title: Cardiovascular disease, diabetes and early exit from paid employment in Europe; the impact of work-related factors.
abstract: OBJECTIVE
  The aims of the study were to examine (i) the association between cardiovascular disease (CVD) or diabetes and exit from paid employment via disability benefits, unemployment, early retirement or other exit routes; and (ii) the impact of work-related factors on exit from paid employment among individuals with CVD or diabetes.
  
  
  METHODS
  Respondents of the longitudinal Survey of Health and Retirement in Europe (SHARE) were included if they were aged >50years, had paid employment at baseline, and a known employment status after 2 or 6years (n=5182). A baseline-interview provided information on the presence of diagnosed CVD and diabetes, and physical and psychosocial work-related factors. During follow-up interviews information on work status was collected. Multinomial regression analyses were used to investigate the association between CVD, diabetes and exit from paid employment, and the impact of work-related factors.
  
  
  RESULTS
  Workers with CVD or diabetes had significantly increased probabilities of disability benefits (OR 2.50, 95% CI 1.69-3.70) and early retirement (OR 1.34, 95% CI 1.05-1.74), but a comparable probability of unemployment (OR 1.10, 95% CI 0.71-1.71). Regarding disability benefits, individuals who had a stroke had the highest probability (OR 3.48, 95% CI 1.31-9.23). Perceived high job demands with low rewards or with low control at work further increased the probability of early exit among individuals with CVD or diabetes.
  
  
  CONCLUSIONS
  Our study shows a prominent role of CVD and diabetes in premature losses to the workforce, and it shows that optimizing psychosocial work-related factors could be beneficial in people with CVD or diabetes.
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands; Department of Occupational Health, Erasmus MC, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands. Electronic address: t.kouwenhoven@erasmusmc.nl.
authors.forename: T A
authors.initials: TA
authors.lastname: Kouwenhoven-Pasmooij
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: A
authors.initials: A
authors.lastname: Burdorf
authors.affiliation: Department of Cardiology, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: J W
authors.initials: JW
authors.lastname: Roos-Hesselink
authors.affiliation: Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands; Department of Radiology, Erasmus MC, Rotterdam, The Netherlands; Center for Health Decision Sciences, Harvard T.H. Chan School of Public Health, Harvard University, Boston, USA.
authors.forename: M G M
authors.initials: MG
authors.lastname: Hunink
authors.affiliation: Department of Public Health, Erasmus MC, Rotterdam, The Netherlands.
authors.forename: S J W
authors.initials: SJ
authors.lastname: Robroek
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000523:psychology*; D003920:Diabetes Mellitus / Q000453:epidemiology / Q000523:psychology*; D004651:Employment / Q000706:statistics & numerical data*; D005060:Europe / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012044:Regression Analysis; D012179:Retirement / Q000706:statistics & numerical data*; D018582:Sick Leave / Q000706:statistics & numerical data*; D012944:Social Support; D014478:Unemployment
keywords: Cardiovascular disease; Diabetes; Exit from paid employment; Job control; Rewards; Work-related factors