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  • Exposure to heavy physical work from early to later adulthood and primary healthcare visits due to musculoskeletal diseases in midlife: a register linked study

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Occupational and environmental medicine
Research
Exposure to heavy physical work from early to later adulthood and primary healthcare visits due to musculoskeletal diseases in midlife: a register linked study
  1. Jaana I Halonen1,
  2. Rahman Shiri1,
  3. Minna Mänty2,
  4. Hilla Sumanen2,3,
  5. Svetlana Solovieva1,
  6. Eira Viikari-Juntura1,
  7. Mika Kähönen4,5,
  8. Terho Lehtimäki6,
  9. Olli T Raitakari7,8,9,
  10. Tea Lallukka1,2
  1. 1Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland
  2. 2Department of Public Health, University of Helsinki, Helsinki, Finland
  3. 3Health Care and Emergency Care, South-Eastern Finland University of Applied Sciences, Kotka, Finland
  4. 4Tampere University Hospital, Tampere, Finland
  5. 5Department of Clinical Physiology and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland
  6. 6Department of Clinical Chemistry, Fimlab Laboratories, and Finnish Cardiovascular Research Center, University of Tampere, Tampere, Finland
  7. 7Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
  8. 8Research Centre of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
  9. 9Centre for Population Health Research, University of Turku and Turku University Hospital, Tampere, Finland
  1. Correspondence to Dr Jaana I Halonen; jaana.halonen{at}thl.fi

Abstract

Objectives To examine whether exposure to heavy physical work from early to later adulthood is associated with primary healthcare visits due to cause-specific musculoskeletal diseases in midlife.

Design Prospective cohort study.

Setting Nationally representative Young Finns Study cohort, Finland.

Participants 1056 participants of the Young Finns Study cohort.

Exposure measure Physical work exposure was surveyed in early (18–24 years old, 1986 or 1989) and later adulthood (2007 and 2011), and it was categorised as: ‘no exposure’, ‘early exposure only’, ‘later exposure only’ and ‘early and later exposure’.

Primary and secondary outcome measures Visits due to any musculoskeletal disease and separately due to spine disorders, and upper extremity disorders were followed up from national primary healthcare register from the date of the third survey in 2011 until 2014.

Results Prevalence of any musculoskeletal disease during the follow-up was 20%, that for spine disorders 10% and that for upper extremity disorders 5%. Those with physically heavy work in early adulthood only had an increased risk of any musculoskeletal disease (risk ratio (RR) 1.55, 95% CI 1.05 to 2.28) after adjustment for age, sex, smoking, body mass index, physical activity and parental occupational class. Later exposure only was associated with visits due to any musculoskeletal disease (RR 1.46, 95% CI 1.01 to 2.12) and spine disorders (RR 2.40, 95% CI 1.41 to 4.06). Early and later exposure was associated with all three outcomes: RR 1.99 (95% CI 1.44 to 2.77) for any musculoskeletal disease, RR 2.43 (95% CI 1.42 to 4.14) for spine disorders and RR 3.97 (95% CI 1.86 to 8.46) for upper extremity disorders.

Conclusions To reduce burden of musculoskeletal diseases, preventive actions to reduce exposure to or mitigate the consequences of physically heavy work throughout the work career are needed.

  • musculoskeletal
  • physical work
  • spine disorder
  • upper extremity

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-031564

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    Footnotes

    • Twitter @FIOH

    • Contributors JIH, RS, MM, HS, EVJ, SS and TLa conceived and designed the experiments. TLa analysed the data. JIH wrote the first draft of the article. MK, TLe and OR contributed materials and/or analysis tools. TLa, MK, TLe and OTR contributed to the funding of the study. TLa is the guarantor of the study. All authors were involved in interpretation of the findings, writing the paper and approved the submitted and published versions.

    • Funding The research was funded by the Finnish Academy (grant numbers 287488 and 319200 for TLa and JIH). The Young Finns Study has been financially supported by the Academy of Finland: grants 286284, 134309 (Eye), 126925, 121584, 124282, 129364, 129378 (Salve), 117787 (Gendi) and 41071 (Skidi); the Social Insurance Institution of Finland; Competitive State Research Financing of the Expert Responsibility area of Kuopio, Tampere and Turku University Hospitals (grant X51001); Juho Vainio Foundation; Paavo Nurmi Foundation; Finnish Foundation for Cardiovascular Research; Finnish Cultural Foundation; the Sigrid Juselius Foundation; Tampere Tuberculosis Foundation; Emil Aaltonen Foundation; Yrjö Jahnsson Foundation; Signe and Ane Gyllenberg Foundation; Diabetes Research Foundation of Finnish Diabetes Association; and EU Horizon 2020 (grant 755320 for TAXINOMISIS); and European Research Council (grant 742927 for MULTIEPIGEN project); Tampere University Hospital Supporting Foundation.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The study has received ethical approval from the Ethics Committee of the Hospital District of Southwest Finland on 21 September 2010.

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

    • Data availability statement Data are available upon reasonable request.