The Prognostic Value of the Work Ability Index for Sickness Absence among Office Workers

Factors associated with self-reported work ability among people with multiple sclerosis in Sweden

Background

Work ability index (WAI) is an instrument that measures work ability in workplace surveys and health examinations in occupational health and research. It has been used in different population groups. But research is limited among people with multiple sclerosis (PwMS).

Objective

To determine the factors associated with work ability among PwMS in Sweden.

Methods

A total of 4103 PwMS who answered a web-based survey were included in the analysis. Work ability was assessed using the work ability score (WAS) component of WAI. Univariable and multivariable linear regression analyses were performed to assess the association of sociodemographic, clinical, and self-reported health variables with WAS.

Results

Just over half of the PwMS reported good (37.0%) or excellent (16.3%) WAS. The overall mean WAS was 6.9 (standard deviation = 2.8). Health-related quality of life (R-squared = 31.6%), fatigue (28.3%), occupation (22.6%), and expanded disability status scale (EDSS) score (18.1%), explained the highest proportions of variation in WAS, individually. In the adjusted model, occupation, EDSS score, and fatigue had the strongest associations with WAS with significantly lower scores in those with no occupation, higher EDSS score, and severe fatigue levels.

Conclusion

Work ability among PwMS was lower than in the general population in Sweden. Occupation, EDSS score and fatigue were among the most important factors associated with work ability.

Exploring work ability, psychosocial job demands and resources of employees in low-skilled jobs: a German cross-sectional study

BACKGROUND

Extending working lives due to labour market and pension regulations makes maintaining and promoting work ability necessary. The coronavirus pandemic has shown that employees in low-skilled jobs (no qualification required) contribute significantly to society and the economy. Research on these employees has been neglected in Germany for many decades despite demanding working conditions. Therefore, we investigate the relationship between low-skilled jobs and work ability. Moreover, we explore this relationship's variation by psychosocial work demands and resources.

METHODS

We use two waves of the German Study on Mental Health at Work (S-MGA). We calculate Ordinary-Least-Squares (OLS) regression models with pooled data (n = 6,050) to analyse the relationship between job requirement level and work ability. We also explore the contribution of job demands and resources on this relationship with interaction models. We use the Copenhagen Psychosocial Questionnaire (COPSOQ), to assess psychosocial work demands and resources.

RESULTS

Employees performing low-skilled jobs report significantly less work ability than those in medium- or high-skilled jobs. Interaction models show significantly greater work ability for employees in medium- and high-skilled jobs with high influence on their work (amount or tasks). Unexpectedly, employees in low-skilled jobs have lower work ability with more influence on their work. Furthermore, high role clarity, describing responsibility, authority and work goals, is associated with lower levels of work ability among employees in low-skilled jobs.

CONCLUSIONS

The moderating effect of role clarity on the work ability of employees in low-skilled jobs can possibly be attributed to skills mismatch and limited responsibility, as well as a lack of self-perceived collective purpose of the job. The moderation of the influence on work dimension supports results of previous studies. Too much job autonomy can have negative effects under certain circumstances and is therefore perceived as a job demand in some studies. Consequently, mechanisms concerning psychosocial work demands and resources must be investigated in further studies with different theoretical approaches. The imbalance of job demands and resources shows that employers should invest in preserving the work ability to prevent early exit from the labour market in an aging society.

Work Ability and Work Nonparticipation: A Prospective Study of 2426 Participants in Germany

OBJECTIVE

The aim of the study is to examine the association between work ability and work nonparticipation, including long-term sickness absence (LTSA), unemployment (UE), and disability pension/early retirement (ER).

METHODS

We conducted a questionnaire-based 5-year follow-up study on a representative sample of the German working population (n = 2426). We used a two-part model to examine the association of continuous Work Ability Index (WAI) scores with the probability of events of work nonparticipation and the duration thereof.

RESULTS

Higher WAI scores were protective against total work nonparticipation (an index combining the three indicators), LTSA, ER and UE, the latter among males only. Higher WAI scores were protective also against duration of total work nonparticipation and LTSA, but not against duration of UE and ER among males and duration of UE among females.

CONCLUSIONS

Higher WAI scores have a protective role against work nonparticipation.

Adolescent Cardiorespiratory Fitness and Future Work Ability

Importance

Although research indicates that low fitness in youth is associated with a higher risk of chronic disability in men, the association of fitness in adolescence with work ability in working men and women remains unknown.

Objective

To examine the associations of adolescent health-related physical fitness with future work ability.

Design, Setting, and Participants

This 45-year observational cohort study, conducted in Finland, examined the direct and indirect longitudinal associations of objectively measured health-related fitness in adolescence (in 1976) with self-reported work ability and sickness absence in early middle age (in 2001) and the Work Ability Index in late middle age (in 2021). A countrywide stratified random baseline sample included fitness measurements for cardiorespiratory fitness (CRF) (running 1.5 km for girls and 2 km for boys), musculoskeletal fitness (MF; standing broad jump and sit-ups for both sexes, pull-ups for boys, and flexed-arm hang for girls), and height and weight, from which body mass index (BMI) was calculated. Structural equation modeling-based path analysis, adjusted for age and sex at baseline and for educational level, work-related physical strain, and leisure-time physical activity in late middle age, was conducted. Data analysis was performed from January to July 2023.

Main Outcomes and Measures

Self-reported work ability was measured with structured questions in early middle age and with the validated Work Ability Index in late middle age.

Results

The final sample from longitudinal analyses (1207 individuals; 579 [48%] male individuals) consisted of participants with fitness measurement from age 12 to 19 years, and work ability assessment from age 37 to 44 years and/or age 57 to 64 years. Higher adolescent CRF was associated with higher work ability (839 participants; β = 0.12; 95% CI, 0.01 to 0.22; P = .03) and lower sickness absence (834 participants; β = -0.07; 95% CI, -0.12 to -0.02; P = .004) in early middle age and, indirectly, mediated by work ability in early middle age, with a higher work ability at the end of working age (603 participants; β = 0.04; 95% CI, 0.001 to 0.08; P = .04). The results remained consistent in both sexes and after adjustment for the confounders. Neither MF nor BMI was associated with work ability (MF, 1192 participants; β = -0.07; 95% CI, -0.17 to 0.03; BMI, 1207 participants, β = 0.09; 95% CI, -0.004 to 0.19) or sickness absence (MF, 1185 participants, β = 0.02; 95% CI, -0.03 to 0.06; BMI, 1202 participants, β = -0.03; 95% CI, -0.09 to 0.03) in early middle age or with late middle age work ability, mediated by work ability in early middle age (MF, 603 participants, β = -0.02; 95% CI, -0.06 to 0.01; BMI, 603 participants, β = 0.03; 95% CI, -0.004 to 0.07).

Conclusions and Relevance

These findings suggest that low CRF in youth is associated with poor work ability at the middle and end of working life, which highlights the informative and prognostic value of CRF assessment early in youth. Enhancing CRF in the first decades of life might contribute to better work capacity and productivity in the labor force, which would have implications for health, quality of life, society, and the economy.

Analysis of the Return to Work Program for Disabled Workers during the Pandemic COVID-19 Using the Quality of Life and Work Ability Index: Cross-Sectional Study

BACKGROUND

Occupational accidents are rising, but there is little evidence on the outcomes of patients who received case management during Return to work (RTW) programs. This study examined the case management-based on RTW program features that improve the work ability index (WAI) and quality of life (QoL).

METHODS

This cross-sectional research involved 230 disabled workers due to an occupational injury in Indonesia, 154 participated in RTW, and 75 did not participate in RTW (non-RTW) during the COVID-19 pandemic. Sociodemographic and occupational factors were used to examine the RTW results. We used the Finnish Institute of Occupational Health's WAI questionnaires to measure the work ability index and World Health Organization Quality of Life Brief Version (WHOQOL-BREF) for quality of life.

RESULTS

The study found a statistically significant difference in working duration and preferred treatment for RTW between the groups (p-value = 0.039). Furthermore, the quality of life in the domain of environmental health and work ability index score also demonstrated a significant difference between the groups (p-value = 0.023 and 0.000, respectively).

CONCLUSIONS

During the COVID-19 pandemic, this study found that the RTW program improved the quality of life and work abilities of disabled workers.

Predictive value of Heart Rate Variability measurements and the Brief Resilience Scale for workability and vitality

BACKGROUND

Sustainable employability is increasingly important with current socio-economic challenges. Screening for resilience could contribute to early detection of either a risk, or a protector for sustainable employability, the latter being operationalized as workability and vitality.

OBJECTIVE

To study the predictive value of Heart Rate Variability (HRV) measurements and the Brief Resilience Scale (BRS) for worker self-reported workability and vitality after 2-4 years.

METHODS

Prospective observational cohort study with mean follow-up period of 38 months. 1,624 workers (18-65 years old) in moderate and large companies participated. Resilience was measured by HRV (one-minute paced deep breathing protocol) and the BRS at baseline. Workability Index (WAI), and the Vitality dimension of the Utrecht Work Engagement Scale-9 (UWES-9-vitality) were the outcome measures. Backward stepwise multiple regression analysis (p < 0.05) was performed to evaluate the predictive value of resilience for workability and vitality, adjusted for body mass index, age and gender.

RESULTS

N = 428 workers met inclusion criteria after follow-up. The contribution of resilience, measured with the BRS, was modest but statistically significant for the prediction of vitality (R2 = 7.3%) and workability (R2 = 9.2%). HRV did not contribute to prediction of workability or vitality. Age was the only significant covariate in the WAI model.

CONCLUSION

Self-reported resilience modestly predicted workability and vitality after 2-4 years. Self-reported resilience may provide early insight into the ability of workers to stay at work, although caution must be applied because explained variance was modest. HRV was not predictive.

Work ability and physical fitness among aging workers: the Finnish Retirement and Aging Study

Background

With advancing age, physical capacity gradually decreases which may lead to decreased work ability, if the physical work requirements remain the same. Examination of the importance of physical fitness for work ability among aging workers will help to find potential strategies to promote work ability in old age. The aim of this study was to investigate the association between physical fitness and work ability among aging workers.

Methods

Aging workers (n = 288, mean age 62.5, 83% women) from the Finnish Retirement and Aging study underwent cardiorespiratory, muscular fitness and functional testing. Work ability was inquired on a scale 0-10 from poor to excellent. Association between physical fitness indicators and work ability was examined using ordinary least squares regression, taking into account age, gender, occupational status, heavy physical work, body mass index and accelerometer-measured daily total physical activity.

Results

VO2peak, modified push-up test and maximal walking speed were positively associated with work ability (β = 0.51, 95% confidence interval (CI) 0.29-0.74, β = 0.46, 95% CI 0.26-0.66 and β = 0.23, 95% CI 0.07-0.39, respectively), while chair rise test time was inversely associated with work ability (β = -0.23, 95% CI -0.39--0.06). No associations were found between hand grip strength or sit-up test and work ability.

Conclusions

Cardiorespiratory fitness, upper body strength, and lower extremity function were positively associated with work ability. Good physical fitness may help to maintain work ability among aging workers.

Supplementary Information

The online version contains supplementary material available at 10.1007/s10433-022-00714-1.

Testing the longitudinal effect of metacognitive beliefs on the trajectory of work ability

There is increasing need to identify factors that contribute to poor work ability with an aim to prevent work related problems such as sick leave and disability pension. In the Metacognitive Control System model, dysfunctional metacognitive beliefs are seen as an underlying factor in psychological vulnerability beyond disorder, and recent studies have reported that metacognitions are associated with work ability and work status. In the present study, we set out to test if there is a prospective relationship between dysfunctional metacognitions and self-assessed work ability. Individuals in working age (M = 37.19; SD = 10.31) participated in a four-timepoint self-report survey (N = 528; 75% females) separated by six weeks between each timepoint. Baseline gender differences and differences between participants by job status were conducted using t-test and one-way ANOVA, respectively. Latent growth curve with covariates assessed the impact of dysfunctional metacognitions on work ability across the four timepoints. Males reported higher work ability. Participants in fulltime job also reported higher work ability followed by those in part-time job, jobseekers, sick leave up to 12 months, and sick leave > 12 months, respectively. Dysfunctional metacognitions predicted work ability over time when controlling for gender, age, physical health status, and three common categories of emotional distress symptoms. This finding suggest that dysfunctional metacognitions are a prospective predictor of work ability beyond health status and implies that these beliefs should be targeted with a view to increasing work ability and thus potentially reduce risk for sick leave and other work-related problems.

Work ability and physical activity after major bone sarcoma resection and reconstruction with tumour prosthesis of the lower extremities. A cross-sectional study

PURPOSE

The aim of this study was to evaluate work ability, activity limitations and physical activity in adults that had gone through major bone sarcoma resection and reconstruction surgery in hip and knee.

MATERIALS AND METHODS

Twenty patients, of 72 enrolled, and 20 controls were included in this cross-sectional study. Work Ability Index scores (general [0-10 points], physical and mental [1-5 points]), the Patient Specific Functional Scale (0-10 points), step counts and the International Physical Activity Questionnaire (IPAQ) were assessed. Adjusted and unadjusted general linear models were applied.

RESULTS

The patients had a mean age of 43 (range, 20-71) years and were assessed 7 years (range, 2-12) after surgery (proximal femoral n = 9, distal femoral n = 7, proximal tibia n = 4). Compared with controls, patients had lower general work ability (mean difference [95%CI], -1.3 points [-2.1, -0.5]) and work ability in relation to physical demands at work (-1.4 points [-2.0, -0.8]). The patients reported higher severities of activity limitation (-6.7 points [-7.9, -5.4]). There were no between-group differences in step counts or IPAQ-scores.

CONCLUSION

Despite similar levels of physical activity, patients showed poorer work ability and severe activity limitation. Post-operative rehabilitation in patients of the working-age population should include assessments of work ability and activities important to the individual.IMPLICATIONS FOR REHABILITATIONAdults that have gone through resection and reconstruction surgery following bone sarcoma in lower extremity show clinically relevant reductions in work ability and self-selected activitiesTo tailor post-operative rehabilitation at short and long term, initial assessment and monitoring should include work ability and activities important to the individual patient.

Influence of work ability and smoking on the prognosis of long-duration activity-limiting neck/back pain: a cohort study of a Swedish working population

OBJECTIVES

Long-duration activity-limiting neck/back pain is common, but the knowledge of what work and lifestyle factors that influence the prognosis is sparse. The objective was therefore to evaluate if two factors, good self-perceived work ability and no daily smoking, are associated with a favourable prognosis of long-duration activity-limiting neck/back pain in a working population, and if these exposures have a synergistic prognostic effect.

DESIGN

A prospective cohort study based on three subsamples from the Stockholm Public Health Cohort.

SETTINGS

A working population in Stockholm County, Sweden.

PARTICIPANTS

Individuals, 18-61 years old, reporting long-duration activity-limiting neck/back pain the previous 6 months at baseline in 2010 (n=5177).

MEASURES

The exposures were: self-perceived work ability (categorised into good, moderate and poor) and daily smoking (no/yes). The outcome in 2014 was 'absence of long-duration activity-limiting neck/back pain' the previous 6 months representing a favourable prognosis of reported problems at baseline in 2010. Risk ratios (RRs) and risk differences (RDs) with 95% CI was estimated by general linear regressions, and the synergistic effect was estimated by the synergy index (SI) with 95% CI.

RESULTS

Participants with moderate or good work ability, respectively, had an adjusted RR for a favourable prognosis of 1.37 (95% CI 1.11 to 1.69), and 1.80 (1.49 to 2.17) in comparison with participants with poor work ability. The corresponding adjusted RD were 0.07 (0.02 to 0.11) and 0.17 (0.12 to 0.22). Participants not smoking on daily basis had an adjusted RR of 1.21 (1.02 to 1.42), and an adjusted RD of 0.05 (0.01 to 0.10) for a favourable outcome compared with daily smokers. The adjusted SI was 0.92 (0.60 to 1.43).

CONCLUSION

For participants with long-duration activity-limiting neck/back pain, moderate or good self-perceived work ability and not being a daily smoker were associated with a favourable prognosis but having both exposures seemed to have no synergistic prognostic effect.

Worldwide prevalence of inadequate work ability among hospital nursing personnel: A systematic review and meta-analysis

PURPOSE

To estimate the worldwide pooled prevalence of inadequate work ability among hospital nursing personnel using the Work Ability Index (WAI).

DESIGN

Systematic review and meta-analysis.

METHODS

A systematic search was conducted on Medline/PubMed, Scopus, Web of Science, Scielo, PsychInfo, CINAHL, Nursing and Allied Health, LILACS, and Google Scholar from inception to July 2021 to identify observational studies on work ability among hospital nursing personnel using the WAI. Two researchers independently completed the study selection, quality assessments, and data extraction on the prevalence of inadequate work ability that was pooled using the random effects model. Finally, subgroup analyses were performed to explore sources of heterogeneity.

FINDINGS

A total of 42 studies were included, consisting of 24,728 subjects worldwide from 14 countries. Of these, 35 studies were included in the meta-analytical analyses. The worldwide pooled prevalence of inadequate work ability among hospital nursing personnel was 24.7% (95% CI = 20.2%-29.4%). High levels of heterogeneity were detected in all studies. Prevalence was higher in studies where samples were composed of nurses and nursing assistive personnel (26.8%; 95% CI = 22.4%-31.5%) than in those of nurses alone (22.2%; 95% CI = 13.1%-32.9%) and in studies where the sample was over 40 (28.1%; 95% CI = 19.5%-37.5%) than in those with a sample under that age (22.4%; 95% CI = 15.8%-29.7%).

CONCLUSIONS

Almost one in four members of hospital nursing staff in the world has inadequate work ability and therefore are at risk of several negative outcomes during their working life. These prevalence data correspond to the pre-pandemic period, so new studies should also be especially useful in quantifying the impact of the COVID-19 pandemic on work ability in the hospital nursing workforce.

CLINICAL RELEVANCE

The above findings justify the launch of initiatives that include annual assessment for the early identification of inadequate work ability, offering the possibility of anticipated corrective measures. Nursing workforce older than 40 years and those belonging to the professional category of nursing assistive personnel should be priority target groups for screening and intervention to improve work ability.

Associations between health-related skills and young adults' work ability within a structural health literacy model

Young adults have a high societal relevance but are still an under-represented target group in health promotion. Health literacy is widely acknowledged as one of the strongest predictors and key determinant of health, so its influence on work ability is of great interest. The purpose of the study was to examine the associations between health-related skills and work ability within the structural model of health literacy of Lenartz, Soellner and colleagues, which explains health behaviour and health through the indirect and direct influence of six 'advanced skills' ('self-perception', 'proactive approach to health', 'dealing with health information', 'self-control', 'self-regulation' and 'communication and cooperation'). The cross-sectional study was based on baseline data of a health literacy promotion intervention (495 vocational school students, 59.0% female, age span 18-25 years). Structural equation modelling with partial least squares was used to examine the associations between the six constructs of the model and the Work Ability Index (WAI). Mean WAI score was 39.7 ± 4.5 (51.1% categorized 'moderate'/'poor'). Five out of six constructs of the model showed a statistically significant indirect or direct effect, respectively, on work ability. The model explained 24.8% of the WAI score variance. Our findings show associations between the health literacy model and the work ability among young employees. In view of demographic change, it is crucial to develop and analyse target group-specific health literacy interventions. The model offers new facets in the modelling of health literacy.

Drivers of productivity: Being physically active increases yet sedentary bouts and lack of sleep decrease work ability

Physical behavior (ie, physical activity, sedentary behavior, and sleep) is a crucial lifestyle factor for preventing and managing diseases across the lifespan. However, less is known about potential work-related psychological and cognitive outcomes such as productivity. The present study examined within-person associations between physical behavior and self-perceived work ability. To investigate the degree to which physical behavior parameters influence self-perceived work ability in everyday life, we conducted an Ambulatory Assessment study in 103 university students over 5 days. Physical behavior was assessed continuously via a multi-sensor system. Self-perceived work ability was assessed repeatedly up to six times per day on smartphones. We employed multilevel modeling to analyze the within-person effects of physical behavior on self-perceived work ability. Physical activity intensity (MET) (β = 0.15 ± 0.06, t = 2.59, p = 0.012) and sit-to-stand transitions (β = 0.07 ± 0.03, t = 2.44, p = 0.015) were positively associated with self-perceived work ability. Sedentary bouts (≥20 min) (β = -0.21 ± 0.08, t = -2.74, p = 0.006) and deviation from a recommended sleep duration (ie, 8 h) (β = -0.1 ± 0.04, t = -2.38, p = 0.018) were negatively associated with self-perceived work ability. Exploratory analyses supported the robustness of our findings by comparing various time frames. Total sedentary time and sleep quality were not associated with self-perceived work ability. Regular sleep durations, breaking up sedentary time through sit-to-stand transitions, and higher intensities of physical activity may be important for the regulation of self-perceived work ability in university students' daily lives.

Work-life balance predicted work ability two years later: a cohort study of employees in the Swedish energy and water sector

Background

Work-life balance (WLB) is the extent to which individual’s multiple life roles and demands carry over between each role. WLB can be divided into work interference with personal life (WIPL) and personal life interference with work (PLIW). This study aimed to investigate longitudinal associations between WIPL, PLIW and work ability outcomes.

Methods

In this cohort study, 224 employees in the energy and water sector in Sweden were followed-up over 2 years. Three questions derived from the Work Ability Index were used for measuring work ability outcome: current work ability compared with lifetime best; work ability regarding physical; and mental demands. Logistic regression models were used to analyse longitudinal associations between work ability and WIPL and WIPL respectively, controlling for workplace (company), position at work, experience of leadership quality, demographics, and work ability.

Results

Work ability compared to lifetime best were associated with WIPL in the adjusted logistic regression models (odds ratio (OR) 1.77, 95% confidence interval (CI) 1.15–2.73), and PLIW (OR 3.34, 95% CI 1.66–6.74). Work ability regarding physical demands was associated with WIPL (OR 1.60, 95% CI 1.07–2.40). Work ability regarding mental demands was associated with WIPL (OR 1.59, 95% CI 1.03–2.44) and PLIW (OR 2.88, 95% CI 1.31–6.32).

Conclusion

In this two-year longitudinal study, lower WIPL predicted good/excellent overall work ability compared with lifetime best, higher work ability regarding physical and mental demands, and lower PLIW predicted good/excellent overall work ability compared with lifetime best and higher work ability regarding and mental demands.

Do work ability and life satisfaction matter for return to work? Predictive ability of the work ability index and life satisfaction questionnaire among women with long-term musculoskeletal pain

Background

Impaired work ability and reduced life satisfaction due to long-term musculoskeletal pain, particularly in neck, shoulders and back, are considered occupational health problems that can result in workers taking sick leave. The aim of the study was to determine whether work ability and life satisfaction predict return to work (RTW) among women with long-term neck/shoulder and/or back pain, and to assess the ability of the Work Ability Index (WAI) and the Life Satisfaction Questionnaire (LiSat-11) to discriminate between those who did RTW and those who did not RTW (NRTW).

Methods

This is a cohort study with 1-year follow-up. A survey was sent to 600 women receiving sick leave benefits from the Swedish Social Insurance Agency. In total, 208 women responded at baseline, and 141 at a 1-year follow-up. To identify whether work ability and life satisfaction predicted RTW, multiple logistic regression analyses were performed with and without adjustment for type of work and pain intensity. To assess the discriminative ability of the WAI and the LiSat-11 for women who did RTW and those who did NRTW, receiver operating characteristic curves were fitted.

Results

Work ability predicted RTW, and the results remained significant after adjusting for type of work and pain intensity (OR 1.12, 95% CI: 1.04–1.22). Life satisfaction was not significant. The WAI at baseline adequately discriminated between RTW and NRTW after 1 year (Area under curve 0.78, 95% CI: 0.70–0.86), but the LiSat-11 did not.

Conclusions

This study supports a relationship between work ability and RTW among women on sick leave for long-term neck/shoulder and/or back pain. The results indicate that the WAI, but not the LiSat-11, can discriminate between RTW and NRTW in the population under study. Although the discriminative ability of the WAI needs to be verified in new samples before it can be recommended for use in rehabilitation settings, we suggest that healthcare professionals consider how women perceive their work ability in order to better support them in their RTW.

Strategy for finding occupational health survey participants at risk of long-term sickness absence

BACKGROUND

When resources are limited, occupational health survey participants are usually invited to consultations based on an occupational health provider's subjective considerations. This study aimed to find health survey participants at risk of long-term (i.e., ≥ 42 consecutive days) sickness absence (LTSA) for consultations with occupational health providers (OHPs).

METHODS

The data of 64 011 non-sicklisted participants in occupational health surveys between 2010 and 2015 were used for the study. In a random sample of 40 000 participants, 27 survey variables were included in decision tree analysis (DTA) predicting LTSA at 1-year follow-up. The decision tree was transferred into a strategy to find participants for OHP consultations, which was then tested in the remaining 24 011 participants.

RESULTS

In the development sample, 1358 (3.4%) participants had LTSA at 1-year follow-up. DTA produced a decision tree with work ability as first splitting variable; company size and sleep problems were the other splitting variables. A strategy differentiating by company size would find 75% of the LTSA cases in small (≤99 workers) companies and 43% of the LTSA cases in medium-sized (100-499 workers) companies. For large companies (≥500 workers), case-finding was only 25%.

CONCLUSIONS

In small and medium-sized companies, work ability and sleep problems can be used to find occupational health survey participants for OHP consultations aimed at preventing LTSA. Research is needed to further develop a case-finding strategy for large companies.

Self-reported work ability predicts health-related exit and absence from work, work participation, and death: longitudinal findings from a sample of German employees

Objective

The cohort study examined the performance of the Work Ability Index in predicting health-related exit and absence from work, work participation, and death among a sample of workers previously receiving sickness absence benefits.

Methods

Workers aged 40–54 years who received sickness absence benefits in 2012 completed the Work Ability Index in 2013. Outcomes were extracted from administrative data records covering the period until the end of 2016.

Results

Data for 2266 participants were included (mean age: 47.9 years; 54.4% women). Maximum follow-up was 43 months. In terms of work ability, 38.4% had good scores, 38.2% moderate scores, and 23.4% poor scores. Fully adjusted analyses showed an increased risk of a disability pension in workers with poor (HR = 12.98; 95% CI 5.81–28.99) and moderate Work Ability Index scores (HR = 3.17; 95% CI 1.36–7.38) compared to workers with good or excellent scores. The risk of a rehabilitation measure was also significantly increased for workers with poor and moderate scores. In addition, poor scores were prospectively associated with a longer duration of sickness absence and unemployment benefits, and fewer employment days and less income from regular employment. Those with poor Work Ability Index scores also had a significantly increased risk of premature death.

Conclusions

The Work Ability Index is a potential tool to identify individuals with previous long-term sickness absence having an increased risk of health-related exit and absence from work and poor work participation outcomes.

Electronic supplementary material

The online version of this article (10.1007/s00420-020-01608-4) contains supplementary material, which is available to authorized users.

Exploring a 1-Minute Paced Deep-Breathing Measurement of Heart Rate Variability as Part of a Workers' Health Assessment

Low heart rate variability (HRV) is related to health problems that are known reasons for sick-leave or early retirement. A 1-minute-protocol could allow large scale HRV measurement for screening of health problems and, potentially, sustained employability. Our objectives were to explore the association of HRV with measures of health. Cross-sectional design with 877 Dutch employees assessed during a Workers' Health Assessment. Personal and job characteristics, workability, psychological and mental problems, and lifestyle were measured with questionnaires. Biometry was measured (BMI, waist circumference, blood pressure, glucose, cholesterol). HRV was assessed with a 1-minute paced deep-breathing protocol and expressed as mean heart rate range (MHRR). A low MHRR indicates a higher health risk. Groups were classified age adjusted for HRV and compared. Spearman correlations between raw MHRR and the other measures were calculated. Significant univariable correlations (p < 0.05) were entered in a linear regression model to explore the multivariable association with MHRR. Age, years of employment, BMI and waist circumference differed significantly between HRV groups. Significant correlations were found between MHRR and age, workability, BMI, waist circumference, cholesterol, systolic and diastolic blood-pressure and reported physical activity and alcohol consumption. In the multivariable analyses 21.1% of variance was explained: a low HRV correlates with aging, higher BMI and higher levels of reported physically activity. HRV was significantly associated with age, measures of obesity (BMI, waist circumference), and with reported physical activity, which provides a first glance of the utility of a 1-minute paced deep-breathing HRV protocol as part of a comprehensive preventive Workers' Health Assessment.

Mediating Factors for the Relationship between Stress and Work Ability over Time in Young Adults

Stress can affect work ability. The aim of this study was to identify how this pathway is mediated over time in young adults. Participants of the Work Ability in Young Adults cohort were selected. A theoretical framework was built, which lead to a statistical model. Selected dimensions of mediators were recovery, work demands affecting private life, feelings of control over private life, and physical activity in leisure time. A quadruple serial mediation model was built with four mediators. The total effect of stress on work ability was -0.3955, 95% CI [-0.4764, -0.3146]. The total indirect effect amounted to 81% with an effect of -0.3182, 95% CI [-0.3750, -0.2642]. The relationship between stress and Work Ability Score five years later in young adults was mediated by stress five years later, work demands affecting private life, feelings of control over private life and feeling well-rested upon waking. These results indicate that work demands affecting private life and feelings of control over private life are important mediators of the relationship between stress and work ability in young adults. A well-balanced relationship between work and private life can counteract the influence of stress on work ability in this age group.

Association between physical work demands and work ability in workers with musculoskeletal pain: cross-sectional study

Background

Musculoskeletal pain is common in the working population and may affect the work ability, especially among those with high physical work demands. This study investigated the association between physical work demands and work ability in workers with musculoskeletal pain.

Methods

Workers with physically demanding jobs (n = 5377) participated in the Danish Work Environment Cohort Study in 2010. Associations between physical work ability and various physical work demands were modeled using cumulative logistic regression analyses while controlling for possible confounders.

Results

In the fully adjusted model, bending and twisting/turning of the back more than a quarter of the workday (reference: less than a quarter of the workday) was associated with higher odds of lower work ability in workers with low-back pain (OR: 1.38, 95% CI: 1.09–1.74) and neck-shoulder pain (OR: 1.29, 95% CI: 1.01–1.64). When adding up the different types of demands, being exposed to two or more physical work demands for more than a quarter of the workday was consistently associated with lower work ability.

Conclusions

Work that involves high demands of the lower back seems especially problematic in relation to work ability among physical workers with musculoskeletal pain. Regardless of the specific type of physical work demand, being exposed to multiple physical work demands for more than a quarter of the workday was also associated with lower work ability.

Physical Activity Promotion for Apprentices in Nursing Care and Automotive Mechatronics-Competence Counts More than Volume

Apprentices in the area of nursing care and automotive mechatronics are exposed to increased health risks. In this context, the promotion of physical activity (PA) is considered an effective strategy for the assurance of work ability. The goal of the PArC-AVE study was therefore to better understand the role of PA for apprentices employed in these two sectors. In an exploratory study, 55 apprentices wore an ActiGraph accelerometer over seven consecutive days and were subject to activity analysis. The objective accelerometer data (18,979 ± 3780 steps/day; 471.00 ± 159.75 min of moderate-to-vigorous PA/week), complemented by questionnaire data, indicated that most met the volume-based PA recommendations. Subsequently, we conducted a multicenter study comprising 745 apprentices from six vocational education institutions. Path analyses showed that competencies for health-enhancing PA were significantly related to indicators of work ability (0.180 ≤ b ≤ 0.452) and psychophysical health (0.139 ≤ b ≤ 0.347), whereas mere volume of PA was not (-0.048 ≤ b ≤ 0.080). In summary, apprentices of nursing care and automotive mechatronics showed high levels of PA. However, the results highlight the importance of competencies for health-enhancing PA. The PAHCO model could provide a useful framework for the conceptualization of effective interventions.

Cardiorespiratory Fitness and Device-Measured Sedentary Behaviour are Associated with Sickness Absence in Office Workers

Physical activity reduces the risk of several noncommunicable diseases, and a number of studies have found self-reported physical activity to be associated with sickness absence. The aim of this study was to examine if cardiorespiratory fitness, device-measured physical activity, and sedentary behaviour were associated with sickness absence among office workers. Participants were recruited from two Swedish companies. Data on sickness absence (frequency and duration) and covariates were collected via questionnaires. Physical activity pattern was assessed using ActiGraph and activPAL, and fitness was estimated from submaximal cycle ergometry. The sample consisted of 159 office workers (67% women, aged 43 ± 8 years). Higher cardiorespiratory fitness was significantly associated with a lower odds ratio (OR) for both sickness absence duration (OR = 0.92, 95% confidence interval (CI) 0.87-0.96) and frequency (OR = 0.93, 95% CI 0.90-0.97). Sedentary time was positively associated with higher odds of sickness absence frequency (OR = 1.03, 95% CI 0.99-1.08). No associations were found for physical activity at any intensity level and sickness absence. Higher sickness absence was found among office workers with low cardiorespiratory fitness and more daily time spent sedentary. In contrast to reports using self-reported physical activity, device-measured physical activity was not associated with sickness absence.

Work ability index in Slovenian hospital nurses aged over fifty years

Nurses with reduced work ability are highly susceptible to the deleterious effects of their working environments, and their rates of sick leave, disability, and early retirement are higher than average. The aim of this study was to evaluate work ability in 433 Slovenian hospital nurses aged over fifty years providing secondary care in thirteen hospitals across Slovenia. To do that we used a standardised instrument known as work ability index (WAI). Mean WAI was 36.98±6.46 and median 38. WAI was not associated with age (Spearman's ρ=-0.034, p=0.475). Total WAI score strongly correlated with the 1st item of the WAI questionnaire "current work ability" (ρ=0.726, p<0.001). Higher WAI scores were also associated with academic education, full-time employment, and working in a single (morning) or three shifts. Our WAI findings in nurses over fifty call for systemic changes in the nursing environment to maintain good work ability among nurses until the retirement age and beyond.

Edmonton Obesity Staging System (EOSS) and Work Ability in the Evaluation of Workers Affected by Obesity: A Preliminary Report

OBJECTIVE

Obesity and work-ability may be influenced by reduced performance, associated diseases, and obesogenic environment.

METHODS

Two hundred seventy-six male (46.7 ± 10.6 years; BMI 33.3 ± 4.4 kg/m) and 658 female (48.4 ± 9.7 years; BMI 33.6 ± 5.4 kg/m) were enrolled. They were classified by Edmonton Obesity Staging System (EOSS) and interviewed for "perceived" work-ability.

RESULTS

Total work ability score was 1.3 ± 2.1 in EOSS 0, 1.2 ± 1.5 in EOSS 1, 1.8 ± 2 in EOSS 2, 2.0 ± 2.2 in EOSS 3. Work-ability, in relation to EOSS adjusted for sex, age, work categories referred to EOSS 0, was highest in EOSS stage 3 (P < 0.001 for trend) and with reference to Administration; Industries showed the worst score (P < 0.001) followed by Health (P = 0.001) and Service (P = 0.01).

CONCLUSION

The relation between EOSS and work-ability empowers clinical decision-making and helps to assess the impact of overweight on health and fitness for work.

Predictors of Work Ability in Individuals With a Common Mental Disorder: Is There an Effect of Metacognitive Beliefs Among Poor Physical Health and Emotional Distress?

Work ability is a prospective predictor of sick leave, disability pension and unemployment, and has been defined as the balance between human resources and the demands of work, taking into consideration that illness is not equivalent to work disability. In the present study we set out to explore predictors of work ability in a sample of individuals with common mental disorders. In particular, we were interested in exploring metacognitive beliefs as a potential predictor of work ability, as Wells’ (2009) metacognitive model of psychological disorder suggests that metacognitions may be an underlying factor in psychological vulnerability generally, and they have been associated with work status in previous studies. One hundred and seventy-seven individuals participated in an online survey and completed a battery of self-report questionnaires. Several factors correlated with reduced work ability: physical disorders, emotional distress symptoms and metacognitive beliefs. We found that confidence in memory predicted work ability even when controlling for gender/age, number of physical disorders, and levels of anxiety and depression symptoms. This finding suggest that metacognitions of poor memory performance are associated with low work ability among those with common mental disorders, and implies that these should be targeted in treatment with a view to increasing work ability and thus potentially facilitate return to work.

Work Ability and Job Survival: Four-Year Follow-Up

Background: Employees with impaired work ability might be at higher risk of remaining shorter in the job than those with adequate work ability. The aim of the study was to establish whether work ability plays a role in job survival. Methods: Four-year follow-up (2008–2012) study of 1037 employees of a hospital in São Paulo, Brazil. Work ability was categorized as “adequate” or “impaired”. Employment status at the end of follow-up was categorized as active, resignation or dismissal. Survival analysis was performed using the Kaplan–Meier method and the Cox proportional-hazards model. Results: About 78.9% of the participants had adequate and 21.1% impaired work ability. Job survival was longer for the participants with adequate work ability independently from the type of job termination (p < 0.001). The odds of job termination were higher for the participants with impaired work ability (p < 0.001) who either resigned (hazard ratio—HR = 1.58) or were dismissed (HR = 1.68). Conclusion: Job survival was shorter for the employees with impaired work ability independently from the type of job termination. It was also shorter for the employees who were dismissed compared to those who resigned. Duration in the job might be extended through actions to enhance work ability.

Work Ability as Determinant of Termination of Employment: To Resign or Be Dismissed?

OBJECTIVE

The aim of this study was to investigate whether work ability plays a role in termination of employment (resignation or dismissal) in the short-to-medium run.

METHODS

Four-year cohort study with 1060 Brazilian hospital workers. The outcome was final employment status (active, resignation, or dismissal). Multinomial models were fit.

RESULTS

At the end of follow-up, 14.3% of the workers had resigned and 34.0% were dismissed. Impaired work ability was a risk factor for dismissal (relative risk ratio  = 1.39), but not for resignation. Also, job strain, age and sex, family income, nutritional status, and workshift were associated with employment termination.

CONCLUSIONS

Impaired work ability was a risk factor for dismissal but not for resignation in the short-to-medium run. Individual and occupational characteristics also contributed to employment termination. Improvement of work ability and working conditions are recommended to prevent quitting the job.

Physical workload and obesity have a synergistic effect on work ability among construction workers

PURPOSE

Obesity and high physical workload are both associated with poor work ability, but the interaction between obesity and high physical workload on work ability is not yet fully understood. Obesity and high physical workload may share a common mechanical pathway, possibly leading to a synergistic negative effect on work ability. The purpose of this study was to investigate the effect of obesity on work ability in workers with high versus low physical work load.

METHODS

A longitudinal study was conducted among 36,435 Dutch construction workers who participated in at least two periodic medical examinations during the years 2008-2015. Logistic regression analyses were used to investigate the effect of manual material handling and strenuous work postures in sports on the association between obesity and work ability. Work ability was measured using the self-reported Work Ability Index consisting of seven dimensions. Confounding effects were tested for age, educational level, smoking, vigorous physical activity, psychosocial work demands, and working hours. Additive interaction between obesity and physical workload on work ability was tested using the relative excess risk due to interaction (RERI).

RESULTS

Construction workers with overweight (OR = 1.09; 95% CI 1.02-1.16) or obesity (OR = 1.27; 95% CI 1.17-1.38) had an increased risk of poor/moderate work ability. Exposure to manual material handling (OR = 1.58; 95% CI 1.49-1.68) or strenuous work postures (OR = 1.80; 95% CI 1.70-1.90) also increased the risk of poor/moderate work ability. The effect of the combination of obesity with high physical workload was greater than the sum of the individual effects (strenuous work postures: RERI = 0.39; 95% CI 0.10-0.67; manual material handling: RERI = 0.26; 95% CI 0.02-0.51).

CONCLUSIONS

Obesity and high physical workload were associated with poor work ability and had a synergistic, negative effect on work ability. Interventions that prevent obesity and high physical workload might have a beneficial effect on work ability.

Predicting long-term sickness absence among employees with frequent sickness absence

PURPOSE

Frequent absentees are at risk of long-term sickness absence (SA). The aim of the study is to develop prediction models for long-term SA among frequent absentees.

METHODS

Data were obtained from 53,833 workers who participated in occupational health surveys in the period 2010-2013; 4204 of them were frequent absentees (i.e., employees with ≥ 3 SA spells in the year prior to the survey). The survey data of the frequent absentees were used to develop two prediction models: model 1 including job demands and job resources and model 2 including burnout and work engagement. Discrimination between frequent absentees with and without long-term SA during follow-up was assessed with the area under the receiver operating characteristic curve (AUC); (AUC) ≥ 0.75 was considered useful for practice.

RESULTS

A total of 3563 employees had complete data for analyses and 685 (19%) of them had long-term SA during 1-year follow-up. The final model 1 included age, gender, education, marital status, prior long-term SA, work pace, role clarity and learning opportunities. Discrimination between frequent absentees with and without long-term SA was significant (AUC 0.623; 95% CI 0.601-0.646), but not useful for practice. Model 2 showed comparable discrimination (AUC 0.624; 95% CI 0.596-0.651) with age, gender, education, marital status, prior long-term SA, burnout and work engagement as predictor variables. Differentiating by gender or sickness absence cause did not result in better discrimination.

CONCLUSIONS

Both prediction models discriminated significantly between frequent absentees with and without long-term SA during 1-year follow-up, but have to be further developed for use in healthcare practice.

Differences in self-rated health and work ability between self-employed workers and employees: Results from a prospective cohort study in the Netherlands

Background

With the increase of the statutory retirement age, the number of self-employed older workers will most likely increase. Therefore, this study aimed to explore: 1) the differences in self-rated health and work ability of self-employed workers and employees, 1) whether self-employment is associated with better self-rated health and work ability across three years, than employment, and 3) the role of sociodemographic, health- and work-related characteristics (e.g., mental load, physical load, and autonomy) in these relationships.

Methods

Data was used from the Study on Transitions in Employment, Ability and Motivation, where self-employed (n = 1,029) and employees (n = 12,055) aged 45–64 years were followed during 2010–2013. Linear regression and generalized estimating equations analyses were carried out to study the differences in self-rated health and work ability (i.e., self-assessed work ability in relation to an individual’s resources and work demands) of self-employed and employees. To explore the role of sociodemographic, health-and work-related characteristics in these associations, we included interaction terms between these characteristics and employment status.

Results

The self-employed had better work ability (8.3 versus 8.2), and better self-rated health (3.4 versus 3.3) than employees. Work ability of self-employed improved over time, compared to the changes over time in work ability among employees, but not no difference in change over time in self-rated health was found. None of the interaction terms were statistically significant (p>0.05).

Conclusion

We observed higher scores in self-rated health and work ability among the self-employed than employees. Being self-employed leads to an increase in work ability across three years. The differences in work ability can be considered small, and more research is needed to establish the role of self-employment as a potential facilitator for sustainable employment.

Self-Reported Work Ability Predicts Rehabilitation Measures, Disability Pensions, Other Welfare Benefits, and Work Participation: Longitudinal Findings from a Sample of German Employees

Purpose The study examined the performance of the Work Ability Index in predicting rehabilitation measures and disability pensions, sickness absence and unemployment benefits, and work participation among a sample of workers previously receiving sickness absence benefits. Methods Workers aged 40 to 54 years who received sickness absence benefits in 2012 completed the Work Ability Index in 2013. Outcomes were extracted from administrative data records. Results Data for 2149 participants were included (mean age: 47.8 years; 54.4% women). Mean follow-up was 19 months. Work Ability Index scores were poor (7-27 points) in 21% of the participants, and moderate (28-36 points) in 38.4%. In all, 224 rehabilitation measures and 35 disability pensions were approved. Fully adjusted analyses showed increased risk of rehabilitation measures in workers with poor (HR 4.55; 95% CI 3.14-6.60) and moderate scores (HR 2.08; 95% CI 1.43-3.01) compared to workers with good or excellent scores (37-49 points). The risk of a disability pension increased significantly for workers with poor scores (HR 7.78; 95% CI 2.59-23.35). In addition, poor scores were prospectively associated with a longer duration of sickness absence and employment benefits, and fewer employment days and less income from regular employment. Conclusions The Work Ability Index is a potential tool for following up workers who already have an increased risk of permanent work disability due to previous long-term sickness absence.

Differences of Four Work-Related Behavior and Experience Patterns in Work Ability and Other Work-Related Perceptions in a Finance Company

The present study applies a salutogenetic approach to psycho-social stress and wellbeing at work and for the first time analyzes the relation of an extended model of four work-related behavior and experience patterns to work related perceptions, like work ability, job satisfaction and turnover intention, or engagement. Employees of an international financial services company (N = 182) completed the questionnaire Work-related behavior and experience pattern (Arbeitsbezogenes Verhaltens- und Erlebensmuster; AVEM). The AVEM has oftentimes been used for research in helping professions, but research in non-helping professions is scarce. In addition to the AVEM, measures of job satisfaction, work ability, work engagement, presenteeism, and turnover intention were included in this study. Almost half (46.2%) of the sample showed a rather unambitious attitude towards work, followed by a burnout-related risk pattern (22.0%), a healthy pattern (19.8%), and a pattern at risk for overexertion (12.1%). Significantly more favorable scores were found for all work-related perceptions in participants with the healthy pattern compared to those with the burnout-related risk pattern, except for turnover intention where no significant differences were found. For work ability and vigor, those with a healthy pattern also had significantly higher scores than those with an unambitious pattern and a pattern at risk for overexertion. Being at risk for burnout not only affects job-related wellbeing and coping resources, but also work ability and work engagement. A need for personnel and organizational development and health promotion is indicated by a high number of individuals with reduced working motivation and risk patterns for overexertion or burnout.

Work ability score and future work ability as predictors of register-based disability pension and long-term sickness absence: A three-year follow-up study

AIMS

We investigated two single items of the Work Ability Index - work ability score, and future work ability - as predictors of register-based disability pension and long-term sickness absence over a three-year follow-up.

METHODS

Survey responses of 11,131 Finnish employees were linked to pension and long-term (more than 10 days) sickness absence register data by Statistics Finland. Work ability score was divided into poor (0-5), moderate (6-7) and good/excellent (8-10) and future work ability into poor (1-2) and good (3) work ability at baseline. Cox proportional hazard regressions were used in the analysis of disability pension, and a negative binomial model in the analysis of long-term sickness absence. The results were adjusted for several background, work- and health-related covariates.

RESULTS

Compared with those with good/excellent work ability scores, the hazard ratios of disability pension after adjusting for all covariates were 9.84 (95% CI 6.68-14.49) for poor and 2.25 (CI 95% 1.51-3.35) for moderate work ability score. For future work ability, the hazard ratio was 8.19 (95% CI 4.71-14.23) among those with poor future work ability. The incidence rate ratios of accumulated long-term sickness absence days were 3.08 (95% CI 2.19-4.32) and 1.59 (95% CI 1.32-1.92) for poor and moderate work ability scores, and 1.51 (95% CI 0.97-2.36) for poor future work ability.

CONCLUSIONS

The single items of work ability score and future work ability predicted register-based disability pension equally well, but work ability score was a better predictor of register-based long-term sickness absence days than future work ability in a three-year follow-up. Both items seem to be of use especially when examining the risk of poor work ability for disability but also for long sick leave.

Decrease in Work Ability Index and sickness absence during the following year: a two-year follow-up study

PURPOSE

Using a 2-year follow-up design, we examined whether changes in work ability during 1 year predicted sickness absence in the following year.

METHODS

Workers (N = 1408) from the Japanese information technology sector each completed the Work Ability Index (WAI), the Brief Job Stress Questionnaire (BJSQ), and the General Health Questionnaire (GHQ) in 2011 and 2012. Absence data during 2013 was obtained from employees' computerized attendance records. We used psychological distress as evaluated by the GHQ; job stress and job support calculated using the BJSQ; and job title, sex, and age as potential confounding variables.

RESULTS

Thirty-five employees had at least one sickness absence lasting more than seven consecutive days in 2013. Forty-nine percent of sickness absences were due to mental illness, and the others were due to orthopedic disease (20%), cancer (9%), and other illnesses (23%). Decrease in WAI scores from 2011 to 2012 predicted sickness absence in 2013 (Odds ratio (OR) 1.19, 95% confidence interval (CI) 1.12-1.27). This association remained unaltered after adjusting for sex, age, job title, WAI score from the year before, job stress, job support, and GHQ score (OR 1.15, 95% CI 1.06-1.25). We analyzed this association separately by reason for absence: mental or other illness. WAI score decreases predicted sickness absence for both reasons (OR for mental illness 1.24, 95% CI 1.14-1.36; OR for other illnesses 1.14, 95% CI 1.04-1.24).

CONCLUSIONS

Decrease in work ability during the year predicts sickness absence in the following year while predictive power was weak.

Overweight and obesity are progressively associated with lower work ability in the general working population: cross-sectional study among 10,000 adults

PURPOSE

Obesity is associated with many diseases and functional limitations. Workplaces are not always designed to accommodate this challenge. This study investigated the association between body mass index (BMI) and work ability in the general working population.

METHODS

Currently employed wage earners (N = 10,427) from the 2010 round of the Danish Work Environment Cohort Study (DWECS) replied to questions about work and health. Cumulative logistic regression analyses controlling for age, gender, physical and psychosocial work factors, lifestyle, and chronic diseases modeled the associations between BMI and work ability.

RESULTS

BMIs above the normal range were progressively associated with lower work ability in relation to the physical demands of the job. Odds ratios for having lower work ability were 1.11 (95% CI 1.01-1.22), 1.17 (95% CI 1.01-1.34), 1.43 (95% CI 1.09-1.88), 1.69 (95% CI 1.10-2.62) for overweight and obesity classes I, II, and III, respectively. In subgroup analyses, the associations between BMI and work ability were more pronounced among individuals with mainly sedentary work than among those with physically active work. BMI was not associated with work ability in relation to the mental demands of the work.

CONCLUSIONS

BMIs above the normal range are progressively associated with lower work ability in relation to the physical demands of the job, especially among individuals with mainly sedentary work. Ergonomic research on how to optimally design workstations for workers with obesity are needed.

Predictive validity of the Work Ability Index and its individual items in the general population

Aim: This study assesses the predictive ability of the full Work Ability Index (WAI) as well as its individual items in the general population. Methods: The Work, Health and Retirement Study (WHRS) is a stratified random national sample of 25–75-year-olds living in Sweden in 2000 that received a postal questionnaire ( n = 6637, response rate = 53%). Current and subsequent sickness absence was obtained from registers. The ability of the WAI to predict long-term sickness absence (LTSA; ⩾ 90 consecutive days) during a period of four years was analysed by logistic regression, from which the Area Under the Receiver Operating Characteristic curve (AUC) was computed. Results: There were 313 incident LTSA cases among 1786 employed individuals. The full WAI had acceptable ability to predict LTSA during the 4-year follow-up (AUC = 0.79; 95% CI 0.76 to 0.82). Individual items were less stable in their predictive ability. However, three of the individual items: current work ability compared with lifetime best, estimated work impairment due to diseases, and number of diagnosed current diseases, exceeded AUC > 0.70. Excluding the WAI item on number of days on sickness absence did not result in an inferior predictive ability of the WAI. Conclusions: The full WAI has acceptable predictive validity, and is superior to its individual items. For public health surveys, three items may be suitable proxies of the full WAI; current work ability compared with lifetime best, estimated work impairment due to diseases, and number of current diseases diagnosed by a physician.

Early Workplace Intervention to Improve the Work Ability of Employees with Musculoskeletal Disorders in a German University Hospital-Results of a Pilot Study

Health promotion is becoming increasingly important in work life. Healthcare workers seem to be at special risk, experiencing musculoskeletal disorders (MSD); their situation is strongly influenced by demographic changes. The aim of this study is to evaluate the feasibility and outcome of a worksite intervention. In a one-group pretest-posttest design, 118 employees of a hospital were recruited from 2010 to 2011. The raised parameters were satisfaction with the program, work ability (Work Ability Index), and sickness absence (provided by human resource management). Patient-reported questionnaire data was raised at baseline (t1) and after three months (t2). Sickness leave was evaluated in the period six months prior to and six months after the intervention. Means, frequencies, standardized effect sizes (SES), analysis of variance, and regression analysis were carried out. Participants were found to be highly satisfied. Work ability increased with moderate effects (SES = 0.34; p < 0.001) and prognosis of gainful employment (SES = −0.19; p ≤ 0.047) with small effects. Days of MSD-related sickness absence were reduced by 38.5% after six months. The worksite intervention program is transferable to a hospital setting and integration in occupational health management is recommended. The use of a control group is necessary to demonstrate the effectiveness.

The impact of menopause on work ability in women with severe menopausal symptoms

OBJECTIVE

To measure the impact of menopause on work ability in women with severe menopausal symptoms.

STUDY DESIGN

This cross-sectional study compared the work ability of a sample of otherwise healthy employed Dutch women (n=205) with that of a sample of first-time attendees of a menopause clinic (n=60); both groups were aged 44-60 years. Self-reported questionnaire data assessing work ability (Work Ability Index; WAI) and menopausal symptoms (Greene Climacteric Scale; GCS) were used.

MAIN OUTCOME MEASURES

Logistic regression analyses were used to examine whether women with severe menopausal symptoms were more likely to have low work ability (defined as a score <37.0 points on the WAI) than were women in the reference group, after adjustment for individual and lifestyle factors.

RESULTS

Symptomatic women had significantly higher total GCS scores (mean 26.7 vs 14.2, t=10.8, P<0.001) and significantly lower WAI scores (median 32.0 vs 40.0, U=2380, P<0.001) than the reference group. They were 8.4 times more likely to report low work ability than their healthy counterparts: 76.7% versus 30.2% (OR 8.4, 95% CI 4.1-17.2).

CONCLUSIONS

Over three-quarters of symptomatic menopausal women report serious problems in dealing with the physical and mental demands of their work (recorded here as low work ability); hence these women might be at risk of prolonged sickness absence from work.