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Effects of Work and Lifestyle on Risk for Future Disability Pension Due to Low Back Diagnoses: A 30-Year Prospective Study of Finnish Twins

Ropponen, Annina PhD; Silventoinen, Karri PhD; Svedberg, Pia PhD; Alexanderson, Kristina PhD; Huunan-Seppälä, Antti MD, PhD; Koskenvuo, Karoliina PhD; Koskenvuo, Markku MD, PhD; Kaprio, Jaakko MD, PhD

Journal of Occupational and Environmental Medicine: November 2012 - Volume 54 - Issue 11 - p 1330–1336
doi: 10.1097/JOM.0b013e3182775881
Original Articles

Objective: To investigate work and lifestyle factors as predictors for disability pension (DP) due to low back diagnoses (LBDs) during a 30-year follow-up.

Methods: Baseline survey data were obtained in 1975 for 16,028 working-age twins followed with register data on DP, emigration, old-age pension, and death until end of 2004; analyzed by Cox proportional hazards regression.

Results: Among those at work at baseline, 470 DPs due to LBDs were granted during the follow-up. Monotonous work, lifting and carrying at work or physically heavy work, and unemployment at least once before baseline were significant predictors for DP. A healthy lifestyle was a protective factor for DP. Family background played a role in all these associations.

Conclusion: The factors shared by family members seemed to influence both work and lifestyle factors, which then influenced the incidence of DP due to LBDs.

From the School of Medicine (Dr Ropponen), University of Eastern Finland, Kuopio, Finland; Population Research Unit (Dr Silventoinen), Department of Sociology, University of Helsinki, Finland; Department of Public Health (Drs Silventoinen, M Koskenvuo, and Kaprio), Hjelt Institute, University of Helsinki, Finland; Division of Insurance Medicine (Drs Svedberg and Alexanderson), Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Department of General Practice (Dr Huunan-Seppälä), University of Tampere, Tampere, Finland; Research Department, The Social Insurance Institution of Finland (Dr K Koskenvuo), Helsinki, Finland; Department of Mental Health and Substance Abuse Services (Dr Kaprio), National Institute for Health and Welfare, Helsinki, Finland; and Institute for Molecular Medicine (Dr Kaprio), University of Helsinki, Finland.

Address correspondence to: Annina Ropponen, PhD, University of Eastern Finland, School of Medicine, PO Box 1627, 70211 Kuopio, Finland (

This work was supported by the Social Insurance Institution, Finland, for the TwinKela-project, and by the Academy of Finland Center of Excellence in Complex Disease Genetics (grants 213506 and 129680) for the Finnish Twin Cohort studies. AR is supported by an Academy of Finland researcher grant 122080, PS by grants from the Swedish Council for Working Life and Social Research (2007-0830) and the Centre for Health Care Science, and KA by grants from the Swedish Council for Working Life and Social Research.

Authors Ropponen, Silventoinen, Svedberg, Alexanderson, Huunan-Seppälä, K. Koskenvuo, M. Koskenvuo, and Kaprio have no relationships/conditions/circumstances that present potential conflict of interest.

The JOEM Editorial Board and planners have no financial interest related to this research.

©2012The American College of Occupational and Environmental Medicine