Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands.
Department of Health Sciences, Community & Occupational Medicine, University Medical Center Groningen, Groningen, The Netherlands.
Occup Environ Med. 2020 Sep;77(9):628-633. doi: 10.1136/oemed-2019-106383. Epub 2020 May 21.
To investigate the relation between changes in working conditions and exit from paid employment among workers with a chronic disease.
Six waves from the longitudinal Study on Transitions in Employment, Ability and Motivation (2010-2016), enriched with tax-based employment information from Statistics Netherlands (2011-2017), were available for 4820 chronically ill workers aged 45-63 years (mean 55.3 years, SD 5.1). A change in working conditions (physical workload, psychological job demands, job autonomy, emotional job demands and social support) was defined as an increase or decrease between two consecutive waves of at least one SD. Discrete-time survival models with repeated measurements were used to estimate the relative risk (RR) of a change in working conditions on exiting paid employment in the following year compared with no change and consecutive favourable working conditions.
A favourable change in physical workload lowered the risk to exit paid employment (RR 0.46, 95% CI 0.22 to 0.94). An adverse change in psychosocial working conditions, especially a decrease in social support (RR 2.07, 95% CI 1.52 to 2.81), increased the likelihood to exit paid employment. In contrast, a favourable change in psychological job demands increased the risk to exit paid employment (RR 1.57, 95% CI 1.09 to 2.24). Multiple adverse changes increased the risk to exit paid employment up to six times (RR 6.06, 95% CI 2.83 to 12.98).
Changes in working conditions among workers with chronic diseases influence exit from paid employment. Ensuring that working conditions can be adapted to the needs of workers with a chronic disease may help to extend working life.
探讨慢性病患者工作条件变化与离职的关系。
本研究使用了纵向职业转型、能力和动机研究（2010-2016 年）的 6 个波次的数据，同时利用荷兰统计局基于税收的就业信息（2011-2017 年）进行了补充，共纳入了 4820 名 45-63 岁（平均 55.3 岁，标准差 5.1）患有慢性病的劳动者。工作条件的变化（体力工作负荷、心理工作要求、工作自主性、情绪工作要求和社会支持）定义为两个连续波次之间至少增加或减少一个标准差。使用具有重复测量的离散时间生存模型来估计工作条件变化与下一年离职相比无变化和连续有利工作条件的相对风险（RR）。
体力工作负荷的有利变化降低了离职的风险（RR 0.46，95%CI 0.22 至 0.94）。心理社会工作条件的不利变化，尤其是社会支持的减少（RR 2.07，95%CI 1.52 至 2.81），增加了离职的可能性。相比之下，心理工作要求的有利变化增加了离职的风险（RR 1.57，95%CI 1.09 至 2.24）。多种不利变化使离职的风险增加了六倍（RR 6.06，95%CI 2.83 至 12.98）。
慢性病患者工作条件的变化会影响离职。确保工作条件能够适应慢性病患者的需求，可能有助于延长工作寿命。
