Metabolic syndrome and employment exit: Longitudinal findings from the Lifelines Cohort Study and Biobank

The Netherlands face a new demographic reality of an aging working population. To ensure the sustainability of the Dutch welfare state and pension system, statutory retirement ages are increasing. To date, many workers still exit employment prematurely, often due to chronic diseases. A potential risk factor for premature employment exit is the growing global Metabolic Syndrome (MetS) epidemic. MetS is an early-stage modifiable risk factor for chronic cardio-metabolic diseases and consists of a combination of hypertension, abdominal obesity and/or unfavorable blood lipid and glucose values.

This dissertation investigates the relationship between MetS and employment exit among middle-aged and older Dutch workers. Longitudinal data from the Lifelines Cohort Study and Biobank suggest that MetS is both a risk factor for and outcome of premature employment exit. MetS was especially associated with work disability and to a lesser extent with unemployment. Workers in lower skilled and blue-collar occupations were at highest risk for developing MetS. This was partly due to a clustering of unhealthy behaviors among workers in blue-collar occupations, i.e., a combination of smoking, lower physical activity, lower diet quality, and/or higher alcohol consumption.

This dissertation concludes that preventing and treating MetS has the potential to extend healthy working lives of middle-aged and older workers. Integrative MetS prevention and treatment strategies are needed which are tailored to the needs of specific risk groups of workers. More awareness about the labor market consequences of MetS is needed among policy makers, employers, occupational health professionals, and middle-aged and older workers.