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Do chronic diseases moderate the association between psychosocial working conditions and work exit? Longitudinal results from 55 950 Dutch workers
  1. Sander K R van Zon1,
  2. Patricia Ots1,
  3. Suzan J W Robroek2,
  4. Alex Burdorf2,
  5. Karen M Oude Hengel2,3,
  6. Sandra Brouwer1
  1. 1Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
  2. 2Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
  3. 3Department of Work, Health & Technology, Netherlands Organization for Applied Scientific Research, TNO, Leiden, The Netherlands
  1. Correspondence to Sander K R van Zon, Department of Health Sciences, Community and Occupational Medicine, University of Groningen, University Medical Center Groningen, Groningen, Netherlands; s.k.r.van.zon{at}umcg.nl

Abstract

Background This study aims to examine whether the presence of chronic diseases or multimorbidity moderates the associations between psychosocial working conditions and work exit through unemployment, work disability or early retirement.

Methods Data from Lifelines (n=55 950), a prospective population-based cohort study, were enriched with monthly information on employment status from Statistics Netherlands. Working conditions were measured with the Copenhagen Psychosocial Questionnaire. Work exit was defined as unemployment, work disability and early retirement. Participants were classified as having no chronic disease, one chronic disease or multimorbidity. Cause-specific Cox proportional hazard regression models, adjusted for age, gender, education and partnership status, were used to analyse associations between working conditions and work exit. Interaction terms were used to examine moderation by chronic disease status.

Results Higher social support decreased the risk for unemployment, work disability and early retirement. Higher meaning of work decreased the risk of unemployment, and more possibilities for development decreased the risk for work disability. Chronic disease status did generally not moderate associations between working conditions and work exit. Only among workers without a chronic disease, more possibilities for development was associated with a lower risk for unemployment (HR: 0.89; 95% CI: 0.85 to 0.94).

Conclusion While efforts to retain workers with chronic diseases in the labour market should continue, favourable psychosocial working conditions are important for all workers.

  • employment
  • epidemiology
  • morbidity
  • public health
  • workplace

Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Lifelines is a facility that is open for all researchers. Information on application and data access procedure is summarised on www.lifelines.nl.

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Data availability statement

Data are available upon reasonable request. Data may be obtained from a third party and are not publicly available. Lifelines is a facility that is open for all researchers. Information on application and data access procedure is summarised on www.lifelines.nl.

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Footnotes

  • Contributors SKRvZ, PO, and SB conceived and designed the study. PO analysed the data. SKRvZ, PO, SJWR, AB, KOH and SB were involved in interpreting the data. SKRvZ has written the first version of the manuscript. PO, SJWR, AB, KOH and SB critically revised, read and approved the final manuscript. SB is the guarantor for the study.

  • Funding The Lifelines initiative has been made possible by subsidy from the Dutch Ministry of Health, Welfare and Sport, the Dutch Ministry of Economic Affairs, the University Medical Center Groningen (UMCG), Groningen University and the Provinces in the North of the Netherlands (Drenthe, Friesland, Groningen).

  • Competing interests None declared.

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

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.