Objectives: This study evaluated perceived changes in stress symptoms and the relationship of these changes to work during an 11-year period.

Methods: The sample consisted of municipal workers in different occupational groups who had remained in the same occupation during 1981-1992 (N = 924, 350 men and 574 women, 14.8% of the original sample in 1981). The age range was 44-51 years in 1981. Changes in the physical and mental stress symptoms and changes at work were analyzed with the aid of a structured questionnaire in 1981 and 1992.

Results: The questionnaire surveys revealed that stress symptoms were markedly increased, especially aches and pain in the upper and lower limbs, but also respiratory and cardiovascular symptoms. Avoidance reactions, including sense of apathy in general and desire to stay at home in the morning, were the most increased psychological symptoms. The women experienced a greater increase in symptoms than the men. Changes in symptoms were associated with changes at work in that, in general, the more symptoms had increased, the more the work had also been changed.

Conclusions: The results suggest that the impact of work on the functional capacity and symptoms of workers might start even earlier than the age of 45 years. This finding is of crucial importance when preventive measures and policies are being planned in regard to stress and physical and mental load at work. Results on the relationship of changes in cardiorespiratory symptoms and work tentatively suggest that, by developing job content and social support, even a positive impact on physical symptoms is possible.