Work stress has been linked to employee ill-health. However, work stress in relation to disability pension has rarely been studied. Thus, three major work-related stressors—job strain, effort-reward imbalance (ERI) and organizational injustice—were studied in relation to disability pensions in three prospective studies among 24,000–69,000 public sector employees in Finland. A fourth prospective study examined both single stressors and the combinations of them among 54,000 employees. Two leading causes of disability pensions, mental and musculoskeletal disorders, were chosen as study endpoints. In addition, disability pensions granted due to ischemic heart diseases were examined in two studies. Stress was measured by self-reports and, more objectively, by work-unit means. National records, employers’ registers and survey responses were used to collect data on baseline covariates and disability pensions. 

Adjusted for demographics, job strain was linked with a 1.4 to 2.4-fold increase in the risk of disability pensioning due to musculoskeletal disorders. ERI was associated with disability pensioning due to mental disorders, when fully adjusted, showing hazard ratios from 1.3 to 1.9. The combination of job strain + ERI showed hazard ratios from 1.5 to 2.1 for the same association. Organizational injustice was not independently associated with disability pensions. Work stress was not a risk factor for disability pension due to ischemic heart diseases. All these results were based on both self-reports and work-unit means. 

Conclusions: Work-related stress is associated with an increased risk of disability pensioning. Reducing work-related stress may be beneficial in preventing disability pensions and improving work ability