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Original research
Physical and psychosocial work exposures as risk factors for disability retirement due to a shoulder lesion
  1. Maria Sirén1,2,
  2. Eira Viikari-Juntura3,
  3. Jari Arokoski1,2,
  4. Svetlana Solovieva3
  1. 1 Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
  2. 2 Faculty of Medicine, University of Helsinki, Helsinki, Finland
  3. 3 Finnish Institute of Occupational Health, Helsinki, Finland
  1. Correspondence to Maria Sirén, Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki 00029, Finland; maria.siren{at}


Objective To assess the longitudinal associations of physical and psychosocial exposures with disability retirement due to a shoulder lesion.

Methods In a nationwide register-based study, we followed 1 135 654 wage earners aged 30–59 years for the occurrence of disability retirement due to a shoulder lesion. The occupational exposures were assessed with job exposure matrices. We used a competing risk regression model to estimate HRs and their 95% CIs and to test for the association between the exposures and the outcome. We also calculated the attributable fraction of disability retirement due to occupational exposures.

Results A total of 2472 persons had full disability retirement due to a shoulder lesion during the follow-up. Physically heavy work showed the strongest association with the outcome in both genders, in men with an HR of 2.90 (95% CI 2.37 to 3.55) and in women with an HR of 3.21 (95% CI 2.80 to 3.90). Of the specific physical exposures, working with hands above shoulder level was statistically significantly associated with disability retirement in men. When all physical exposures were taken into consideration, 46% and 41% of disability retirement due to a shoulder lesion were attributed to physical work load factors in men and women, respectively. In addition, 49% (men) and 35% (women) of disability retirement were attributed to psychosocial work-related factors.

Conclusions Our findings suggest that a considerable proportion of disability retirement due to a shoulder lesion could be prevented by reducing physical and psychosocial exposures at work to a low level.

  • epidemiology
  • ergonomics
  • longitudinal studies
  • physical work
  • musculoskeletal

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  • Contributors All authors planned the study. SS made the analyses. MS drafted the manuscript. All authors critically reviewed and approved the manuscript.

  • Funding This study was funded by NordForsk (grant number 76659), the Finnish Work Environment Fund (grant number 115105), by the Academy of Finland (grant number 303534) and by a university-level health research (Helsinki University Hospital/Internal Medicine and Rehabilitation) project (Y101500007) (grant number HUS/174/2019).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study was fully register based and applied identification numbers pseudonymised by Statistics Finland. Research using such data does not need to undergo review by an ethics committee according to Finnish legislation.

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

  • Data availability statement Data may be obtained from a third party and are not publicly available.

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