{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T07:55:47Z","timestamp":1790063747188,"version":"4.0.1"},"reference-count":40,"publisher":"BMJ","issue":"11","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2018,10,22]]},"published-print":{"date-parts":[[2018,11]]},"abstract":"<jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>To examine the association of education and physical work load factors on the occupational differences in disability retirement due to knee osteoarthritis (OA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Design<\/jats:title>\n                  <jats:p>Longitudinal study.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Setting<\/jats:title>\n                  <jats:p>Linkage of several nationwide registers and a job exposure matrix in Finland.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Participants<\/jats:title>\n                  <jats:p>A total of 1 135 654 Finns aged 30\u201360 years in gainful employment were followed from 2005 to 2013 for full disability retirement due to knee OA.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Primary and secondary outcome measures<\/jats:title>\n                  <jats:p>We calculated age-adjusted incidence rates and examined the association of occupation, education and physical work load factors with disability retirement using competing risk regression model. Disability retirement due to other causes than knee OA, old-age retirement and death were treated as competing risk.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>A total of 6117 persons had disability retirement due to knee OA. Women had a higher age-adjusted incidence rate than men (72 vs 60 per 100\u2009000 person-years, respectively). In men, a very high risk of disability retirement was found among construction workers, electricians and plumbers (HR 16.6, 95%\u2009CI 12.5 to 22.2), service workers (HR 12.7, 95%\u2009CI 9.2 to 17.4) and in women among building caretakers, cleaners, assistant nurses and kitchen workers (HR 15.5, 95%\u2009CI 11.7 to 20.6), as compared with professionals. The observed occupational differences were largely explained by educational level and noticeably mediated by physical work load factors in both genders.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>Our observational study suggests that the risk of disability retirement among manual workers is strongly attributed to the physically heavy work.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-023057","type":"journal-article","created":{"date-parts":[[2018,12,2]],"date-time":"2018-12-02T15:45:19Z","timestamp":1543765519000},"page":"e023057","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["To what extent do education and physical work load factors explain occupational differences in disability retirement due to knee OA? A nationwide register-based study in Finland"],"prefix":"10.1136","volume":"8","author":[{"given":"Tea","family":"Kontio","sequence":"first","affiliation":[{"name":"Medical Faculty, University of Helsinki, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eira","family":"Viikari-Juntura","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Svetlana","family":"Solovieva","sequence":"additional","affiliation":[{"name":"Finnish Institute of Occupational Health, Helsinki, Finland"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,2,22]]},"reference":[{"key":"2025101810263263000_8.11.e023057.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(14)61462-8"},{"key":"2025101810263263000_8.11.e023057.2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2016.72"},{"key":"2025101810263263000_8.11.e023057.3","doi-asserted-by":"crossref","first-page":"1087","DOI":"10.1007\/s40273-016-0424-x","article-title":"Economic and humanistic burden of osteoarthritis: a systematic review of large sample studies","volume":"34","author":"Xie","year":"2016","journal-title":"Pharmacoeconomics"},{"key":"2025101810263263000_8.11.e023057.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(16)31460-X"},{"key":"2025101810263263000_8.11.e023057.5","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1016\/j.berh.2015.03.004","article-title":"Ageing, musculoskeletal health and work","volume":"29","author":"Palmer","year":"2015","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025101810263263000_8.11.e023057.6","doi-asserted-by":"publisher","DOI":"10.1093\/bmb\/lds012"},{"key":"2025101810263263000_8.11.e023057.7","doi-asserted-by":"crossref","first-page":"454","DOI":"10.1016\/j.berh.2015.05.005","article-title":"Knee pain, knee injury, knee osteoarthritis & work","volume":"29","author":"Dulay","year":"2015","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2025101810263263000_8.11.e023057.8","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.101210"},{"key":"2025101810263263000_8.11.e023057.9","doi-asserted-by":"publisher","DOI":"10.1136\/oemed-2013-101997"},{"key":"2025101810263263000_8.11.e023057.10","doi-asserted-by":"publisher","DOI":"10.1093\/rheumatology\/kev428"},{"key":"2025101810263263000_8.11.e023057.11","doi-asserted-by":"publisher","DOI":"10.1097\/01.jom.0000063621.37065.26"},{"key":"2025101810263263000_8.11.e023057.12","first-page":"465","article-title":"Industrial differences in disability retirement rates in Denmark, 1996-2000","volume":"14","author":"Hannerz","year":"2004","journal-title":"Int J Occup Med Environ Health"},{"key":"2025101810263263000_8.11.e023057.13","doi-asserted-by":"crossref","first-page":"84","DOI":"10.1080\/14034940410019208","article-title":"Occupation, work environment, and disability pension: a prospective study of construction workers","volume":"33","author":"Stattin","year":"2005","journal-title":"Scand J Public Health"},{"key":"2025101810263263000_8.11.e023057.14","doi-asserted-by":"crossref","DOI":"10.1186\/1471-2458-11-406","article-title":"Disability pension by occupational class--the impact of work-related factors: the Hordaland Health Study Cohort","volume":"11","author":"Haukenes","year":"2011","journal-title":"BMC Public Health"},{"key":"2025101810263263000_8.11.e023057.15","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2008.09.007"},{"key":"2025101810263263000_8.11.e023057.16","doi-asserted-by":"crossref","first-page":"49","DOI":"10.1080\/14034950410021853","article-title":"Swedish Council on Technology Assessment in Health Care (SBU). Chapter 5. Risk factors for sick leave - general studies","volume":"63","author":"Allebeck","year":"2004","journal-title":"Scand J Public Health Suppl"},{"key":"2025101810263263000_8.11.e023057.17","doi-asserted-by":"publisher","DOI":"10.1177\/1403494810378916"},{"key":"2025101810263263000_8.11.e023057.18","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811435492"},{"key":"2025101810263263000_8.11.e023057.19","doi-asserted-by":"publisher","DOI":"10.1177\/1403494811435494"},{"key":"2025101810263263000_8.11.e023057.20","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.01.035"},{"key":"2025101810263263000_8.11.e023057.21","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3441"},{"key":"2025101810263263000_8.11.e023057.22","doi-asserted-by":"crossref","first-page":"226","DOI":"10.1002\/acr.22909","article-title":"Understanding occupation, sick leave, and disability pension due to knee and hip osteoarthritis from a sex perspective","volume":"69","author":"Hubertsson","year":"2017","journal-title":"Arthritis Care Res"},{"key":"2025101810263263000_8.11.e023057.23","unstructured":"Prinz C . Disability pensions in Finland. European disability pension policies. Vienna: Ashgate, 2003:165\u201396."},{"key":"2025101810263263000_8.11.e023057.24","doi-asserted-by":"publisher","DOI":"10.1007\/s10926-014-9554-1"},{"key":"2025101810263263000_8.11.e023057.25","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0048680","article-title":"Development and validation of a job exposure matrix for physical risk factors in low back pain","volume":"7","author":"Solovieva","year":"2012","journal-title":"PLoS One"},{"key":"2025101810263263000_8.11.e023057.26","unstructured":"Rothman KJ GS . Modern epidemiology. 2nd edn. Philadelphia: Lippincott-Raven, 1998."},{"key":"2025101810263263000_8.11.e023057.27","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwp283"},{"key":"2025101810263263000_8.11.e023057.28","doi-asserted-by":"publisher","DOI":"10.1136\/oem.60.11.882"},{"key":"2025101810263263000_8.11.e023057.29","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2003.010389"},{"key":"2025101810263263000_8.11.e023057.30","doi-asserted-by":"publisher","DOI":"10.1136\/oem.2004.018135"},{"key":"2025101810263263000_8.11.e023057.31","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbspin.2006.03.001"},{"key":"2025101810263263000_8.11.e023057.32","doi-asserted-by":"publisher","DOI":"10.1002\/1529-0131(200007)43:7<1443::AID-ANR5>3.0.CO;2-1"},{"key":"2025101810263263000_8.11.e023057.33","doi-asserted-by":"publisher","DOI":"10.1007\/s00420-011-0614-y"},{"key":"2025101810263263000_8.11.e023057.34","doi-asserted-by":"crossref","first-page":"891","DOI":"10.2478\/s13382-014-0318-0","article-title":"Anthropometric indicators of obesity in policemen: a systematic review of observational studies","volume":"27","author":"Da Silva","year":"2014","journal-title":"Int J Occup Med Environ Health"},{"key":"2025101810263263000_8.11.e023057.35","doi-asserted-by":"publisher","DOI":"10.1002\/ajim.20399"},{"key":"2025101810263263000_8.11.e023057.36","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1002\/ajim.22400","article-title":"Investigating obesity among professional drivers: the high risk professional driver study","volume":"58","author":"Rosso","year":"2015","journal-title":"Am J Ind Med"},{"key":"2025101810263263000_8.11.e023057.37","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3182"},{"key":"2025101810263263000_8.11.e023057.38","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0042567","article-title":"Lost working years due to mental disorders: an analysis of the Norwegian disability pension registry","volume":"7","author":"Knudsen","year":"2012","journal-title":"PLoS One"},{"key":"2025101810263263000_8.11.e023057.39","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3413"},{"key":"2025101810263263000_8.11.e023057.40","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.3411"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2018-023057","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,18]],"date-time":"2025-10-18T17:26:39Z","timestamp":1760808399000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2018-023057"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,11]]},"references-count":40,"journal-issue":{"issue":"11","published-online":{"date-parts":[[2019,2,22]]},"published-print":{"date-parts":[[2018,11]]}},"alternative-id":["10.1136\/bmjopen-2018-023057"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2018-023057","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,11]]}}}