Work participation and working life expectancy after a disabling shoulder lesion

Abstract

Objective: To examine the impact of a disabling non-traumatic shoulder lesion on work participation and working life expectancy.

Methods: From a 70% random sample of the Finnish population, we selected 30-59-year-old wage earners with prolonged sickness absence due to a shoulder lesion (n=7644). We followed the persons from 2006 to 2014 and calculated the proportion of time a person spent in different work participation statuses. The associations of potential determinants with a preterm exit from paid employment were tested using Cox regression. Years expected to be spent in different work participation statuses were estimated applying the Sullivan method for healthy life expectancy.

Results: During 9 years of follow-up time spent at work was reduced from 77.7% to 46.7%, and 15.8% of the persons were granted disability retirement, mostly due to shoulder and other musculoskeletal diseases. Compared with the general population persons with a disabling shoulder disease are expected to lose from 1.8 to 8.1 years of working life, depending on their age. Age, gender, education, duration of initial sickness absence due to the shoulder lesion, not being able to return to work sustainably and participation in vocational rehabilitation predicted preterm exit from work. Heavy lifting increased the risk of preterm exit marginally.

Conclusions: Working life expectancy is markedly reduced in persons with a disabling shoulder lesion, mainly because of disability retirement due to musculoskeletal problems. Clinicians should consider interventions targeted at improving musculoskeletal functioning and necessary work modifications before shoulder problems become chronic or the persons develop disabling comorbid musculoskeletal conditions.

Keywords: epidemiology; musculoskeletal; oh services; sickness absence; workload.

Figure 1

Time spent during follow-up in different work participation statuses after prolonged SA due to a shoulder lesion. The work participation statuses are: (1) at work (having employment and not receiving any benefit), (2) on partial work disability (receiving partial work disability benefit, including part time SA and partial disability retirement), (3) on SA due to a shoulder lesion (receiving full-time SA benefit), (4) on time restricted full-time work disability (receiving a full-time, ill-health-related benefit paid for a restricted time period, including SA benefit due to other reason than shoulder lesion, temporary disability retirement and vocational rehabilitation), (5) unemployed, (6) economically inactive (not at work and not receiving ill-health related or unemployment benefit, or pension), (7) on permanent disability retirement, and (8) on old age retirement. SA, sickness absence.

Figure 2

Years expected to be spent in different work participation statuses by the age of onset of the prolonged sickness absence due to a shoulder lesion.

Figure 3

Working life expectancy in 2006 among the general Finnish population (21) and persons with a disabling shoulder lesion (after a prolonged SA due to a shoulder lesion). SA, sickness absence.