Scoping Review of Work Disability Policies and Programs

Trends in severe functional limitations among working and non-working adults in Germany: Towards an (un)-healthy working life?

We examined trends in severe functional limitations among working and non-working adults in Germany (ages 40-65). Four population-based samples of 11,615 participants were used, spanning the time periods 2002-2021. The overall prevalence of severe limitations was found to be 12.8% in the sample, but also varied from 10 to 20% according to occupational group. Over time, severe limitations were found to have increased, from 10.6% in 2002 to 13.2% in 2021. Logistic regression analysis showed that severe limitations increased significantly in certain subgroups, including working women with a low skilled white collar occupational group, working men with a low skilled blue collar occupational group and, particularly, among the whole non-working population, whereas limitations remained largely the same in the other groups, including most of the working population. In terms of expectancies, overall working life expectancy increased. Along with this increase, healthy (non-severely limited) working life expectancy increased, but this trend was accompanied by a clear increase in unhealthy working life expectancy (severely limited). Thus, although severe limitations have increased in some groups in the working-age adults, people today can expect to work more years free from severe limitations than before. In the future, potentials to increase working life expectancy may come to an end, as severe limitations increased strongly in the non-working population, which could limit the prospects for a further increase in the proportion of the population in employment. Further studies are needed to investigate the potential impact of the increasing prevalence of severe limitations on the population's ability to work.

Functionality and factors associated with work behaviour among Brazilian breast cancer survivors: A cross-sectional study

BACKGROUND

Breast cancer treatments lead to several comorbidities in the upper limbs, such as pain and stiffness, hindering physical functions and the return to work.

OBJECTIVE

To explore the functionality and factors associated with work behaviour among manual and non-manual Brazilian workers who have recovered from breast cancer.

METHODS

This is an observational cross-sectional study involving Brazilian breast cancer survivors. The sociodemographic, work, and clinical aspects were assessed through clinical records, upper limb disability, and human functionality obtained from 62 women. Multiple and univariate logistic regressions were used to identify the association of variables on return to work, p < 0.05.

RESULTS

56.5% of women did not return to work, the mean time for returning to work was 16 months (±15.21), absenteeism from work lasted 41 months (±34.58). Modified radical mastectomy (OR = 5.13, 95% CI = 1.35 to 18.66) and moderate-to-severe disability levels in the upper limbs (OR = 6.77, 95% CI = 1.86 to 24.92) were associated with not returning to work. The loss of productivity was higher among non-manual workers (21.5%) (p = 0.040).

CONCLUSIONS

The rates of not returning to work after breast cancer treatment are high. Women who did not return to work presented higher levels of disability.

The Uneven Foci of Work Disability Research Across Cause-based and Comprehensive Social Security Systems

This scoping review identified what kinds of work disability policy issues are critiqued in articles published in countries with cause-based versus comprehensive welfare systems. Drawing on a review of work disability policy research, we identified 74 English-language, peer-reviewed articles that focused on program adequacy and design. Articles on cause-based systems dwelled on system fairness and policies of proof of entitlement, while those on comprehensive systems focused more on system design complexities relating to worker inclusion and scope of medical certificates. Overall, we observed a clear difference in the nature of problems examined in the different systems. Gaps in work disability policy literature are identified, and challenges for comparative policy research are discussed.