title: The impact of ill health on exit from paid employment in Europe among older workers.
abstract: OBJECTIVE
  To determine the impact of ill health on exit from paid employment in Europe among older workers.
  
  
  METHODS
  Participants of the Survey on Health and Ageing in Europe (SHARE) in 11 European countries in 2004 and 2006 were selected when 50-63 years old and in paid employment at baseline (n=4611). Data were collected on self-rated health, chronic diseases, mobility limitations, obesity, smoking, alcohol use, physical activity and work characteristics. Participants were classified into employed, retired, unemployed and disabled at the end of the 2-year follow-up. Multinomial logistic regression was used to estimate the effect of different measures of ill health on exit from paid employment.
  
  
  RESULTS
  During the 2-year follow-up, 17% of employed workers left paid employment, mainly because of early retirement. Controlling for individual and work related characteristics, poor self-perceived health was strongly associated with exit from paid employment due to retirement, unemployment or disability (ORs from 1.32 to 4.24). Adjustment for working conditions and lifestyle reduced the significant associations between ill health and exit from paid employment by 0-18.7%. Low education, obesity, low job control and effort-reward imbalance were associated with measures of ill health, but also risk factors for exit from paid employment after adjustment for ill health.
  
  
  CONCLUSIONS
  Poor self-perceived health was strongly associated with exit from paid employment among European workers aged 50-63 years. This study suggests that the influence of ill health on exit from paid employment could be lessened by measures targeting obesity, problematic alcohol use, job control and effort-reward balance.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
authors.forename: Tilja
authors.initials: T
authors.lastname: van den Berg
authors.forename: Merel
authors.initials: M
authors.lastname: Schuring
authors.forename: Mauricio
authors.initials: M
authors.lastname: Avendano
authors.forename: Johan
authors.initials: J
authors.lastname: Mackenbach
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000437:Alcoholism / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D006233:Persons with Disabilities / Q000706:statistics & numerical data; D004651:Employment / Q000706:statistics & numerical data*; D004812:Epidemiologic Methods; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009765:Obesity / Q000453:epidemiology; D012179:Retirement / Q000706:statistics & numerical data*; D014478:Unemployment / Q000706:statistics & numerical data