{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T16:24:34Z","timestamp":1787502274383,"version":"build-2736575974"},"reference-count":22,"publisher":"BMJ","issue":"5","license":[{"start":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T00:00:00Z","timestamp":1785196800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det f\u00f6r h\u00e4lsa, arbetsliv och v\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["2021-01548"],"award-info":[{"award-number":["2021-01548"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Occup Environ Med"],"accepted":{"date-parts":[[2026,7,16]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>This register-based study examined whether changes over 14 years in occupational physical workload (PWL) affected the risk of registered work disability due to a musculoskeletal disorder (MSD).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 1\u2009703\u2009935 workers in Sweden in 2005. PWL exposure was measured using job-exposure matrices linked to registered occupations in 1990 and 2005; change in PWL was defined between categories (low, medium, high) in either direction. The outcome was cumulative incidence of \u2018work disability\u2019 (either long-term sickness of at least 2 years or disability pension) due to MSD from 2006 to 2019. Crude and multivariate Cox proportional hazards regression models estimated sex-specific HRs with 95% CIs. Models were adjusted for sociodemographic factors and health and employment history.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 33\u2009369 individuals (1.96%) became work disability cases during follow-up. Compared with workers with consistently high PWL, any reduction in PWL was associated with a decreased risk of work disability due to MSD (women: HR 0.57, 95% CI 0.52 to 0.63, men: HR 0.59, 95% CI 0.52 to 0.66 for change from high to low exposure). Compared with workers with consistently low PWL, any increase was associated with a higher risk of work disability due to MSD (women: HR 1.68, 95% CI 1.53 to 1.86, men: HR 2.19, 95% CI 1.89 to 2.52 for change from low to high).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In both sexes, decreases in PWL exposure were associated with a lower risk of MSD disability and increases in exposure with a higher risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/oemed-2026-111034","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T17:20:37Z","timestamp":1785259237000},"page":"261-267","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Change in physical workload and the risk of work disability due to musculoskeletal disorders: a register-based study of 1 703 935 workers in Sweden"],"prefix":"10.1136","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4441-7003","authenticated-orcid":false,"given":"Daniel","family":"Falkstedt","sequence":"first","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomas","family":"Hemmingsson","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Department of Public Health Sciences, Stockholm University, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Punnett","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Massachusetts, Lowell, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0458-6243","authenticated-orcid":false,"given":"Katarina","family":"Kjellberg","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"},{"name":"Centre for Occupational and Environmental Medicine, Region Stockholm, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alicia","family":"Kurowski","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, University of Massachusetts, Lowell, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0523-663X","authenticated-orcid":false,"given":"Kuan-Yu","family":"Pan","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4167-9174","authenticated-orcid":false,"given":"Melody","family":"Almroth","sequence":"additional","affiliation":[{"name":"Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,7,28]]},"reference":[{"key":"2026082308400582000_83.5.261.1","doi-asserted-by":"crossref","first-page":"101558","DOI":"10.1016\/j.berh.2020.101558","article-title":"Musculoskeletal health in the workplace","volume":"34","author":"Crawford","year":"2020","journal-title":"Best Pract Res Clin Rheumatol"},{"key":"2026082308400582000_83.5.261.2","doi-asserted-by":"crossref","first-page":"337","DOI":"10.1007\/s00420-018-1393-5","article-title":"Long-term exposure to heavy physical work, disability pension due to musculoskeletal disorders and all-cause mortality: 20-year 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