Trapped in harmful work? How psychosocial job exposure, sex, and education shape occupational mobility in Norway

BACKGROUND: While the health risks of psychosocial job exposure are well established, the extent to which workers reduce exposure by changing occupations remains unclear. This study examines whether Norwegian workers in high-exposure occupations are more likely to change their occupation compared to those in lower-exposure occupations, whether such changes lead to less exposure, and whether these patterns vary by educational attainment and sex. METHODS: Comprehensive Norwegian register data were linked to a validated, sex-specific psychosocial job exposure index covering 322 occupations to track occupational mobility across different exposure levels from 2006 to 2019. Linear probability models were used to estimate the likelihood of mobility from one year to the next and, amongst those who changed, moving to an occupation with lower exposure. To assess whether observed patterns were driven by large, female-dominated professions, further analyses excluding teaching and health care occupations were estimated. All analyses were stratified by sex, and estimates were reported both overall and by educational level. RESULTS: Workers in high-exposure occupations were less mobile than workers in lower-exposure occupations. However, much of this pattern was largely shaped by the concentration of highly-educated women in teaching and health care. Among those who changed occupations, women were more likely than men to move into occupations with lower exposure, even when excluding teachers and health care workers. Although the differences weakened when teaching and health care occupations were excluded, higher education did not increase the likelihood of moving into lower-exposure occupations for either sex. CONCLUSIONS: Higher psychosocial exposure is associated with lower occupational mobility in the Norwegian workforce. The low mobility observed among highly-educated women in high-exposure occupation is largely shaped by their concentration in teaching and health care. Taken together, the findings suggests that exposure, sex and education interact in ways that may limit movement out of high-exposure work, particularly for certain occupational groups.