The contribution from psychological, social, and organizational work factors to risk of disability retirement: a systematic review with meta-analyses.

BACKGROUND: Previous studies indicate that psychological, social, and organizational factors at work contribute to health, motivation, absence from work, and functional ability. The objective of the study was to assess the current state of knowledge of the contribution of psychological, social, and organizational factors to disability retirement by a systematic review and meta-analyses.

METHODS: Data sources: A systematic literature search for studies of retirement due to disability in Medline, Embase, and PsychINFO was performed. Reference lists of relevant articles were hand-searched for additional studies.

DATA EXTRACTION: Internal validity was assessed independently by two referees with a detailed checklist for sources of bias. Conclusions were drawn based on studies with acceptable quality.

DATA SYNTHESIS: We calculated combined effect estimates by means of averaged associations (Risk ratios) across samples, weighting observed associations by the study's sample size. Thirty-nine studies of accepted quality were found, 37 of which from the Nordic countries.

RESULTS: There was moderate evidence for the role of low control (supported by weighted average RR = 1.40; 95% CI = 1.21-1.61) and moderate evidence for the combination of high demands and low control (although weighted average was RR = 1.45; 95% CI = 0.96-2.19) as predictors of disability retirement. There were no major systematic differences in findings between the highest rated and the lowest rated studies that passed the criterion for adequate quality. There was limited evidence for downsizing, organizational change, lack of employee development and supplementary training, repetitive work tasks, effort-reward imbalance to increase risk of disability pension. Very limited evidence was found for job demands, evening or night work, and low social support from ones superior.

CONCLUSIONS: Psychological and organizational factors at work contribute to disability retirement with the most robust evidence for the role of work control. We recommend the measurement of specific exposure factors in future studies.