Papers by Clas-håkan Nygård
Canadian Medical Association Journal, Jan 31, 2011
rospective studies with a follow-up time stretching from midlife to old age have shown that lower... more rospective studies with a follow-up time stretching from midlife to old age have shown that lower socioeconomic status, as indicated by lower education level or occupational grade, predicts a decline in health and functioning in the working population. 1-4 This association is similar, if not more pronounced, in old age. 5-7 Higher levels of work-related mental and physical strain increase the risk of early retirement and predict a decline in health and an increase in mortality among the working population. 3,8-15 However, the association between the demands of the work in conjunction with inadequate mental or physical resources (i.e., work ability) 16 and health and functioning in old age has not been studied. 17 Using a population-based 28-year follow-up study involving middle-aged municipal employees, we investigated whether work ability in midlife predicts the risk of death and disability during old age among white-collar and blue-collar employees. Methods Participants and design The Finnish Institute of Occupational Health's Finnish Longitudinal Study on Municipal Employees (FLAME) targeted 7344 individuals aged 44-58 years at baseline in 1981. 18 The participants had been chosen at random from members of all municipal professions in Finland. The baseline cohort consisted of 6257 employees (44.7% men), for a response rate of 85.2%. The first questionnaire, which explored work, health and lifestyle factors, was sent out in 1981, and follow-up data were collected in 1985, 1992, 1997 and 2009. Data on work ability were missing for 199 women and 87 men. The analyses in this study are based on the responses of 5971
PubMed, 1997
The objective of this follow-up study of aging workers was to determine changes in the work, life... more The objective of this follow-up study of aging workers was to determine changes in the work, life-style, health, functional capacity, and stress symptoms of Finnish municipal employees from 1981 to 1992. In addition, factors that predict improvement or decline in the ability to work were studied. With the use of this information, attempts were made to produce practical measures to decrease the work-related health risks of elderly workers and increase factors promoting work ability. Along with the stress-strain model applied in the study, the reference frame of the World Health Organization (WHO) was used. The WHO model emphasizes the interaction between work, life-style, aging, and health. Work, life-style, health, work ability, and stress symptoms were studied through the use of comprehensive questionnaire surveys in 1981, 1985 and 1992. Initially, all the subjects (N = 6257) were employed in municipal occupations. During the follow-up, the data were supplemented by information on disability to work and mortality. The changes in work, life-style, health, work ability, and stress symptoms were examined among employees who worked in the same job (N = 924) during the entire follow-up period.
PubMed, 1997
of the Finnish research project (1981-1992) to promote the health and work ability of aging worke... more of the Finnish research project (1981-1992) to promote the health and work ability of aging workers. Scand J Work Environ
International Archives of Occupational and Environmental Health, 2022
Purpose To study the workers’ perception of the quality of work community and its association wit... more Purpose To study the workers’ perception of the quality of work community and its association with intention to retire early, separately among women and men working in Finnish postal service. Methods A questionnaire survey was sent to all Finnish postal services employees aged ≥ 50 years in 2016 and 44% (n = 2096) replied to the survey (mean age 56.3, 40% women). Employee’s intention to retire before statutory retirement was measured on a scale of 1–5 and dichotomized. The quality of work community was defined by four composite variables: equality at work, flexibility at work, supportive work environment and health or other reason and trichotomized by their tercile values. Odds ratio (ORs) and their 95% confidence intervals (CIs) for associations of quality of work community with intention to retire were calculated separately for men and women using log binomial regression models adjusted for potential confounders. Results About one-third of respondents intended to retire early with...
European Journal of Public Health, 2020
Background Low back pain (LBP) is a leading cause for mobility limitations and disability at olde... more Background Low back pain (LBP) is a leading cause for mobility limitations and disability at older age. However, little is known about the developmental pathways of LBP and its associations with old age mobility and disability. We studied trajectories of LBP from midlife to retirement (16-years follow-up) and assessed the association after 12 years with mobility limitations and disability in activities of daily living (ADL) at old age. Methods Finnish municipal employees were studied at baseline in 1981 and followed for 28 years. A total of 6257 persons aged 44-58 years, answered a questionnaire on health, work ability, and working conditions. Follow-up data on frequency of LBP (never, occasionally, consistently) was collected similarly at four waves. The study population consisted of persons who answered questions about LBP at baseline and at least in one of the follow-up waves and had information about ADL disability (n = 2787) and mobility limitations (n = 2723) at the 28-year fo...
Scandinavian Journal of Work, Environment & Health, 2017
Objective Extended working lives due to an ageing population will necessitate the maintenance of ... more Objective Extended working lives due to an ageing population will necessitate the maintenance of work ability across the life course. This systematic review aimed to analyze whether workplace interventions positively impact work ability. Methods We searched Medline, PsycINFO, CINAHL and Embase databases using relevant terms. Work-based interventions were those focused on individuals, the workplace, or multilevel (combination). Work abilitymeasured using the work ability index (WAI) or the single-item work ability score (WAS)-was the outcome measure. Grading of Recommendations Assessment, Development & Evaluation (GRADE) criteria was used to assess evidence quality, and impact statements were developed to synthesize the results. Meta-analysis was undertaken where appropriate. Results We reviewed 17 randomized control trials (comprising 22 articles). Multilevel interventions (N=5) included changes to work arrangements and liaisons with supervisors, whilst individual-focused interventions (N=12) involved behavior change or exercise programs. We identified only evidence of a moderate quality for either individual or multilevel interventions aiming to improve work ability. The meta-analysis of 13 studies found a small positive significant effect for interventions on work ability [overall pooled mean 0.12, 95% confidence interval (CI) 0.03-0.21] with no heterogeneity for the effect size (Chi 2 =11.28, P=0.51; I 2 =0%). Conclusions The meta-analysis showed a small positive effect, suggesting that workplace interventions might improve work ability. However, the quality of the evidence base was only moderate, precluding any firm conclusion. Further high quality studies are require to establish the role of interventions on work ability.
International journal of occupational safety and ergonomics : JOSE, 2008
In this study perceived mental stress during occupational work was compared to heart rate variabi... more In this study perceived mental stress during occupational work was compared to heart rate variability (HRV) using a traditional questionnaire and a novel wristop heart rate monitor with related software. The aim was to find HRV parameters useful for mental stress detection. We found the highest correlation between perceived mental stress with the differences between the values of triangular interpolation of rhythm-to-rhythm (RR) interval histogram (TINN) and the root mean square of differences of successive RR intervals (RMSSD) obtained in the morning and during the workday (r=-.73 and r=-.60, respectively). The analysis shows that as the RMSSD and TINN value differences increase from night to morning, the stress decreases.
Occupational Medicine, 2011
Canadian Medical Association Journal, 2011
International Journal of Environmental Research and Public Health
Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working fro... more Background: Due to COVID-19 pandemic, many employees were forced to suddenly shift to working from home (WFH). How this disruption of work affected employees’ work ability is not known. In this study, we investigated the developmental profiles of work ability among Finnish higher education employees in a one-year follow-up during the enforced WFH. Secondly, we investigated demographic, organizational, and ergonomic factors associated with the developmental profiles. Methods: A longitudinal web-survey was conducted with four measurement points (April 2020–February 2021). Employees of a Finnish university who answered the questionnaire at baseline and at least at two follow-up surveys (n = 678) were included (71% women, 45% teachers/research staff, 44% supporting staff, 11% hired students). Perceived work ability was measured on a scale of 1–5 in all timepoints. Latent class growth curve analysis was used to identify profiles of work ability. Multinomial logistic regression was used t...
Sustainability
We first clarify the definition of sustainable employability, and then we study how the indicator... more We first clarify the definition of sustainable employability, and then we study how the indicators of sustainable employability among older Finnish postal service employees have changed over time. Finally, we estimate the effect of age on these indicators in a two-year follow up. A questionnaire survey among the Finnish postal service employees was conducted in 2016, and a follow-up was conducted in 2018. We analyze data from 1262 subjects who replied to both the baseline and the follow-up surveys. Sustainable employability is defined as a multidimensional construct using nine indicators and covering three domains (health, well-being and employability) based on Fleuren and colleagues’ model. Measurement time (repeated measure) is used as a within-subjects factor, and age is used as a between-subjects factor. The estimated marginal means of the indicators of sustainable employability at the baseline and the follow-up by age in years are calculated. No significant change is found in e...
© 2021 World Health Organization Background: The World Health Organization (WHO) and the Internat... more © 2021 World Health Organization Background: The World Health Organization (WHO) and the International Labour Organization (ILO) are developing joint estimates of the work-related burden of disease and injury (WHO/ILO Joint Estimates), with contributions from a large network of experts. Evidence from mechanistic data suggests that occupational exposure to ergonomic risk factors may cause selected other musculoskeletal diseases, other than back or neck pain (MSD) or osteoarthritis of hip or knee (OA). In this paper, we present a systematic review and meta-analysis of parameters for estimating the number of disability-adjusted life years from MSD or OA that are attributable to occupational exposure to ergonomic risk factors, for the development of the WHO/ILO Joint Estimates. Objectives: We aimed to systematically review and meta-analyse estimates of the effect of occupational exposure to ergonomic risk factors (force exertion, demanding posture, repetitiveness, hand-arm vibration, li...
International Journal of Environmental Research and Public Health, 2019
Background: We investigated work ability and trajectories of work life satisfaction (WLS) as pred... more Background: We investigated work ability and trajectories of work life satisfaction (WLS) as predictors of intention to retire (ITR) before the statutory age. Methods: Participants were Finnish postal service employees, who responded to surveys in 2016 and 2018 (n = 1466). Survey measures included ITR, work ability and WLS. Mixture modelling was used to identify trajectories of WLS. A generalized linear model was used to determine the measures of association (Risk Ratios, RR; 95% Confidence Intervals, CI) between exposures (work ability and WLS) and ITR. Results: Approximately 40% of respondents indicated ITR. Four distinct trajectories of WLS were identified: high (33%), moderate (35%), decreasing (23%) and low (9%). Participants with poor work ability (RR 1.79, 95% CI 1.40–2.29) and decreasing WLS (1.29, 1.13–1.46) were more likely to indicate an ITR early compared to the participants with excellent/good work ability and high WLS. Job control mediated the relationship between ITR ...
Scandinavian Journal of Work, Environment & Health, 2016
Work ability index and perceived work ability as predictors of disability pension: a prospective ... more Work ability index and perceived work ability as predictors of disability pension: a prospective study among Finnish municipal employees
Occupational and Environmental Medicine, 2016
Objective To investigate the developmental pathways of multisite musculoskeletal pain (MSP) and t... more 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. The questionnaire covered MSP, physical and psychosocial working conditions (physical strain, environmental factors, repetitive movements, awkward postures; mental strain, team support, leadership, possibility to influence) and work ability. MSP as an outcome was defined as the number of painful areas of the body on a scale of 0-4. Latent class growth modelling and multinomial logistic regression were used to analyse the impact of working conditions on MSP pathways. Results Five MSP trajectories (no MSP 35.6%, persistent MSP 28.8%, developing MSP 8.8%, increasing MSP 15.3% and decreasing MSP 11.5%) were identified. In a multivariable model, the no MSP pathway was set as the reference group. High physical strain (OR 3.26, 95% CI 2.10 to 5.04), poor environmental factors (3.84, 2.48 to 5.94), high repetitive movements (3.68, 2.31 to 5.88) and high mental strain (3.87, 2.53 to 5.92) at baseline predicted the persistent MSP pathway, allowing for poor work ability (2.81, 1.84 to 4.28) and female gender (1.80, 1.14 to 2.83). High physical strain and female gender predicted the developing MSP pathway. High physical strain, poor environmental factors and high repetitive movements predicted the increasing and decreasing MSP pathways. Conclusions A substantial proportion of individuals reported having persistent MSP, and one-third reported changing patterns of pain. Adverse physical working conditions and mental strain were strongly associated with having high but stable levels of MSP.
Occupational and Environmental Medicine, 2016
Objective Multi-site musculoskeletal pain at multiple sites is more common than single-site pain.... more 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 = 873) and collected in two years intervals starting from 2003 until 2009. The information on self-perceived musculoskeletal pain during preceding week, work related physical and psychosocial working conditions and various individual factors was obtained through a structured questionnaire distributed to workers. Latent class growth modelling and multinomial logistic regression were used. Results A five-group multi-site musculoskeletal pain trajectory model (no pain stable 35.6%, stable multi-site pain 28.8%, no pain to increasing pain sites 8.8%, L-shaped 11.5% and slow increasing multi-site pain 15.3%) was identified. In a multivariate model physical strain (OR 3.34, 95% CI: 2.12–6.27), environmental factors (3.37, 1.94–5.86), repetitive movements (2.13, 1.09–4.16) awkward posture (2.26, 1.13–4.52) and mental strain (3.85, 2.25–6.57) significantly predicted stable multi-site pain trajectory. These factors also predicted slow increasing multi-site pain trajectory in a more or less in a same fashion. The associations were more prominent among blue-collar workers than their white-collar counterparts. Conclusions A substantial proportion of individual seems to have multi-site pain persistently. Most of the physical working conditions predict the development of multi-site musculoskeletal pain.
International Archives of Occupational and Environmental Health, 2016
repetitive movements, for middle age team support and for older workers change in awkward posture... more repetitive movements, for middle age team support and for older workers change in awkward posture were significant predictors of MSD risk. Conclusions These results support the need for workplacespecific hazard surveillance data. This will ensure that all contributing factors to MSD risk can be accurately identified and controlled independent of age.
Work, 2016
BACKGROUND: Work-related musculoskeletal pain is a major occupational problem. Those with pain in... more BACKGROUND: Work-related musculoskeletal pain is a major occupational problem. Those with pain in multiple sites usually report worse health outcomes than those with pain in one site. OBJECTIVE: This study explored prevalence and associated predictors of multi-site pain in health care sector employees. METHOD: Survey responses from 1348 health care sector employees across three organisations (37% response rate) collected data on job satisfaction, work life balance, psychosocial and physical hazards, general health and work ability. Musculoskeletal discomfort was measured across 5 body regions with pain in ≥ 2 sites defined as multi-site pain. Generalized linear models were used to identify relationships between work-related factors and multi-site pain. RESULTS: Over 52% of the employees reported pain in multiple body sites and 19% reported pain in one site. Poor work life balance (PRR = 2.33, 95% CI = 1.06-5.14). physical (PRR = 7.58, 95% CI = 4.89-11.77) and psychosocial (PRR = 1.59, 95% CI = 1.00-2.57) hazard variables were related to multi-site pain (after controlling for age, gender, health and work ability. Older employees and females were more likely to report multi-site pain. CONCLUSION: Effective risk management of work related multi-site pain must include identification and control of psychosocial and physical hazards.
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Papers by Clas-håkan Nygård