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BMJ Open. 2012 Nov 12;2(6). pii: e000991. doi: 10.1136/bmjopen-2012-000991. Print 2012.

Differences in risk factors for voluntary early retirement and disability pension: a 15-year follow-up in a cohort of nurses' aides.

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  • 1Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Denmark.



To estimate the extent of early retirement and to examine risk factors for voluntary early retirement and disability pension in a cohort of nurses' aides.


Register study including baseline questionnaire and register data covering all transfer incomes from 1991 to 2008 in a cohort of nurses' aides established in 1993 with a follow-up period of 15 years.


Nurses' aides working in nursery homes, homecare or hospitals.


3332 gainfully employed nurses' aides at the time of inclusion in the study.


Disability pension or early voluntary retirement.


16.2% of the population was granted disability pension and 27.1% entered early voluntary retirement in the follow-up period representing 11 186 lost working years with a direct cost in transfer payment amounting about €410 million. Health-related risk factors for disability pension was long-lasting low-back pain (HR 2.27(95% CI 1.55 to 3.34), sick leave because of upper-extremity disorders (HR 2.18 (95% CI 1.08 to 2.11), and inflammatory rheumatic disease (HR 2.42 (95% CI 1.67 to 3.52)). Of non-health-related factors, low education, workers compensation case, evening work and high-rated perceived exertion at work all were minor risk factors for disability pension. The primary risk factor for early voluntary retirement was low education (HR 3.19 (95% CI 2.65 to 3.85)).


43.3% of nurses' aides gainfully employed in 1993 retired before due time during the follow-up period. Work-related factors at baseline only seemed to have a minor prognostic role. Risk factors for disability pension were mainly health-related factors, whereas economical factors seemed to influence the decision to choose early voluntary retirement. The number of persons and the amount of lost working years underscores the need of a more active counselling towards maintaining employment especially among those with persistent musculoskeletal disorders.

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