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健康状况不佳、体力工作负荷和职业社会阶层作为与健康相关的失业决定因素:英国一项前瞻性队列研究的结果

Poor health, physical workload and occupational social class as determinants of health-related job loss: results from a prospective cohort study in the UK.

作者信息

Sewdas Ranu, van der Beek Allard J, Boot Cecile R L, D'Angelo Stefania, Syddall Holly E, Palmer Keith T, Walker-Bone Karen

机构信息

Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, VU University Amsterdam, Amsterdam, The Netherlands.

MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, Hampshire, The United Kingdom.

出版信息

BMJ Open. 2019 Jul 11;9(7):e026423. doi: 10.1136/bmjopen-2018-026423.

Abstract

OBJECTIVES

The aims of the present study were to assess the association and interactions of physical workload and poor health with health-related job loss (HRJL) among older workers, and the association and interactions of occupational social class and poor health with HRJL.

METHODS

Data were used from an existing prospective cohort study, Health and Employment after Fifty, where employed or self-employed workers aged 50-64 years (n=4909) were followed-up between 2014 and 2016. Associations between potential determinants (self-perceived health status, physical workload and occupational social class) and 2-year HRJL were examined by Cox regression analyses. To study whether physical workload or occupational social class moderates the influence of poor health on HRJL, additive and multiplicative interactions were calculated.

RESULTS

Older workers with poor self-perceived health status had increased risk of HRJL during the 2-year follow-up period (men: HR 2.57 (95%CI: 1.68 to 3.92); women: HR 3.26 (95%CI: 2.33 to 4.55)). Furthermore, men with high physical workload were at increased risk for HRJL (HR 1.63 (95%CI: 1.09 to 2.43)). No significant interactions (p<0.05) were identified between poor health and high physical workload, nor between poor health and lower occupational social class.

CONCLUSION

Our study indicates that older workers in poor health, and older workers with a physically demanding job, are at increased risk of HRJL. Having a physically demanding job or working in routine/manual occupations does not moderate the association between poor health and HRJL.

摘要

目的

本研究旨在评估老年工人身体工作量、健康状况不佳与健康相关失业(HRJL)之间的关联及相互作用,以及职业社会阶层、健康状况不佳与HRJL之间的关联及相互作用。

方法

数据来自一项现有的前瞻性队列研究“五十岁后的健康与就业”,该研究对2014年至2016年间年龄在50 - 64岁的受雇或自营职业工人(n = 4909)进行了随访。通过Cox回归分析研究潜在决定因素(自我感知健康状况、身体工作量和职业社会阶层)与两年HRJL之间的关联。为了研究身体工作量或职业社会阶层是否会调节健康状况不佳对HRJL的影响,计算了相加和相乘相互作用。

结果

自我感知健康状况不佳的老年工人在两年随访期间HRJL风险增加(男性:风险比2.57(95%置信区间:1.68至3.92);女性:风险比3.26(95%置信区间:2.33至4.55))。此外,身体工作量大的男性HRJL风险增加(风险比1.63(95%置信区间:1.09至2.43))。未发现健康状况不佳与高身体工作量之间、健康状况不佳与较低职业社会阶层之间存在显著相互作用(p < 0.05)。

结论

我们的研究表明,健康状况不佳的老年工人以及从事体力要求高的工作的老年工人,HRJL风险增加。从事体力要求高的工作或从事常规/体力职业并不会调节健康状况不佳与HRJL之间的关联。

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