Acts of offensive behaviour and risk of disability pension in Danish female eldercare workers: prospective cohort with 11-year register follow-up

Abstract

Objectives: To investigate whether acts of offensive behaviour (threats, violence, workplace bullying and sexual harassment) in the workplace and type of perpetrator (internal or external to the workplace) of the offensive behaviours predicted risk of disability pension in Danish eldercare workers. Methods: We merged survey responses from 8731 female eldercare workers with a national register on social transfer payments (Danish Register for Evaluation of Marginalisation (DREAM)), including all types of disability benefits. Using Cox proportional hazards models, we investigated the prospective association between self-reported exposures at baseline and the risk of receiving disability pension (any type of disability benefit payment) during 11 years of follow-up, while adjusting for potential confounders. Results: Self-reported exposure to threats (hazard ratio (HR) 1.14; 95% confidence interval (CI) 1.00–1.32), violence (HR 1.16; 95% CI 1.00–1.35) and bullying (HR 1.44; 95% CI 1.22–1.71) predicted increased risk of disability pension during follow-up, when adjusted for age and educational attainment. When further adjusted for psychosocial working conditions only bullying remained a statistically significant (HR 1.39; 95% CI 1.16–1.67) predictor of disability pension. The results indicated no elevated risk for participants reporting sexual harassment. Moreover, we observed stronger associations between self-reported exposure to threats, violence and workplace bullying and risk of disability pension when the perpetrator was internal to the workplace (i.e. colleagues, managers and/or subordinates), than when the perpetrator was reported to be external to the workplace (i.e. service users, and/or relatives of service users). Conclusions: Results indicate that prevention of work-related exposure to threats, violence and workplace bullying may contribute to reduce involuntary early retirement in female eldercare workers.