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Retrospectively assessed physical work environment during working life and risk of sickness absence and labour market exit among older workers
  1. Emil Sundstrup1,
  2. Åse Marie Hansen1,2,
  3. Erik Lykke Mortensen2,3,
  4. Otto Melchior Poulsen1,
  5. Thomas Clausen1,
  6. Reiner Rugulies1,2,4,
  7. Anne Møller5,6,
  8. Lars L Andersen1,7
  1. 1 National Research Centre for the Working Environment, Copenhagen, Denmark
  2. 2 Department of Public Health, University of Copenhagen, Copenhagen, Denmark
  3. 3 Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
  4. 4 Department of Psychology, University of Copenhagen, Copenhagen, Denmark
  5. 5 Department of Occupational Medicine, Holbæk Hospital, Copenhagen, Denmark
  6. 6 Department of Public Health, The Research Unit for General Practice and Section of General Practice, University of Copenhagen, Copenhagen, Denmark
  7. 7 Department of Health Science and Technology, Physical Activity and Human Performance group, SMI, Aalborg University, Copenhagen, Denmark
  1. Correspondence to Emil Sundstrup, National Research Centre for the Working Environment, Lersø Parkallé 105 2100 Copenhage, Denmark; esu{at}


Objective To determine the prospective association between retrospectively assessed physical work environment during working life and prospectively assessed sickness absence and labour market exit among older workers.

Methods Using Cox regression analyses we estimated the 4-year to 6-year prospective risk of register-based long-term sickness absence (LTSA), disability pension, early retirement and unemployment from exposure to different physical work environmental factors during working life among 5076 older workers (age 49–63 at baseline) from the Copenhagen Aging and Midlife Biobank cohort.

Results Very hard physical work throughout working life was a risk factor for LTSA (HR 1.66,95% CI 1.32 to 2.07), disability pension (HR 2.21,95% CI 1.04 to 4.72) and early retirement (HR 1.57,95% CI 1.13 to 2.17). Both short-term (<10 years) and long-term (≥20 years) exposures to lifting or carrying of heavy burdens predicted the risk of LTSA (HRs 1.49–1.56) and disability pension (HRs 2.26–3.29). In contrast, exposure to dust was associated with LTSA and disability pension only following 20 or more exposure years.

Conclusions Retrospectively assessed hard physical work during working life and exposure to several factors in the physical work environment, especially heavy lifting, were important for labour market exit and sickness absence. This study underscores the importance of reducing physical work exposures throughout the working life course for preventing sickness absence and premature exit from the labour market.

  • disability pension
  • sickness absence
  • physical workloads

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  • Contributors LLA obtained the funding. LLA and ES designed the study and performed the statistical analyses. ÅMH and ELM initiated and established the Copenhagen Aging and Midlife Biobank. ÅMH, ELM, OMP, TC, RR and AM provided feedback to the study design and interpretation of the results. ES drafted the manuscript. All authors approved and critically reviewed the final version of the manuscript.

  • Funding This study was supported by a grant from the Danish Working EnvironmentResearch Fund (Grant no. 20130068772/3).

  • Competing interests None declared.

  • Ethics approval The local ethical committee and Danish Data Protection Agency.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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