Emil Sundstrup

National Research Centre for the Working Environment · Musculoskeletal Disorders

Determining predictors of sickness absence could allow for better screening, guidance, and development of preventive efforts aimed at those in increased risk. This study aimed to determine the prospective association between musculoskeletal pain intensity and risk of incident register-based long-term sickness absence in the general working populati...

Background A growing population of elderly necessitates a sharpened focus on sustainable employment through aging. Physically demanding work can be challenging, especially for senior workers. Establishing determinants of labor market participation could guide policy development and preventive efforts at the workplaces aiming at keeping senior worke...

Background Surveying expected reasons for retirement may be a useful strategy to maintain labor market affiliation. The aim was to investigate the prospective association between self-reported expected reasons for leaving the labour market and subsequent loss of paid employment before the state pension age among older workers. Methods The prospect...

Objective: This study aimed to investigate the prospective association of lifting duration and lifting load with the risk of long-term sickness absence (LTSA). Methods: We followed manual workers with occupational lifting (N=45 346) from the Work Environment and Health in Denmark Study (2012-2018) for two years in a high-quality national registe...

Objectives Prevention of disability in all its forms is a major public health challenge and promoting a healthy lifestyle with sufficient physical activity (PA) may be a way forward. In contrast to long-term deprivation of usual activities, usually linked to critical injuries or conditions, little is known about shorter periods of those limitations...

Re-entering the labour market after a period of unemployment can be challenging for seniors. This study investigates personal as well as circumstantial barriers and facilitators of re-employment. Unemployed seniors in Denmark (≥50 years, n = 1636) from the first wave (mid-2018) of the SeniorWorkingLife study were prospectively followed until March...

It is increasingly urgent to retain older workers in the workforce. In the present study, we analysed the prospective associations between employees’ perceptions of their managers’ attitudes towards older workers, and of having experienced age discrimination in the labour market with the risk of loss of paid work before the state pension age. Quest...

Background: This study investigates the association between the implementation of new technology in the workplace and the subsequent loss of paid employment among older workers. Methods: We estimated the prospective risk of loss of paid employment (register-based) from questions on new technology among 10,320 older workers (≥50 years). To invest...

Objective: This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA). Methods: We followed 69 371 employees in the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Dan...

Objectives: To investigate and characterize the influence of sex, age, muscle strength, and cardiovascular fitness on manual lifting patterns using exposure variation analysis (EVA) during a full working day among blue-collar workers. Methods: Muscular activity (surface electromyography [sEMG]) of the thigh, low-back, and shoulder was measured t...

Background: Aging increases the risk of chronic diseases, which can challenge the ability to work and thereby push senior workers out of the labour market. This study investigates the association between non-communicable diseases (NCDs) and work ability among workers ≥50 years (senior workers) with physically demanding and sedentary work, respecti...

This study assesses the potential of workplace-based micro-exercise (brief and simple exercise bouts) to prevent long-term sickness absence (LTSA) at the population level. In the Work Environment and Health in Denmark Study (2012–2018), we followed 70,130 workers from the general working population, without prior LTSA, for two years in the Danish R...

Background: This study investigates the role of physical work demands and psychosocial work factors for early retirement among older workers. Methods: Data from three Danish surveys on work environment and health among employed older workers (age 55-59) were merged with a national register containing information on labour market participation. R...

Background: Poor psychosocial work conditions are known to foster negative health consequences. While the existing literature on this topic focus mainly on white-collar workers, the influence of different aspects of the psychosocial work environment in physically demanding jobs remain understudied. Likewise, senior workers represent a population o...

Dette studie undersøger sammenhængen mellem muskelskeletbesvær (MSB) og a) viden om arbejdsmiljø og helbred blandt arbejdstagere med fysisk belastende arbejde og b) deres adgang til information om arbejdsmiljø og helbred. Derefter undersøges og diskuteres, hvorfra og i hvilket format information om arbejdsmiljø og helbred med fordel kan formidles t...

Objective This study investigates the role of age for the prospective association between physical work demands and long-term sickness absence (LTSA). Methods We followed 69 117 employees of the general working population (Work Environment and Health in Denmark study 2012–2018), without LTSA during the past 52 weeks preceding initial interview, fo...

Background: Due to demographic changes, the need to prolong working life has become increasingly salient. Paradoxically, stereotyping and discrimination against workers based on their age can limit possibilities for a long working life. A large body of research has investigated attitudes towards older workers; however, less is known about differen...

Purpose Many older workers are working despite having neck-shoulder pain (NSP), which may give rise to work limitations due to pain, especially among those with high physical work demands. This study investigated the joint association of neck-shoulder pain intensity and physical work demands with work limitations among older workers. Methods In Se...

Objective: This study aimed to investigate the importance of combined ergonomic exposures at work for the development of musculoskeletal pain. Methods: Through four rounds (2012-2018) of the Work Environment and Health in Denmark Study, 18 905 employees of the general working population replied to a baseline and 2-year follow-up questionnaire. F...

Objectives To evaluate whether safety climate items would be predictive of future physical and mental work ability among blue-collar workers. Methods Blue-collar workers (n=3822) from the Danish Work Environment and Health study replied to questions on safety climate, physical and mental work ability, and health in 2012 and 2014. Using multivariat...

Introduction Maintaining good health with advancing age is increasingly important as most European countries experience an increase in retirement age. In order to decrease the risk of premature departure from the workforce, identifying groups at increased risk of musculoskeletal pain and psychosocial stress is essential in designing workplace polic...

Objectives Physically demanding work increases the risk of developing musculoskeletal disorders during working life, with low back pain (LBP) as the most prevalent and debilitating musculoskeletal disorder worldwide. However, a lack of knowledge exists about the role of early working years on musculoskeletal health later in life. This study investi...

Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to...

Background Leg pain, especially of the knees and hips, is common among senior workers and may limit the ability to perform physically demanding work. In light of the aging workforce, this study determined the joint association of physical work demands and leg pain intensity for work-limiting pain in senior workers. Methods Currently employed senio...

Background: Low-back pain (LBP) is highly prevalent among senior workers and may affect work ability, especially among those with hard physical work. This study determined the joint association of LBP intensity and physical work demands with work limitiations due to pain in senior workers. Methods: In the SeniorWorkingLife study (2018), 11,738 s...

Labor market participation has a positive impact on social inclusion and is linked to financial security. This study identifies barriers and willingness to accept re-employment among unemployed seniors that could highlight opportunities for societal action. From the first wave of SeniorWorkingLife in 2018 combined with the Danish version of the Int...

Background The study aimed to determine the association of individual cognitive ability in late midlife with labor market participation among older workers. Methods This prospective cohort study estimates the risk of long-term sickness absence (LTSA), disability pension, early retirement, and unemployment from scores on the Intelligenz-Struktur-Te...

Aims: The interplay between physical and psychosocial working conditions for the risk of developing poor health is not well understood. This study aimed to determine the joint association of physical and psychosocial working conditions with risk of long-term sickness absence (LTSA) in the general working population. Methods: Based on questionnaire...

Objectives The demographic changes in Europe underline the need for an extension of working lives. This study investigates the importance of physical work demands and psychosocial work factors for working beyond the state pension age (65 years). Methods We combined data from three cohorts of the general working population in Denmark (DWECS 2005 an...

Den demografi ske udvikling med en aldrende befolkning og den lovbestemte hævelse af pensionsalderen har medvirket til, at især spørgsmålet om seniorers deltagelse på arbejdsmarkedet fylder meget i den offentlige debat. Sideløbende gennemgår arbejdsmarkedet, og den måde vi arbejder på, grundlæggende forandringer i disse år, hvor en stigende grad af...

Aim: Analyse factors affecting retirement decisions comparing employees expecting to retire before, at, and after the state pension age. Methods: In the SeniorWorkingLife cohort, 12,269 workers aged +50 replied to questions about expected retirement age, reasons for leaving, and reasons for staying longer. Results: For all groups, poor health, wish...

Objectives: This study examined the association of leisure-time physical activity (LTPA) with the risk of long-term sickness absence (LTSA). Methods: A total of 10427 subjects from the general working population in Denmark answered questions about physical activity habits, health and work environment in the 2010 Danish Work Environment Cohort St...

Background: Musculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between physical work demands and work ability in workers with musculoskeletal pain. Methods: Workers with physically demanding jobs (n = 5377) parti...

A total of 22 RCTs comprising 1,209 participants were identified for inclusion in the review. There was a high risk of bias across most of the included studies (12 studies). Only two studies were classified as low risk of bias, and eight studies were classified as moderate risk of bias. The intervention duration ranged from 2 to 13 weeks, frequency...

Background: Work-related musculoskeletal pain is a major cause of work disability and sickness absence. While pain is a multifactorial phenomenon being influenced by work as well as lifestyle, less is known about the association between specific lifestyle factors and the type of musculoskeletal pain. The aim of the study was to investigate if a do...

Background: Persistent bodily fatigue after working days may indicate an imbalance between work demands and capacity of the workers. This study aimed to investigate associations between physical exposures at work and bodily fatigue after work. Methods: Danish workers with physical work (N=5377) answered questions about various physical exposures...

Most European countries are gradually increasing the state pension age, but this may run counter to the capabilities and wishes of older workers. The objective of this study is to identify opportunities in the workplace for supporting a prolonged working life in different groups in the labour market. A representative sample of 11,200 employed worke...

Background: Increasing retirement age is a pivotal issue in labour market reforms. This study analyses factors conditioning retirement intentions. Methods: In SeniorWorkingLife, 11 444 employed workers ≥50 years replied to questions in random order about expected reasons for leaving and potential reasons for staying longer at the labour market....

Background: Musculoskeletal disorders (MSDs) are the leading cause of work disability and sickness absence worldwide. The prevalence of MSDs increases with age, consequently challenging sustainable employability among the growing ageing workforce. Knowledge of feasible and efficient workplace-based interventions to rehabilitate MSD or prevent its...

OBJECTIVE: The aim of this study was to determine the association of physical capability with health-related labor market outcomes among older workers. METHODS: The prospective risk of disability pension and long-term sickness absence (LTSA) of ≥6 weeks was estimated from physical capability on 5076 older workers (age 49–63 years) from the Copenha...

Background: Sleep problems are common in the general population and negatively affect both private and work life. A vicious circle may exist between poor sleep and an unhealthy lifestyle. For example, poor sleep may drain the energy to do health-promoting physical activity during leisure-time after work. The aim of the present study was to investig...

This report is about the health and safety among young people (18-29 years) in Denmark. It is based on a representative sample of young employed people in Denmark. The survey on Working Environment and Health included 3.457 young people in 2016 (1.832 women and 1.625 men). In total 32.849 persons responded to the survey questionnaire. Young people...

Background Due to demographic changes across Europe there are strong political interests in maintaining the labour force by prolonging working life, i.e. increasing retirement age. This may pose both challenges and opportunities for societies, workplaces, and individuals. The SeniorWorkingLife (Danish: SeniorArbejdsLiv) project investigates push an...

Background Construction work frequently involves heavy physical work, and a reduction of the physical workload should have high priority. Technological development has made it possible to obtain field measurements with surface electromyography (sEMG), kinematics measured with inertial measurement units (IMUs), and video recordings. However, no stud...

Background and aims Musculoskeletal pain may negatively affect work ability, especially when work demands are high and/or physical capacity of the worker is low. This study investigated the association between intensity of musculoskeletal pain in multiple body regions and work ability among young and old workers with sedentary and physical demandin...

Background and Objective Musculoskeletal pain is common in the population. Negative beliefs about musculoskeletal pain and physical activity may lead to avoidance behavior resulting in absence from work. The present study investigates the influence of fear avoidance beliefs on long-term sickness absence. Methods Workers of the general working popu...

This study aims to quantify physical workload of the low-back using exposure variation analysis (EVA) during a full working day among blue-collar workers with manual lifting tasks. One hundred and ten male employees (39 warehouse workers, 27 operators, 24 postal workers and 20 slaughterhouse workers) with manual lifting tasks from 12 workplaces par...

Lifting and falls comprise a large proportion of work related injuries. Repetitive lifting to the point of fatigue can affect postural sway, which is associated with fall risk. To investigate the effects of lifting and fatigue on postural sway in males and females, 35 participants (18 male, 17 female) were asked to lift a weighted box in sets of 25...

Aim: In spite of the many health-related benefits of regular physical activity, fatiguing work may be a barrier to performing leisure-time physical activity. This study investigates the association between work-related fatigue and the duration of low- and high-intensity leisure-time physical activity in workers with sedentary and physically demand...

Objectives The capability of safety climate to predict accidents has been the target of widespread debate in occupational health and safety research. The objective of this prospective cohort study was to employ a shortened five-item safety climate survey to investigate whether safety climate reports in 2012 are predictive for accidents reported wit...

BACKGROUND Construction work frequently involves heavy physical work, and a reduction of the physical workload should have high priority. Technological development has made it possible to obtain field measurements with surface electromyography (sEMG), kinematics measured with inertial measurement units (IMUs), and video recordings. However, no stud...

Objective: Muscle atrophy is a common side-effect of bed rest during hospitalization. However, resistance training may minimize or even prevent these complications. Therefore, we evaluated the efficiency of four upper-body elastic resistance exercises that could be performed while lying or sitting in a hospital bed. Methods: Twenty-two healthy subj...

Background: High physical exertion during work is a risk factor for back pain and long-term sickness absence. Objective: To investigate which factors are associated with physical exertion during manual lifting. Methods: From 14 workplaces across Denmark, 200 blue-collar workers reported perceived physical exertion (Borg-CR10) during manual lif...

Background and aims The association between different types of physical activity and fear-avoidance beliefs remains unclear. This study investigates the association between work-related and leisure-time physical activity with fear-avoidance beliefs in the general working population. Methods Currently employed wage earners ( Results The level of f...

Background The aim was to explore the association between retrospectively assessed psychosocial working conditions during working life and prospectively assessed risk of sickness absence and disability pension among older workers. Methods The prospective risk of register-based long-term sickness absence (LTSA) and disability pension was estimated f...

Background While physical exercise is beneficial for back and neck-shoulder pain, only few intervention studies have evaluated effects on pain in multiple body regions. Furthermore, direct measurement of pain threshold can provide additional information to self-reported pain intensity. Objectives To evaluate the effect of workplace versus home-bas...

This study evaluated the influence of different attentional foci for varied grip widths in the bench press. Eighteen resistance-trained men were familiarized with the procedure and performed a one-repetition maximum (1RM) test during Session 1. In Session 2, they used three different standardized grip widths (100%, 150%, and 200% of biacromial widt...

Purpose Obesity is associated with many diseases and functional limitations. Workplaces are not always designed to accommodate this challenge. This study investigated the association between body mass index (BMI) and work ability in the general working population. Methods Currently employed wage earners (N = 10,427) from the 2010 round of the Dani...

Background While benefits of workplace physical exercise on physical health is well known, little is known about the psychosocial effects of such initiatives. This study evaluates the effect of workplace versus home-based physical exercise on psychosocial factors among healthcare workers. Methods A total of 200 female healthcare workers (Age: 42.0...

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 a...

The purpose of this study was to investigate whether using different focus affects electromyographic (EMG) amplitude and contraction duration during bench press performed at explosive and controlled speeds. Eighteen young male individuals were familiarized with the procedure and performed the one-maximum repetition (1RM) test in the first session....

Objectives The aim of this study was to determine the prospective association of cumulative mechanical exposure during working life with health-related labor market outcomes. Methods This prospective cohort study combines data from 5076 older workers (age 49-63 years) from the Copenhagen Aging and Midlife Biobank with a job exposure matrix and a na...

The cover image, by L. L. Andersen et al., is based on the Original Article Validity and reliability of elastic resistance bands for measuring shoulder muscle strength, DOI: 10.1111/sms.12695.

Introduction We aim to determine the prospective association of different physical capacity tests with health related labour market outcomes among older workers. Methods The prospective risk of register-based long-term sickness absence (LTSA) and disability pension from measured musculoskeletal capacity (jump performance, postural balance, sit-to-...

Purpose: Prolonged hospital bed rest after severe injury or disease leads to rapid muscle atrophy and strength loss. Therefore, the main aim of this study was to evaluate the efficacy of lower extremity strengthening exercises using elastic resistance that can be performed while lying in a hospital bed. Methods: Using a cross-sectional design, 2...

Purpose: To investigate the effect of different attentional focus conditions on muscle activity during the push-up exercise and to assess the possible influence of muscle strength and training experience. Methods: Eighteen resistance-trained men performed 1RM bench press testing and were familiarized with the procedure during the first session....

Study design: Cross-sectional. Purpose of the study: This study evaluates finger flexion and extension strengthening exercises using elastic resistance in chronic stroke patients. Methods: Eighteen stroke patients (mean age: 56.8 ± 7.6 years) with hemiparesis performed 3 consecutive repetitions of finger flexion and extension, using 3 differen...

While musculoskeletal pain is common in the population, less is known about its labor market consequences in relation to physical activity at work. This study investigates whether hard physical work aggravates the consequences of back disorder. Using Cox regression analyses, we estimated the joint association of physical activity at work and physic...

While workplace physical exercise can help manage musculoskeletal disorders, less is known about psychosocial effects of such interventions. This aim of this study was to investigate the effect of workplace physical exercise on psychosocial factors among workers with chronic musculoskeletal pain. The trial design was a 2-armed parallel-group random...

Objectives The aim of this study was to determine the joint association of multimorbidity and work ability with the risk of long-term sickness absence (LTSA) in the general working population. Methods Cox regression analysis censoring for competing events (statutory retirement, early retirement, disability pension, immigration, or death) was perfor...

Objective: To investigate whether bodyweight exercises can induce comparable levels of muscle activity as conventional machine exercises in chronic stroke patients. Methods: Eighteen patients performed three repetitions of bilateral- and unilateral machine leg press and the bodyweight exercises chair rise and hip thrust. Surface electromyography...

The aim of this study is to identify factors associated with musculo-skeletal pain reduction during workplace-based or home-based physical exercise interventions among healthcare workers. Two hundred female healthcare workers (age: 42.0, BMI: 24.1, average pain intensity: 3.1 on a scale of 0-10) from three hospitals participated. Participants were...

Background: Cognitive and physical performance can be negatively affected by chronic pain. This study evaluates the effect of combined physical-, cognitive-, and mindfulness training (PCMT) on cognitive and physical performance. Methods: From a large pharmaceutical company in Denmark we randomly allocated 112 female laboratory technicians with c...

Objective: This study aimed to investigate the association between occupational lifting and day-to-day change in low-back pain (LBP) intensity. Methods: Each day for three consecutive weeks, 95 full-time workers from 51 Danish supermarkets with frequent occupational lifting replied to daily text messages about LBP intensity (scale 0-10). Supervi...

People with chronic musculoskeletal pain often experience pain-related fear of movement and avoidance behavior. The Fear-Avoidance model proposes a possible mechanism at least partly explaining the development and maintenance of chronic pain. People who interpret pain during movement as being potentially harmful to the organism may initiate a vicio...