Systematic Review of Workplace Interventions to Support Young Workers' Safety, Work Environment and Health.

PURPOSE: This systematic review investigates the effectiveness of workplace interventions to support young workers' work environment, safety and health. METHODS: A systematic search was conducted in bibliographic databases including PubMed, Web of Science Core Collection and PsycInfo for English or Scandinavian articles published from 2007 to 2022. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were young workers (mean age: 15-29), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) an outcome measure related to work environment, safety and health was reported. We categorized each included study using the intervention classification framework. The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada). RESULTS: A total of 33 high and medium quality studies showed a moderate level of evidence for no benefit of 'Mental training' on stress. We found limited evidence of a positive effect of the following intervention types: 'Attitude and belief' on mental health problems, 'Behavior based' on anxiety, and 'Multifaceted' on hand eczema. We found limited evidence for no benefit of the following intervention types: 'Mental training' on mental health problems, and 'Physiological modifications' on musculoskeletal disorders. The remaining intervention types showed mixed or insufficient evidence. CONCLUSIONS: Except for a moderate level of evidence for no benefit of 'Mental training' on stress, the evidence synthesis recommends, that there is not enough evidence from the scientific literature to guide current practices. The results emphasizes a strong need for high quality interventions specifically aiming at increasing or maintaining young workers' work environment, safety and health. Included studies focused mainly on individual measures, highlighting the need for studies investigating possible preventive measures at the group or organizational level.

Musculoskeletal pain intensity and risk of long-term sickness absence in the general working population: A prospective cohort study with register follow-up.

Determining predictors of sickness absence could allow for better screening, guidance, and development of preventive efforts aimed at those in increased risk. This study aimed to determine the prospective association between musculoskeletal pain intensity and risk of incident register-based long-term sickness absence in the general working population, as well as to determine the population attributable fraction. Drawing on data from a nation-wide questionnaire survey, this prospective cohort study followed a representative sample of the Danish general working population without recent long-term sickness absence (≥6 consecutive weeks) (n = 69,273) for long-term sickness absence up to two years (mean follow-up: 93 weeks) in a national register. The predictor was musculoskeletal pain intensity in the neck/shoulder and low-back during the preceding three months rated on an 11-point numerical rating scale from 0 to 10. The weighted incidence of long-term sickness-absence was 8.9% during two-year follow-up (n = 6165). We observed a clear dose-response association between musculoskeletal pain intensity of the neck/shoulder or low-back and the risk of incident long-term sickness absence, with a lower threshold of increased risk of 4 and 3 (scale 0-10) for neck/shoulder (HR (95% CI): 1.25 (1.09-1.42)) and low-back pain (HR (95% CI): 1.13 (1.00-1.29)), respectively. Prevention of pain intensities at or above 4 out of 10 could potentially prevent 17% (population attributable fraction, PAF (95% CI): 16.8 (13.6-20.1)) of the total long-term sickness absence in the general working population. Large-scale interventions to prevent and manage musculoskeletal pain need to be documented and implemented.

Work-limiting musculoskeletal pain and its association with loss of paid employment among senior workers: prospective cohort study with register follow-up.

BACKGROUND: A growing population of elderly necessitates a sharpened focus on sustainable employment through aging. Physically demanding work can be challenging, especially for senior workers. Establishing determinants of labor market participation could guide policy development and preventive efforts at the workplaces aiming at keeping senior workers longer in the labor market. METHODS: We used data from SeniorWorkingLife, a comprehensive questionnaire survey among a representative sample of Danish +50-year workers, and investigated the prospective association between self-reported work limitations due to musculoskeletal pain ('work-limiting pain') in 2018 and register-based loss of paid employment before state pension age at 2-year follow-up among +50-year Danish workers with physically demanding work (n = 3050). RESULTS: Results showed that work-limiting pain increased the risk of loss of paid employment before the state pension age in a progressive manner, i.e. the higher degree of work-limiting pain, the higher risk of loss of paid employment (P < 0.001). Experiencing a low degree of work-limiting pain was associated with an 18% increased risk of loss of paid employment [risk ratio (RR): 1.18, 95% confidence interval (CI): 1.14-1.21], whereas experiencing a very high degree of work-limiting pain increased the risk of loss of paid employment by 155% (RR: 2.55, 95% CI: 2.43-2.69) compared to no work-limiting pain. CONCLUSION: In conclusion, work-limiting pain constitutes an important risk factor for loss of paid employment among senior workers with physically demanding work, and effective preventive efforts at both policy and workplace levels should be documented and implemented.

Duration and intensity of occupational lifting and risk of long-term sickness absence: Prospective cohort study with register follow-up among 45 000 workers.

OBJECTIVE: This study aimed to investigate the prospective association of lifting duration and lifting load with the risk of long-term sickness absence (LTSA). METHODS: We followed manual workers with occupational lifting (N=45 346) from the Work Environment and Health in Denmark Study (2012-2018) for two years in a high-quality national register on social transfer payments (DREAM). Cox regressions with model-assisted weights were employed to estimate the risk of LTSA from lifting duration and loads. RESULTS: During follow-up, 9.6% of the workers had an episode of LTSA. Compared to workers with seldom lifting (reference), workers lifting ½ and ¾ of the workday had increased risk of LTSA [hazard ratios (HR) of 1.36 [95% confidence interval (CI) 1.20-1.56] and 1.22 (95% CI 1.07-1.39)], respectively. Lifting load showed a positive exposure-response association with LTSA (trend test, P<0.01), with HR for lifting 5-15, 16-29, and ≥30 kg at 1.11 (95% CI 1.02-1.22), 1.17 (95% CI 1.03-1.34), and 1.29 (95% CI 1.11-1.50), respectively. Age-stratified analyses showed increased risk of LTSA among workers ≥50 years with a high proportion of work-related lifting compared to their younger counterparts. CONCLUSIONS: Occupational lifting for ½ the workday increased the risk of LTSA, while higher occupational lifting load exacerbated this risk in an exposure-response manner. The study underscores the importance of reducing both lifting duration and loads for prevention of LTSA at the workplace, especially among older workers.

Expected reasons for leaving the labour market and loss of paid employment among older workers: prospective cohort study.

BACKGROUND: Surveying expected reasons for retirement may be a useful strategy to maintain labor market affiliation. The aim was to investigate the prospective association between self-reported expected reasons for leaving the labour market and subsequent loss of paid employment before the state pension age among older workers. METHODS: The prospective risk of loss of paid employment before the official state pension age was estimated from expected reasons for leaving the labour market among 10,320 currently employed older workers (50-63 years) from the SeniorWorkingLife study. In 2018, participants replied to 15 randomly ordered questions about expected reasons for leaving the labour market and were in 2020 followed in a national register containing information on labour market participation. RESULTS: Loss of paid employment before state pension age was predicted by expected reasons related to 'Health, work demands and occupational well-being': 'Poor physical health' (RR 1.47, 95% CI 1.45-1.49), 'Poor mental health' (RR 1.36, 95% CI 1.32-1.40), 'Not being capable of doing the job' (RR 1.20, 95% CI 1.18-1.22), and 'Not thriving at the workplace' (RR 1.14, 95% CI 1.11-1.17). Expected reasons related to the possibility of receiving voluntary early retirement benefits also increased this risk. Expected reasons related to 'Leisure' ('Wish for more self-determination'; 'Wish for more time for hobbies'), 'Economy' ('Economic considerations'; 'Possibility of receiving pension'), and 'Norms' ('Retirement norms'; 'To make space for younger employees') decreased the risk of loss of paid employment before state pension age. Age-stratified analyses revealed that expected reasons related to the domain of 'Health, work demands and occupational well-being' predicted risk of loss of paid employment to a greater extent among workers aged 50-55 compared to those aged 56-63. CONCLUSIONS: Expected reasons for leaving the labour market predicted actual labour market participation among older workers in Denmark. Expected reasons related to poor physical and mental health, and not being capable of doing the job seem to be stronger PUSH-factors among workers aged 50-55 compared to those aged 56-63. Preventing early labour market detachment should take the worker's expected reasons for leaving into account.

Employee perception of managers' attitudes towards older workers is associated with risk of loss of paid work before state pension age: prospective cohort study with register follow-up.

It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees' perceptions of their managers' attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Questionnaire data from 10,320 currently employed workers aged 50 + on perceptions of managers' attitudes towards older workers and perceived age discrimination were collected at baseline in the SeniorWorkingLife study. Data on labour market affiliation were obtained from national registers at baseline and two-year follow-up. Results show that the perception of negative attitudes was prospectively associated with an increased risk of loss of paid work for three of the five negative attitudes "older workers create conflicts, their qualifications are outdated, and they cannot keep up with the pace and development". Perception of positive attitudes was prospectively associated with a reduced risk of loss of paid work. The perception of age discrimination was prospectively associated with an increased risk of loss of paid work. The results strengthen existing evidence on associations between ageism and labour market attachment, by applying a longitudinal design and including actual change in labour market participation. However, some negative attitudes may be more detrimental to the older workers' labour market participation. Employees' positive perceptions of managers' attitudes reduced the risk. Good relations between employees and managers appear to be important for retaining older workers in the labour market.

Barriers and Facilitators of Re-Employment among Senior Workers: Prospective Cohort Study.

Re-entering the labour market after a period of unemployment can be challenging for seniors. This study investigates personal as well as circumstantial barriers and facilitators of re-employment. Unemployed seniors in Denmark (≥50 years, n = 1636) from the first wave (mid-2018) of the SeniorWorkingLife study were prospectively followed until March 2020 in national registers on labour market participation. Using weighted logistic-regression-modelled odds ratios (ORs), we estimated the association between personal and circumstantial factors at baseline and re-employment during follow-up. During follow-up, 28% re-entered paid employment. The desire to have a job (reference: not having the desire to have a job) increased the likelihood of re-employment (OR 2.35, 95% CI 1.14-4.85). Contrastingly, a higher age (60-63 vs. 50-54 years; OR 0.36, 95% CI 0.16-0.79) and poor health (OR 0.32, 95% CI 0.16-0.61) decreased the likelihood of re-employment. Sex, education and belief that age constitutes a barrier to re-employment were not associated with the likelihood of re-employment. Unemployed seniors desiring to have a job are more likely to get a job. However, a higher age and poor health are important barriers that should be taken into account, e.g., by ensuring employment opportunities for these groups in society.

Combined psychosocial work factors and risk of long-term sickness absence in the general working population: Prospective cohort with register follow-up among 69 371 workers.

OBJECTIVE: This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA). METHODS: We followed 69 371 employees in the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Danish Register for Evaluation of Marginalization. Using k-means cluster analyses and weighted Cox-regression controlling for age, gender, survey year, education, health-behaviors, and physical work demands, we determined the prospective association of 11 identified clusters - based on the combination of nine psychosocial work factors (recognition, quantitative demands, work pace, emotional demands, influence, justice, role clarity, role conflicts, and support from colleagues) - with the risk of LTSA. RESULTS: During 124 045 person-years of follow-up, 6197 employees developed LTSA (weighted 8.5%). Using the cluster with the most favorable psychosocial scores as reference, clusters scoring poorly on several combined psychosocial factors had increased risk of LTSA. The cluster scoring poor on all nine psychosocial factors exhibited the highest risk [hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45-1.94]. Scoring poorly on one or two psychosocial factors did not increase the risk of LTSA when combined with favorable scores on the other psychosocial factors. Interaction analyses showed that gender, but not age and education, modified the association between cluster and LTSA. CONCLUSION: Scoring poorly on several combined psychosocial work factors plays an important role in the risk of LTSA. Scoring favorably on several psychosocial factors outweighed the potentially adverse effects of scoring poorly on one or two factors.

New Technology and Loss of Paid Employment among Older Workers: Prospective Cohort Study.

BACKGROUND: This study investigates the association between the implementation of new technology in the workplace and the subsequent loss of paid employment among older workers. METHODS: We estimated the prospective risk of loss of paid employment (register-based) from questions on new technology among 10,320 older workers (≥50 years). To investigate potential differences between work types, analyses were stratified by job function: (1) work with symbols (office, administration, analysis, IT), (2) work with people (people, service, care), (3) work in the field of production (processing, producing or moving things). RESULTS: The introduction of new technology at the workplace reduced the risk of losing paid employment among older workers working with symbols (risk ratio [RR] 0.74, 95% CI 0.72-0.76) and in the field of production (RR 0.83, 95% CI 0.80-0.85), whereas new technology increased this risk among those working with people (RR 1.22, 95% CI 1.19-1.26). Being involved in the introduction of new technology and receiving adequate training in its use decreased the risk of loss of paid employment. CONCLUSIONS: Depending on the context, the introduction of new technology at work associates positively as well as negatively with future labour market participation among older workers. Worker involvement and adequate training in the use of new technology seem to be important for retaining workers in the labour market.

The Interplay between Multimorbidity, Physical Work Demands and Work Ability: Cross-Sectional Study among 12,879 Senior Workers.

Background: Aging increases the risk of chronic diseases, which can challenge the ability to work and thereby push senior workers out of the labour market. This study investigates the association between non-communicable diseases (NCDs) and work ability among workers ≥50 years (senior workers) with physically demanding and sedentary work, respectively. Methods: In the SeniorWorkingLife study, 12,879 senior workers replied to a questionnaire survey on work and health in 2018. Associations between the type and number of NCD and work ability (scale 0−10) were modelled using a general linear model adjusting for potential confounders and combined with model-assisted weights from national registers. Results: A higher number of NCD (multimorbidity) was progressively associated with a lower work ability (trend test, p-value < 0.001). Physical work influenced the association between the number of NCDs and work ability. For specific diseases, mental disorders, including burn-out syndrome (least square mean difference (LSMD): −1.46, 95% CI: −1.61 to −1.32) and stress ( LSMD: −1.18, 95% CI: −1.29 to −1.07), demonstrated a stronger association with a lower work ability compared with somatic diseases, such as back diseases (LSMD: −0.72, 95% CI: −0.80 to −0.64). Conclusions: Multimorbidity was progressively associated with a lower work ability in senior workers, especially among those with physical work.

Characterization of Occupational Lifting Patterns with Exposure Variation Analysis. Cross-sectional Workplace Study among Blue-Collar Workers.

OBJECTIVES: To investigate and characterize the influence of sex, age, muscle strength, and cardiovascular fitness on manual lifting patterns using exposure variation analysis (EVA) during a full working day among blue-collar workers. METHODS: Muscular activity (surface electromyography [sEMG]) of the thigh, low-back, and shoulder was measured throughout the working day in 173 employees with manual lifting tasks from 14 workplaces. Relative sEMG loading was expressed as % of maximal voluntary contraction (MVC). As an additional and more practically oriented analysis, calibration of load from standardized box lifts (5, 10, 20, and 30 kg) identified corresponding sEMG values in kg. Using an EVA 'lifting periods' of [1 to 5, >5 to 10, >10 to 20, >20 to 30, and >30] kg in time intervals [0 to 0.5, >0.5 to 1, >1 to 2, >2 to 5, >5 to 10, and >10] s were identified. Arm elevation and back inclination were measured using accelerometers. RESULTS: Females and older workers (≥50 years) primarily used the thighs for lifting and were exposed to more frequent thigh muscle 'lifting periods' of varying duration and load and performed more thigh lifts >30 kg and >60% of MVC compared with males and younger workers (P < 0.05). Females had less brief shoulder lifting periods and more work with bent back >30° than the males (P < 0.05), whereas stronger workers performed more work with elevated arm >60° and >90° than workers with low muscle strength (P < 0.05). However, besides a single difference where workers with lower cardiovascular fitness were exposed to more light (1-5 kg) and moderate duration (5-10 s) trapezius loading, the number of lifting periods was not affected by muscle strength nor cardiovascular fitness (P > 0.05). CONCLUSIONS: This EVA demonstrated sex- and age-related differences in exposure to lifting periods involving shoulder and thigh muscles.

Potential of micro-exercise to prevent long-term sickness absence in the general working population: prospective cohort study with register follow-up.

This study assesses the potential of workplace-based micro-exercise (brief and simple exercise bouts) to prevent long-term sickness absence (LTSA) at the population level. In the Work Environment and Health in Denmark Study (2012-2018), we followed 70,130 workers from the general working population, without prior LTSA, for two years in the Danish Register for Evaluation of Marginalisation. We used Cox regression with model-assisted weights and controlled for various confounders. From 2012 to 2018, the percentage of workers in Denmark using workplace-based micro-exercise during and outside of working hours increased from 7.1 to 10.9% and from 0.8 to 1.4%, respectively. The incidence of long-term sickness absence (at least 30 days) was 8.4% during follow-up. The fully adjusted model showed reduced risk of long-term sickness absence from using micro-exercise during working hours, (HR 0.86, 95% CI 0.77-0.96), but not when used outside of working hours. If used by all workers, micro-exercise during working hours could potentially prevent 12.8% of incident long-term sickness absence cases (population attributable fraction). In conclusion, micro-exercise performed during working hours holds certain potential to prevent incident long-term sickness absence in the general working population. Large-scale implementation of workplace-based micro-exercise may represent an unexploited opportunity for public health promotion.

Importance of the Working Environment for Early Retirement: Prospective Cohort Study with Register Follow-Up.

BACKGROUND: This study investigates the role of physical work demands and psychosocial work factors for early retirement among older workers. METHODS: Data from three Danish surveys on work environment and health among employed older workers (age 55-59) were merged with a national register containing information on labour market participation. Robust Poisson regression modelled the risk ratios (RR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and early retirement, that is, not working after the age of 64. RESULTS: Of the 2800 workers, 53% retired early. High physical work demands (RR 1.33, 95% CI 1.19-1.48), poor overall psychosocial working conditions (RR 1.43, 95% CI 1.26-1.61), and access to early retirement benefits (RR 1.79, 95% CI 1.53-2.10) predicted early retirement. Subgroup analyses revealed that poor overall psychosocial working conditions were a stronger predictor for early retirement among workers with seated jobs than those with physically active jobs. CONCLUSIONS: High physical work demands and poor psychosocial working conditions are factors that can push older workers out of the labour market prematurely. Poor psychosocial working conditions seem to be a particularly strong push factor among workers with seated work.

The Psychosocial Work Environment and Perceived Stress among Seniors with Physically Demanding Jobs: The SeniorWorkingLife Study.

BACKGROUND: Poor psychosocial work conditions are known to foster negative health consequences. While the existing literature on this topic focus mainly on white-collar workers, the influence of different aspects of the psychosocial work environment in physically demanding jobs remain understudied. Likewise, senior workers represent a population of the workforce at increased risk of adverse health outcomes and premature exit from the labour market. This study investigates the association between psychosocial work factors and perceived stress among the senior work force. METHODS: Utilizing cross-sectional findings, this study reports associations between psychosocial factors (organizational justice, cooperation and collegial support, decision latitude, clarity of tasks, and quality of leadership) and the outcome of perceived stress quantified by Cohen's Perceived Stress Scale (CPSS). Currently employed senior workers with physically demanding jobs were included in the analyses (n = 3386). Associations were modeled using general linear models with weights to make the estimates representative. RESULTS: For all individually adjusted psychosocial variables, the category of "good" was consistently associated with lower stress scores compared to the categories of both "moderate" and "poor" (all p < 0.0001). Likewise, in the mutually adjusted analysis, the category of "good" was statistically different from "poor" for all included variables, while the category of "moderate" remained different from "poor" for "clarity of tasks", "cooperation and collegial support", and "decision latitude". CONCLUSIONS: Among senior workers with physically demanding jobs, poor ratings of organizational factors related to the psychosocial work environment are consistently associated with high stress scores. Blue-collar occupations focusing primarily on physical risk factors are recommended to increase awareness on psychosocial aspects that may be relevant to the local work environment.

High physical work demands have worse consequences for older workers: prospective study of long-term sickness absence among 69 117 employees.

OBJECTIVE: This study investigates the role of age for the prospective association between physical work demands and long-term sickness absence (LTSA). METHODS: We followed 69 117 employees of the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the past 52 weeks preceding initial interview, for up to 2 years in the Danish Register for Evaluation of Marginalisation. Self-reported physical work demands were based on a combined ergonomic index including seven different types of exposure during the working day. Using weighted Cox regression analyses controlling for years of age, gender, survey year, education, lifestyle, depressive symptoms and psychosocial work factors, we determined the interaction of age with physical work demands for the risk of LTSA. RESULTS: During follow-up, 8.4% of the participants developed LTSA. Age and physical work demands interacted (p<0.01). In the fully adjusted model, very high physical work demands were associated with LTSA with HRs of 1.18 (95% CI 0.93 to 1.50), 1.57 (95% CI 1.41 to 1.75) and 2.09 (95% CI 1.81 to 2.41) for 20, 40 and 60 years old (point estimates), respectively. Results remained robust in subgroup analyses including only skilled and unskilled workers and stratified for gender. CONCLUSION: The health consequences of high physical work demands increase with age. Workplaces should consider adapting physical work demands to the capacity of workers in different age groups.

What Do the Managers Think of Us? The Older-Worker-Perspective of Managers' Attitudes.

BACKGROUND: Due to demographic changes, the need to prolong working life has become increasingly salient. Paradoxically, stereotyping and discrimination against workers based on their age can limit possibilities for a long working life. A large body of research has investigated attitudes towards older workers; however, less is known about differences across occupational groups as well gender differences. AIM: To compare perceptions of the managers' perceptions of older workers between employees from mainly seated work and mainly physical work as well as men and women. METHOD: Data from 11,444 workers aged 50+ from the baseline questionnaire survey in the SeniorWorkingLife study were analyzed. RESULTS: Across all groups, a larger proportion of the respondents indicated that their managers had more positive than negative perceptions of older workers. Respondents from the International Standard Classification of Occupations (ISCO) group 5-9 (mainly physical work) and women were less likely to point at both positive and negative perceptions than the ISCO group 14 (mainly seated work) and men, respectively. CONCLUSIONS: The results indicate that there are differences between those with mainly physical and mainly seated work as well as gender differences. More research is warranted to explore the nature of these differences and, in particular, attitudes towards older female and male workers, respectively.

Combined ergonomic exposures and development of musculoskeletal pain in the general working population: A prospective cohort study.

OBJECTIVE: This study aimed to investigate the importance of combined ergonomic exposures at work for the development of musculoskeletal pain. METHODS: Through four rounds (2012-2018) of the Work Environment and Health in Denmark Study, 18 905 employees of the general working population replied to a baseline and 2-year follow-up questionnaire. First, a k-means cluster analysis of seven ergonomic factors (back bending, arm above shoulders, lifting etc., from 'never' to 'almost all the time') identified nine naturally occurring clusters. Second, using a weighted survey regression model controlling for age, gender, survey year, education, lifestyle, influence at work, and pain intensity at baseline, we estimated development of pain intensity (0-10) in the neck-shoulder and low-back in these clusters. The largest cluster served as reference to the other clusters and was characterized by low ergonomic exposures. RESULTS: Clusters characterized by multiple combined ergonomic exposures for a relatively high percentage of the working time showed the largest increase in neck-shoulder as well as low-back pain intensity from baseline to follow-up. However, clusters characterized by high exposure to a few specific ergonomic factors also increased pain significantly, eg, standing/walking combined with lifting/carrying or twisted/bent back for the majority of the working time increased low-back pain, whereas repetitive arm movements for the majority of the working time with or without standing/walking increased neck-shoulder pain. CONCLUSION: Combined occupational ergonomic exposures play an important role in the development of musculoskeletal pain. Workplace preventive approaches should consider this in risk assessments and organization of the work.

Psychosocial stress and musculoskeletal pain among senior workers from nine occupational groups: Cross-sectional findings from the SeniorWorkingLife study.

INTRODUCTION: Maintaining good health with advancing age is increasingly important as most European countries experience an increase in retirement age. In order to decrease the risk of premature departure from the workforce, identifying groups at increased risk of musculoskeletal pain and psychosocial stress is essential in designing workplace policies. Therefore, the aim of this study was to investigate the relationship between occupational groups differing in terms of physical demands and skill requirement, and the outcomes of stress and pain. METHODS: This cross-sectional study reports associations of nine different occupational groups with stress and pain among 11 474 senior workers; stratified by occupational group and based on the International Standard Classification of Occupations (ISCO). A large-scale questionnaire survey was dispatched to Danish workers; drawn as a probability sample and merged with national registers. Representative estimates were produced using logistic regression controlling for various confounders, combined with model-assisted weights. RESULTS: The prevalence of daily pain and high stress among occupational groups ranged between 20.0%-50.5% and 3.9%-10.0%, respectively. Compared with occupations characterised by being mostly sedentary (ISCO group 1-4), those with primarily physical demanding work (ISCO group 5-9) had higher odds of daily pain (OR 1.53, 95% CI 1.37 to 1.70) and a tendency towards higher stress scores (OR 1.20, 95% CI 0.98 to 1.46). Lastly, female workers experience increased odds of daily pain (OR 1.50, 95% CI 1.35 to 1.66) and high stress (OR 1.56, 95% CI 1.29 to 1.89) compared with male workers. CONCLUSIONS: Occupational settings characterised by mainly physical work and low skill requirements are more likely to experience daily pain compared with those entailing mainly sedentary work. Likewise, in this sample of senior workers, women are more likely to experience pain and stress. These results highlights the need for improving occupation-specific and sex-specific guidelines in the prevention of musculoskeletal pain and psychological stress in workplaces. TRIAL REGISTRATION NUMBER: ClinicalTrials identifier: NCT03634410.

Safety climate as a predictor of work ability problems in blue-collar workers: prospective cohort study.

OBJECTIVES: To evaluate whether safety climate items would be predictive of future physical and mental work ability among blue-collar workers. METHODS: Blue-collar workers (n=3822) from the Danish Work Environment and Health study replied to questions on safety climate, physical and mental work ability, and health in 2012 and 2014. Using multivariate logistic regression, we estimated the association of number of safety climate items (0-5) in 2012 with physical and mental work ability in 2014. Potential confounders included sex, age, socioeconomic class, occupational group, lifestyle (smoking habits and body mass index) and previous accidents. RESULTS: In the fully adjusted model, workers reporting two and three or more safety climate problems (reference: 0) had higher risk for reduced physical work ability at follow-up (OR 1.29 [95% CI 1.03 to 1.61] and OR 1.52 [95% CI 1.27 to 1.84], respectively). Similar outcomes were observed for mental work ability. Using number of safety climate items as a continuous variable, a doseresponse association existed both for physical and mental work ability (trend-test <0.0001). CONCLUSION: A dose-response association between the number of safety climate items at baseline and lower physical and mental work ability was detected after 2 years. Safety climate items should be highly prioritised in blue-collar companies.

Work factors facilitating working beyond state pension age: Prospective cohort study with register follow-up.

Objectives The demographic changes in Europe underline the need for an extension of working lives. This study investigates the importance of physical work demands and psychosocial work factors for working beyond the state pension age (65 years). Methods We combined data from three cohorts of the general working population in Denmark (DWECS 2005 and 2010, and DANES 2008), where actively employed workers aged 55-59 years replied to questionnaires about work environment and were followed until the age of 66 years in the Danish AMRun register of paid employment. Using logistic regression analyses, we calculated prevalence ratios (PR) and 95% confidence intervals (CI) for the association between physical and psychosocial work factors and working beyond state pension age, adjusted for age, sex, cohort, cohabiting, sector, income, vocational education, working hours, lifestyle, and previous sickness absence. Results Of the 2884 workers aged 55-59 years, 1023 (35.5%) worked beyond the state pension age. Higher physical work demands was associated with a lower likelihood (PR 0.69, 95% CI 0.58-0.82) and a good psychosocial work environment was associated with higher likelihood (average of 7 items: PR 1.81, 95% CI 1.49-2.20) of working beyond state pension age. Stratified analyses did not change the overall pattern, ie, a good overall psychosocial work environment - as well as several specific psychosocial factors - increased the likelihood of working beyond state pension age, both for those with physically active and seated work. Conclusion While high physical work demands was a barrier, a good psychosocial work environment seems to facilitate working beyond state pension age, also for those with physically active work.