Work environment and disability pension-- an 18-year follow-up study in a Norwegian working population.

AIMS: To investigate the associations between work environment indicators and health- related work disability. METHODS: A health survey of 5,749 working 40-42-year-old Norwegians from Nordland County were linked to a national register for disability pension during a follow-up of over 18 years. The risk for disability pension following various self-reported physical and psychosocial work environmental exposures (individual and cumulative) were estimated using Cox regression analysis. RESULTS: Both cumulative physical and psychosocial work environmental exposures were associated with an increased risk for disability pension, although this association was attenuated for most variables after adjusting for health and education. An increase in five poor psychosocial work environmental exposures was associated with a 22% increased risk for disability (adjusted hazard ratio, aHR, 1.22, 95% CI 1.04-1.44), whereas a similar increase in five poor physical work environmental exposures was associated with a 29% increased risk (aHR, 1.29, 95% CI 1.16-1.44). There were no indications of statistical interaction between either sex or education and work exposures. CONCLUSIONS: People who report a poor work environment are at a higher risk for subsequent work disability. This finding suggests that improving working conditions may be an area of intervention in order to reduce the number of people who leave the labour market with a disability pension.

Underreporting of Work-Related COVID-19 Cases in Norway.

Background: This register-based study provides a profile of work-related Covid-19 cases reported by physicians to the Norwegian Labor Inspection Authority (NLIA). Methods: All the reports of work-related Covid-19 cases reported by a physician to the NLIAs Registry for Work-Related Diseases (RAS) between February 2020 and February 2022 were included. Descriptive statistics and the incidence rate of reported cases were computed for age, gender, and occupation. Results: Two hundred and seventeen work-related Covid-19 cases were reported to RAS during the study period. Sixty-five percent of the cases were females (n = 141), and 35 percent (n = 76) were males. Doctors, nurses, and ambulance personnel yielded higher incidence rates than other healthcare and nonhealthcare occupations. Conclusions: This study indicates that women aged 25-39 and employed in the healthcare sector had the highest reported incidence and number of work-related Covid-19 cases. Physician underreporting of work-related Covid-19 cases is an important finding. Plausibly, underreporting is more substantial for at-risk non-healthcare occupations such as waiters, bartenders, food couriers, and taxi drivers than occupations in healthcare.

Unemployment and disability pension--an 18-year follow-up study of a 40-year-old population in a Norwegian county.

BACKGROUND: This study explored the association of unemployment and an increased risk of receiving disability pension, and the possibility that this risk is attributed to municipality-specific characteristics. METHODS: A cohort of 7,985 40-42 year olds was followed for 18 years in national registers, identifying new episodes of unemployment and cases of disability pension. The association between an unemployment period and disability pension in the subsequent year was estimated using discrete time multilevel logistic regressions and clustering individuals by municipality. The association between unemployment and disability pension was adjusted for age in the follow up-period, sex, baseline health status, health behaviour and education level. A conditional intra-class correlation coefficient (ICC) was estimated as a measure of inter-municipality variance. RESULTS: In the follow-up period, 2784 (35%) of the participants were granted disability pension. The crude odds ratio for receiving disability pension after unemployment (adjusted for age in follow-up period and sex only) was 1.42 (95% CI 1.1-1.8). Adjusting for baseline health indicators reduced the odds ratio of unemployment to 1.33 (CI 1.1-1.7). A fully adjusted model, including education level, further reduced the odds ratio of unemployment to 1.25 (CI 1.00-1.6). The ICC of the municipality level was approximately 2%. CONCLUSIONS: Becoming unemployed increased the risk of receiving subsequent disability pension. However, adjusting for baseline health status, health behaviour and education attenuated this impact considerably. The multilevel analysis indicated that a minor, yet statistically significant, proportion of the risk of disability pension can be attributed to the municipality of residence.

Rehabilitation time before disability pension.

BACKGROUND: The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. METHODS: A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. RESULTS: The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. CONCLUSIONS: There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.