.49). After adjustment, the estimates for SI remained above 1 but were not statistically significant.Conclusion Heavy physical workload and low decision authority were separately associated with DP. The combination of heavy PWL and low decision authority was often associated with higher risks of DP than would be expected from adding the effects of the single exposures. Increasing decision authority among workers with heavy PWL could help reduce the risk of DP.
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| 3. |
- Badarin, Kathryn
(författare)
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Physical workload and exit from the labour market : epidemiological studies with a focus on employees with musculoskeletal disorders
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Background: The length of working life is expanding in the light of the ageing population. In response, countries including Sweden are increasing the retirement age. However, many workers, especially workers with heavy physical workload, exit the labour market prematurely often because of poor health. Musculoskeletal disorders (MSDs) are a leading cause of premature exit from work and are expected to become more prevalent among the workforce as the average age of the working population increases. More knowledge is needed on how occupational exposures, specifically heavy physical workload, can impact on worsening MSDs, work ability and early health-related exit from work. Aims: The aim of this thesis is to investigate the effect of exposure to a heavy physical workload and changes to lower exposure levels for the prognosis of employees with MSDs with regards to worsening pain, reduced self-reported work ability and disability pension. This thesis also aims to identify how the co-occurrence of high physical workload and low job control impact on disability pension. Methods: This thesis is comprised of four cohort studies. The first two studies used the Stockholm Public Health Cohort (SPHC), a population-based cohort that comprises of participants aged 18–84-year-old from Stockholm County. Study I used a sample of 5715 employees with baseline occasional musculoskeletal pain (MSP) to investigate the impact of exposure to heavy physical workload (eight specific ergonomic exposures) on more frequent musculoskeletal pain. Study II used a sample of 9419 employees with good baseline work ability to investigate the separate and combined effects of strenuous work (heavy physical workload/low job control) and MSP on later reduced physical work ability. The last two studies used the Swedish Work, Illness, and labour-market Participation (SWIP) cohort. The SWIP cohort is a population-based cohort created through the linkage of registers. Study III used a sample of 1,804,242 workers to investigate the separate and combined associations between heavy physical work and low job control on the risk of disability pension. Study IV used a sample of 359 453 workers who were exposed to heavy physical workload to investigate if a change to an occupation with a lower exposure to physical work was associated with a reduced risk of disability pension. In all studies, Job Exposure Matrices (JEMs) were used to estimate exposure to heavy physical workload and/or job control. Results: Heavy physical workload was associated with an increased risk of more frequent MSP (e.g., men and heavy lifting OR 1.57 95%CI 1.13 to 2.20 and women and strenuous work OR 1.76 95%CI 1.35 to 2.29) (study I). After adjustment, small changes in the OR were found for both sexes and, among men, many of the ORs for PWL were no longer statistically significant. Male and female workers with a combination of exposure to MSP and strenuous work often had higher risks of poor physical workability (e.g., MSP and overall heavy physical workload, men: OR 4.04 95% CI 2.00–8.15 and women: OR 3.25 95% CI 1.81–5.83) than when summing the risks of the single exposures (study II). However, the results of the synergy index (SI) for additive interaction were not statistically significant. Workers with combined exposure to overall heavy physical workload and low decision authority often had higher risks of all-cause disability pension (men: HR 3.23 95%CI 3.07-3.39 and women: 2.46 95%CI 2.37-2.57) and MSD disability pension (men: HR 7.61 95%CI 6.48-8.94 and women: 4.21 95%CI 3.82–4.64) than when adding the effects of the separate exposures (study III). The results for the SI were above 1 for all-cause disability pension for both sexes, and MSD disability pension for men. After adjustment, the estimates for SI remained above 1 but were not statistically significant. A change from a high to a lower level of physical workload was associated with a reduced risk of all-cause (men: HR 0.59, 95% CI 0.46–0.77, women: HR 0.63, 95% CI 0.52–0.76) and musculoskeletal (men: HR 0.52, 95% CI 0.31–0.89, women: HR 0.61, 95% CI 0.44–0.84) disability pension (study IV). The reduction in risk of musculoskeletal disability pension appeared greater among older workers than middle-aged workers. Furthermore, a change to low physical workload was associated with a greater reduced risk of disability pension than a change to medium-high physical workload. Conclusion: The results of this thesis contribute to the state of art by indicating that heavy physical workload is associated with an increased risk of later worsening musculoskeletal pain, reduced work ability and disability pension. The results also suggest that workers with combined MSP and strenuous work may be a more vulnerable group regarding reduced work ability than workers with only one of the exposures. In addition, to some extent, the results suggest that job control exacerbates the effect of heavy physical on disability pension. Last, compared to staying in an occupation with heavy physical workload, changing to an occupation with a lower level of physical workload was associated with a reduced risk of disability pension.
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| 4. |
- Badarin, Kathryn, et al.
(författare)
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Physical workload and increased frequency of musculoskeletal pain : a cohort study of employed men and women with baseline occasional pain
- 2021
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Ingår i: Occupational and Environmental Medicine. - : BMJ. - 1351-0711 .- 1470-7926. ; 78:8, s. 558-566
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Tidskriftsartikel (refereegranskat)abstract
- Objectives Musculoskeletal pain (MSP) is prevalent among the workforce. This study investigates the long-term association between physical workload (PWL) and increased frequency of MSP among male and female employees with pre-existing occasional MSP.Methods This study uses the Stockholm Public Health cohort survey data from the baseline 2006. The sample includes 5715 employees with baseline occasional MSP (no more than a few days per month). Eight PWL exposures and overall PWL were estimated using a job-exposure matrix (JEM). The JEM was assigned to occupational titles from a national register in 2006. Follow-up survey data on frequent MSP (a few or more times a week) were collected from 2010. Logistic regressions produced sex-specific ORs with 95% CIs and were adjusted for education, health conditions, psychological distress, smoking, BMI, leisure-time physical activity and decision authority.Results Associations were observed between several aspects of heavy PWL and frequent MSP for men (eg, OR 1.57, 95% CI 1.13 to 2.20, among those in the highest exposure quartile compared with those in the lowest quartile for heavy lifting) and women (eg, OR 1.76, 95% CI 1.35 to 2.29, among those in the highest exposure quartile compared with those in the the lowest quartile for physically strenuous work). Small changes were observed in the OR after adjustment, but most of the ORs for PWL exposures among the men were no longer statistically significantly increased.Conclusion A high level of exposure to heavy PWL was associated with increased frequency of MSP 4 years later for men and women with baseline occasional pain.
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| 5. |
- Badarin, Kathryn, et al.
(författare)
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Safety and health among undeclared workers : A mixed methods study investigating social partner experiences and strategies
- 2024
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Ingår i: Safety Science. - : Elsevier B.V.. - 0925-7535 .- 1879-1042. ; 175
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Tidskriftsartikel (refereegranskat)abstract
- Little is known about the experiences of the social partners in helping undeclared workers resist Occupational Safety and Health (OSH) issues. This study draws upon Walter Korpi’s ‘power resource theory’ to gain a deeper understanding of how power resources within the construction, transport, and cleaning sectors influence the ability of social partners to respond to OSH issues related to undeclared work. This mixed-method study uses survey data from employer representatives in the construction (n = 686) and transport (n = 650) sectors in Sweden in 2019 to estimate the nature and magnitude of undeclared work-related problems. To also study the view of union representatives, a duplicate survey was sent to union representatives in the transport, construction, and cleaning sectors (n = 57) in 2020, followed by 13 semi-structured interviews with Regional Safety Representatives (RSRs) in 2021–2023. Our findings show that employer representatives in construction and transport reported that the violation of OSH regulations was uncommon and remained unchanged, most union representatives said the opposite. We found a gradient of activism among the unions towards OSH issues related to undeclared work dependent on their power resources. Furthermore, structural and organizational factors limited the RSRs’ ability to address undeclared work. The RSRs identified strategies to tackle OSH issues related to undeclared work in their sectors, these included but were not limited to, dismantling the language barrier between unions and undeclared foreign-born workers, for OSH coordinators and main contractors to be held responsible for OSH violations and greater cooperation between the relevant authorities dealing with undeclared work.
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| 6. |
- Badarin, Kathryn, et al.
(författare)
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The impact of musculoskeletal pain and strenuous work on self-reported physical work ability : a cohort study of Swedish men and women
- 2022
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95:5, s. 939-952
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Tidskriftsartikel (refereegranskat)abstract
- Objective We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA).Methods This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: moderate, rather poor and very poor indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27.Results MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00-8.15, women: AOR: 3.25 95% CI 1.81-5.83). The SI was non-significant for both sexes.Conclusion Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces.
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| 7. |
- d'Errico, Angelo, et al.
(författare)
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Long-term sick leave for back pain, exposure to physical workload and psychosocial factors at work, and risk of disability and early-age retirement among aged Swedish workers
- 2022
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Ingår i: International Archives of Occupational and Environmental Health. - : Springer Science and Business Media LLC. - 0340-0131 .- 1432-1246. ; 95:7, s. 1521-1535
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To assess the risk of disability and early-age retirement associated with previous long-term sickness absence for back pain (back-pain SA), exposure to high physical workload, low job control, high demands and high strain, and to evaluate effect modification by work factors on the relationship between back-pain SA and premature retirement.Methods All employed Swedish residents born 1946–1955 (n = 835,956) were followed up from 2010 to 2016 for disability (DP) and early-age pension (EAP). Associations of premature retirement with exposure to work factors and back-pain SA in the 3 years before follow-up were estimated through proportional hazards models. Retirement, back-pain SA and covariates were assessed through administrative sources, and exposure to work factors through a job-exposure matrix.Results In both genders, back-pain SA was associated with DP (> 1 episode: HR 3.23 among men; HR 3.12 among women) and EAP (> 1 episode: HR 1.24 among men; HR 1.18 among women). Higher physical workload and lower job control were also associated with an increased DP risk in both genders, whereas higher job demands showed a decreased risk. For EAP, associations with work factors were weak and inconsistent across genders. No effect modification by work factors was found, except for a negative effect modification by job strain on DP risk among women, i.e. a reduced effect of back-pain SA with increasing exposure.Conclusion Back-pain SA was a significant predictor of both DP and EAP, while work factors were consistently associated only with DP. Our results indicate that the joint effect of back-pain SA and work factors on DP is additive and does not support effect modification by work factors.
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| 8. |
- Hernando-Rodriguez, Julio C., et al.
(författare)
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Unequal access? Use of sickness absence benefits by precariously employed workers with common mental disorders : a register-based cohort study in Sweden
- 2023
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Ingår i: BMJ Open. - 2044-6055. ; 13:7
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Tidskriftsartikel (refereegranskat)abstract
- Objective This study compares the use of sickness absence benefits (SABs) due to a common mental disorder (CMD) between precariously employed and non-precariously employed workers with CMDs. DesignRegister-based cohort study. Participants The study included 78 215 Swedish workers aged 27-61 who experienced CMDs in 2017, indicated by a new treatment with selective serotonin reuptake inhibitors (SSRIs). Excluded were those who emigrated or immigrated, were self-employed, had an annual employment-based income <100 Swedish Krona, had >90 days of unemployment per year, had student status, had SABs due to CMDs during the exposure measurement (2016) and the two previous years, had an SSRI prescription 1 year or less before the start of the SSRI prescription in 2017, had packs of >100 pills of SSRI medication, had a disability pension before 2017, were not entitled to SABs due to CMDs in 2016, and had no information about the exposure. Outcome The first incidence of SABs due to CMDs in 2017. Results The use of SABs due to a CMD was slightly lower among precariously employed workers compared with those in standard employment (adjusted OR [aOR] 0.92, 95% CI 0.81 to 1.05). Particularly, women with three consecutive years in precarious employment had reduced SABs use (aOR 0.48, 95% CI 0.26 to 0.89), while men in precarious employment showed weaker evidence of association. Those in standard employment with high income also showed a lower use of SABs (aOR 0.74, 95% CI 0.67 to 0.81). Low unionisation and both low and high-income levels were associated with lower use of SABs, particularly among women. ConclusionsThe study indicates that workers with CMDs in precarious employment may use SABs to a lower extent. Accordingly, there is a need for (1) guaranteeing access to SABs for people in precarious employment and/or (2) reducing involuntary forms of presenteeism.
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| 9. |
- Thern, Emelie, 1987-, et al.
(författare)
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Precarious employment in young adulthood and later alcohol-related morbidity : a register-based cohort study
- 2024
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Ingår i: Occupational and Environmental Medicine. - 1351-0711 .- 1470-7926. ; 81:4, s. 201-208
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Tidskriftsartikel (refereegranskat)abstract
- Objectives The prevalence of precarious employment is increasing, particularly among young adults where less is known about the long-term health consequences. The present study aims to test if being precariously employed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.Methods A register-based cohort study was conducted in Sweden. The Swedish Work, Illness, and Labor-market Participation (SWIP) cohort was used to identify individuals who were aged 27 years between 2000 and 2003 (n=339 403). Information on labour market position (precarious employment, long-term unemployment, substandard employment and standard employment relations) was collected for young people 3 years after graduation from school using nationwide registers. Details about alcohol-related morbidity during a 28-year follow-up period were collected from the National Hospital Discharge Register. Data on sex, age, country of birth, education and previous poor health were also obtained from the registers.Results Young adults in precarious employment had an increased risk of alcohol-related morbidity compared with individuals of the same age in standard employment (HR 1.43, 95% CI 1.32 to 1.55), after adjusting for several important covariates. A stronger association was found among young men who were precariously employed compared with young women.Conclusion This nationwide register-based study conducted in Sweden with a long-term follow-up suggests that being precariously employed in young adulthood is associated with an increased risk of alcohol-related morbidity later in life.
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