title: Early retirement among Danish female cleaners and shop assistants according to work environment characteristics and upper extremity complaints: an 11-year follow-up study.
abstract: BACKGROUND
  Studies have shown a negative social gradient in the incidence of early retirement. To prevent undesired early retirement, there is a need for knowledge of specific predictors in addition to social factors with a limited potential for change. The main purpose of this study was to examine musculoskeletal complaints and working conditions as predictors of early retirement among Danish female cleaners.
  
  
  METHODS
  Using Cox regression with an adjustment for extraneous factors, we compared the risk of disability pension and retirement before the nominal retirement age (65 years) in an 11-year cohort study with registry-based follow-up of 1430 female cleaners and 579 shop assistants. In subsequent analyses of female cleaners, disability pension and voluntary early retirement were modeled according to work characteristics and upper extremity complaints.
  
  
  RESULTS
  The adjusted hazard rate (HR) for disability pension among cleaners compared to the control group was 2.27 (95% CI 1.58 to 3.28) and, for voluntary early retirement, 1.01 (95% CI 0.85 to 1.20). In the subset of cleaners, the predictors of disability pension were persistent shoulder pain HR: 1.98 (95% CI 1.47 to 2.67), elbow pain HR: 1.41 (95% CI 1.02 to 1.94) and symptoms of nerve entrapment of the hand HR: 1.58 (95% CI 1.14 to 2.20). Predictors of voluntary early retirement were persistent shoulder pain HR: 1.40 (95% CI 1.16 to 1.67) and floor mopping for more than 10 h per week HR: 1.20 (95% CI 1.03 to 1.40).
  
  
  CONCLUSIONS
  Cleaners have a twofold higher risk of disability pension compared to the control group. Risk factors for disability pension among cleaners were persistent shoulder and elbow pain together with symptoms of nerve entrapment of the hand. The findings of specific health related predictors of early retirement could be used in secondary prevention with targeted temporary reduced workload.
authors.affiliation: Department of Occupational and Environmental Medicine, Aarhus University Hospital, Aarhus, Denmark. lonjesen@rm.dk.
authors.forename: Lone Donbæk
authors.initials: LD
authors.lastname: Jensen
authors.affiliation: Department of Occupational and Environmental Medicine, Bispebjerg-Frederiksberg University Hospital, Copenhagen, Denmark.
authors.forename: Jens Peter Ellekilde
authors.initials: JP
authors.lastname: Bonde
authors.affiliation: Department of Occupational and Environmental Medicine, Aarhus University Hospital, Aarhus, Denmark.
authors.forename: Michael Victor
authors.initials: MV
authors.lastname: Christensen
authors.affiliation: Rehabilitation Center Marselisborg, Department of Public Health, Clinical Social Medicine and Rehabilitation Section, Aarhus University, Aarhus, Denmark.|Public Health and Quality Improvement, Central Denmark Region, Aarhus, Denmark.
authors.forename: Thomas
authors.initials: T
authors.lastname: Maribo
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003718:Denmark / Q000453:epidemiology; D006233:Persons with Disabilities; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008875:Middle Aged; D009784:Occupational Diseases / Q000175:diagnosis* / Q000453:epidemiology*; D012042:Registries; D012179:Retirement / Q000639:trends*; D012307:Risk Factors; D034941:Upper Extremity / Q000473:pathology*; D016526:Workload
keywords: Cleaners; Follow up study; Persistent shoulder pain; Predictors early retirement; Secondary prevention