Karpansalo Minna, Manninen Pirjo, Lakka Timo A, Kauhanen Jussi, Rauramaa Rainer, Salonen Jukka T
Research Institute of Public Health, University of Kuopio, PO Box 1927, 70120 Kuopio, Finland.
J Occup Environ Med. 2002 Oct;44(10):930-9. doi: 10.1097/00043764-200210000-00012.
Early retirement produces a heavy economic burden in many western societies. There is a need to identify single risk factors for early retirement and to find methods for preventing it. To estimate the effect of heavy physical work on early retiring, a cohort of 1755 men aged 42 to 65 years from eastern Finland was followed up from 1984 to 2000. Self-estimated physical workload was assessed at baseline. The inclusive pension records were obtained from national pension institutions. Logistic regression modeling was used to estimate the effect of physical workload and single physical risk factors on the risk of disability pension and nonillness-based pension. Risks were estimated for both disease-specific and all disability pensions. The interaction of physical fitness and physical workload and the resulting effects on risk were also estimated. During the follow-up, 861 (49.1%) men retired on a disability pension and 331 men (18.9%) retired on a nonillness-based early pension. Only 273 (15.6%) men reached the age for getting the normal old-age pension without having had any other early pension After adjustment for age, body mass index, alcohol consumption, smoking, maximal oxygen uptake, education and corresponding illness at baseline, heavy physical work was found to be associated with an increased risk of being retired on a disability pension due to musculoskeletal disorders (odds ratio (OR) 2.21, 95% confidence interval 1.36 to 3.61) but not due to cardiovascular or mental diseases. The association was stronger if cardiorespiratory fitness was poor. Lifting, static muscular loading and uncomfortable work positions increased the risk of early retirement especially due to musculoskeletal disorders. Loading of the upper extremity alone or with the neck and shoulder region seems to be an independent risk factor for early retirement. We concluded that physical workload increases the risk of retirement on a disability pension especially due to musculoskeletal disorders. In heavy physical work, the risk is increased especially among men with musculoskeletal or cardiovascular disease and poor cardiorespiratory fitness.
在许多西方社会,提前退休带来了沉重的经济负担。有必要确定提前退休的单一风险因素,并找到预防提前退休的方法。为了评估繁重体力劳动对提前退休的影响,对1984年至2000年期间芬兰东部1755名年龄在42至65岁之间的男性进行了队列随访。在基线时评估自我估计的体力工作量。从国家养老金机构获取包容性养老金记录。使用逻辑回归模型来估计体力工作量和单一身体风险因素对残疾养老金和非疾病型养老金风险的影响。对特定疾病和所有残疾养老金的风险进行了估计。还估计了身体健康与体力工作量的相互作用及其对风险的影响。在随访期间,861名(49.1%)男性因残疾养老金退休,331名男性(18.9%)因非疾病型提前养老金退休。只有273名(15.6%)男性在没有领取任何其他提前养老金的情况下达到了领取正常养老金的年龄。在对年龄、体重指数、饮酒、吸烟、最大摄氧量、教育程度和基线时相应疾病进行调整后,发现繁重体力劳动与因肌肉骨骼疾病而领取残疾养老金的风险增加有关(优势比(OR)为2.21,95%置信区间为1.36至3.61),但与心血管或精神疾病无关。如果心肺功能较差,这种关联更强。提举、静态肌肉负荷和不舒服的工作姿势增加了提前退休的风险,尤其是因肌肉骨骼疾病导致的提前退休风险。仅上肢或上肢与颈部和肩部区域的负荷似乎是提前退休的一个独立风险因素。我们得出结论,体力工作量增加了因残疾养老金退休的风险,尤其是因肌肉骨骼疾病导致的风险。在繁重体力劳动中,风险尤其在患有肌肉骨骼或心血管疾病且心肺功能较差的男性中增加。