O6A.1 Aggregation of work-related health problems throughout working-life in a population-based sample of women

Introduction Multimorbidity potentiates a spectrum of adverse health outcomes that surpass those of individual diseases. However, little is known on disease aggregation related to occupational exposures. Objective To assess the impact of life course occupational experience on health problem aggregation. Methods We evaluated 4330 adult women at the 10-year-old follow-up wave of the population-based birth cohort Generation XXI, using a self-administered version of the Labour Force Survey item inquiring whether they had ever had a ‘physical or mental health problem that was caused or made worse by your current work or any previous work’ with 11 close-ended and one open-ended response options. Disease aggregation was assessed using principal components (PC) analysis and component scores were summarized by sociodemographic, anthropometric and work-related characteristics. Results We identified five components to describe disease aggregation which accounted for 54.7% of observed variance. PC1 gathered all items on musculoskeletal disorders (back, upper and lower limb); participants with lower educational level, higher BMI, blue-collar jobs, working in the private sector, and with a history of occupational accidents scored higher in this component. PC2 gathered the item on mental disorders (including anxiety and depression) together with headache and/or eyestrain, and showed higher scores among women with higher educational level, white-collar jobs, and in the public sector. PC3 included the item on other disorders (comprising neurological, endocrine, autoimmune and voice-related) with some loading from digestive and hearing disorders, and showed higher scores in older and blue-collar workers. PC4 grouped respiratory with infectious diseases; it associated with working in the public sector and reporting work-related accident history. PC5 was composed by circulatory system conditions and associated with former smoking, higher BMI, and white-collar jobs. Conclusion Work-related diseases aggregated in five distinct components, supporting the need for a shift from a disease-by-disease approach towards a worker-centered approach.