{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T11:27:47Z","timestamp":1790422067992,"version":"4.1.0"},"reference-count":49,"publisher":"BMJ","issue":"12","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Occup Environ Med"],"published-print":{"date-parts":[[2001,12,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVES<\/jats:title><jats:p>To study the association between organisational downsizing and subsequent musculoskeletal problems in employees and to determine the association with changes in psychosocial and behavioural risk factors.<\/jats:p><\/jats:sec><jats:sec sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>Participants were 764 municipal employees working in Raisio, Finland before and after an organisational downsizing carried out between 1991 and 1993. The outcome measures were self reports of severity and sites of musculoskeletal pain at the end of 1993 and medically certified musculoskeletal sickness absence for 1993\u20135. The contribution of changes in psychosocial work characteristics and health related behaviour between the 1990 and 1993 surveys was assessed by adjustment.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>After adjustment for age, sex, and income, the odds ratio (OR) for severe musculoskeletal pain between major and minor downsizing and the corresponding rate ratios for musculoskeletal sickness absence were 2.59 (95% confidence interval (95% CI) 1.5 to 4.5) and 5.50 (3.6 to 7.6), respectively. Differences between the mean number of sites of pain after major and minor downsizing was 0.99 (0.4 to 1.6). The largest contribution from changes in work characteristics and health related behaviour to the association between downsizing and musculoskeletal problems was from increases in physical demands, particularly in women and low income employees. Additional contributory factors were reduction of skill discretion (relative to musculoskeletal pain) and job insecurity. The results were little different when analyses were confined to initially healthy participants.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>Downsizing is a risk factor for musculoskeletal problems among those who remain in employment. Much of this risk is attributable to increased physical demands, but adverse changes in other psychosocial factors may also play a part.<\/jats:p><\/jats:sec>","DOI":"10.1136\/oem.58.12.811","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T10:32:19Z","timestamp":1027765939000},"page":"811-817","source":"Crossref","is-referenced-by-count":77,"title":["Organisational downsizing and musculoskeletal problems in employees: a prospective study"],"prefix":"10.1136","volume":"58","author":[{"given":"M","family":"Kivim\u00e4ki","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Vahtera","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J E","family":"Ferrie","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Hemingway","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J","family":"Pentti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2001,12,1]]},"reference":[{"key":"2024052310464913000_58.12.811.1","doi-asserted-by":"crossref","first-page":"1012","DOI":"10.2105\/AJPH.88.7.1012","article-title":"Editorial.","volume":"88","author":"Hurrell","year":"1998","journal-title":"Am J Public Health"},{"key":"2024052310464913000_58.12.811.2","doi-asserted-by":"crossref","unstructured":"Cascio WF (1998) Learning from outcomes: financial experiences of 311 firms that have downsized. in The new organizational reality. eds Gowing MK Kraft JD Quick JC (American Psychological Association, Washington), pp 55\u201370.","DOI":"10.1037\/10252-013"},{"key":"2024052310464913000_58.12.811.3","doi-asserted-by":"crossref","first-page":"1508","DOI":"10.1136\/bmj.296.6635.1508","article-title":"Certificated sickness absence in industrial employees threatened with redundancy.","volume":"296","author":"Beale","year":"1988","journal-title":"BMJ"},{"key":"2024052310464913000_58.12.811.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.311.7015.1264"},{"key":"2024052310464913000_58.12.811.5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(97)03216-9"},{"key":"2024052310464913000_58.12.811.6","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.2105\/AJPH.88.7.1030","article-title":"An uncertain future: the health effects of threats to employment security in white-collar men and women.","volume":"88","author":"Ferrie","year":"1998","journal-title":"Am J Public Health"},{"key":"2024052310464913000_58.12.811.7","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.320.7240.971"},{"key":"2024052310464913000_58.12.811.8","first-page":"5","article-title":"Epidemiology of rheumatic disease in Finland in 1964\u201376.","volume":"47","author":"Klaukka","year":"1982","journal-title":"Scand J Rheumatol"},{"key":"2024052310464913000_58.12.811.9","unstructured":"Office of Population Censuses and Surveys (1988) OPCS surveys of disability in Great Britain; report 1 (prevalence of disability among adults). (The Stationery Office, London). Martin J . Melzer H . ."},{"key":"2024052310464913000_58.12.811.10","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1136\/oem.55.2.91","article-title":"Socioeconomic and sex differentials in reason for sickness absence from the Whitehall II study.","volume":"55","author":"Feeney","year":"1998","journal-title":"Occup Environ Med"},{"key":"2024052310464913000_58.12.811.11","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.89.7.1029"},{"key":"2024052310464913000_58.12.811.12","first-page":"679","article-title":"Epidemiology of work related musculoskeletal disorders.","volume":"27","author":"Hales","year":"1996","journal-title":"Occup Disorder Management"},{"key":"2024052310464913000_58.12.811.13","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1177\/14034948980260031101","article-title":"Gender trends in sick-listing with musculoskeletal symptoms in a Swedish county during a period of rapid increase in sickness absence.","volume":"26","author":"Leijon","year":"1998","journal-title":"Scand J Soc Med"},{"key":"2024052310464913000_58.12.811.14","first-page":"67","article-title":"An overview of psychosocial and behavioral factors in neck-and-shoulder pain.","volume":"32","author":"Linton","year":"1992","journal-title":"Scand J Rehabil Med"},{"key":"2024052310464913000_58.12.811.15","doi-asserted-by":"crossref","first-page":"297","DOI":"10.5271\/sjweh.1470","article-title":"Psychosocial factors at work and musculoskeletal disease.","volume":"19","author":"Bongers","year":"1993","journal-title":"Scand J Work Environ Health"},{"key":"2024052310464913000_58.12.811.16","doi-asserted-by":"crossref","first-page":"139","DOI":"10.5271\/sjweh.1419","article-title":"Psychosocial stressors at work and musculoskeletal problems.","volume":"20","author":"Houtman","year":"1994","journal-title":"Scand J Work Environ Health"},{"key":"2024052310464913000_58.12.811.17","doi-asserted-by":"crossref","first-page":"134","DOI":"10.5271\/sjweh.20","article-title":"Psychosocial factors at work in relation to back and limb disorders.","volume":"21","author":"Leino","year":"1995","journal-title":"Scand J Work Environ Health"},{"key":"2024052310464913000_58.12.811.18","doi-asserted-by":"publisher","DOI":"10.1136\/oem.53.5.351"},{"key":"2024052310464913000_58.12.811.19","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1136\/jech.53.4.197","article-title":"Are risk factors for atherothrombotic disease associated with back pain sickness absence? The Whitehall II study.","volume":"53","author":"Hemingway","year":"1999","journal-title":"J Epidemiol Community Health"},{"key":"2024052310464913000_58.12.811.20","doi-asserted-by":"crossref","first-page":"130","DOI":"10.5271\/sjweh.190","article-title":"Associations between self-rated psychosocial work conditions and musculoskeletal symptoms and signs.","volume":"23","author":"Toomingas","year":"1997","journal-title":"Scand J Work Environ Health"},{"key":"2024052310464913000_58.12.811.21","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.189"},{"key":"2024052310464913000_58.12.811.22","doi-asserted-by":"publisher","DOI":"10.1016\/S0160-2527(99)00019-9"},{"key":"2024052310464913000_58.12.811.23","doi-asserted-by":"publisher","DOI":"10.1080\/02678379708252998"},{"key":"2024052310464913000_58.12.811.24","doi-asserted-by":"crossref","first-page":"243","DOI":"10.1016\/S0277-9536(97)00158-5","article-title":"The health effects of major organisational change and job insecurity.","volume":"46","author":"Ferrie","year":"1998","journal-title":"Soc Sci Med"},{"key":"2024052310464913000_58.12.811.25","doi-asserted-by":"crossref","first-page":"26","DOI":"10.1037\/1076-8998.6.1.26","article-title":"Job insecurity in white-collar workers: towards an explanation of associations with health.","volume":"2","author":"Ferrie","year":"2001","journal-title":"J Occup Health Psychol"},{"key":"2024052310464913000_58.12.811.26","doi-asserted-by":"publisher","DOI":"10.1136\/jech.49.2.124"},{"key":"2024052310464913000_58.12.811.27","unstructured":"(1998) Statistical yearbook of Finland. (Statistics Finland, Helsinki)."},{"key":"2024052310464913000_58.12.811.28","doi-asserted-by":"publisher","DOI":"10.1097\/00007632-198205000-00004"},{"key":"2024052310464913000_58.12.811.29","doi-asserted-by":"crossref","first-page":"286","DOI":"10.1080\/02678379608256809","article-title":"The effects of objective job demands on registered sickness absence spells: do personal, social, and job-related resources act as moderators?","volume":"19","author":"Vahtera","year":"1996","journal-title":"Work Stress"},{"key":"2024052310464913000_58.12.811.30","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(87)90010-X"},{"key":"2024052310464913000_58.12.811.31","doi-asserted-by":"publisher","DOI":"10.1016\/0003-6870(92)90225-K"},{"key":"2024052310464913000_58.12.811.32","unstructured":"World Health Organisation (1977) International classification of diseases, 1977 revision. (WHO, Geneva)."},{"key":"2024052310464913000_58.12.811.33","unstructured":"Lehto A-M (1991) Ty\u00f6el\u00e4m\u00e4n laatu ja tasa-arvo tuotannossa (Quality of working life and equity). (Statistics Finland, Helsinki)."},{"key":"2024052310464913000_58.12.811.34","doi-asserted-by":"publisher","DOI":"10.1037\/0021-9010.82.6.858"},{"key":"2024052310464913000_58.12.811.35","doi-asserted-by":"publisher","DOI":"10.1001\/jama.279.6.440"},{"key":"2024052310464913000_58.12.811.36","unstructured":"SAS Institute (1993) SAS technical report P-243, SAS\/STAT software: the GENMOD procedure, release 6.09. (SAS Institute, Cary, NC)."},{"key":"2024052310464913000_58.12.811.37","unstructured":"Winer BJ (1971) Statistical principles in experimental design. (McGraw-Hill, London)."},{"key":"2024052310464913000_58.12.811.38","doi-asserted-by":"crossref","first-page":"1173","DOI":"10.1037\/0022-3514.51.6.1173","article-title":"The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations.","volume":"51","author":"Baron","year":"1984","journal-title":"J Personality Soc Psychol"},{"key":"2024052310464913000_58.12.811.39","first-page":"1","article-title":"Scientific approach to the assessment and management of activity related spinal disorders: a monograph for clinicians: report of the Quebec Task Force on Spinal Disorders.","volume":"12","author":"Spitzer","year":"1987","journal-title":"Spine"},{"key":"2024052310464913000_58.12.811.40","doi-asserted-by":"crossref","first-page":"165","DOI":"10.2340\/165019779123165173","article-title":"Psychosocial job factors and symptoms from the locomotor system\u2014a multicausal analysis.","volume":"23","author":"Theorell","year":"1991","journal-title":"Scand J Rehabil Med"},{"key":"2024052310464913000_58.12.811.41","unstructured":"Kuorinka I Forcier L , eds (1995) Work related musculoskeletal disorders: a reference book for prevention. (Taylor and Francis, London)."},{"key":"2024052310464913000_58.12.811.42","unstructured":"Bernard BP (1997) Musculoskeletal disorders and workplace factors: a critical review of epidemiologic evidence for work related musculoskeletal disorders of the neck, upper extremity, and low back. (US Department of Health and Human Services, Public Health Service, Center for Disease Control, and National Institute of Occupational Safety and Health, Washington, DC)."},{"key":"2024052310464913000_58.12.811.43","doi-asserted-by":"crossref","first-page":"145","DOI":"10.5271\/sjweh.292","article-title":"Occupational factors affecting sick leave attributed to low back pain.","volume":"24","author":"Wickstr\u00f6m","year":"1998","journal-title":"Scand J Work Environ Health"},{"key":"2024052310464913000_58.12.811.44","doi-asserted-by":"crossref","first-page":"559","DOI":"10.1016\/S0950-3579(05)80127-X","article-title":"Epidemiology of low back pain.","volume":"6","author":"Skovron","year":"1992","journal-title":"Ballerie's Clinical Rheumatology"},{"key":"2024052310464913000_58.12.811.45","unstructured":"Vahtera J Pentti J (1999) Employees in the storm of economy: development of psychosocial work environment between 1990\u20137. (Finnish Institute of Occupational Health, Helsinki)."},{"key":"2024052310464913000_58.12.811.46","doi-asserted-by":"publisher","DOI":"10.5271\/sjweh.1891"},{"key":"2024052310464913000_58.12.811.47","doi-asserted-by":"crossref","first-page":"354","DOI":"10.1207\/s15327558ijbm0104_5","article-title":"Psychophysiological stress and EMG activity of the trapezius muscle.","volume":"1","author":"Lundberg","year":"1994","journal-title":"Int J Behav Med"},{"key":"2024052310464913000_58.12.811.48","unstructured":"Cobb S Kasl SV (1977) Termination: the cconsequences of job loss. (National Institute for Occupational Safety and Health, Cincinatti)."},{"key":"2024052310464913000_58.12.811.49","unstructured":"Kivim\u00e4ki M Vahtera J Griffiths A (2000) Sickness absence and organizational downsizing. in The organization in crisis: downsizing, restructuring, and privatization. eds Burke RJ Cooper CL (Blackwell, Oxford), pp 78\u201394."}],"container-title":["Occupational and Environmental Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/oem.58.12.811","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,23]],"date-time":"2024-05-23T18:48:18Z","timestamp":1716490098000},"score":1,"resource":{"primary":{"URL":"https:\/\/oem.bmj.com\/lookup\/doi\/10.1136\/oem.58.12.811"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2001,12,1]]},"references-count":49,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2001,12,1]]},"published-print":{"date-parts":[[2001,12,1]]}},"alternative-id":["10.1136\/oem.58.12.811"],"URL":"https:\/\/doi.org\/10.1136\/oem.58.12.811","relation":{},"ISSN":["1351-0711","1470-7926"],"issn-type":[{"value":"1351-0711","type":"print"},{"value":"1470-7926","type":"electronic"}],"subject":[],"published":{"date-parts":[[2001,12,1]]}}}