title: Health Problems during Compulsory Military Service Predict Disability Retirement: A Register-Based Study on Secular Trends during 40 Years of Follow-Up.
abstract: Disability retirement causes a significant burden on the society and affects the well-being of individuals. Early health problems as determinants of disability retirement have received little attention. The objective was to study, whether interrupting compulsory military service is an early indicator of disability retirement among Finnish men and whether seeking medical advice during military service increases the risk of all-cause disability retirement and disability retirement due to mental disorders and musculoskeletal diseases. We also looked at secular trends in these associations. We examined a nationally representative sample of 2069 men, who had entered military service during 1967-1996. We linked military service health records with cause-specific register data on disability retirement from 1968 to 2008. Secular trends were explored in three service time strata. We used the Cox regression model to estimate proportional hazard ratios and their 95% confidence intervals. During the follow-up time altogether 140 (6.8%) men retired due to disability, mental disorders being the most common cause. The men who interrupted service had a remarkably higher cumulative incidence of disability retirement (18.9%). The associations between seeking medical advice during military service and all-cause disability retirement were similar across the three service time cohorts (overall hazard ratio 1.40 per one standard deviation of the number of visits; 95% confidence interval 1.26-1.56). Visits due to mental problems predicted disability retirement due to mental disorders in the men who served between 1987 and 1996 and a tendency for a similar cause-specific association was seen for musculoskeletal diseases in the men who served in 1967-1976. In conclusion, health problems-in particular mental problems-during late adolescence are strong determinants of disability retirement. Call-up examinations and military service provide access to the entire age cohort of men, where persons at risk for work disability can be identified and early preventive measures initiated.
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.|Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Heikki
authors.initials: H
authors.lastname: Frilander
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.|Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Tea
authors.initials: T
authors.lastname: Lallukka
authors.affiliation: Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Eira
authors.initials: E
authors.lastname: Viikari-Juntura
authors.affiliation: Department of Health, National Institute for Health and Welfare, Helsinki, Finland.
authors.forename: Markku
authors.initials: M
authors.lastname: Heliövaara
authors.affiliation: Centre of Expertise for Health and Work Ability, Finnish Institute of Occupational Health, Helsinki, Finland.|Disability Prevention Research Centre, Finnish Institute of Occupational Health, Helsinki, Finland.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Solovieva
mesh_terms: D000293:Adolescent; D000328:Adult; D004185:Disability Evaluation; D006233:Persons with Disabilities / Q000706:statistics & numerical data*; D005387:Finland / Q000453:epidemiology; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D008889:Military Personnel / Q000706:statistics & numerical data*; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009784:Occupational Diseases / Q000453:epidemiology*; D010808:Physical Examination; D012042:Registries; D012179:Retirement / Q000706:statistics & numerical data*; D014729:Veterans Disability Claims / Q000706:statistics & numerical data*; D055815:Young Adult