{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T18:05:44Z","timestamp":1774980344315,"version":"3.50.1"},"reference-count":36,"publisher":"Public Library of Science (PLoS)","issue":"3","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"\n Objective<\/jats:title>\n This study determines a set of medical, occupational, and social risk factors of professional disengagement that can be documented early in occupational health practice.<\/jats:p>\n <\/jats:sec>\n \n Method<\/jats:title>\n This study was carried out on a cohort of French workers. Data were extracted from computerised occupational health medical follow up records. The professional disengagement risk was assessed by healthcare professionals. Logistic regression models were applied.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n 181,676 workers were included. Of these, 4.05% had a high professional disengagement risk index (PDRI) and 13.0% a moderate risk. Women (OR: 1.21) and 50\u201361-year-old (OR: 5.17) workers appear to be the most at high risk. White-collar (OR: 1.63) and blue-collar (OR: 1.60) have a higher at risk compared with manager. The main disorder risk factors of high PDRI were mental disorders (OR: 8.79), musculoskeletal disorders including shoulder (OR: 6.23), arm (OR: 3.80), or hand (OR: 3.21) and kidney disorders (OR: 5.57). Recognition of a professional disengagement (OR: 7.55) or long\/iterative sick leave (OR: 5.08) is associated with high PDRI. Occupational exposure associated with high PDRI include \u201cpoor interpersonal relationships\u201d (OR: 6.05), \u201cjob insecurity\u201d (OR: 4.14) and \u201cconflicts of values\u201d (OR: 3.88). Exposure to noise (OR: 1.33) and heavy work (OR: 1.25) are associated with a high PDRI, however some physical exposures appear to be \u2018protective\u2019 such as lower limb postures (OR: 0.68) or whole-body vibrations (OR: 0.64).<\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n Mental and musculoskeletal disorders, poor working relationships, job insecurity and conflicts of values all appear to be avoidable risk factors for professional disengagement These results reinforce the importance of targeted prevention and orientates future research to refine the accuracy of the variables and better distinguish gradients and thresholds of risk.<\/jats:p>\n <\/jats:sec>\n \n What is already known<\/jats:title>\n Numerous studies have investigated the factors facilitating or limiting a return to work after professional disengagement.<\/jats:p>\n <\/jats:sec>\n \n What this study adds<\/jats:title>\n This study highlights the medical and professional factors which should be early documented to prevent professional disengagement.<\/jats:p>\n <\/jats:sec>","DOI":"10.1371\/journal.pone.0346149","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:25:47Z","timestamp":1774977947000},"page":"e0346149","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["Modelling the risk of professional disengagement from a cohort study of 181,676 workers in the south of France"],"prefix":"10.1371","volume":"21","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6735-344X","authenticated-orcid":true,"given":"Gauthier","family":"Bellagamba","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vincent","family":"Houtin","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anne","family":"Landi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marie-Pascale","family":"Lehucher-Michel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"pone.0346149.ref001","author":"P Aballea","year":"2017"},{"key":"pone.0346149.ref002","article-title":"Study of predictive factors of professional disengagement: the use of big data in occupational health in the primary prevention of job exits","author":"L Dogbla","year":"2022","journal-title":"Geneve, Switzerland"},{"key":"pone.0346149.ref003","article-title":"Factors associated with return to work of breast cancer survivors: a systematic review","author":"T Islam","year":"2014","journal-title":"BMC Public Health"},{"issue":"3","key":"pone.0346149.ref004","first-page":"463","article-title":"Returning to work after breast cancer: A systematic review of reviews","volume":"61","author":"RA Cocchiara","year":"2018","journal-title":"Work"},{"issue":"2","key":"pone.0346149.ref005","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1177\/2165079918812483","article-title":"Return to Work Among Stroke Survivors","volume":"67","author":"KD Ashley","year":"2019","journal-title":"Workplace Health Saf"},{"issue":"4","key":"pone.0346149.ref006","first-page":"501","article-title":"The efficacy and efficiency of Disability Management in job-retention and job-reintegration. A systematic review","volume":"59","author":"M Lefever","year":"2018","journal-title":"Work"},{"issue":"3","key":"pone.0346149.ref007","first-page":"272","article-title":"Predictive factors for maintaining employment and returning to work after cancer","volume":"108","author":"M Mersni","year":"2021","journal-title":"Bull Cancer"},{"issue":"7","key":"pone.0346149.ref008","doi-asserted-by":"crossref","first-page":"845","DOI":"10.1080\/13548506.2020.1795212","article-title":"Cancer survivors\u2019 efforts to facilitate return to work","volume":"26","author":"G Bellagamba","year":"2021","journal-title":"Psychol Health Med"},{"issue":"4","key":"pone.0346149.ref009","article-title":"Analysis of the profile of employees declared unfit for the job: what place for societal or extra-professional factors and what consequences for employment? [French","author":"R Courtois","year":"2023","journal-title":"Rev D\u00c9pid\u00e9miologie Sant\u00e9 Publique"},{"key":"pone.0346149.ref010","article-title":"Medico-social predictors of low work ability: a cross-sectional study of 2104 workers in southern France","author":"G Bellagamba","journal-title":"BMJ Open"},{"issue":"2","key":"pone.0346149.ref011","first-page":"102270","article-title":"Validation of a clinical method for assessing the risk of professional disengagement","volume":"85","author":"G Bellagamba","year":"2024","journal-title":"Arch Mal Prof Environ"},{"key":"pone.0346149.ref012","article-title":"Cross-sectional validation of a clinical method assessing medical work disability risk","author":"G Bellagamba","year":"2025","journal-title":"WORK J Prev Assess Rehabil"},{"key":"pone.0346149.ref013","unstructured":"International Classification of Diseases (ICD). https:\/\/www.who.int\/standards\/classifications\/classification-of-diseases. Accessed 2024 September 26."},{"key":"pone.0346149.ref014","first-page":"65","article-title":"Methodology for updating a thesaurus of occupational exposures","volume":"168","author":"C Chauvet","year":"2021","journal-title":"R\u00e9f En Sant\u00e9 Au Trav"},{"key":"pone.0346149.ref015","article-title":"Exposure to occupational risks. Organizational and relational constraints","author":"B Matinet","year":"2019","journal-title":"Minist\u00e8re du Travail, Direction de l\u2019animation de la recherche, des \u00e9tudes et des statistiques (DARES)"},{"key":"pone.0346149.ref016","author":"E Masson"},{"issue":"5","key":"pone.0346149.ref017","first-page":"435","article-title":"Assessment of well-being at work: comparison of two measurement instruments [French]","volume":"770","author":"C Delmas","year":"2007","journal-title":"Arch Mal Prof Environ"},{"key":"pone.0346149.ref018","unstructured":"What is recognition of disabled worker status (DW)?. https:\/\/www.service-public.fr\/particuliers\/vosdroits\/F1650. Accessed 2025 January 29."},{"key":"pone.0346149.ref019","unstructured":"What is disability in the sense of social security?. https:\/\/www.service-public.fr\/particuliers\/vosdroits\/F13093. Accessed 2025 January 29."},{"key":"pone.0346149.ref020","unstructured":"Incapacity, incapacity, disability: what are the differences?. https:\/\/travail-emploi.gouv.fr\/inaptitude-incapacite-invalidite-quelles-differences. 2022. Accessed 2025 January 29."},{"key":"pone.0346149.ref021","unstructured":"Insee. Employment statuses \u2212 Employment, unemployment, earned income [French] [Internet]. 2021 [cited 2025 Feb 10]. Available from: https:\/\/www.insee.fr\/fr\/statistiques\/5391966?sommaire=5392045"},{"issue":"2","key":"pone.0346149.ref022","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1037\/1082-989X.7.2.147","article-title":"Missing data: our view of the state of the art","volume":"7","author":"JL Schafer","year":"2002","journal-title":"Psychol Methods"},{"key":"pone.0346149.ref023","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-34801-4","volume-title":"Multilevel Modelling for Public Health and Health Services Research: Health in Context","author":"AH Leyland","year":"2020"},{"issue":"4","key":"pone.0346149.ref024","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1136\/oem.2008.039883","article-title":"The effects of work-related and individual factors on the Work Ability Index: a systematic review","volume":"66","author":"TIJ van den Berg","year":"2009","journal-title":"Occup Environ Med"},{"key":"pone.0346149.ref025","unstructured":"Bellagamba G, Blancquaert D, Dalvai J, Grolleau N, Dubois A, Lehucher-Michel M. Study of the reasons behind medical unfitness notices in the South PACA region in 2017. 2019."},{"issue":"1","key":"pone.0346149.ref026","doi-asserted-by":"crossref","first-page":"13","DOI":"10.1016\/j.jelekin.2003.09.015","article-title":"Work-related musculoskeletal disorders: the epidemiologic evidence and the debate","volume":"14","author":"L Punnett","year":"2004","journal-title":"J Electromyogr Kinesiol"},{"issue":"6","key":"pone.0346149.ref027","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0128834","article-title":"Intelligence and disability pension in swedish men and women followed from childhood to late middle age","volume":"10","author":"A Lundin","year":"2015","journal-title":"PLoS One"},{"issue":"7","key":"pone.0346149.ref028","article-title":"Permanent unfitness for work and musculoskeletal diseases: a multicentric cross-sectional study of 2788 unfit employees","volume":"65","author":"Members of the Steering Committee","year":"2023","journal-title":"J Occup Environ Med"},{"key":"pone.0346149.ref029","doi-asserted-by":"crossref","DOI":"10.1136\/oemed-2018-105647","article-title":"Work participation and working life expectancy after a disabling shoulder lesion","volume":"76","author":"M Siren","year":"2019","journal-title":"Occup Environ Med"},{"issue":"7","key":"pone.0346149.ref030","doi-asserted-by":"crossref","first-page":"1222","DOI":"10.1080\/13548506.2022.2118796","article-title":"Permanent unfitness for work and mental disorders: a multicentric cross-sectional study of 2,788 unfit employees","volume":"29","author":"Members of the Steering Committee","year":"2024","journal-title":"Psychol Health Med"},{"issue":"8","key":"pone.0346149.ref031","doi-asserted-by":"crossref","first-page":"842","DOI":"10.1001\/jamapsychiatry.2020.0322","article-title":"Psychosocial Stressors at Work and the Risk of Sickness Absence Due to a Diagnosed Mental Disorder: A Systematic Review and Meta-analysis","volume":"77","author":"CS Duchaine","year":"2020","journal-title":"JAMA Psychiatry"},{"issue":"5","key":"pone.0346149.ref032","first-page":"564","article-title":"The impact of shoulder pathologies on job discontinuation and return to work: a pilot ultrasonographic investigation","volume":"59","author":"P-C Chu","year":"2023","journal-title":"Eur J Phys Rehabil Med"},{"key":"pone.0346149.ref033","doi-asserted-by":"crossref","first-page":"536","DOI":"10.1016\/j.jad.2019.06.041","article-title":"The relationship between depression symptoms, absenteeism and presenteeism","volume":"256","author":"DA Johnston","year":"2019","journal-title":"J Affect Disord"},{"issue":"1","key":"pone.0346149.ref034","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/j.1467-789X.2008.00521.x","article-title":"Obesity status and sick leave: a systematic review","volume":"10","author":"K Neovius","year":"2009","journal-title":"Obes Rev"},{"issue":"3","key":"pone.0346149.ref035","doi-asserted-by":"crossref","first-page":"237","DOI":"10.1016\/j.amepre.2013.11.002","article-title":"Prevalence of obesity among U.S. workers and associations with occupational factors","volume":"46","author":"SE Luckhaupt","year":"2014","journal-title":"Am J Prev Med"},{"issue":"5","key":"pone.0346149.ref036","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1001\/jama.2012.39","article-title":"Prevalence of obesity and trends in the distribution of body mass index among US adults, 1999-2010","volume":"307","author":"KM Flegal","year":"2012","journal-title":"JAMA"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346149","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T17:25:56Z","timestamp":1774977956000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0346149"}},"subtitle":[],"editor":[{"given":"S\u0131d\u0131ka","family":"Bulduk","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2026,3,31]]},"references-count":36,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2026,3,31]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0346149","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,3,31]]}}}