The relationship between physical and psychosocial workplace exposures and life expectancy free of musculoskeletal and cardiovascular disease in working life - an analysis based on German health insurance data.

ABSTRACT

BACKGROUND: Against the backdrop of the debate on extending working life, it is important to identify vulnerable occupational groups by analysing inequalities in healthy life years. The aim of the study is to analyse partial life expectancy (age 30-65) [1] free of musculoskeletal diseases (MSD) and [2] free of cardiovascular diseases (CVD) in occupational groups with different levels of physical and psychosocial exposures. METHODS: The study is based on German health insurance claims data from 2015 to 2018. The study population comprises all employed insured persons aged 18 to 65 years (N = 1,528,523). Occupational exposures were assessed using a Job Exposure Matrix. Life years free of MSD / CVD and life years with MSD /CVD during working age were estimated using multistate life tables. RESULTS: We found inequalities in MSD-free and CVD-free life years, with less disease-free years among men and women having jobs with high levels of physical and psychosocial exposures. Men with low physical exposures had 2.4 more MSD-free and 0.7 more CVD-free years than men with high physical exposures. Women with low psychosocial exposures had 1.7 MSD-free and 1.0 CVD-free years more than women with high psychosocial exposures. CONCLUSIONS: Employees in occupations with high physical and psychosocial demands constitute vulnerable groups for reduced life expectancy free of MSD and CVD. Given the inequalities and high numbers of disease-affected life years during working age, the prevention potential of occupational health care and workplace health promotion should be used more extensively.