Work disability following major organisational change: The Whitehall II study

Article (PDF Available)inJournal of epidemiology and community health 64(5) · May 2010with11 Reads
DOI: 10.1136/jech.2009.095158 · Source: OAI
Background: Privatisation and private sector practices have been increasingly applied to the public sector in many industrialised countries. Over the same period, long-term work disability has risen substantially. We examined whether a major organisational change--the transfer of public sector work to executive agencies run on private sector lines--was associated with an increased risk of work disability. Methods: The study uses self-reported data from the prospective Whitehall II cohort study. Associations between transfer to an executive agency assessed at baseline (1991-1994) and work disability ascertained over a period of approximately 8 years at three follow-up surveys (1995-1996, 1997-1999 and 2001) were examined using Cox proportional hazard models. Results: In age- and sex-adjusted models, risk of work disability was higher among the 1263 employees who were transferred to an executive agency (HR 1.90, 95% CI 1.46 to 2.48) compared with the 3419 employees whose job was not transferred. These findings were robust to additional adjustment for physical and mental health and health behaviours at baseline. Conclusions: Increased work disability was observed among employees exposed to the transfer of public sector work to executive agencies run on private sector lines. This may highlight an unintentional cost for employees, employers and society.

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Available from: Archana Singh-Manoux, Dec 12, 2015
    • "However, another study of a longterm follow-up of downsizing survivors in Finland did not show increased mortality [Martikainen et al., 2008], suggesting that long-term job stability may compensate for the more temporary stress of downsizing. Privatization: One study of British civil servants, whose agency was privatized, showed a 90% elevated risk of work disability over 8 years of follow-up [Virtanen et al., 2010]. Another study showed increases in body mass index, ischemia, cholesterol, and, for women, blood pressure, but little change in health behaviors over 5 years of follow-up, compared to those who remained in the civil service [Ferrie et al., 1998]. "
    [Show abstract] [Hide abstract] ABSTRACT: Background: Changes in employment conditions in the global economy over the past 30 years have led to increased job insecurity and other work organization hazards. These hazards may play a role in creating and sustaining occupational health disparities by socioeconomic position, gender, race, ethnicity, and immigration status. Methods: A conceptual model was developed to guide the review of 103 relevant articles or chapters on the role of work organization and occupational health disparities identified through a comprehensive search conducted by NIOSH. A second review was conducted of employment and workplace policies and programs designed to reduce the health and safety risks due to job insecurity and other work organization hazards. Results: There is consistent evidence that workers in lower socioeconomic or social class positions are exposed to greater job insecurity and other work organization hazards than workers in higher socioeconomic positions. Likewise, racial and ethnic minorities and immigrants are exposed to greater job insecurity. Limited research examining the effects of interventions targeting work organization hazards on disparities has been conducted; nonetheless, intervention strategies are available and evidence suggests they are effective. Conclusions: Job insecurity and work organization hazards play a role in creating and sustaining occupational health disparities. Employment and workplace policies and programs have the potential to reduce these hazards, and to reduce disparities.
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    • "However, the study had comprehensive information on several diseases and complaints that are well known risk factors for disability pension. Furthermore, the study included self-rated health, a common measure for both physical and mental health and also an independent predictor for disability pension192021. The present study had only a crude measure of alcohol consumption, which may have underestimated the impact of alcohol consumption.Table 3 Multilevel linear regression of the logarithm of days (95% confidence intervals) in rehabilitation time prior to disability pension award for subjects with musculoskeletal diagnosis (Continued)Table 4 Multilevel linear regression of the logarithm of days (95% confidence intervals) in rehabilitation time prior to disability pension award for subjects with psychiatric diagnosis The number of participants was limited to those with complete information for all study variables (1,757) in the regression models. "
    [Show abstract] [Hide abstract] ABSTRACT: Background The decision to grant a disability pension is usually the end of a long process of medical examinations, treatment and rehabilitation attempts. This study investigates to what extent the time spent on rehabilitation time prior to disability pension is associated with characteristics of the individual or the local employment and welfare office, measured as municipality variance. Methods A study of 2,533 40 to 42 year olds who received disability pension over a period of 18 years. The logarithm of the rehabilitation time before granting a disability pension was analysed with multilevel regression. Results The rehabilitation time before a disability pension was granted ranged from 30 to 5,508 days. Baseline health characteristics were only moderately associated with rehabilitation time. Younger people and people with unemployment periods had longer rehabilitation time before a disability pension was granted. There were only minor differences in rehabilitation time between men and women and between different levels of education. Approximately 2% of the total variance in rehabilitation time could be attributed to the municipality of residence. Conclusions There is a higher threshold for granting a disability pension to younger persons and those who are expecting periods of unemployment, which is reflected in the extended rehabilitation requirements for these groups. The longer rehabilitation period for persons with psychiatric disorders might reflect a lack of common knowledge on the working capacity of and the fitted rehabilitation programs for people with psychiatric disorders.
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    • "Work arrangements have received little previous study as risk factors for disability retirement, and the existing evidence is heterogeneous. Organisational changes [10] as well as long working hours [12] have shown associations with disability retirement. However, employees in regular day-time work have been shown to be at a higher risk of retirement than those doing shift work [12]. "
    [Show abstract] [Hide abstract] ABSTRACT: Early retirement due to disability is a public health and work environment problem that shortens working careers. Transition to disability retirement is based on ill-health, but working conditions are also of relevance. We examined the contributions of work arrangements, physical working conditions and psychosocial working conditions to subsequent disability retirement. The data were derived from the Helsinki Health Study cohort on employees of the City of Helsinki, Finland. Information on working conditions was obtained from the baseline surveys conducted in 2000, 2001 and 2002. These data were linked with register data on disability retirement and their main diagnoses obtained from the Finnish Centre for Pensions. Follow up by the end of 2008 yielded 525 disability retirement events. The analysed data included 6525 participants and 525 disability retirement events. Hazard ratios (HR) and 95% confidence intervals (95% CI) were calculated from Cox regression analysis. Several working conditions showed own associations with disability retirement before adjustment. After adjustment for all working conditions, the primary risk factors for all-cause disability retirement were physical workload among women (HR 2.02, 95% CI 1.57-2.59) and men (HR 2.00, 95% CI 1.18-3.38), and low job control among women (HR 1.60, 95% CI 1.29-1.99). In addition, for disability retirement due to musculoskeletal causes, the risk factors were physical workload and low job control. For disability retirement due to mental causes the risk factors were computer work and low job control. Furthermore, occupational class was a risk factor for disability retirement due to all causes and musculoskeletal diseases. Among various working conditions, those that are physically demanding and those that imply low job control are potential risk factors for disability retirement. Improving the physical working environment and enhancing control over one's job is likely to help prevent early retirement due to disability.
    Full-text · Article · Apr 2012
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