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Work participation and working life expectancy after a disabling shoulder lesion
  1. Maria Sirén1,2,
  2. Eira Viikari-Juntura1,
  3. Jari Arokoski2,3,
  4. Svetlana Solovieva1
  1. 1 Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2 Department of Physical and Rehabilitation Medicine, Helsinki University Hospital, Helsinki, Finland
  3. 3 University of Helsinki, Helsinki, Finland
  1. Correspondence to Maria Sirén, Finnish Institute of Occupational Health, Helsinki, Finland; maria.siren{at}


Objective To examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.

Methods From a 70% random sample of the Finnish population, we selected 30–59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.

Results During 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.

Conclusions Working life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.

  • epidemiology
  • musculoskeletal
  • oh services
  • sickness absence
  • workload

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  • Contributors All authors have contributed in planning the study design and revising the article. SS: has conducted the statistical analyses. MS: has done the most of the writing but especially SS and EV-J have strongly took part in writing, too. All authors have accepted the final version of the article.

  • Funding This study was funded by NordForsk (grant number 76659), the Finnish Work Environment Fund (grant number 115105), and by the Academy of Finland (grant number 303534).

  • Competing interests None declared.

  • 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.

  • Patient and public involvement Not required.

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