Aims We investigated how the nature of work predicts musculoskeletal disorder (MSDs) in a 28-year follow-up.

Methods In total 6257 people aged 44–58 years participated in the Finnish study of Municipal Employees (FLAME) in 1981 and were followed up for the next 28 years in 5 different waves. For this study, 2 waves: early retirement (1992, N = 4534) and very old age (2009, N = 3093) were used. Nature of work done in midlife was classified and used as mental, mixed (physical and mental) and physical according to type of exposures. We have used 3 types of MSDs namely degenerative disorder, back disorder and osteoarthritis of limb joints which were diagnosed by physician. Log-binomial regression with a log link was used to model gender stratified risk ratios (RR) and their 95% confidence intervals (CI).

Results Adjusted for age, smoking, alcohol use, BMI and physical exercise, in early retirement period women in physical works had a higher risk of all 3 disorders and the risk being highest in osteoarthritis (RR 1.53, 95% CI: 1.32–1.78) and those in mental works had a higher risk of degenerative and back disorders compared to those who did mental works in midlife. Whereas, both mixed and physical works carried an increased risk of all 3 disorders among men (1.72, 1.37–2.16 for osteoarthritis for those in physical works). In a very old age, women in both mixed and physical works at midlife had significantly higher risk of all 3 disorders (1.38, 1.16–1.65 for back disorder due to physical) but among men only those in physical works carried a higher risk of back disorder (1.31, 1.02–1.71).

Conclusions Nature of work done in midlife predicts the musculoskeletal health during the early retirement period and a very old age, with women being at higher risk at old age compared to men.