Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden.
Center for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden.
Int Arch Occup Environ Health. 2024 Jan;97(1):45-55. doi: 10.1007/s00420-023-02023-1. Epub 2023 Nov 16.
Understanding the impact of physical capacity in combination with high physical workload could be beneficial for the prevention of health-related exits from work. Therefore, the aim of this study was to investigate the separate and combined effects of low cardiorespiratory fitness and high physical workload on disability pension (DP) due to any cause, musculoskeletal disorders (MSD), and cardiovascular diseases (CVD).
A total of 279 353 men born between 1951 and 1961 were followed regarding DP between 2006 and 2020, ages 45-64. Cardiorespiratory fitness was assessed during military conscription, using an ergometer bicycle test. Physical workload was based on a job-exposure matrix (JEM) linked to occupational title in 2005. Cox regression models estimated separate and combined associations with DP.
Low cardiorespiratory fitness and high physical workload were associated with increased risk of DP. For all cause DP, the fully adjusted hazard ratio and 95% confidence interval for those with low cardiorespiratory fitness was 1.38 (1.32-1.46) and for those with high physical workload 1.48 (1.39-1.57). For all cause and MSD DP, but not for CVD DP, the combination of low cardiorespiratory fitness and high physical workload resulted in higher risks than when adding the effect of the single exposures.
Both low cardiorespiratory fitness in youth and later exposure to high physical workload were associated with an increased risk of DP, where workers with the combination of both low cardiorespiratory fitness and a high physical workload had the highest risks (all-cause and MSD DP).
了解身体能力与高强度体力工作负荷相结合的影响可能有助于预防与健康相关的工作离职。因此，本研究的目的是调查低心肺功能适应性和高强度体力工作负荷对任何原因、肌肉骨骼疾病（MSD）和心血管疾病（CVD）导致的残疾抚恤金（DP）的单独和联合影响。
共随访了 279353 名 1951 年至 1961 年出生的男性，观察其 2006 年至 2020 年期间的 DP，年龄为 45-64 岁。在兵役期间，使用测功自行车测试评估心肺功能适应性。体力工作负荷基于 2005 年与职业头衔相关的职业暴露矩阵（JEM）。Cox 回归模型估计了 DP 的单独和联合关联。
低心肺功能适应性和高强度体力工作负荷与 DP 风险增加相关。对于所有原因的 DP，心肺功能适应性低的个体的完全调整危险比和 95%置信区间为 1.38（1.32-1.46），体力工作负荷高的个体为 1.48（1.39-1.57）。对于所有原因和 MSD DP，但不是 CVD DP，低心肺功能适应性和高强度体力工作负荷的组合导致的风险高于单一暴露的影响相加时的风险。
青年时期的低心肺功能适应性和以后暴露于高强度体力工作负荷均与 DP 风险增加相关，而同时具有低心肺功能适应性和高强度体力工作负荷的工人风险最高（所有原因和 MSD DP）。
