Does a change to an occupation with a lower physical workload reduce the risk of disability pension? A cohort study of employed men and women in Sweden

Abstract

Objective This study aimed to examine if a change to an occupation with a lower physical workload reduces the risk of all-cause disability pension (DP) and musculoskeletal DP (MDP). Methods The sample comprised 359 453 workers who were registered as living in Sweden in 2005 and aged 44–63 in 2010. Exposure to physical workload was measured from 2005–2010 by linking a mean value from a job exposure matrix to occupational codes. The mean values were then split into quartiles. All included participants had high exposure to physical workload (top quartile) from 2005–2007. A change in physical workload was measured as a change to (i) any lower quartile or (ii) medium-high or low quartiles from 2008–2010. DP cases were taken from register data from 2011–2016. Crude and multivariate Cox proportional-hazards regression models estimated sex-specific hazard ratios (HR) with 95% confidence intervals (CI). Results Compared to workers with consistently high physical workload, a change to any lower quartile of physical workload was associated with a decreased risk of all-cause DP (men: HR 0.59, 95% CI 0.46–0.77, women: HR 0.63, 95% CI 0.52–0.76) and MDP (men: HR 0.52, 95% CI 0.31–0.89, women: HR 0.61, 95% CI 0.44–0.84). Older workers had the largest decreased risk for MDP. Generally, changing from high to low physical workload was associated with a greater reduced risk of DP than changing from high to medium-high physical workload. Conclusion Changing to an occupation with lower exposure to physical workload was associated with reduced risks of DP and MDP among both sexes.