[Morbidity and early retirement among teachers at vocational schools].
OBJECTIVE
Teachers at vocational schools often feel overburdened and emotionally exhausted. The aim of our study was to gather new evidence-based information on the type and extent of the morbidity spectrum and health-related early retirement of teachers at vocational schools, using objective parameters and larger numbers of cases.


METHODS
In a prospective total assessment (the entire state of Bavaria) over the period of 1996-1999 all official medical examinations among teachers of vocational schools in the public health centres were evaluated with regard to premature unfitness for work. The analysis included for example socio-demographic/occupational factors, the morbidity spectrum, assessment of performance, rehabilitation and a comparison of the prevalence rates of psychiatric disorders and rehabilitation among disabled teachers of various types of schools in Bavaria ("Erlanger Lehrerstudie"). The answers given in a standardised, anonymous questionnaire provided the database. Evaluation was carried out by means of descriptive statistics.


RESULTS
Of the 451 teachers studied, 31% (n=138) were women and 69%(n=313) were men. The median age was 56 years (range: 29-62 years). 70% (n=314) of the teachers were assessed to be unfit for work. The main reasons for early retirement were psychic and psychosomatic illnesses (F-ICD10) which made up 53% of the cases. Among the psychiatric diagnoses, depressive disorders (43%) and burnout syndrome (16%) dominated. The most frequent somatic diseases were muscular/skeletal disorders (M-ICD10) in 13% of cases, then cardiovascular disorders (I-ICD10) in 7% and malignant tumours (C-ICD10) in 7% of cases. In the gender-based analysis the relative frequency of psychiatric disorders (58% vs. 50%) and malignant tumours (15% vs. 3%--difference of statistical significance) was higher in women than in men, while the prevalence of cardiovascular (3% vs. 9%) and muscular/ skeletal disorders (6% vs. 16%--difference of statistical significance) was lower in women than in men. 63% (n=198) of the teachers assessed unfit for work had participated in at least one medical rehabilitation measure before early retirement.


CONCLUSIONS
The main reason for early retirement of teachers at vocational schools is mental ill health. Beyond this fact there is a striking gender difference in the psychic and somatic morbidity. Measures of prevention and intervention would have to focus on mental health at the workplace and also take gender aspects into consideration.
Institut für Qualitätssicherung in Prävention und Rehabilitation an der Deutschen Sporthochschule.
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Weber
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Lederer
D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004185:Disability Evaluation; D004608:Eligibility Determination / Q000331:legislation & jurisprudence; D005104:Expert Testimony / Q000331:legislation & jurisprudence; D005260:Female; D005858:Germany; D006801:Humans; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D009784:Occupational Diseases / Q000453:epidemiology; D011602:Psychophysiologic Disorders / Q000453:epidemiology; D012179:Retirement / Q000331:legislation & jurisprudence*; D013663:Teaching / Q000706:statistics & numerical data*; D014829:Vocational Education / Q000706:statistics & numerical data*