Working conditions as risk factors for early exit from work-in a cohort of 2351 employees in Germany.

Objectives: We would assess the possible impact of a range of physical and psychosocial working conditions on early exit from paid employment (i.e., before retirement age) in a representative employee population in Germany.

Methods: We analysed a cohort from the German Study on Mental Health at Work (S-MGA) with a baseline of 2351 employees in 2011/12, sampled randomly from the register of integrated employment biographies (IEB) at the Institute for Employment Research (IAB). Follow-up ended mid-2015. Early Exit comprised episodes of either pensioning, long-term sickness absence or unemployment ≥ 18 months. Total follow-up years were 8.422. Working conditions were partly assessed by the Copenhagen Psychosocial Questionnaire (COPSOQ). Through Cox regressions, associations of baseline working conditions with time to event of exit were estimated-adjusting for baseline age, gender, poverty, fixed-term contract and socioeconomic position.

Results: In multiple regressions, awkward body postures (HR = 1.24; 95% CI = 1.07-1.44), heavy lifting (1.17; 1.00-1.37) and high work pace (1.41; 1.16-1.72) were associated with exit. The estimated attributable fraction of exit for being exposed to less than optimal work environment was 25%. Regarding specific exit routes, repetitive movements (1.25; 1.03-1.53) increased the risk for the long-term sickness absence; work pace (1.86; 1.22-2.86) and role clarity (0.55; 0.31-1.00) were associated to unemployment; and control over working time (0.72; 0.56-0.95) decreased the risk of the early retirement.

Conclusions: Work environment seems to be important for subsequent early exit from work. Physical and psychosocial demands seem to be associated to exit to a stronger extent than resources at work.