Päivi Leino-Arjas

• MD, Adjunct prof.
• Senior Researcher at Finnish Institute of Occupational Health

Self-rated health is a major indicator of an individual's overall health status, but its development during midlife to old age, as well as influence of sociodemographic and work-related factors on it, are poorly understood. We used longitudinal individual-level data to examine trajectories of self-rated health and their determinants in 38,163 parti...

Self-rated health is a major indicator of an individual’s overall health status, but its development during midlife to old age, as well as influence of sociodemographic and work-related factors on it, are poorly understood. We used longitudinal individual-level data to examine trajectories of self-rated health and their determinants in 38,163 parti...

Self-rated health is a major indicator of an individual's overall health status, but its development during midlife to old age, as well as influence of sociodemographic and work-related factors on it, are poorly understood. We used longitudinal individual-level data to examine trajectories of self-rated health and their determinants in 38,163 parti...

We studied the developmental trajectories of satisfaction with work–family reconciliation (WFS) and their associations with family—related factors and quality of life measures among municipal employees. The study was based on the Helsinki Health Study of municipal employees of the City of Helsinki in 2001–02 and its follow-up surveys in 2007, 2012,...

Background . Decreased work ability due to mental disorders is a growing concern in Europe. We studied the role of work-family conflicts in association with long-term sickness absence due to mental disorders (LTSA-MD). Methods . Baseline data were extracted from the Helsinki Health Study for women aged 40 to 55 in full-time work in 2001 − 2002 (N...

Objectives Amyotrophic lateral sclerosis (ALS) is a serious neurodegenerative disease that usually leads to death within a few years from diagnosis. The risk factors for ALS are still largely unknown. However, it is assumed that environmental factors play a role in disease onset. Occupation is suggested as a potential risk factor, but findings are...

The effect of flexible work on mental health is not well known. The aim of this systematic review was to assess the effects of employee-oriented flexible work on mental health problems and associated disability. Literature searches were conducted in the PubMed, Scopus, Web of Sciences, Cochrane Library, PsycINFO, ProQuest and EconPapers databases f...

Objective: This study aimed to examine duration of sickness absence due to knee osteoarthritis (OA) and sustained return to work (RTW) among municipal employees, who had at least one compensated sickness absence period due to knee OA. The contribution of sociodemographic characteristics, diabetes and previous sickness absence were assessed. We dif...

The authors wish to make the following correction to this paper [...]

Work disability may originate early during work history and involve sickness absences (SA) and eventually permanent disability. We studied this process over 15 years. Questionnaire data collected in 1981 on health, working conditions, and lifestyle of Finnish municipal employees aged 44–58 years (n = 6257) were linked with registers on SA (≥10 work...

Background A rising number of women will go through menopause while working. We aimed to examine the association of menopausal status with multisite pain and pain interfering with work ability. Methods We analysed cross sectional data collected in the Helsinki Health Study. Female full-time municipal employees aged 45, 50, 55 or 60 years and of at...

Objective: To estimate the effects of excess body mass and leisure time physical activity on the incidence and persistence of chronic pain. Design: A prospective cohort study. Methods: As a part of the Finnish Helsinki Health Study, we included three cohorts of employees of the City of Helsinki (18,562 observations) and defined incident chronic p...

Background We examined the developmental trajectories of multisite musculoskeletal pain to acquire the developmental patterns of musculoskeletal pain among midlife municipal employees and whether pain trajectories associate with common mental disorders or behaviors. Methods Middle-aged (44 to 67 years) municipal employees from the city of Helsinki...

Objectives: We examined developmental trajectories of multisite musculoskeletal pain in midlife, and their associations with mental well-being. Methods: Midlife municipal employees at baseline aged 40, 45, 50, 55 or 60 years (80% women) from the City of Helsinki, Finland, responded to a baseline questionnaire in 2000-02 (N=8960; response rate 67...

The contribution of physically demanding work to the developmental trajectories of sickness absence (SA) has seldom been examined. We analyzed the associations of 12 physical work exposures, individually and in combination, with SA trajectories among the occupationally active in the Finnish nationally representative Health 2000 survey. We included...

Background We aimed to investigate trajectories of mobility limitations (MLs) over a period of 24 years. In addition, we aimed to study how shift work and leisure-time physical activity (LTPA) in midlife predict assignment to MLs trajectories separately for those retired on statutory pensions (SPs) and on disability pensions (DPs). Methods Subject...

Background Physical workload factors have been linked to the risk of sickness absence, however, some work exposures can also be protective of work ability. We aimed to first identify sickness absence trajectories in a nationally representative occupational cohort, and second to examine the associations between physical workload factors, potential p...

Objectives We studied the developmental trajectories of multisite musculoskeletal pain (MSP) to learn whether pain in midlife persists to old age, and whether pain trajectories associate with midlife work or lifestyle exposures or retirement from work. Methods Municipal employees aged 44–58 years were studied in 1981 (n=6257) with follow-ups in 19...

Long sickness absences pose a considerable burden to the labour market and so- cial welfare system. Health insurance compensates for loss of income when an illness leads to acute work incapacity. In addition to enabling rest and recovery, repeti- tive and prolonged sickness absence may have adverse consequences for the work- er, such as an increas...

Background Despite the hard effort in OA genetic studies only a small part of the estimated effect has been found so far and thus the focus has been changing from genetic to epigenetic studies. The most widely studied epigenetic control mechanism is DNA methylation. There are only few studies on hand OA concerning DNA methylation but their results...

Objectives We aimed to investigate the long-term association of insomnia and fatigue due to shift work (with and without night shifts) in midlife and mobility limitations (ML) among initially middle-aged subjects followed over 28 years. Methods The Finnish Longitudinal Study on Ageing Municipal Employees (FLAME) was conducted by the Finnish Instit...

Background Previous studies have not distinguished between different alcohol-use histories, which could have contributed to the current inconsistent evidence regarding the relationship between alcohol use and subsequent sickness absence. We thus examined alcohol use and subsequent diagnosis-specific sickness absence in groups with different levels...

Background Functional somatic symptoms (FSS), or symptoms without a clear medical explanation are a considerable challenge for health care systems. There is no general consensus as to which symptoms should be regarded functional. Few longitudinal studies on the development of FSS exist and these have mainly been based on the assumption that the fac...

Background: Osteoarthritis (OA) is the most common degenerative joint disease afflicting people in the Western world and has a strong genetic influence. The aim of this study was to examine the association of two known functional polymorphisms in the TGF-β inhibiting genes, asporin (ASPN) and cartilage intermediate layer protein (CILP), with hand...

Objective: This study aimed to develop and validate a risk screening tool using a points system to assess the risk of future disability retirement due to musculoskeletal disorders (MSD). Methods: The development population, the Health 2000 Survey, consisted of a nationally representative sample of Finnish employees aged 30–60 years (N=3676) and th...

Depression and musculoskeletal pain are associated, but long-term follow-up studies are rare. We aimed to examine the relationship of early depressive symptoms with developmental patterns of musculoskeletal pain from adolescence to middle age. Adolescents ending compulsory school (age 16) in Luleå, Northern Sweden, in 1981 (n = 1083) were studied a...

Objectives: Available evidence suggests that genetic factors and overweight play major roles in the aetiology of osteoarthritis (OA). We analysed the association of 18 single-nucleotide polymorphisms (SNPs) from nine adipokine and adipokine receptor genes (LEP, LEPR, ADIPOQ, RETN, NAMPT, SERPINA12, ITLN1, RARRES2, and APLN) with radiographic hand O...

Background It is important to identify individuals at high risk of work disability and target healthcare interventions at the high risk group. The objective of this study was to develop and validate a novel risk prediction tool using a points system to predict the risk of future disability pension due to musculoskeletal disorders (MSDs). Methods T...

Objectives We investigated whether the extent of biomechanical exposures and job strain in midlife separately and jointly predict disability in old age. Methods Participants of the Finnish Longitudinal Study on Aging Municipal Employees (FLAME) in 1981 (aged 44-58 years) responded to disability questionnaires in 2009 (1850 women and 1082 men). Diff...

Abstract We investigated how work-related biomechanical exposure and job strain in midlife separately and jointly predict back and degenerative Musculoskeletal Diseases (MSDs). A total of 6257 employees participated in the Finnish Longitudinal study on Aging Municipal Employees (FLAME) in 1981 and were followed up for 28-years. Risk ratios and the...

The EULAR recommendations for the management of fibromyalgia are based on more than 100 reviews and meta-analyses of individual therapies and medicines.1 Thus, the quality of the evidence in making recommendations on effectiveness and efficacy is generally very high. In contrast, there is little published research …

In order to test our hypothesis, and compare relationships, we chose to include the following parameters in the study; weight, height, waist circumference, hip circumference, neck circumference, and gender. The two methods for weight categorization used were the BMI and the US Navy Body Fat calculator. We developed a multiple choice questionnaire t...

Objective: Although several studies have shown that adolescent musculoskeletal pain is associated with psychological problems in a cross-sectional setting, the associations of long-term musculoskeletal pain with psychological distress and anxiety are not known. Methods: The study included 1773 adolescents belonging to the Northern Finland Birth...

Objective To investigate the developmental pathways of multisite musculoskeletal pain (MSP) and the effect of physical and psychosocial working conditions on the development of MSP trajectories. Methods The study was conducted among food industry workers (N=868) using a longitudinal design. Surveys were conducted every 2 years from 2003 to 2009. T...

We identified factors protective of all-cause sickness absence (SA) among subjects with multisite musculoskeletal pain (MSP). The nationally representative source sample comprised 3420 actively working Finns aged 30-55 in year 2000 and alive at follow-up. Pain in 18 body locations was combined into four sites (neck, low back, upper limbs, lower lim...

Objective Multi-site musculoskeletal pain at multiple sites is more common than single-site pain. We investigated the developmental paths of multi-site musculoskeletal pain and the effect of work-related physical and psychosocial working conditions among blue- and white-collar workers. Methods The study was conducted among food industry workers (N...

Aims We investigated how the nature of work predicts musculoskeletal disorder (MSDs) in a 28-year follow-up. Methods In total 6257 people aged 44–58 years participated in the Finnish study of Municipal Employees (FLAME) in 1981 and were followed up for the next 28 years in 5 different waves. For this study, 2 waves: early retirement (1992, N = 453...

Purpose Occupations during adult life may have long-term effects and subsequently increase the risk of disability in old age. We investigated the associations between job profile groups in midlife and disability in old age for women and men. Methods This prospective 28-year follow-up study (1981–2009) examined 2998 municipal employees (1892 women a...

Objective The original European League Against Rheumatism recommendations for managing fibromyalgia assessed evidence up to 2005. The paucity of studies meant that most recommendations were ‘expert opinion’. Methods A multidisciplinary group from 12 countries assessed evidence with a focus on systematic reviews and meta-analyses concerned with pha...

Aims: Previously, among food industry workers, multisite pain predicted sickness absence (SA) only in those with low biomechanical workload. Here we studied among a wide range of occupations whether the relationship of pain with SA was modified by the level of physical or psychosocial workload. Methods: A nationally representative sample (Health...

Objectives: We analyzed the work ability index (WAI) and its first item (work ability score, WAS) - and subsequent four-year changes thereof - as predictors of disability pension (DP). Methods: We linked survey responses of 5251 Finnish municipal employees, aged 44-58 years, to pension and death register data until 2009. Job content (physical, m...

Aim: Although multisite pain (MSP) often threatens work ability (WA), some of those with MSP retain good WA. Our aim was to identify factors associated with good WA among subjects with MSP. Methods: A nationally representative sample (the Health 2000-Study, response rate 87%) comprising 3884 occupationally active Finns aged 30-64 years. Data on...

Objectives Osteoarthritis (OA) is a joint disease common in the elderly. There is a prior functional evidence for different matrix metalloproteinases (MMPs), such as MMP8 and MMP9, having a role in the breakdown of cartilage extracellular matrix in OA. Thus we analyzed whether the common genetic variants of MMP8 and MMP9 contribute to the risk of O...

Pain and emotional exhaustion are prevalent conditions with consequences for sickness absence. Although they often co-occur, their combined associations with sickness absence are poorly understood. This study aimed to examine the separate and combined associations of pain and emotional exhaustion with subsequent sickness absence.The data were deriv...

Introduction: We examined the socio-demographic and behavioral determinants of perceived barriers to leisure-time physical activity (LTPA) in a population-based sample of working-aged adults. Methods: Data comprised the National FINRISK 2002 Study, a population-based health examination study. Analyses were restricted to those aged 25-64 years an...

Musculoskeletal pain at several sites (multisite pain) is more common than single-site pain. Little is known on its effects on disability pension (DP) retirement. A nationally representative sample comprised 4071 Finns in the workforce aged 30 to 63. Data (questionnaire, interview, clinical examination) were gathered in 2000-2001 and linked with na...

To justify alcohol-related health promotion programs and target them at the correct workplaces, it is important to identify occupations with increased risk of severe health outcomes caused by alcohol. Data on hospital admissions (854 555 men and 801 653 women) from the Finnish health care register and data on deaths from Statistics Finland from 1 J...

Occupational psychosocial stress has been identified as a risk factor for obesity, whereas dietary habits have a key role in weight control. We examined whether dietary habits modify the association between occupational psychosocial factors and waist circumference. Data comprised 31-year-old men (n=2222) and women (n=2053) in the Northern Finland B...

To examine the associations between occupational psychosocial factors and obesity among 31-year-olds, adjusting for adolescent body mass index, physical strenuousness of work, and adverse health behaviors (ie, stress-related eating/drinking, leisure-time physical inactivity, smoking, and high alcohol consumption). The study population comprised 208...

Aim: According to previous studies, abstinence from alcohol increases the risk of disability retirement (DR). We studied whether former alcohol users' poor mental or physical health might have contributed to this result. Methods: Prospective population-based study of 3621 occupationally active Finns aged 30-55 years at baseline. Disability pension...

Background: The development of osteoarthritis (OA) involves inflammation, but the evidence for participation of genes propagating or inhibiting inflammation in the OA process is inconsistent. We investigated the associations of common variants in the TNFα gene, and their interactions with other cytokine genes, with hand OA among Finnish women. Me...

Objective: To investigate developmental paths in multisite musculoskeletal pain (MPS) and depressive symptoms (DPS) and the effects of job demands (JD), job resources (JR), optimism and health-related lifestyle on these paths. We expected to find four trajectories--Low Symptoms, High Pain, High Depression and High Symptoms--and hypothesised that h...

Aim: To investigate single-site and multi-site musculoskeletal pain as predictors of future sickness absence due to musculoskeletal disorders (MSD) among blue-collar employees in food industry, and to study to what extent this relationship depends on physical loading at work. Methods: Survey responses of 901 employees on working conditions and m...

Objectives To investigate the importance of multi-site musculoskeletal pain as a predictor of sickness absence days due to musculoskeletal disorders (MSD) among blue-collar employees, and to study what extent such a relationship might be confounded by physical loading at work. Method Survey responses from 901 employees were linked to a food industr...

Our aims were to replicate some previously reported associations of single nucleotide polymorphisms (SNPs) in five genes (A2BP1, COG5, GDF5, HFE, ESR1) with hand osteoarthritis (OA), and to examine whether genes (BCAP29, DIO2, DUS4L, DVWA, HLA, PTGS2, PARD3B, TGFB1 and TRIB1) associated with OA at other joint sites were associated with hand OA amon...

To identify work ability trajectories among Finnish firefighters during a 13-year follow-up. We examined whether baseline musculoskeletal pain and depressive symptoms (DPS) predicted membership of the trajectories. We studied 411 male firefighters who responded to a questionnaire at both baseline and at least one of two follow-ups. The outcome vari...

We studied predictors of sickness absences (SA) due to musculoskeletal pain over two years among 386 municipal female kitchen workers. Pain and SA periods (no/yes) due to pain in seven sites during the past three months were assessed at 3-month intervals over two years by questionnaire. Age, musculoskeletal pain, multisite pain (pain in ≥3 sites),...

Background: high job strain increases the risk of health decline, but little is known about the specific consequences and long-term effects of job strain on old age health. Objectives: purpose was to investigate whether physical and mental job strain in midlife was associated with hospital care use in old age. Methods: study population included 5,6...

Prospective cohort study. To study the associations between strenuous leisure time physical activity (LTPA) and subsequent hospitalization due to back disorders. Socioeconomic and lifestyle factors are associated with back-related hospitalization, but the significance of strenuous LTPA in the working population is unclear. The cohort (n = 902) was...

To examine the relationship of musculoskeletal pain and depressive symptoms, occurring alone or both together, with self-rated current work ability and thoughts of early retirement. In a nationally representative sample drawn in 2000-2001, we studied actively working subjects aged 30 to 64 years (n = 4009). Musculoskeletal pain was associated with...

Pain and emotional exhaustion are prevalent conditions with consequences for sickness absence. These conditions may co-occur but their joint associations with sickness absence have not been studied. We aimed to examine separate and joint associations of pain and emotional exhaustion with sickness absence. Data derived from the City of Helsinki reg...

Background: Available information about the association between education and physical fitness (PF) is scarce. The purpose of this study was to examine educational differences in PF in the working age population using different methods to assess PF. Methods: The Health 2000 Survey was carried out for adults aged ≥ 30 years (n = 8028) in Finland....

Objectives: We aimed to investigate the relationship of task variation during dental work history with pinch grip strength among dentists. Methods: We measured pinch grip strength among 295 female Finnish dentists aged 45-63 years. Variation in dental work tasks during work history was empirically defined by cluster analysis. Three clusters of t...

Background: We investigated the separate and joint effects of multi-site musculoskeletal pain and physical and psychosocial exposures at work on future work ability. Methods: A survey was conducted among employees of a Finnish food industry company in 2005 (n = 1201) and a follow-up survey in 2009 (n = 734). Information on self-assessed work abi...

We studied the number of musculoskeletal pain sites as a predictor of sickness absence during a 7-year follow-up among a nationally representative sample (the Health 2000 survey) of occupationally active Finns 30 to 55years of age (3420 subjects who did not retire or die during the follow-up). Baseline data (questionnaire, interview, clinical exami...

Background The aim of this study was to explore long-term predictors of leisure time physical activity in the general population. Methods This study comprised 718 men and women who participated in the national Mini-Finland Health Survey from 1978–1980 and were re-examined in 2001. Participants were aged 30–80 at baseline. Measurements included int...

To study the associations of sociodemographic factors, working conditions, lifestyle and previous pain in the spine with new onset chronic neck pain (NP). The participants were municipal employees free of chronic NP at baseline, aged 40, 45, 50, 55 or 60 years (n = 5277, 80% women). Self-reported data on occupational class, working conditions, body...

The aim of this prospective study was to examine the role of physical workload, leisure-time physical activity, obesity and smoking in predicting the occurrence and course of multisite musculoskeletal pain (MSP). Data on physical and psychosocial workload, lifestyle factors and MSP were based on questionnaire surveys of 385 Finnish female kitchen w...

To study whether having ever had local low back pain (LBP), sciatica, neck pain (NP), or some combination of LBP and NP, predicts sickness absence among municipal employees. The study sample (n=6911, 80% women, response rate 67%) included employees of the City of Helsinki who reached the age of 40, 45, 50, 55, or 60 years between 2000-02. Survey da...

This study examined the association of pain with subsequent disability retirement due to all causes as well as musculoskeletal diseases, mental disorders, and a heterogeneous group of other diseases and to study whether pain has an effect of its own after taking into account long-standing illness, physician-diagnosed diseases, working conditions, a...

To evaluate the role of physical workload in low back pain (LBP) among adolescents. Working history and physical workload factors at 18 years were assessed for 1984 members of the Northern Finland Birth Cohort 1986. The associations between work characteristics and LBP were analysed by multinomial logistic regression. Those with and without LBP at...

We reviewed work histories of manual handling of loads >20 kg in relation to hip osteoarthritis by age, exposure and work participation. A nationally representative sample of 3110 Finnish men and 3446 women aged 30-97 was recruited. Diagnosis of hip osteoarthritis was based on standardised clinical examination by trained physicians. Previous exposu...

Introduction We investigated whether self-perceived work ability related to co-occurring musculoskeletal and mental symptoms has changed over time. Methods Five cross-sectional telephone surveys were conducted triennially in 1997–2009 among representative samples of working Finns (n=2000–2400/survey year, total N=11 000). The risk of reduced work a...

To investigate the association of radiographic finger osteoarthritis (OA), hand use, and lifestyle factors with incident and persistent finger joint pain among female dentists and teachers. Random samples of female dentists (n = 295) and teachers (n = 248) ages 45-63 years were examined by radiography for the presence of finger joint OA. Body weigh...

Introduction To investigate the association of radiographic finger osteoarthritis (OA), hand use, and lifestyle factors with incident and persistent finger joint pain among female dentists and teachers. Methods Random samples of female dentists (n=295) and teachers (n=248) aged 45–63 years were examined for the presence of finger joint OA by radio...

Population-based cross-sectional study of clinically assessed low back syndromes. To investigate whether exposure to professional car driving, either alone or in combination with strenuous physical work is associated with clinically defined sciatica or other clinically diagnosed chronic low back syndromes. Several studies have found an association...

Lifestyle factors such as smoking, obesity, and level of physical activity predict low back pain (LBP) and sciatica. The authors investigated whether participating in sports, smoking, and being overweight or obese at 14 years of age predicted hospitalizations due to LBP or sciatica in adulthood. In 1980, at the age of 14 years, a total of 11,399 me...

To assess whether symptoms of fibromyalgia (FM) predict disability retirement or mortality. All Finnish Twin Cohort members and diagnosed FM-patients who had answered the same health questionnaire in 1990-1992 were studied. A sample of 10,608 working aged individuals of the cohort was classified in homogenous groups based on symptom profile with la...

To study the effects of occupational class, physical and psychosocial working conditions, health behaviours, and pain in the low back and the neck on sciatic pain among middle-aged employees. The participants were municipal employees without previous sciatica, aged 40, 45, 50, 55, and 60 years at baseline (n=5261, 80% women). Sciatica was defined a...

To address the need for standardization of osteoarthritis (OA) phenotypes by examining the effect of heterogeneity among symptomatic (SOA) and radiographic osteoarthritis (ROA) phenotypes. Descriptions of OA phenotypes of the 28 studies involved in the TREAT-OA consortium were collected. We investigated whether different OA definitions result in di...

The aim of this study was to examine different domains of health functioning as predictors of sickness absence. The Short Form 36 (SF-36) is one of the best known instruments measuring various domains of physical and mental health functioning. A questionnaire including the SF-36 was mailed to 40-60-year-old employees of the City of Helsinki in 2000...

Among 385 female kitchen workers, we examined (1) whether mental stress and psychosocial factors at work (job control, skill discretion, supervisor support, co-worker relationships, and hurry) predict multiple-site musculoskeletal pain (MSP; defined as pain at ≥ 3 of seven sites) and (2) reversedly, whether MSP predicts these psychosocial factors....

To investigate the impact of employment characteristics on the occurrence of long-term sickness absence taking socioeconomic covariates into account. A longitudinal analysis was conducted for 62,745 employees aged 18 to 64 during 1990-1999. A nonlinear random-effects model was used. In particular, the missing data patterns and their relationship wi...

Little is known about the relationships of clinical findings in the low back with low back pain (LBP) in the normal working population. We studied whether physiotherapist's findings in the low back were associated with local and radiating LBP among a cohort (n=902) of employees in the engineering industry. A systematic non-proportional sample was d...

To assess the association between smoking and low back pain with meta-analysis. We conducted a systematic search of the MEDLINE and EMBASE databases until February 2009. Eighty-one studies were reviewed and 40 (27 cross-sectional and 13 cohort) studies were included in the meta-analyses. In cross-sectional studies, current smoking was associated wi...