Chronic conditions and self-perceived health among older employees in relation to indicators of labour participation and retirement over time.

BACKGROUND: A significant proportion of older employees leave the labour market early, amongst others via unemployment or disability benefits, implying that health might affect possibilities to extend working life. OBJECTIVE: This study 1) examined associations between chronic conditions (subtypes) and self-perceived health (SPH), independently, and indicators of labour participation and retirement over six-year follow-up among older employees, and 2) explored the impact of differences between prevalent and incident presence of chronic condition(s) in this relation. METHODS: Older workers (aged > 45 years) included in the Maastricht Cohort Study were studied (n = 1,763). The Health and Work Performance Questionnaire assessed chronic conditions and one item from the Short Form health survey-36 assessed SPH. Cox regression analyses assessed associations between chronic conditions and SPH, independently, and retirement intentions, employment status, decreasing working hours, and changes in work over time. RESULTS: Employees with coexistent physical-mental chronic conditions showed higher risks to lose employment and to receive a disability benefit (HR 1.85, 95% CI 1.23-2.78; HR 8.63, 95% CI 2.47-30.11) over time compared to healthy employees. No statistically significant associations were found between SPH and indicators of labour participation and retirement over time. Having chronic condition(s) was cross-sectionally associated with lower SPH scores and larger proportion of part-timers -compared to healthy employees. CONCLUSIONS: Chronic condition(s) among older employees were substantially associated with indicators of labour participation and retirement over time. The role of SPH was mainly instantaneous. Findings provide valuable input for preventive measures aiming to prevent an early labour market exit of older employees.

Impact of Development and Accommodation Practices on Older Workers' Job Characteristics, Prolonged Fatigue, Work Engagement, and Retirement Intentions Over Time.

OBJECTIVE: The impact of development and accommodation practices on older workers' retirement intentions was investigated in this prospective study, together with potential pathways and the role of career stage. METHODS: A subsample of full-time, older workers (n = 678) from the Maastricht Cohort Study was followed-up for 2 years. Regression analysis was conducted for three age groups. RESULTS: Development practices related positively with later retirement intentions in workers aged 55 to 59 years. The accommodation practice of demotion related negatively with later retirement intentions in worker aged at least 60 years. Decision latitude and work engagement were found to link development and accommodation practices with later retirement intentions in particular in workers aged 55 to 59 years. CONCLUSIONS: It was indicated in this prospective study that development and accommodation practices may be useful for prolonging working careers.

Cancer mortality in workers exposed to dieldrin and aldrin: over 50 years of follow up.

OBJECTIVE: Dieldrin and aldrin, pesticides widely used until the 1970s, have been under suspicion of being carcinogenic. In this study, overall and cause-specific mortality was assessed in a cohort of 570 employees occupationally exposed to the pesticides dieldrin and aldrin to investigate the long-term health effects, in particular carcinogenic effects. METHODS: All of the employees worked in the production plants between January 1954 and January 1970 and were followed for cause-specific mortality until 30 April 2006. Based on dieldrin levels in blood samples taken from 343 workers during the exposure period, the total intake of dieldrin was estimated for each individual subjects in the cohort. The estimated total intake ranged from 11 to 7,755 mg of dieldrin, with an average of 737 mg. RESULTS: Two hundred and twenty-six workers had died before 30 April 2006 compared with an expected number of 327.3, giving a standardized mortality ratio (SMR) of 69.0 (95% confidence interval (CI): 60.3-78.7). Overall cancer mortality was also significantly lower than expected (SMR: 76.4, 95% CI: 60.8-94.9). Also, none of the specific cancer sites showed a significant excess mortality and no association between exposure level and cancer mortality was found. CONCLUSION: The results from this study support findings from other epidemiological and recent animal studies concluding that dieldrin and aldrin are not likely human carcinogens.

Mortality update of workers exposed to acrylonitrile in The Netherlands.

To study the possible carcinogenic effects of acrylonitrile, we updated the follow up of a cohort of 2842 acrylonitrile workers. The comparison group consisted of 3961 workers from a nitrogen fixation plant. Industrial hygiene assessments quantified past exposure to acrylonitrile, 8-hour averages as well as peak exposure, the use of personal protective equipment, and exposure to other potential carcinogenic agents. Standardized mortality ratios were calculated to adjust for the effect of age distribution, length of follow up, and temporal changes in background mortality rates. Cumulative dose-effect relations were determined for 3 exposure categories and 3 latency periods. The results show that no cancer excess seems related to exposure to acrylonitrile. This additional follow up of a cohort of 2842 workers exposed to acrylonitrile further supports the notion that occupational exposures to acrylonitrile that have occurred in the past have not noticeably increased workers' cancer mortality rates.

Cancer mortality in a cohort of licensed herbicide applicators.

OBJECTIVES: In order to expand our knowledge on the possible long-term health effects of exposure to herbicides, we updated the follow-up of a cohort of 1341 licensed herbicide applicators in the Netherlands. The earlier report indicated that there might be an increased risk for multiple myeloma in this group. Although that finding was statistically significant, the result was based on a small number of cases. METHODS: We expanded the follow-up from 1 January 1988 to 1 January 2001, which added 13 years to the follow-up. We now report on the causes of death of 196 exposed workers. RESULTS: Our findings indicate that licensed herbicide applicators were at an increased risk for skin cancer mortality [standardized mortality ratio (SMR)=357.4, 95% confidence interval (CI) 115.1-827.0]. It is not clear if this excess of skin cancer should be attributed to herbicide exposure or to excess exposure to sunlight.

Cancer mortality in workers exposed to dieldrin and aldrin: an update.

This study was conducted to investigate the possible long-term health effects, in particular carcinogenic effects, of occupational exposure to the organochlorine insecticides dieldrin and aldrin. We updated an earlier cohort mortality study of 570 employees involved in the production of these insecticides. All of the employees had worked in the production plants between 1 January 1954 and 1 January 1970 and were followed for cause-specific mortality until 1 January 2001. Based on dieldrin levels in blood samples taken during the exposure period, available for 343 workers, individual estimates of the total intake of dieldrin were estimated for all individual subjects in the cohort. The estimated total intake ranged from 11 to 7755 mg of dieldrin, with an average of 737 mg. One hundred and seventy-one workers had died before 1 January 2001, compared with an expected number of 226.6, giving a standardized mortality ratio (SMR) of 75.6 [95% confidence interval (CI): 64.6-87.7]. This deficit in total mortality was mainly attributable to a deficit in cardiovascular disease mortality, but cancer mortality was also lower than expected. The observed number of deaths from rectal cancer was significantly higher than expected (SMR = 300.0; 95% CI: 109.5-649.3), but was most pronounced in the low-intake subgroup and appears to be unrelated to exposure to dieldrin and aldrin. This study reinforces the earlier findings that occupational exposure of workers to significant amounts of dieldrin and aldrin has not led to a higher cancer mortality than would be found in an unexposed population.