van Zon Sander K R, Ots Patricia, Robroek Suzan J W, Burdorf Alex, Oude Hengel Karen M, Brouwer Sandra
Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands.
J Epidemiol Community Health. 2022 Jul 7. doi: 10.1136/jech-2021-218432.
This study aims to examine whether the presence of chronic diseases or multimorbidity moderates the associations between psychosocial working conditions and work exit through unemployment, work disability or early retirement.
Data from Lifelines (n=55 950), a prospective population-based cohort study, were enriched with monthly information on employment status from Statistics Netherlands. Working conditions were measured with the Copenhagen Psychosocial Questionnaire. Work exit was defined as unemployment, work disability and early retirement. Participants were classified as having no chronic disease, one chronic disease or multimorbidity. Cause-specific Cox proportional hazard regression models, adjusted for age, gender, education and partnership status, were used to analyse associations between working conditions and work exit. Interaction terms were used to examine moderation by chronic disease status.
Higher social support decreased the risk for unemployment, work disability and early retirement. Higher meaning of work decreased the risk of unemployment, and more possibilities for development decreased the risk for work disability. Chronic disease status did generally not moderate associations between working conditions and work exit. Only among workers without a chronic disease, more possibilities for development was associated with a lower risk for unemployment (HR: 0.89; 95% CI: 0.85 to 0.94).
While efforts to retain workers with chronic diseases in the labour market should continue, favourable psychosocial working conditions are important for all workers.
本研究旨在探讨慢性病或多种慢性病共存是否会缓和心理社会工作条件与因失业、工作残疾或提前退休而退出工作之间的关联。
来自基于人群的前瞻性队列研究“生命线”（n = 55950）的数据，通过荷兰统计局提供的关于就业状况的月度信息进行了补充。使用哥本哈根心理社会问卷来衡量工作条件。工作退出定义为失业、工作残疾和提前退休。参与者被分类为无慢性病、患有一种慢性病或患有多种慢性病。使用针对年龄、性别、教育程度和伴侣状况进行调整的特定病因Cox比例风险回归模型，来分析工作条件与工作退出之间的关联。交互项用于检验慢性病状况的缓和作用。
更高的社会支持降低了失业、工作残疾和提前退休的风险。更高的工作意义降低了失业风险，更多的发展可能性降低了工作残疾风险。慢性病状况一般并未缓和工作条件与工作退出之间的关联。仅在没有慢性病的工人中，更多的发展可能性与较低的失业风险相关（风险比：0.89；95%置信区间：0.85至0.94）。
虽然应继续努力让患有慢性病的工人留在劳动力市场，但良好的心理社会工作条件对所有工人都很重要。
