Effects of age on psychosocial working conditions and future labour market marginalisation: a cohort study of 56,867 Swedish twins

PURPOSE: Previous studies have reported an elevated risk of sickness absence (SA) and disability pension (DP) due to adverse psychosocial working conditions, yet the influence of age and familial factors on the associations have not been examined. We aimed to investigate associations between psychosocial working conditions and labour market marginalisation (LMM) in terms of unemployment, SA and DP adjusting for familial confounding and possible differences in these associations with different age groups and different unemployment and sick leave days. METHODS: All twins living in Sweden in 2001, aged 16–64 years and not on old-age pension or DP were included (n = 56,867). The twins were followed from 2002 to 2016 regarding unemployment, SA and DP. Cox proportional hazards regression models were performed for the whole sample, and for discordant twin pairs, in five age groups. RESULTS: Each one-unit increase in job demands and job control was associated with a lower risk of unemployment, SA and DP in all age groups. Moreover, each one-unit increase in social support was associated with an increased risk of 1–30 days unemployment in individuals older than 45 years and SA and DP. Social support decreased the risk of unemployment longer than 365 days in age groups 16–25 and 36–45 years. In the discordant twin pair analyses, the estimates attenuated towards statistical non-significance. CONCLUSION: Even though familial factors seem to influence the associations between psychosocial working conditions and LMM, improving psychosocial working conditions by for example promoting high job control and social support at workplace may reduce the risk of future short- and long-term LMM in all age groups. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00420-021-01704-z.