Indicators and determinants of the years of working life lost: a narrative review.

OBJECTIVE: This narrative review summarizes the available indicators for working life expectancy and years of working life lost (YWLL) and their determinants. METHODS: We searched PubMed and Embase databases from their inception until August 2020 and screened all studies proposing an indicator for working life expectancy or YWLL. We also reviewed studies focusing on sociodemographic, lifestyle and work-related determinants of working life expectancy and YWLL. The results were synthesized narratively. RESULTS: We identified 13 different indicators for the length of working life or YWLL. The most frequently used indicators were 'working life expectancy', 'healthy working life expectancy', and YWLL. Working life expectancy and healthy working life expectancy are longer for men than women. Working life expectancy at the age of 50 has been increasing since the mid-90s, and the increase has been larger for women, reducing the sex difference. Working life is shorter for people with a low level of education, in lower occupational classes, for people exposed to high physical work demands, those living in the most socioeconomically deprived areas, people with overweight or obesity, smokers, people who are inactive during leisure time and in people with a chronic health problem. CONCLUSIONS: Despite increasing interest in understanding the determinants of YWLL, only a few studies have simultaneously considered multiple exit routes from the labour market. We propose a new measure for total YWLL considering all relevant exit routes from employment. This comprehensive measure can be used to assess the effect of given policy changes on prolonging working life.

Predictors of working days lost due to sickness absence and disability pension.

OBJECTIVE: To identify social and health-related predictors of the number of days lost due to sickness absence (SA) and disability pension (DP) among initially 55-year-old public-sector workers. METHODS: The data from the Finnish Helsinki Health Study included participants aged 55 years at the baseline (in 2000-2002, N = 1630, 81% women), and were enriched with register-based information on SA and DP. The cumulative number of calendar days lost due to SA ≥ 1 day or DP between ages 55 and 65 was calculated. Negative binomial regression model was used to identify the predictors of days lost. RESULTS: The average calendar days lost was 316 days (about 220 working days) during a 10-year follow-up, and 44% were due to SA and 56% due to DP. Smoking [incidence rate ratio (IRR) = 1.19, 95% CI 1.01-1.40 for past and IRR = 1.30, CI 1.07-1.58 for current], binge drinking (IRR = 1.22, CI 1.02-1.46), lifting or pulling/pushing heavy loads (IRR = 1.35, CI 1.10-1.65), awkward working positions (IRR = 1.24, CI 1.01-1.53), long-standing illness limiting work or daily activities (IRR = 2.32, CI 1.93-2.79), common mental disorder (IRR = 1.52, CI 1.30-1.79), and multisite pain (IRR = 1.50, CI 1.23-1.84) increased the number of days lost, while high level of education (IRR = 0.66, CI 0.52-0.82) and moderate level of leisure-time physical activity (IRR = 0.80, CI 0.67-0.94) reduced the number of days lost. CONCLUSIONS: Modifiable lifestyle risk factors, workload factors, common mental disorder, and multisite pain substantially increase the number of days lost. However, the findings of this study could be generalized to female workers in the public sector. Future research should also consider shorter SA spells in estimating working years lost and working life expectancy.

Carpal tunnel release: Lifetime prevalence, annual incidence, and risk factors.

INTRODUCTION: We estimated the lifetime prevalence and incidence of carpal tunnel release (CTR) and identified risk factors for CTR. METHODS: The study population consisted of individuals aged ≥30 years living in Finland during 2000-2001 (N = 6,256) and was linked to the Finnish Hospital Discharge Register from 2000 to 2011. RESULTS: Lifetime prevalence of CTR was 3.1%, and incidence rate was 1.73 per 1,000 person-years. Female sex (adjusted hazard ratio [HR] = 1.8, 95% confidence interval [CI] 1.2-2.8), age of 40-49 years (HR = 2.5, CI 1.7-3.8 compared with other age groups), education (HR = 0.6, CI 0.4-0.9 for high level vs. low/medium level), obesity (HR = 1.7, CI 1.2-2.5 for body mass index ≥30 vs. < 30 kg/m2 ), and hand osteoarthritis (HR = 2.4, CI 1.4-3.9) were associated with incidence of CTR. DISCUSSION: CTR is a common surgical procedure, performed on 1.9% of men and 4.1% of women during their lifetimes. Obesity and hand osteoarthritis are associated with an increased risk of CTR. Muscle Nerve 58: 497-502, 2018.

Emergency contraception among Finnish adolescents: awareness, use and the effect of non-prescription status.

BACKGROUND: Adolescents need to be aware that there is a method of preventing pregnancy even after an unprotected intercourse. Limited information is available on the awareness of young adolescents and the effects of selling emergency contraception (EC) over-the-counter, and the findings are controversial. The aims of this study were to investigate awareness and use of EC among Finnish girls aged 12-18 years in 1999-2003, and to assess the effect of the 2002 non-prescription status on the use. METHODS: A self-administered questionnaire was sent to a population-based sample of 12-18-year-olds girls in 1999, 2001, and 2003. Response rate was 83% in 1999 (N = 4,369), 79% in 2001 (N = 4,024) and 77% in 2003 (N = 3,728), altogether N = 12,121. Logistic regression model was used to examine the association of unawareness and use of EC with socio-economic background and health behaviour. RESULTS: In 2001, nearly all 14-18-year-olds and a majority of 12-year-olds were aware of EC. Among 12-14-year-olds, a slight increase in awareness between 1999 and 2003 was observed but this was not related to non-prescription status. Health-compromising behavior (alcohol use, smoking), dating and having good school achievement were related to higher awareness of EC.Nine percent of 14-18-year-olds had used EC once and 1% three times or more. No statistically significant change in EC use was found after non-prescription status. EC use increased with increasing alcohol consumption, particularly at age 14. Smoking, dating, and poor school achievement were related to increased use as well as not living in nuclear family. A lower use was observed if living in rural area or father's education was high. Mother's education was not related to use. CONCLUSION: Adolescent girls were well aware of the existence of emergency contraception even before the non-prescription status. Over-the-counter selling did not increase the use.