MRC Versus Arthritis Centre for Musculoskeletal Health and Work, University of Southampton SO16 6YD, Southampton, UK.
MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton SO16 6YD, UK.
Occup Med (Lond). 2022 Oct 18;72(7):470-477. doi: 10.1093/occmed/kqac068.
Governments need people to work to older ages, but the prevalence of chronic disease and comorbidity increases with age and impacts work ability.
To investigate the effects of objective health diagnoses on exit from paid work amongst older workers.
Health and Employment After Fifty (HEAF) is a population cohort of adults aged 50-64 years recruited from English GP practices which contribute to the Clinical Practice Research Datalink (CPRD). Participants have completed questionnaires about health and work at baseline and annually for 2 years: their responses were linked with their objective health diagnoses from the CPRD and data analysed using Cox regression.
Of 4888 HEAF participants ever in paid work, 580 (25%) men and 642 (25%) women exited employment, 277 of them mainly or partly for a health reason (health-related job loss (HRJL)). Amongst HEAF participants who remained in work (n = 3666) or who exited work but not for health reasons (n = 945), there was a similar prevalence of background health conditions. In men and women, HRJL was associated with inflammatory arthritis, sleep disorders, common mental health conditions and musculoskeletal pain. There were however gender differences: widespread pain and lower limb osteoarthritis were associated with HRJL in women but hypertension and cardiovascular disease in men.
Improved diagnosis and management of common conditions might be expected to increase working lives. Workplace well-being interventions targeting obesity and increasing mobility might contribute to extended working lives. Employers of predominantly female, as compared with male workforces may need different strategies to retain older workers.
政府需要人们工作到老年，但随着年龄的增长，慢性病和合并症的患病率增加，这会影响工作能力。
调查客观健康诊断对老年工人离职的影响。
健康与 50 岁后就业（HEAF）是一个成年人的人群队列，年龄在 50-64 岁之间，从参与临床实践研究数据链接（CPRD）的英国全科医生诊所招募。参与者已经在基线和每年完成了两次关于健康和工作的问卷调查：他们的回答与他们从 CPRD 获得的客观健康诊断相关联，并使用 Cox 回归进行数据分析。
在 4888 名曾经有过带薪工作的 HEAF 参与者中，有 580 名（25%）男性和 642 名（25%）女性离职，其中 277 人主要或部分是因为健康原因（与健康相关的工作流失（HRJL））。在继续工作的 HEAF 参与者（n=3666）或因非健康原因离职的参与者（n=945）中，存在类似的背景健康状况。在男性和女性中，HRJL 与炎症性关节炎、睡眠障碍、常见心理健康状况和肌肉骨骼疼痛有关。然而，存在性别差异：广泛性疼痛和下肢骨关节炎与女性的 HRJL 相关，而高血压和心血管疾病与男性的 HRJL 相关。
预计改善常见疾病的诊断和管理将延长工作寿命。针对肥胖和增加活动能力的工作场所健康干预措施可能有助于延长工作寿命。与男性劳动力相比，以女性为主的雇主可能需要不同的策略来留住老年工人。
