Abstract

Objective: To examine whether high job strain (a combination of high job demands and low job control) is a risk factor for disability pension.

Setting: Ten municipalities and 21 hospitals in Finland.

Design and participants: A prospective cohort study of 20 386 female and 4 764 male Finnish public sector employees aged 19-50 using data from two surveys (baseline in 2000-2002 and follow-up in 2005) and employers' registers. In addition to self-reported job strain, we computed work-unit aggregated job strain for each participant (the average of scores of all workers of participant's work unit except the participant him/herself).

Main results: 93 employees (0.4%) retired because of disability during the follow-up. In multilevel logistic regression analysis adjusted for demographic characteristics and health risk behaviour, odds for disability pension was 2.60 (95% CI 1.26 to 5.34) times higher for employees with high self-assessed job strain than for those with low self-assessed job strain at baseline. The corresponding odds ratio for passive job vs. low job strain was 2.82 (95% CI 1.34 to 5.96). Analysis of work-unit aggregated scores replicated the association for high job strain, odds ratio 2.25 (95% CI 1.17 to 4.35), but not that for passive job. The association between work-unit job strain and disability pension remained significant after further adjustment for prevalent diseases, psychological distress and perceived health status.

Conclusions: Job strain is associated with risk of subsequent disability pension. If causal, this association suggests that organizational interventions to reduce job strain may also reduce early exit from work.