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Purpose This systematic review investigates the effectiveness of workplace interventions to rehabilitate musculoskeletal disorders (MSDs) among employees with physically demanding work. Methods A systematic search was conducted in bibliographic databases including PubMed and Web of Science Core Collection for English articles published from 1998 to 2018. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were adult workers with physically demanding work and MSD (including specific and non-specific MSD and musculoskeletal pain, symptoms, and discomfort), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) a measure of MSD was reported (including musculoskeletal pain, symptoms, prevalence or discomfort). The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada) focusing on developing practical recommendations for stakeholders. Relevant stakeholders were engaged in the review process. Results Level of evidence from 54 high and medium quality studies showed moderate evidence of a positive effect of physical exercise. Within this domain, there was strong evidence of a positive effect of workplace strength training. There was limited evidence for ergonomics and strong evidence for no benefit of participatory ergonomics, multifaceted interventions, and stress management. No intervention domains were associated with “negative effects”. Conclusions The evidence synthesis recommends that implementing strength training at the workplace can reduce MSD among workers with physically demanding work. In regard to workplace ergonomics, there was not enough evidence from the scientific literature to guide current practices. Based on the scientific literature, participatory ergonomics and multifaceted workplace interventions seem to have no beneficial effect on reducing MSD among this group of workers. As these interventional domains were very heterogeneous, it should also be recognized that general conclusions about their effectiveness should be done with care.Systematic review registration PROSPERO CRD42018116752 (https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=116752).

Background Due to demographic changes across Europe there are strong political interests in maintaining the labour force by prolonging working life, i.e. increasing retirement age. This may pose both challenges and opportunities for societies, workplaces, and individuals. The SeniorWorkingLife (Danish: SeniorArbejdsLiv) project investigates push and stay mechanisms for labour market participation – now and in the future - among older workers (≥50 years). Methods In July 2018, 30,000 Danes age 50 or older (18,000 employed, 7000 unemployed, 3000 voluntary early retirements, 2000 disability pensions) were invited to participate, of which 15,721 (52.4%) replied to the entire questionnaire and 17,885 (59.6%) replied at least in part. Baseline data collection was terminated in October 2018. The questionnaire covers 14 domains in relation to push and stay mechanisms for labour market participation: 1) basic information (demographics, employment status etc.), 2) multiple-choice question covering a wide range of push and stay mechanisms, 3) role of the workplace, 4) age-discrimination, 5) personal economy, 6) possibility for voluntary early retirement among employed and unemployed, 7) gradual retirement, 8) competencies and continued education, 9) return-to-work, 10) new technologies at the workplace, 11) job satisfaction and well-being, 12) working environment, 13) lifestyle, 14) health and functional capacity. The project aspires to repeat the survey as a prospective cohort every 2–3 years and to perform longitudinal follow-up in Danish high-quality registers about work and health. Discussion The SeniorWorkingLife project will provide important knowledge about push and stay mechanisms for labour market participation among older workers. Push refers to mechanisms that increase the risk of premature exit from the labour marker, e.g. due to poor health, poor working environment, age discrimination, and stay to mechanisms prolonging working life e.g. due to attractive working conditions and a good working environment. The project will also to some degree investigate stuck, pull and jump mechanisms. Collaboration and use of the data for scientific purposes by other researchers are encouraged. Interested researchers should contact the corresponding author. Trial Registration Registered as cohort study in ClinicalTrials.gov Identifier NCT03634410 (August 16, 2018).

ObjectiveThis study investigates the role of age for the prospective association between physical work demands and long-term sickness absence (LTSA).MethodsWe followed 69 117 employees of the general working population (Work Environment and Health in Denmark study 2012–2018), without LTSA during the past 52 weeks preceding initial interview, for up to 2 years in the Danish Register for Evaluation of Marginalisation. Self-reported physical work demands were based on a combined ergonomic index including seven different types of exposure during the working day. Using weighted Cox regression analyses controlling for years of age, gender, survey year, education, lifestyle, depressive symptoms and psychosocial work factors, we determined the interaction of age with physical work demands for the risk of LTSA.ResultsDuring follow-up, 8.4% of the participants developed LTSA. Age and physical work demands interacted (p<0.01). In the fully adjusted model, very high physical work demands were associated with LTSA with HRs of 1.18 (95% CI 0.93 to 1.50), 1.57 (95% CI 1.41 to 1.75) and 2.09 (95% CI 1.81 to 2.41) for 20, 40 and 60 years old (point estimates), respectively. Results remained robust in subgroup analyses including only skilled and unskilled workers and stratified for gender.ConclusionThe health consequences of high physical work demands increase with age. Workplaces should consider adapting physical work demands to the capacity of workers in different age groups.

Background Work-related musculoskeletal pain is a major cause of work disability and sickness absence. While pain is a multifactorial phenomenon being influenced by work as well as lifestyle, less is known about the association between specific lifestyle factors and the type of musculoskeletal pain. The aim of the study was to investigate if a dose-response association existed between lifestyle factors and musculoskeletal pain intensity in the low back and neck-shoulder. Methods Currently employed wage earners ( N  = 10,427) replied in 2010 to questions about work environment, lifestyle and health. Logistic regression analyses adjusted for various confounders tested the association of alcohol intake, physical activity, fruit and vegetable intake, and smoking (explanatory variables) with low back pain and neck-shoulder pain intensity (outcomes variables, scale 0–9, where ≥4 is high pain). Results The minimally adjusted model found that physical activity and fruit and vegetable intake were associated with lower risk of musculoskeletal pain, while smoking was associated with higher risk of musculoskeletal pain. In the fully adjusted model, physical activity ≥5 h per week was associated with lower risk of low back pain and neck-shoulder pain with risk ratios (RR) of 0.95 (95% CI 0.90–1.00) and 0.90 (95% CI 0.82–0.99), respectively. No association was found between alcohol intake and pain. Conclusion Being physically active associated with lower risk of having musculoskeletal pain, while smoking habits and healthy eating were associated with higher pain when adjusting for age and gender. Considering the continuously increasing retirement age in many societies, initiatives to promote healthy habits should still be a political priority to help the workers to stay healthy and cope to their work.

Purpose The benefits of preoperative training programmes compared with alternative treatment are unclear. The purpose of this study was to evaluate the effectiveness of a high-intensity preoperative resistance training programme in patients waiting for total knee arthroplasty (TKA). Methods Forty-four subjects (7 men, 37 women) scheduled for unilateral TKA for osteoarthritis (OA) during 2014 participated in this randomized controlled trial. Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), the Physical Functioning Scale of the Short Form-36 questionnaire (SF-36), a 10-cm visual analogue scale (VAS), isometric knee flexion, isometric knee extension, isometric hip abduction, active knee range of motion and functional tasks (Timed Up and Go test and Stair ascent–descent test) were assessed at 8 weeks before surgery (T1), after 8 weeks of training (T2), 1 month after TKA (T3) and finally 3 months after TKA (T4). The intervention group completed an 8-week training programme 3 days per week prior to surgery. Results Isometric knee flexion, isometric hip abduction, VAS, WOMAC, ROM extension and flexion and all the functional assessments were greater for the intervention group at T2, T3 and T4, whereas isometric knee extension was greater for this group at T2 and T4 compared with control. Conclusion The present study supports the use of preoperative training in end-stage OA patients to improve early postoperative outcomes. High-intensity strength training during the preoperative period reduces pain and improves lower limb muscle strength, ROM and functional task performance before surgery, resulting in a reduced length of stay at the hospital and a faster physical and functional recovery after TKA. The present training programme can be used by specialists to speed up recovery after TKA. Level of evidence I

Background Musculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between physical work demands and work ability in workers with musculoskeletal pain. Methods Workers with physically demanding jobs ( n  = 5377) participated in the Danish Work Environment Cohort Study in 2010. Associations between physical work ability and various physical work demands were modeled using cumulative logistic regression analyses while controlling for possible confounders. Results In the fully adjusted model, bending and twisting/turning of the back more than a quarter of the workday (reference: less than a quarter of the workday) was associated with higher odds of lower work ability in workers with low-back pain (OR: 1.38, 95% CI: 1.09–1.74) and neck-shoulder pain (OR: 1.29, 95% CI: 1.01–1.64). When adding up the different types of demands, being exposed to two or more physical work demands for more than a quarter of the workday was consistently associated with lower work ability. Conclusions Work that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain. Regardless of the specific type of physical work demand, being exposed to multiple physical work demands for more than a quarter of the workday was also associated with lower work ability.

This study assesses the potential of workplace-based micro-exercise (brief and simple exercise bouts) to prevent long-term sickness absence (LTSA) at the population level. In the Work Environment and Health in Denmark Study (2012–2018), we followed 70,130 workers from the general working population, without prior LTSA, for two years in the Danish Register for Evaluation of Marginalisation. We used Cox regression with model-assisted weights and controlled for various confounders. From 2012 to 2018, the percentage of workers in Denmark using workplace-based micro-exercise during and outside of working hours increased from 7.1 to 10.9% and from 0.8 to 1.4%, respectively. The incidence of long-term sickness absence (at least 30 days) was 8.4% during follow-up. The fully adjusted model showed reduced risk of long-term sickness absence from using micro-exercise during working hours, (HR 0.86, 95% CI 0.77–0.96), but not when used outside of working hours. If used by all workers, micro-exercise during working hours could potentially prevent 12.8% of incident long-term sickness absence cases (population attributable fraction). In conclusion, micro-exercise performed during working hours holds certain potential to prevent incident long-term sickness absence in the general working population. Large-scale implementation of workplace-based micro-exercise may represent an unexploited opportunity for public health promotion.

Aim: Analyse factors affecting retirement decisions comparing employees expecting to retire before, at, and after the state pension age. Methods: In the SeniorWorkingLife cohort, 12,269 workers aged +50 replied to questions about expected retirement age, reasons for leaving, and reasons for staying longer. Results: For all groups, poor health, wish for more leisure, and economy were the most salient expected reasons for retiring. Many would stay longer if there were better possibilities for more leisure time, more work flexibility, and economic benefits. Those expecting to retire before state pension age were more likely to point at desire for more leisure time as expected reason for retiring, and less likely to point at economic reasons, and more likely to point at health and work demands as possible reasons for prolonging working life. Those expecting to retire after state pension age were more likely to point at external factors and recognition from the management. Conclusion: Factors influencing retirement decisions are similar across the groups. Initiatives for better work–life balance, healthy lifestyle, and economic incentives to continue working may help prevent early retirement and motivate prolonging work life beyond retirement. Results also indicate that less strenuous work is particularly relevant to prevent early retirement.

This study aimed to investigate the importance of combined psychosocial work factors for the risk of long-term sickness absence (LTSA). We followed 69 371 employees in the general working population (Work Environment and Health in Denmark study 2012-2018), without LTSA during the preceding year, for up to two years in the Danish Register for Evaluation of Marginalization. Using k-means cluster analyses and weighted Cox-regression controlling for age, gender, survey year, education, health-behaviors, and physical work demands, we determined the prospective association of 11 identified clusters - based on the combination of nine psychosocial work factors (recognition, quantitative demands, work pace, emotional demands, influence, justice, role clarity, role conflicts, and support from colleagues) - with the risk of LTSA. During 124 045 person-years of follow-up, 6197 employees developed LTSA (weighted 8.5%). Using the cluster with the most favorable psychosocial scores as reference, clusters scoring poorly on several combined psychosocial factors had increased risk of LTSA. The cluster scoring poor on all nine psychosocial factors exhibited the highest risk [hazard ratio (HR) 1.68, 95% confidence interval (CI) 1.45-1.94]. Scoring poorly on one or two psychosocial factors did not increase the risk of LTSA when combined with favorable scores on the other psychosocial factors. Interaction analyses showed that gender, but not age and education, modified the association between cluster and LTSA. Scoring poorly on several combined psychosocial work factors plays an important role in the risk of LTSA. Scoring favorably on several psychosocial factors outweighed the potentially adverse effects of scoring poorly on one or two factors.

Objective Continuous skills development is important for keeping up with new demands in workplaces and may also influence labour market participation. This systematic review aims to determine whether skills development affects labour market participation among workers aged 35 or older. Materials and methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was conducted. We searched Web of Science Core Collection, PubMed, EBSCO, ProQuest and Ovid in May 2023, and conducted an additional search in Google Scholar in November 2023. Eligibility criteria were; 1) prospective cohort studies 2) workers 35+ years 3) participation in, or opportunities to participate in skills development 4) outcomes related to labour market participation and 5) studies published in English or Scandinavian languages. Two independent reviewers’ extracted data, assessed the risk of bias (Newcastle Ottawa Scale) and evaluated the certainty of the evidence (GRADE) of the included studies. Results The literature search identified 5,147 records, of which 19 (n=1,089,749 and 759,931 person-years) met the inclusion criteria. GRADE indicated a “very low” quality of evidence for all outcomes. Overall, 12 studies found an association: 1) four studies found that skills development / opportunities for skills development reduced early retirement, 2) one study found that a lack of skills development increased the likelihood of early retirement, and 3) seven studies found that skills development / opportunities for skills development were associated with working longer. Conclusions This systematic review presents varied findings concerning the link between skills development and labour market participation. Trial registration This systematic review was registered with PROSPERO (CRD42023419005).