Koskela R S, Korhonen H, Järvinen E, Kolari P J, Mutanen P
Scand J Work Environ Health. 1984 Dec;10(6 Spec No):451-4. doi: 10.5271/sjweh.2299.
The aim of this study was to determine which age and exposure categories are the most prone to health selection. Mortality and morbidity were studied on three different exposure levels defined primarily according to the physical demands of the work, heavy (iron foundries), medium (manufacture of metal products), and light (manufacture of electrical devices). The population comprised 15 714 men hired in 1950-1976 to work in the three branches of the metal industry. A questionnaire on occupational history, morbidity, and the causes of turnover was sent to 3 450 current and former workers. The occupational histories of current and former workers were compared for changes in heaviness throughout their complete occupational histories. Occupations during a lifetime were also classified into three levels of exposure on the basis of physical demand (heavy, medium, and light). The three levels of exposure showed different patterns of changes in heaviness of the work according to age throughout the workers' complete occupational histories. Selection into and out of jobs within and between different levels of exposure seemed to be some kind of continuous process, a chain of selection. Similarly as changes in the heaviness of the work formed a chain of selection during lifetime, the workers' health also changed to form a chain through their life cycle. Hard and soft measures formed a continuum (dissatisfaction - death), and they followed each other as explanations for termination of employment. The points of inflection in age, where the measures of different stages of disease turned from soft to hard, varied according to the level of exposure. The life-table technique was used to show the turning of the measures.
本研究的目的是确定哪些年龄和接触类别最容易出现健康选择。我们主要根据工作的体力需求定义了三种不同的接触水平，即高强度（铸铁厂）、中等强度（金属制品制造）和低强度（电气设备制造），并对死亡率和发病率进行了研究。研究对象包括1950年至1976年受雇于金属行业三个分支部门工作的15714名男性。我们向3450名在职和离职员工发放了一份关于职业史、发病率和离职原因的问卷。我们比较了在职和离职员工在其完整职业史中工作强度的变化情况。一生中的职业也根据体力需求分为三个接触水平（高强度、中等强度和低强度）。在员工完整的职业史中，这三个接触水平显示出工作强度随年龄变化的不同模式。在不同接触水平内部和之间的工作选择似乎是某种连续的过程，即一系列的选择。同样，由于工作强度的变化在一生中形成了一系列的选择，员工的健康状况在其生命周期中也发生变化，形成了一个链条。硬性和软性指标形成了一个连续体（不满 - 死亡），它们依次作为就业终止的解释。不同疾病阶段指标从软性转为硬性的年龄拐点，因接触水平而异。我们使用生命表技术来展示这些指标的转变。
