Work-Related Psychosocial and Mechanical Risk Factors for Work Disability: A 3-Year Follow-Up Study of the General Working Population in Norway

By Sterud, Tom | Scandinavian Journal of Work, Environment & Health, September 1, 2013 | Go to article overview

Work-Related Psychosocial and Mechanical Risk Factors for Work Disability: A 3-Year Follow-Up Study of the General Working Population in Norway


Sterud, Tom, Scandinavian Journal of Work, Environment & Health


Sterud T. Work-related psychosocial and mechanical risk factors for work disability: a 3-year follow-up study of the general working population in Norway. Scand J Work Environ Health. 2013;39(5):468-476. doi:10.5271/sjweh.3359

Objectives This study examines the impact of work-related psychosocial and mechanical risk factors for work disability in the general working population.

Methods A randomly drawn cohort from the general population in Norway aged 18-66 years was followed for 3 years (N=12 550, 67% response rate at baseline). Eligible respondents were in paid work for ≥10 hours per week in 2006 and were still in paid work or had quit working because of health problems (work disability) in 2009 (N=6745). Five work-related psychosocial factors and eight mechanical exposures were measured. The outcome of interest was self-reported work disability at 3-year follow-up.

Results In total, 2.6% (176 individuals) reported work disability at the 3-year follow-up. Disability rates were higher among women, older workers, and those with fewer years of education and higher levels of psychological distress and musculoskeletal complaints. After adjusting for these factors, work-related psychosocial predictors of disability were low levels of supportive leadership [odds ratio (OR) 1.61, 95% confidence interval (95% CI) 1.02-2.56] and monotonous work (OR 1.53, 95% CI 1.09-2.16). Mechanical factors were neck flexion (OR 2.49, 95% CI 1.36-4.56), prolonged standing (OR 1.79, 95% CI 1.21-2.46), whole-body vibration (OR 4.15, 95% CI 1.77-9.71), and heavy physical work (OR 2.23. 95% CI 1.08-4.57). The estimated population risk attributable to these factors was about 45%.

Conclusion Monotonous work, prolonged standing, neck flexion, and whole-body vibration appear to be the most consistent and important predictors of work disability.

Key terms biomechanical exposure; disability pension; job control; job demand; job exposure; prospective study; stress; workload; workplace.

The inability to work because of sickness and disability generate considerable costs to the individual as well as society. OECD statistics show that, on average, 6% of the working-age population is on disability benefits; in Norway, the disability rate is close to 10% (1). However, disability rates vary considerably between occupations (2), and more knowledge is needed about the impact of specific risk factors at the workplace.

Occupational disability is usually the result of a long process of sickness absence relating to deteriorating health and failing ability to cope with the demands of work. In addition to work-related mechanical exposure, work-related psychosocial factors have been acknowledged as potential risk factors. Several studies have shown that heavy physical work is associated with increased risk of disability (3-5). Other mechanical factors like prolonged standing (6), whole body vibration (7), and work in uncomfortable positions (8) have been discussed as possible risk factors, but the evidence still remains limited (9). Low job control at work (eg, little influence on the work situation and decision authority) appears to be the most consistent work-related psychosocial risk factor (10-14). Some studies have indicated that job strain (15, 16), lack of social support (8, 17), and job demands (14) may be important. However, other studies have not supported these associations (18, 19).

Despite an increase in the number of studies on the relationship between exposure to work-related risk factors and work disability, assessment of the impact of work on disability remains a topic of great interest. Firstly, the effects of multiple factors are supported by evidence from few studies, and the consistency across studies is low. Secondly, several studies have argued that psychosocial factors may be confounded by mechanical exposures at work and vice versa (20, 21), yet there are few large prospective studies on general working populations with a sufficient variety of both mechanical and psychosocial factors to distinguish between their effects on work disability (18, 19). …

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