National Research Centre for the Working Environment, Copenhagen, Denmark.
Department of Sociology, University of Western Ontario, London, ON, Canada.
Eur J Public Health. 2020 Dec 11;30(6):1212-1218. doi: 10.1093/eurpub/ckaa107.
Previous studies have found low job control to be associated with a higher risk of disability pension (DP). Most studies have measured job control only at one time-point, and there is a lack of knowledge regarding the role of exposure duration. This study examines the prospective association between job control and DP measuring exposure both cumulated throughout work life and most recent.
We included 712 519 individuals (about 4.5 million person-years) from The Danish Work Life Course Cohort which follows young employees in Denmark from their entry into the labour market. Job control was assessed with a job exposure matrix and DP with register data on public transfer payments. We adjusted for several potential life course confounders, including physical demands at work and parental socioeconomic position and psychiatric and somatic diagnoses.
Employees in occupations with low job control had a higher risk of DP. There were effects of both cumulated and most recent job control when mutually adjusted. Fully adjusted hazard ratios (HRs) were 1.14 [95% confidence intervals (CIs) 1.11-1.17] and 1.15 (95% CI 1.02-1.29) for cumulated and most recent job control, respectively. Without mutual adjustment, estimates were 1.15 (95% CI 1.13-1.18) and 1.55 (95% CI 1.39-1.72) for cumulated and most recent low job control, respectively.
Low job control predicts a higher risk of DP, even after adjustment for physical demands at work. The results indicate both gradual and short-term effects of low job control on DP risk.
先前的研究发现，工作控制程度较低与残疾养老金（DP）的风险增加有关。大多数研究仅在一个时间点测量工作控制程度，对于暴露持续时间的作用知之甚少。本研究通过测量整个工作生涯和最近的累积暴露，检查工作控制与 DP 之间的前瞻性关联。
我们纳入了来自丹麦工作生活历程队列的 712519 名个体（约 450 万人年），该队列跟踪丹麦年轻员工从进入劳动力市场到现在的情况。使用工作暴露矩阵评估工作控制，使用公共转移支付登记数据评估 DP。我们调整了几个潜在的生命历程混杂因素，包括工作中的体力需求以及父母的社会经济地位和精神和躯体诊断。
职业控制程度较低的员工 DP 风险较高。当相互调整时，累积和最近的工作控制都有影响。完全调整后的危险比（HRs）分别为 1.14（95%置信区间 [CI] 1.11-1.17）和 1.15（95% CI 1.02-1.29）。在没有相互调整的情况下，累积和最近低工作控制的估计值分别为 1.15（95% CI 1.13-1.18）和 1.55（95% CI 1.39-1.72）。
即使在调整了工作中的体力需求后，工作控制程度较低也预示着 DP 风险增加。结果表明，工作控制程度较低对 DP 风险的影响既具有渐进性又具有短期性。
