Health-related job loss: findings from a community-based survey

Christine Solomon ¹, Jason Poole ¹, Keith T Palmer ² and David Coggon ^1*

¹ MRC Epidemiology Resource Centre, United Kingdom
² MRC Epidemiology Resource Centre, United Kingdom

^* To whom correspondence should be addressed. E-mail: dnc{at}mrc.soton.ac.uk.

Accepted 2 April 2006

Abstract

Aims: To explore the frequency, nature, determinants and outcome of health-related job loss (HRJL) in men sampled from the general population. Methods: Data on lifetime occupational history, including any HRJL, were obtained as part of a postal survey of men aged 24-70 years in three rural areas of England and Wales. Incidence rates were calculated for first health-related loss of a job that had been held for a year or longer. Associations with risk factors were examined by Poisson regression, and by application of conditional logistic regression in a nested case-control study. Results: HRJL was reported by 1408 (13%) of the 10,559 men who had held long-term jobs. Incidence rose steeply with age for cardio-respiratory and neurological disorders, but for accidents and poisoning the trend was, if anything, in the reverse direction. An increase in incidence over time was most marked for musculo-skeletal disorders and mental illness, and much less prominent for cardio-respiratory and neurological disease. In comparison with other occupations, risk was lower in agricultural workers (OR 0.6, 95%CI 0.5-0.8), and higher in policemen (OR 2.4, 95%CI 1.6-3.7) and teachers (OR 2.0, 95%CI 1.5-2.7), this differential being even greater for HRJL due to mental illness. Risk was also elevated in employees relative to the self-employed (OR 2.0, 95%CI 1.7-2.3). Shift work was associated with a higher incidence of job loss because of mental illness (OR 1.5, 95%CI 1.1-2.2), and heavy lifting with HRJL for musculo-skeletal disorders (OR 2.6, 95%CI 2.0-3.5). Following HRJL, 61% of subjects had subsequently obtained further long-term employment, usually within one year. Conclusions: HRJL is increasingly common, especially in relation to musculo-skeletal disorders and mental illness. As well as being associated with ergonomic stresses in the workplace, it appears to be importantly influenced by cultural and economic factors. Future research should focus on the minority of workers who leave a job for health reasons and do not rapidly return to further work.

Keywords: health, job loss, public sector, unemployment

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