Programme 2: Determinants of musculoskeletal health in the mid-lifecourse

The aim of this programme is to determine how mechanical and non-mechanical environments contribute to musculoskeletal health during midlife and, in turn, determine capacity to maintain working life and to achieve healthy ageing. Occupational aspects of the programme have been further supported by the externally-funded Versus Arthritis/MRC Centre of Excellence in Musculoskeletal Health and Work, which is now directed by Professor Karen Walker-Bone. Our programme has already contributed to policy, informing evidence to the Work and Pensions Select Committee about the disability employment gap, and the Green Paper “Work, health and disability: Improving Lives” (Nov 2017). Moreover, the Joint Health and Work Unit (DH and DWP) is taking an active interest in the Health and Employment After Fifty (HEAF) cohort study from the policy perspective.

Scientific abstract (around 400 words – max. 3,500 characters including spaces) Summary: This programme will determine how mechanical and non-mechanical environments contribute to musculoskeletal health during midlife and, in turn, determine capacity to maintain working life and to achieve healthy ageing.
Objectives: To (a) reduce the disability for work caused by musculoskeletal disorders; (b) further explore the impacts of working to older ages on health and future healthy retirement; (c) prevent musculoskeletal disorders caused by work and: (d) undertake intervention studies to maximise work participation amongst people with MSDs.
Research plan: Occupational aspects of the programme are complemented by the externally-funded MRC Versus Arthritis Centre of Excellence for Musculoskeletal Health and Work, which is directed by Professor Karen Walker-Bone. The programme has already contributed to policy, informing evidence presented to the Work and Pensions Select Committee about the disability employment gap, and the Green Paper “Work, health and disability: Improving Lives” (Nov 2017). Moreover, the Joint Health and Work Unit (DHSC and DWP) is taking an active interest in the Health and Employment after Fifty (HEAF) study from the policy perspective. In the last quinquennium, we have demonstrated the psychosocial determinants of work and musculoskeletal health, through investigations using the HEAF study, UK Biobank, and the HCS cohorts. A key finding from HEAF was the 30-fold increased risk of being out of employment for health reasons amongst those who fulfilled the Fried criteria for frailty between the ages of 50 and 64 years. We will assess the value of physiological measures of bone strength, muscle strength, mass and function and degenerative joint disease as predictors of impaired intrinsic capacity in order to understand which component(s) of musculoskeletal reserve are adversely impacted. Occupation constitutes one important aspect of midlife, and our work-related analyses will be undertaken alongside investigations of the role of environmental, nutritional and physical activity exposures as determinants of physical capability, body composition and musculoskeletal health in these cohorts and links with Programmes 1 and 3 through the Hertfordshire Intergenerational Study and Southampton Women’s Survey. We will investigate factors influencing successful return to work after elective surgery for osteoarthritis, and the impact of osteoarthritis in people of working age, both on their work and their wider life.
Impact: Increased understanding of relationships between environmental influences (including those related to occupation) and adverse musculoskeletal outcomes will enable us to develop novel strategies, involving individuals and employers, to improve musculoskeletal health in midlife, maximise work participation and achieve optimally healthy ageing.