Perceived Work Ability in the Light of Long-Term and Stress-Related Unhealthy Behaviors-a Prospective Cohort Study

Urinary incontinence associates with poor work ability in middle-aged women: A Northern Finland Birth cohort 1966 study

INTRODUCTION

Urinary incontinence is a common ailment in women and is likely to affect their work ability. We investigated the associations between the different subtypes of urinary incontinence and several dimensions of perceived work ability in middle-aged general population.

MATERIAL AND METHODS

Cross-sectional survey at age 46 among participants of the Northern Finland Birth Cohort 1966 study (n = 3706, response rate 72%). Urinary incontinence symptoms and several items of Work Ability Index were collected by postal questionnaire. Work ability was dichotomized as good or poor work ability in general, in relation to physical job demands, to diseases and own 2-year prospect of work ability. The associations between urinary incontinence and work ability measures were assessed using logistic regression models, with further adjustments for biological, behavioral and work-related factors as well as general health.

RESULTS

The odds ratio (OR), from lowest to highest, for poor work ability were 1.4-fold among women with stress urinary incontinence (OR 1.37, 95% confidence interval [CI] 1.09-1.72), 2.5-fold with mixed urinary incontinence (OR 2.51, 95% CI 1.68-3.74) and 3.3-fold with urgency urinary incontinence (OR 3.34, 95% CI 1.95-5.70). We note that our results reflect work ability in a Nordic society.

CONCLUSIONS

Especially urgency and mixed types of urinary incontinence are associated with poor work ability among middle-aged women.

Measurements and observations of movements at work for warehouse forklift truck operators

Inclinometry and video analyses can provide objective measures of physical workloads. The study aim was to measure and observe arm, back and head postures and movements among forklift truck operators (FLTOs) during a working day, analyzing differences between types of forklift trucks and to assess reported workload and health. Twenty-five male FLTOs in a high-level warehouse were randomly included. The data collected comprised technical measurements, video analyses of postures and movements, and a questionnaire measuring health, pain and workload. On average, the FLTOs rotated their head more than 45°, in total, 232 times/h. Video analysis revealed that FLTOs periodically drive the forklift truck sideways with the head rotated in the direction of travel, and in periods look upwards, in which the head is highly rotated and extended. Inclinometry and observations during the working day has the potential to be a valuable part of risk assessment promoting occupational safety and health.

The association of endometriosis with work ability and work life participation in late forties and lifelong disability retirement up till age 52: A Northern Finland Birth Cohort 1966 study

INTRODUCTION

Endometriosis may cause a deterioration of daily functioning due to related symptoms such as pain, fatigue and psychological distress. Accordingly, endometriosis may jeopardize work ability, as suggested in mainly survey-based case-control studies, including clinically established cases at fertile age. This is the first general population-level study to evaluate how endometriosis is associated with (1) self-rated work ability and sick leave dates at age 46 years, (2) registered disability and unemployment days between age 46 and 48 and (3) lifelong emergence of registered disability retirement up to age 52.

MATERIAL AND METHODS

Endometriosis case identification was based on the Care Register for Health Care and self-reported diagnosis from a population-based birth cohort, which covers 96% of children born in Northern Finland in 1966. A total of 348 women with endometriosis and 3487 women without endometriosis were identified. Questionnaire data on Work Ability Index Score was collected at age 46. Unemployment and disability days were determined from the Social Insurance Institution of Finland and the Finnish Center for Pensions registers. Finally, each individual's first-ever granted pension decision and diagnoses were collected until age 52 years. The associations between endometriosis and work ability were assessed using logistic regression models.

RESULTS

Endometriosis was associated with poor work ability at age 46 (odds ratio [OR] 1.62, 95% confidence interval [CI] 1.06-2.47). Furthermore, the association between endometriosis and over 10 days of absenteeism was increased (OR 1.53; 95% CI 1.05-2.23). Between ages 46 and 48, women with endometriosis had 10 days more disability days (55.5 vs 45.5, p = 0.030) in comparison to women without endometriosis, but 20 days less unemployment days (40.6 vs 59.2 days, p = 0.013). There were no differences in early retirement between the study groups until age 52.

CONCLUSIONS

Our study showed that endometriosis associates with poor work ability at age 46. Women with endometriosis have more disability days. However, their employment rate and risk of early retirement are comparable to those of women without endometriosis at late fertile age.

Life-course leisure-time physical activity trajectories in relation to health-related behaviors in adulthood: the Cardiovascular Risk in Young Finns study

Background

Evidence on whether leisure-time physical activity (LTPA) facilitates individuals’ adoption of multiple healthy behaviors remains scarce. This study investigated the associations of diverse longitudinal LTPA trajectories from childhood to adulthood with diet, screen time, smoking, binge drinking, sleep difficulties, and sleep duration in adulthood.

Methods

Data were drawn from the Cardiovascular Risk in Young Finns Study. Participants were aged 9–18 years (N = 3553; 51% females) in 1980 and 33–49 years at the latest follow-up in 2011. The LTPA trajectories were identified using a latent profile analysis. Differences in self-reported health-related behaviors across the LTPA trajectories were studied separately for women and men by using the Bolck-Croon-Hagenaars approach. Models were adjusted for age, body mass index, education level, marital status, total energy intake and previous corresponding behaviors.

Results

Persistently active, persistently low-active, decreasingly and increasingly active trajectories were identified in both genders and an additional inactive trajectory for women. After adjusting the models with the above-mentioned covariates, the inactive women had an unhealthier diet than the women in the other trajectories (p <  0.01; effect size (ES) > 0.50). The low-active men followed an unhealthier diet than the persistently and increasingly active men (p <  0.01; ES > 0.50). Compared to their inactive and low-active peers, smoking frequency was lower in the increasingly active women and men (p <  0.01; ES > 0.20) and persistently active men (p <  0.05; ES > 0.20). The increasingly active men reported lower screen time than the low-active (p <  0.001; ES > 0.50) and persistently active (p <  0.05; ES > 0.20) men. The increasingly and persistently active women reported fewer sleep difficulties than the inactive (p <  0.001; ES > 0.80) and low-active (p <  0.05; ES > 0.50 and > 0.80, respectively) women. Sleep duration and binge drinking were not associated with the LTPA trajectories in either gender, nor were sleep difficulties in men and screen time in women.

Conclusions

Not only persistently higher LTPA but also an increasing tendency to engage in LTPA after childhood/adolescence were associated with healthier diet and lower smoking frequency in both genders, having less sleep difficulties in women and lower screen time in increasingly active men. Inactivity and low activity were associated with the accumulation of several unhealthy behaviors in adulthood. Associations were stronger in women.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10554-w.

Accumulated unhealthy behaviors and psychosocial problems in adolescence are associated with labor market exclusion in early adulthood - a northern Finland birth cohort 1986 study

Background

The relevance of health-related behaviors to exclusion from the labor market in early adulthood remains poorly studied in relation to the magnitude of the problem. We explored whether adolescents’ accumulated unhealthy behaviors and psychosocial problems are associated with later labor market exclusion, and whether multisite musculoskeletal pain (MMSP) impacts these relations.

Methods

We gathered questionnaire data on unhealthy behaviors and psychosocial problems and MMSP among adolescents aged 15 to 16 belonging to the Northern Finland Birth Cohort 1986. The findings were combined with registry data on unemployment, employment and permanent work disability during a five-year follow-up between the ages of 25 and 29 (n = 6692). In the statistical modeling we used education, family leave and socioeconomic status of childhood family as potential confounders, as well as latent class and logistic regression analyses.

Results

The Externalizing behavior cluster associated with over one year of unemployment (RR 1.64, CI 1.25–2.14) and permanent work disability (OR 2.49, CI 1.07–5.78) in the follow-up among the men. The Sedentary cluster also associated with over one year (RR 1.41, CI 1.13–1.75) and under one year of unemployment (RR 1.25, CI 1.02–1.52) and no employment days (RR 1.93, CI 1.26–2.95) among the men. Obese male participants were at risk of over one year of unemployment (RR 1.50, CI 1.08–2.09) and no employment days (RR 1.93, CI 1.07–3.50). Among the women, the Multiple risk behavior cluster related significantly to over one year of unemployment (RR 1.77, CI 1.37–2.28). MMSP had no influence on the associations.

Conclusions

Unhealthy behavior patterns and psychosocial problems in adolescence have long-term consequences for exclusion from the labor market in early adulthood, especially among men. Simultaneously supporting psychological well-being and healthy behaviors in adolescence may reduce labor market inclusion difficulties in the early phase of working life.

How Is the Self-Perceived Work Ability Affected by the Duration of Unemployment, Heart Rate Variability and the Amount of Physical Activity in Older Long-Term Unemployed Persons?

BACKGROUND

This study investigated whether work ability is associated with the duration of unemployment, heart rate variability (HRV), and the level of physical activity.

METHODS

Thirty-four unemployed persons (mean 55.7 ± standard deviation 33.3 years, 22 female, 12 male, unemployed: range 1-22.5 years) participated in the cross-sectional study. The Work Ability Index (WAI) and International Physical Activity Questionnaire (IPAQ) were applied. Short-term (five minutes) resting HRV (Low Frequency (LF), High Frequency (HF), Total Power (TP)) was collected.

RESULTS

Work ability was positively associated with the HRV: LF (r = 0.383; p = 0.025), HF (r = 0.412; p = 0.015) and TP (r = 0.361; p = 0.036). The WAI showed a positive linear correlation with the amount of total physical activity (r = 0.461; p = 0.006) as well as with the amount of moderate to vigorous physical activity (r = 0.413; p = 0.015). No association between the WAI and the duration of unemployment occurred.

CONCLUSIONS

the relation between self-perceived work ability, health-associated parameters, the HRV and the level of physical activity points out the relevance of health-care exercise and the need of stress-reducing interventions to improve perceived work ability. Our results point out the need for the further and more holistic development of healthcare for the unemployed.

Physical-work ability and chronic musculoskeletal complaints are related to leisure-time physical activity: Cross-sectional study among manual workers aged 50–70 years

Aims: To investigate the associations between both high- and low-intensity leisure-time physical activity on physical-work ability and chronic musculoskeletal complaints among manual workers aged 50–70 years. Methods: In this cross-sectional study, 1763 manual workers (mean age 57.1, SD ± 4.7 years) replied to questions about leisure-time physical activity, physical-work ability, chronic musculoskeletal complaints as well as health and lifestyle factors. Ordinal and binomial logistic regression models were constructed to assess the influence of the duration of both low- and high-intensity physical activity on physical-work ability and chronic musculoskeletal complaints, respectively. Models were adjusted for gender, age, smoking, alcohol intake, body mass index, physical-work demand, work experience, chronic disease and, regarding physical-work ability, also for chronic musculoskeletal complaints. Results: A statistically significant association between greater physical-work ability and high-intensity physical activity was found for workers engaged in 3–4 h/wk and ⩾ 5 h/wk (OR 1.59, 95% CI 1.15–2.19 and OR 1.56, 95% CI 1.10–2.22, respectively). For both high- and low-intensity physical activity, a duration of 3–4 h/wk was associated with lower odds of reporting chronic musculoskeletal complaints in the knees (OR 0.65, 95% CI 0.42–1.00 and OR 0.61, 95% CI 0.38–0.99, respectively). Conclusions: Engaging in ⩾ 3 h/wk of high-intensity leisure-time physical activity was associated with greater physical-work ability among manual workers aged 50–70 years. Both high- and low-intensity physical activity related to lower odds of having chronic musculoskeletal complaints in the knees.

Personal meaning of work and perceived work ability among middle-aged workers with physically strenuous work: a Northern Finland Birth Cohort 1966 Study

PURPOSE

To investigate the association between personal meaning of work and perceived work ability among middle-aged workers with physically strenuous or light work. We evaluated the course of perceived work ability from 31 to 46 years and examined the possible differences in the association between personal meaning of work and perceived work ability at the age of 46 depending on physical workload.

METHODS

The study population consisted of participants of the Northern Finland Birth Cohort 1966 (n = 4420). Data were collected through questionnaires at 31 and 46 years. The main outcome was perceived work ability (0-7 = poor, 8-10 = good) and the main explanatory measures were physically strenuous work and personal meaning of work. Multivariate logistic regression analyses were adjusted for unhealthy habits, number of diseases, job strain, social support at work, employment history and gender. They were also stratified for the strenuousness of work.

RESULTS

Perceived work ability decreased during the 15-year follow-up in both the strenuous and light work groups, and was lowest among workers with strenuous work. Perceived work ability remained poor or decreased in 22% of men and 21% of women in the strenuous work group vs. 14% and 13% in the light work group, respectively. After adjusting for confounders, the participants in both groups who reported low personal meaning of work were at approximately a twofold risk of having poor perceived work ability at 46 years compared to the participants who reported high personal meaning of work.

CONCLUSIONS

Perceived work ability was significantly lower and deteriorated more during the follow-up among participants with strenuous work. High personal meaning of work was important for good work ability, irrespective of the strenuousness of work.

Association between good work ability and health behaviours among unemployed: A cross-sectional survey

BACKGROUND

There has been relatively little research on the possible factors promoting good work ability among unemployed people. Consequently, the role of health behaviours in good work ability among the unemployed is unknown.

PURPOSE

To explore the work ability and health behaviours of unemployed people through sociodemographic factors and examine the association between good work ability and health behaviours.

DESIGN

A cross-sectional survey.

METHODS

The study is based on the Finnish nationwide Regional Health and Well-being Study using mailed and online questionnaires in 2014-2015. A total of 1973 unemployed or laid-off people between the ages of 20 and 65 responded to the survey. The associations of work ability with sociodemographic factors - gender, age, marital status, minors (i.e. under-18s) living in the household, education, living environment, and duration of unemployment - and health behaviours with sociodemographic factors were first explored using cross-tabulations. Health behaviours included body mass index, daily smoking, alcohol consumption, vegetable consumption, health promotion groups, physical exercise, and sitting in one's leisure time. Health behaviours were then examined using logistic regression analyses, in association with good work ability; the latter was measured with the Work Ability Score.

RESULTS

Being aged below 45, being married or cohabiting, having a high level of education, and short-term unemployment were associated with good work ability. A quarter of participants were daily smokers. A proportion of women with risk level alcohol use (79%) was higher than that of men (59.9%). A third of unemployed people participated in high-intensity physical activity. In regression analyses, high-intensity physical activity (OR 2.25, 95% CI 1.06-4.78) was associated with good work ability.

CONCLUSIONS

Unemployed women and men widely exhibited unhealthy behaviours such as daily smoking and a risk level use of alcohol. Health promotion actions for enhancing a healthy lifestyle and good work ability among unemployed people, particularly in emphasizing the importance of physical activity, are highly recommended.

National policies for the promotion of physical activity and healthy nutrition in the workplace context: a behaviour change wheel guided content analysis of policy papers in Finland

Background

Health policy papers disseminate recommendations and guidelines for the development and implementation of health promotion interventions. Such documents have rarely been investigated with regard to their assumed mechanisms of action for changing behaviour. The Theoretical Domains Framework (TDF) and Behaviour Change Techniques (BCT) Taxonomy have been used to code behaviour change intervention descriptions, but to our knowledge such “retrofitting” of policy papers has not previously been reported. This study aims first to identify targets, mediators, and change strategies for physical activity (PA) and nutrition behaviour change in Finnish policy papers on workplace health promotion, and second to assess the suitability of the Behaviour Change Wheel (BCW) approach for this purpose.

Method

We searched all national-level health policy papers effectual in Finland in August 2016 focusing on the promotion of PA and/or healthy nutrition in the workplace context (n = 6). Policy recommendations targeting employees’ nutrition and PA including sedentary behaviour (SB) were coded using BCW, TDF, and BCT Taxonomy.

Results

A total of 125 recommendations were coded in the six policy papers, and in two additional documents referenced by them. Psychological capability, physical opportunity, and social opportunity were frequently identified (22%, 31%, and 24%, respectively), whereas physical capability was almost completely absent (1%). Three TDF domains (knowledge, skills, and social influence) were observed in all papers. Multiple intervention functions and BCTs were identified in all papers but several recommendations were too vague to be coded reliably. Influencing individuals (46%) and changing the physical environment (44%) were recommended more frequently than influencing the social environment (10%).

Conclusions

The BCW approach appeared to be useful for analysing the content of health policy papers. Paying more attention to underlying assumptions regarding behavioural change processes may help to identify neglected aspects in current policy, and to develop interventions based on recommendations, thus helping to increase the impact of policy papers.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-017-4574-3) contains supplementary material, which is available to authorized users.

Associations between common diseases and work ability and sick leave among health care workers

PURPOSE

This study investigates whether common diseases, i.e., musculoskeletal diseases (MSD), cardiovascular diseases (CVD), mental disorders (MD), and respiratory diseases (RD), influence work ability and sick leave and whether lifestyle-related factors, and psychosocial and physical work-related factors are associated with low work ability and sick leave.

METHODS

In a cross-sectional study among 8364 Dutch health care employees, self-reported information was acquired concerning common diseases, lifestyle-related factors, psychosocial and physical work-related factors, work ability, and sick leave. Logistic regression analyses were performed to describe the associations between common diseases with low work ability and sick leave, and to evaluate differences in associations between lifestyle-related and work-related factors with low work ability and sick leave among healthy employees and employees with common diseases.

RESULTS

Employees with MD (OR 6.35), CVD (OR 2.63), MSD (OR 2.62), and RD (OR 2.11) had a higher risk of low work ability compared to healthy employees. Workers with common diseases also reported more often sick leave (ORs > 1.60), in particular long-term sick leave (>25 days). Multimorbidity increased both the occurrence of low work ability and sick leave. Unfavourable psychosocial work-related factors were associated with low work ability and sick leave regardless of health status. Physical work-related factors and lifestyle factors were less consistently associated with low work ability and sick leave.

CONCLUSIONS

Common diseases, and foremost mental disorders, were related to both low work ability and sick leave. To maintain or improve work ability and prevent sick leave, interventions that promote a healthy psychosocial work environment are needed.