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We studied the independent and joint contributions of long-term exposure to (i) rotation of the back and (ii) repetitive movements to disability pension, particularly due to musculoskeletal disorders.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Exposures were measured with the Helsinki Health Study Job Exposure Matrix during 1996\u20132005 and linked to register data on employees of the City of Helsinki, Finland (n = 18 585). Outcomes were followed up during 2006\u20132015. Competing risk survival analyses were performed and synergy indices computed, adjusting for sociodemographic factors.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Long-term exposure to rotation of the back was associated with disability pension due to any cause [age and sex-adjusted subhazard ratio (SHR) 2.39, 95% confidence interval (CI) 1.73\u20133.30], and specifically disability pension due to musculoskeletal disorders (SHR = 3.39, 95% CI 1.52\u20137.56) when compared to employees exposed to neither of the two exposures. Repetitive movements alone did not increase the risk of disability pension (all-cause SHR = 1.08, 95% CI 0.84\u20131.38, musculoskeletal SHR = 1.65, 95% CI 0.91\u20132.97). Employees with exposure to both rotation of the back and repetitive movements had the highest risk of disability pension due to musculoskeletal disorders (SHR = 5.98, 95% CI 3.85\u20139.28), but the interaction between exposures was additive rather than synergistic. Adjustment for education diluted the associations by 42\u2013108%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Long-term exposure to awkward work postures increased the risk of disability pension. Educational inequalities largely account for differences in occupational exposures.<\/jats:p><\/jats:sec>","DOI":"10.1093\/eurpub\/ckz108","type":"journal-article","created":{"date-parts":[[2019,5,13]],"date-time":"2019-05-13T11:08:55Z","timestamp":1557745735000},"page":"1079-1084","source":"Crossref","is-referenced-by-count":3,"title":["Joint contribution of rotation of the back and repetitive movements to disability pension using job exposure matrix data"],"prefix":"10.1093","volume":"29","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9113-2428","authenticated-orcid":false,"given":"Jenni","family":"Ervasti","sequence":"first","affiliation":[{"name":"Department of Public Health, University of Helsinki, Helsinki, Finland"},{"name":"Finnish Institute of Occupational Health, Helsinki, Finland"},{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, 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