• Patricia Ots, Sander K R van Zon, Jolinda L D Schram, Alex Burdorf, Robroek Suzan J W SJW Erasmus Medical Center Rotterdam, Department of Public Health, Rotterdam, the Netherlands. Electronic address: s.roboek@erasmusmc.nl., Karen M Oude Hengel, and Sandra Brouwer.
• University of Groningen, University Medical Center Groningen, Department of Health Sciences, Community & Occupational Medicine, Groningen, the Netherlands. Electronic address: p.ots@umcg.nl.
• Prev Med. 2020 Oct 1; 139: 106228.

ObjectivesThis study examined the risk of unhealthy behaviours and the additive effects of multiple unhealthy behaviours on exit from paid employment among workers with a chronic disease and investigated effect modification by gender and educational level.MethodsData from the Lifelines cohort, collected between 2006 and 2013, were enriched with registry data from Statistics Netherlands with up to 11 years follow-up. Workers with a chronic disease were selected (n = 11,467). The influence of unhealthy behaviours (physical inactivity, smoking, unhealthy diet, high alcohol intake, and obesity) on exit from paid employment (unemployment, disability benefits, early retirement, and economic inactivity) was examined using competing risk models. To examine effect modification by gender and educational level, interaction terms were added.ResultsSmoking and low fruit intake increased the risk to exit paid employment through unemployment and disability benefits. Low vegetable intake increased the risk of unemployment, obesity the risk of receiving disability benefits, and high alcohol intake the risk of early retirement. Physical inactivity was not associated with any exit from paid employment. Having multiple unhealthy behaviours increased the risk of both unemployment and of receiving disability. No consistent effect modification for gender or educational level was found.ConclusionsUnhealthy behaviours increased the risk to exit paid employment through unemployment and disability benefits among workers with a chronic disease, and this risk increased when having multiple unhealthy behaviours. Health promotion to support workers with chronic diseases to make healthier choices may help to extend their working life.Copyright © 2020 The Author(s). Published by Elsevier Inc. All rights reserved.

9 keywords...

hide…