The effectiveness of interventions for ageing workers on (early) retirement, work ability and productivity: a systematic review

Individual Work Attitudes and Work Ability

Work capacity depends on many factors, including the age and health status of the employee, but also on personal characteristics and attitudes, such as reduced tolerance of unfavorable working conditions (Work Annoyance, WA), excessive commitment to work (Overcommitment, OC), passion for work (Work Engagement, WE), and social interactions (Social Capital, SC). A total of 1309 workers who underwent a medical examination at work completed questionnaires on work attitudes and assessed their work ability using the Work Ability Score (WAS). The relationship between variables expressing work attitudes and WAS was studied using hierarchical linear regression and moderation analyses. WA is associated with low WAS values; SC is a positive predictor of WAS and moderates the effect of WA on WAS. OC reduces work ability, while Vigor and Dedication, components of WE, have a strong positive effect on work ability. To improve the work ability of employees, employers and managers should improve social relations in the workplace and discourage overcommitment. A positive working environment can increase engagement and avoid triggers of work annoyance.

Factors associated with work ability among employees of an Italian university hospital

BACKGROUND

A growing body of evidence clearly documents the benefits of integrated systems approaches to protecting and promoting the safety, health and well-being of workers. The purpose of this study is to provide a holistic view of the work ability of employees of an Italian University Hospital measuring their resources in relation to job demands. In particular, it examines socio-demographics, family and organizational antecedents of health professionals' work ability.

METHODS

A survey was conducted to assess the work ability of healthcare professionals, including physicians, nurses and administrative staff, working at the University Hospital of Modena (Italy). The data collection allows us to get a sample of 443 workers, who correspond to 11% of the target population. The data were analyzed using preliminary statistics on the main characteristics of the sample in terms of work ability, socio-demographic variables, family and organizational characteristics. In addition, logit models of the likelihood of having high work ability were estimated using SPSS version 25.

RESULTS

Work ability decreases with increasing age, comorbidity, high body mass index, having at least one child under 5 and/or a dependent adult, having a poor work-life balance, and doing more than 20 h of housework. Specific job resources can significantly promote work ability, including relationship-oriented leadership, autonomy in decision making and individuals' skill match. The nursing profession is associated with a low work ability. Finally, a significant gender gap has been documented. Women find it more difficult to reconcile life and work, especially when they have children of preschool age and work in professions with greater responsibilities, as in the case of women doctors, who experience lower work capacity.

CONCLUSIONS

Our results suggest that it is necessary to consider other factors, in addition to age, that are equally relevant in influencing work ability. Consequently, organisational interventions could be implemented to improve the work ability of all workers. In addition, we propose targeted interventions for groups at risk of reduced work capacity, in particular older workers (45 years and over), nurses, women with children of preschool age and in the position of physician.

Factors associated with return-to-work outcomes in inpatient rehabilitation - a systematic scoping review

Inpatient rehabilitation is common in Germany to improve return-to-work outcomes. The objective of this systematic scoping review was to identify factors associated with return-to-work outcomes in musculoskeletal, psychological and oncological health conditions to improve tailoring of rehabilitation therapies. A search was completed in Embase, Medline, PsycInfo and AMED until May 2023 for articles investigating inpatient rehabilitation including working-age patients with oncological, musculoskeletal, or psychological diseases using a quantitative design and reporting factors associated with return-to-work outcomes. Screening of all titles and abstracts was completed by one reviewer, full texts were read by two reviewers. Quality appraisal and data extraction was completed by two reviewers. Data was analysed using a narrative synthesis. Eighteen studies of moderate quality were included. The review identified a wide range of return-to-work parameters including employment status, work ability, sickness absence, retirement status and duration of employment since rehabilitation. In addition, 48 psychological, health- and work-related factors associated with return-to-work parameters were identified. Only one RCT investigated the relationship between a depression prevention intervention and a return-to-work outcome (work ability), which showed a significant effect. In addition to the depression prevention intervention, only the factor 'health literacy' could be considered modifiable and be addressed as part of an inpatient rehabilitation programme. Furthermore, gradual work reintegration programs and/or workplace interventions in addition to inpatient rehabilitation should be further explored to improve return-to-work outcomes.

Workplace Mental Health Disclosure, Sustainable Employability and Well-Being at Work: A Cross-Sectional Study Among Military Personnel with Mental Illness

Purpose Disclosure of mental illness to a supervisor can have positive (e.g. supervisor support) and negative consequences (e.g. stigma). However, research on the association between disclosure and sustainable employability and well-being at work is scarce. The aim of this study was to investigate the association between the disclosure decision (yes/no), experiences with the decision (positive/negative) and sustainable employment and well-being at work among military personnel with mental illness (N = 323). Methods A cross-sectional questionnaire study was conducted. Descriptive and regression (linear and ordinal) analyses were performed. Comparisons were made between those with positive and negative disclosure experiences. Results Disclosure decision (yes/no) was not significantly associated with any of the measures of sustainable employability and well-being at work. However, positive disclosure experiences were significantly associated with higher scores on almost all measures of sustainable employability and well-being at work. Those with negative disclosure experiences reported significantly more shame (M_pos = 2.42, M_neg = 2.78, p < .05) and discrimination (M_pos = 1.70, M_neg = 2.84, p < .001). Those with a positive disclosure experience, reported significantly more supervisor support (M_pos = 3.20, M_neg = 1.94, p < .001). Conclusion We did not find evidence that the disclosure decision itself is related to measures of sustainable employment and well-being at work. In contrast, how participants had experienced their (non-)disclosure decision was significantly related to almost all measures. This emphasizes the importance of the work environments reactions to disclosure and mental illness in the workplace. Future research and interventions should focus on increasing the likelihood of positive disclosure experiences through creating a more inclusive work environment, with more supervisor support and less stigma.

Aging engineers' occupational self-efficacy-a mixed methods study

Introduction

Engineers' work has become more complex with increased demands in today's changing working life. Self-efficacy is essential to successfully adapt to work-related changes and to cope with adverse job demands. However, less is known about aging engineers' occupational self-efficacy. Therefore, this study explores facilitators and barriers to aging engineers' occupational self-efficacy beliefs to continue working until expected retirement age. An additional purpose is to explore if any of the aspects described by the engineers are more prominent.

Methods

The study design was exploratory, using mixed methods with a qualitative to quantitative approach. A total of 125 engineers, aged between 45 and 65 years, answered two open-ended survey questions about what positively and negatively affect their occupational self-efficacy beliefs to continue working. First, data was analyzed using an inductive manifest qualitative content analysis. Next, descriptive statistics were performed based on the results of the qualitative study.

Results

The analyses revealed that health and working conditions that affect health were crucial facilitators and barriers for the aging engineers' occupational self-efficacy to continue working until expected retirement age. Furthermore, the engineers emphasized competence, motivation from meaningful tasks, family and leisure, and private economy.

Discussion

The aging engineers' own health seems to be prominent in their self-efficacy regarding a full working life; consequently, support still needs to address issues affecting health.

Effectiveness of Team and Organisational Level Workplace Interventions Aimed at Improving Sustainable Employability of Aged Care Staff: A Systematic Review

Purpose The sustainable employability of healthcare professionals in aged care is under pressure, but research into the effectiveness of interventions aimed at improving employees' sustainable employability is scarce. This review therefore aimed to investigate the effectiveness of workplace interventions on sustainable employability of healthcare professionals in aged care. Methods A systematic literature search was performed. Studies were included when reporting about the effect of an intervention at work in an aged care setting on outcomes related to one of the three components of sustainable employability (i.e. workability, vitality, employability). The methodological quality of each study was assessed and a rating system was used to determine the level of evidence. Additionally, a sensitivity analysis was performed, accounting for the match between the intervention's focus and the targeted component of sustainable employability. Results Current review includes 32 interventions published between 1996 and 2019. Interventions covered learning and improving skills, changing the workplace, and exercising or resting. The initial analysis showed a strong level of evidence for employability and insufficient evidence for workability and vitality. The sensitivity analysis revealed strong evidence for the effectiveness of interventions addressing either employability or workability, and insufficient evidence for vitality. Conclusions Evidence for workplace interventions on sustainable employability of healthcare professionals in aged care differed. We found strong evidence for effects of workplace interventions on employability and for those directly targeting workability. Evidence for effects of interventions on vitality was insufficient. The alignment of the interventions to the targeted component of sustainable employability is important for effectiveness.

Chronic diseases and productivity loss among middle-aged and elderly in India

CONTEXT

Chronic diseases are growing in India and largely affecting the middle-aged and elderly population; many of them are in working age. Though a large number of studies estimated the out-of-pocket payment and financial catastrophe due to this condition, there are no nationally representative studies on productivity loss due to health problems. This paper examined the pattern and prevalence of productivity loss, due to chronic diseases among middle-aged and elderly in India.

METHODS

We have used a total of 72,250 respondents from the first wave of Longitudinal Ageing Study in India (LASI), conducted in 2017-18. We have used two dependent variables, limiting paid work and ever stopped work due to ill health. We have estimated the age-sex adjusted prevalence of ever stopped working due to ill health and limiting paid work across MPCE quintile and socio- demographic characteristics. Propensity Score Matching (PSM) and logistic regression was used to examine the effect of chronic diseases on both these variables.

FINDINGS

We estimated that among middle aged adults in 45-64 years, 3,213 individuals accounting to 6.9% (95%CI:6.46-7.24) had ever-stopped work and 6,300 individuals accounting to 22.7% (95% CI: 21.49-23.95) had limiting paid work in India. The proportion of ever-stopped and limiting work due to health problem increased significantly with age and the number of chronic diseases. Limiting paid work is higher among females (25.1%), and in urban areas (24%) whereas ever-stopped is lower among female (5.7%) (95% CI:5.16-6.25 ) and in urban areas (4.9%) (95% CI: 4.20-5.69). The study also found that stroke (21.1%) and neurological or psychiatric problems (18%) were significantly associated with both ever stopped work and limiting paid work. PSM model shows that, those with chronic diseases are 4% and 11% more likely to stop and limit their work respectively. Regression model reveals that more than one chronic conditions had a consistent and significant positive impact on stopping work for over a year (increasing productivity loss) across all three models.

CONCLUSION

Individuals having any chronic disease has higher likelihood of ever stopped work and limiting paid work. Promoting awareness, screening and treatment at workplace is recommended to reduce adverse consequences of chronic disease in India.

Stimulating Employability and Job Crafting Behaviour of Physicians: A Randomized Controlled Trial

The demanding work context of physicians challenges their employability (i.e., their ability and willingness to continue to work). This requires them to proactively manage their working life and employability, for instance, through job crafting behaviour. This randomized controlled intervention study aimed to examine the effects of a personalized feedback report on physicians’ employability and job crafting behaviour. A total of 165 physicians from two hospitals in a large Dutch city were randomly assigned to a waitlist control or intervention group in May 2019. Physicians in the intervention group received access to a personalized feedback report with their employability scores, suggestions to improve these and to engage in job crafting. Participants completed a pre-test and eight weeks later a post-test. RM MANOVAs and RM ANOVAs showed that the intervention enhanced participants’ perceptions of their mental (F (1,130) = 4.57, p < 0.05) and physical (F (1,135) = 16.05, p < 0.001) ability to continue working. There was no effect on their willingness to continue to work. Furthermore, while job crafting behaviour significantly increased over time, the personalized feedback report did not account for this change. This low-investment intervention is relevant for organizations to stimulate employees’ proactivity and create positive perceptions of their ability to continue to work. Moreover, this study contributes to the literature by examining a novel approach of a job crafting intervention that does not require many resources to implement.

Exploring Health Trends Prior to State Pension Age for The Netherlands up to 2040

BACKGROUND

In many Western countries, the state pension age is being raised to stimulate the extension of working lives. It is not yet well understood whether the health of older adults supports this increase. In this study, future health of Dutch adults aged 60 to 68 (i.e., the expected state pension age) is explored up to 2040.

METHODS

Data are from the Dutch Health Interview Survey 1990-2017 (N ≈ 10,000 yearly) and the Dutch Public Health Monitor 2016 (N = 205,151). Health is operationalized using combined scores of self-reported health and limitations in mobility, hearing or seeing. Categories are: good, moderate and poor health. Based on historical health trends, two scenarios are explored: a stable health trend (neither improving nor declining) and an improving health trend.

RESULTS

In 2040, the health distribution among men aged 60-68 is estimated to be 63-71% in good, 17-28% in moderate and 9-12% in poor health. Among women, this is estimated to be 64-69%, 17-24% and 12-14%, respectively.

CONCLUSIONS

This study's explorations suggest that a substantial share of people will be in moderate or poor health and, thus, may have difficulty continuing working. Policy aiming at sustainable employability will, therefore, remain important, even in the case of the most favorable scenario.

The MAastricht Instrument for Sustainable Employability - Italian version (MAISE-IT): a validation study

BACKGROUND

Governments and employers aim to promote sustainable employability (SE) in aging societies. In the Netherlands, an instrument for capturing the employee perspective on SE, the MAastricht Instrument for Sustainable Employability (MAISE-NL), has recently been developed. This study seeks to validate the Italian version of the MAISE (MAISE-IT).

METHODS

The MAISE-IT (a translated and culturally adapted version of the MAISE for the Italian population), the Work-Health Balance questionnaire and a demographic survey (age, gender, education, and occupational activity) were completed online by 455 respondents (328 public administration workers and 127 respondents recruited from social networks). Construct and criterion validity were tested by CFA; reliability, correlational analyses and subgroup differences with ANOVAs.

RESULTS

The CFA analysis revealed that the MAISE-IT consists of 12 scales distributed in four areas: (1) Meaning of SE; (2) Level and Factors affecting SE; (3) Overall responsibility for SE; and (4) Responsibility for factors affecting SE. Construct and criterion validity and reliability were good. Italian workers reported a moderately high level of SE. They regarded employers to be somewhat more responsible for SE than employees.

CONCLUSIONS

This study showed the validity of the MAISE-IT in the Italian context. The MAISE-IT is valuable for tapping employees' needs in order to develop SE interventions tailored to the employee perspective.

Systematic Review of Intervention Studies to Foster Sustainable Employability Core Components: Implications for Workplace Promotion

This review aims to outline the effectiveness of employer-initiated workplace interventions in promoting sustainable employability (SE), which means developing workers’ capabilities to foster productivity, health, and valuable work in the long term. A systematic search of the literature is performed in three databases covering the period from January 1999 to February 2022. Fourteen studies are included. Considering SE core components, all interventions cover the valuable work component in terms of content, and the majority also cover the health component. Interventions addressing at least three SE components have more positive effects on SE outcomes. More positive effects are found for valuable work outcomes. Overall, the findings highlight the importance of developing workplace interventions considering a comprehensive model of SE and promoting an organizational culture for SE. Future directions and limits are discussed.

Work motivation and occupational self-efficacy belief to continue working among ageing home care nurses: a mixed methods study

Background

It is important to support ageing home care nurses (HCNs) to remain in work for longer, since the need for home care services is increasing. Personal resources such as self-efficacy belief contribute to work ability, as does work motivation. Few studies have targeted the ageing workers’ self-efficacy belief to manage their final working years. This study explores ageing HCNs’ work motivation, and occupational self-efficacy, i.e. belief in one’s capabilities, to continue working until expected retirement age.

Methods

The design of the study is exploratory using a mixed method with a qualitative to quantitative approach. A total of 234 HCNs answered four open-ended questions from a cross-sectional survey, regarding their work motivation and self-efficacy beliefs. First, data was analysed using manifest qualitative content analysis. Next, a quantitative analysis was performed based on the results of the qualitative study, and the categories that emerged were quantitatively ranked.

Results

The open-ended questions yielded 2339 utterances. The findings showed that several categories concurrently affected both work motivation and self-efficacy belief. When they were well-functioning, they positively affected both work motivation and self-efficacy belief, and when they were insufficient, they negatively affected either or both motivation and/or belief. Meaningfulness, job satisfaction, social support, and work environmental and organizational characteristics affected work motivation most. Perceived health highly affected the self-efficacy belief to continue working until expected retirement age, as well as meaningfulness of work, support from colleagues and home care managers, and work characteristics.

Conclusions

Through highlighting the meaningfulness of work, and supporting the perceived health, the work community and leadership, both work motivation and self-efficacy belief to continue working might be facilitated among ageing HCNs. However, the still present draining workload must be handled.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12912-021-00780-3.

Comparison of the work ability index and the work ability score for predicting health-related quality of life

PURPOSE

To compare the relationship of the 7-item Work Ability Index (WAI) and the single-item Work Ability Score (WAS) with individual and work-related factors, and to investigate the predictive role of these two work ability assessments for health-related quality of life (HRQOL).

METHODS

This is a cross-sectional study. 407 of 445 employees working on a construction project in Shiraz, Iran consented to participate in an anonymous survey. 381 surveys were returned completed. Correlation analyses were used to evaluate relationships between WAI and WAS, and the total score and four domains of the WHOQOL-BREF, our measure of HRQOL, and individual and work-related variables. Hierarchical multivariate linear regression analyses were performed to compare WAI and WAS in predicting HRQOL and its four dimensions.

RESULTS

WAI and WAS were both significant predictors of HRQOL and its four dimensions and the explained variance was very similar. The WAI and WAS explained 46% and 44% of the variance related to the HRQOL, respectively. WAI and WAS explained 36-38% and 35-37% of the variance related to dimensions of the HRQOL, respectively. There were significant relationships of both WAS and WAI with job type, work schedule, smoking, and exercise habit.

CONCLUSIONS

The WAS and WAI showed a very similar relationship with participants' individual and work-related factors and HRQOL. The Work Ability Score is a valid and suitable measure for assessment of work ability among Iranian workers. Use of this simple measure could be advantageous to reduce demands on research participants and in workability assessments.

Occupational self-efficacy and work engagement associated with work ability among an ageing work force: A cross-sectional study

BACKGROUND

Occupational self-efficacy (OSE) is an appropriate adaption capability to react to continuous changes in work life today. While self-efficacy is an important component in work context, there is less knowledge regarding older workers' OSE.

OBJECTIVE

This study examined the relationship between work ability, OSE and work engagement among a middle-aged workforce, and whether there were any differences between age groups and between professionals in different work context.

METHODS

Data were collected by questionnaire, which included Work Ability Index (WAI), Occupational Self-Efficacy Scale, and Utrecht Work Engagement Scale.

RESULTS

A total of 359 home care workers and engineers (response rate 43%) participated. The average age was 54 (SD±5.3) years, 69%were women. The results of logistic regression analyses revealed an association between WAI, OSE (OR 0.66; 95%CI 0.52 to 0.86) and work engagement (OR 0.61; 95%CI 0.47 to 0.78). Higher OSE and work engagement were related to higher work ability. No difference in OSE (5.9; ±0.8) between professional groups was seen, but the home care workers scored considerably higher work engagement (5.1; ±0.9) than the engineers (4.5; ±1.3).

CONCLUSIONS

Improving OSE could be worthwhile to support work ability among middle-aged workers, despite dissimilarities in work context and educational level.

Effects of 9/11-related injury on retirement patterns among World Trade Center Health Registry enrollees

BACKGROUND

Many survivors of the 9/11/2001 terrorist attacks in New York City sustained injuries. The aim of this study was to understand how 9/11-related injuries affected retirement patterns of World Trade Center Health Registry enrollees.

METHODS

The study included enrollees who participated in the 2017 Health & Quality of Life Survey, focused on 9/11-related injuries and quality of life, and the 2017-2018 Health & Employment Survey, focused on retirement and employment (N = 3535). Using Cox proportional hazards and logistic regression modeling, we calculated the risk of retiring at earlier ages and the odds of retirees working again, controlling for relevant covariates.

RESULTS

Results showed that 9/11-related injuries did affect retirement patterns. Injured enrollees were at greater risk of retiring at younger age compared to non-injured enrollees. Compared to more severely injured retirees, non-injured and less severely injured retirees were significantly more likely to work again postretirement. Our results suggested that being injured on 9/11 was associated with retirement, meaning that if the injury had not occurred, the individual may have continued working longer.

CONCLUSIONS

The need to retire earlier than planned could be addressed with employer and societal changes. Employers should consider making accommodations for those impacted by 9/11 a priority, as it is imperative for those who were injured on 9/11 to have the ability to work to support their physical, mental, and financial well-being.

Aging and the Future of Decent Work

The United Nations identified decent work and economic growth as a sustainable development goal for 2030. Decent work is a term that sums up aspirations for people in their working lives. One of the factors that influences the achievement of decent work is aging. This article examines how aspects of aging and organizational factors affect work ability across the lifespan and throughout one's work career. Additionally, the critical issue of worker physical mobility was also addressed as a practical limitation to functional aging. Through our investigation, we identified gaps in the literature where research and interventions should be promoted. These include early disability studies; population dashboards of workers' health metrics; intervention and cost effectiveness in health promotion and prevention of early functional aging at work; policies for tailoring demands to individual needs and abilities; and inequities of social protection for aging workers.

Challenges arising for older workers from participating in a workplace intervention addressing work ability: a qualitative study from Germany

OBJECTIVE

Studies examining what renders workplace interventions to sustain and promote work ability of older workers successful have largely neglected older workers´ perspective. This paper outlines the results of a study with regard to older workers´ experiences and expectations of a workplace intervention. Based on these findings, some reflections on how to improve the design and the implementation of workplace interventions for older workers are provided.

METHODS

Semi-structured interviews were conducted with older workers (N = 8) participating in a workplace intervention undertaken at one production site of a large manufacturing company in Baden-Wurttemberg/Germany. The interview guide included questions on participants´ experiences with and expectations of the intervention. The interviews were recorded, transcribed verbatim and analyzed using qualitative content analysis according to Mayring (2014).

RESULTS

Older workers´ reported some challenges they face due to their participation in the workplace intervention. These resulted from the work environment (physical challenges), the work process design (new long work cycle), the work organization (tight time allowances, little job rotation, change of teams, age stereotypes) and the management of the workplace intervention (bad information, feeling of occupational insecurity and lack of being valued).

CONCLUSIONS

The study shows that challenges arising for older workers from their participation in the workplace intervention may have counteracted the promotion of work ability. As findings suggest, some of these challenges might have been avoided either by considering workers´ perspective during design and implementation of an intervention or by referring to evidence on aging and work ability.

Work Ability among Upper-Secondary School Teachers: Examining the Role of Burnout, Sense of Coherence, and Work-Related and Lifestyle Factors

Maintaining and promoting teachers’ work ability is essential for increasing productivity and preventing early exit from the teaching profession. This study aimed to identify the predictors of work ability among upper-secondary school teachers and examine the mediating role of burnout. A large and diverse group of Czech upper-secondary school teachers was surveyed to address this goal. The sample comprised 531 upper-secondary school teachers (50.0 ± 9.94 years, 19.9 ± 10.62 in the teaching profession, 57.6% females). Relatively greater empirical support was found for the effects of burnout, sense of coherence, work–life balance, and perceived relationships in the school environment on work ability than for the impact of age, homeroom teacher duties, workload, and caring for elderly relatives. Furthermore, burnout served as an important mediator of the relationship between sense of coherence and work ability. Teachers with a higher sense of coherence are thus better able to cope with adverse work circumstances and identify and mobilize internal and external resources to prevent professional exhaustion and the subsequent decline in work ability. The study can guide interventions on the work ability of teachers.

Workplace interventions that support older employees' health and work ability - a scoping review

BACKGROUND

The aim of this study was to examine workplace interventions that support older employees' health and work ability and the effect of these interventions.

METHODS

We used a scoping review, a type of a systematic literature review in which selected published academic articles and grey literature reports are included, to answer the following questions: 1) What kind of interventions have been made to support older employees' health? and 2) What effects do these interventions have on older employees' work ability? The scoping review framework proposed by Arksey and O'Malley and summarized by the Joanna Briggs Institute was used. Four key concepts comprised the basis for the research: health, intervention, older employee and work ability. A total of 8 articles were found to meet the inclusion and exclusion criteria. The study was limited to published academic articles between 2007 and 2019. Participant age varied between 37 and 74 years (overall average age 50-55) and workplaces comprised the intervention settings.

RESULTS

Three main intervention categories were discerned: health checks and counselling for employees on the individual level, interventions based on screenings, and improvements in work environment or organization. Positive behavioral change and lowered health risks can be achieved through health counselling, which increases work ability. Measurements and screenings comprise good ways to chart and follow-up on employees' work ability and health status. Supervisor training and support from supervisors were seen to have a positive effect on health outcomes and increased work ability.

CONCLUSIONS

To guarantee good results, employers should focus on employees' health and interventions should occur when employees are younger than the studied group. The small number of articles related to intervention studies for the age group studied here indicate that a knowledge gap exists. We maintain that workplaces that promote employees' health by strengthening older employees' vitality can encourage employees to have longer careers.

Effects of six month personalized endurance training on work ability in middle-aged sedentary women: a secondary analysis of a randomized controlled trial

Background

To test the effects of guided endurance training on work ability in middle-aged female hospital workers of various occupations.

Methods

We randomized 265 healthy, sedentary, middle-aged women (45–65 years) to an endurance training group (EG 210 min/week) or a wait-list control group (CG). At baseline and at 6-month follow-up, we assessed work ability (Work Ability Index [WAI]), physical activity (Freiburger activity questionnaire) and peak oxygen uptake (VO_2peak) by cardiopulmonary exercise testing. To examine the influence of baseline work ability, participants were divided into poor-moderate (WAI 1, 7–36 points, n = 83), good (WAI 2, 37–43 points, n = 136) and excellent (WAI 3, 44–49 points, n = 46) WAI subgroups.

Results

Cardiorespiratory fitness improved significantly after 6 months in the EG but not in the CG. The WAI total score increased significantly in the EG (38.3 ± 5.0 to 39.8 ± 4.9 points) but not in the CG (39.4 ± 4.7 to 39.3 ± 4.9 points), with a significant difference between groups (p < 0.01). In the EG, only the poor-moderate subgroup (WAI 1, 33.0 ± 2.9 to 36.6 ± 4.8 points, p < 0.05) increased the WAI total score, with this increase being significantly higher compared to the good (WAI 2, 40.2 ± 2.1 to, 40.4 ± 3.7 points) and excellent (WAI 3, 45.6 ± 1.5 to 45.7 ± 1.8 points) subgroup.

Conclusions

A 6-month guided exercise training intervention significantly increases cardiorespiratory fitness with concomitant improvements in work ability in middle-aged previously sedentary hospital employees. Women with low baseline work ability seem to particularly benefit from the intervention, which implies that similar interventions may be particularly beneficial for this group of individuals.

Trial registration

German Clinical Trails Register Identifier: DRKS00005159. Registered 25 September 2013.

Trends in working conditions and health across three cohorts of older workers in 1993, 2003 and 2013: a cross-sequential study

Background

Over the past decades, the number of older workers has increased tremendously. This study examines trends from 1993 to 2013 in physical, cognitive and psychological functioning among three successive cohorts of Dutch older workers. The contribution of the changes in physical and psychosocial work demands and psychosocial work resources to change in functioning is examined. Insight in health of the older working population, and in potential explanatory variables, is relevant in order to reach sustainable employability.

Methods

Data from three cohorts (observations in 1993, 2003 and 2013) of the Longitudinal Aging Study Amsterdam (LASA) were used. Individuals aged 55–65 with a paid job were included (N = 1307). Physical functioning was measured using the Timed Chair Stand Test, cognitive functioning by a Coding Task and psychological functioning by the positive affect scale from the CES-D. Working conditions were deduced from a general population job exposure matrix. Linear and logistic regression analyses were performed.

Results

From 1993 to 2013, time needed to perform the Timed Chair Stand Test increased with 1.3 s (95%CI = 0.89–1.71), to a mean of 11.5 s. Coding Task scores increased with 1.7 points (95%CI = 0.81–2.59), to a mean of 31 points. The proportion of workers with low positive affect increased non-significantly from 15 to 20% (p = 0.088). Only the improvement in cognitive functioning was associated with the change in working conditions. The observed decrease of physically demanding jobs and increase of jobs with higher psychosocial resources explained 8% of the improvement.

Conclusions

Changes in working conditions may not contribute to improved physical and psychological functioning, but do contribute to improved cognitive functioning to some extent. Further adjustment of physical work demands and psychosocial work resources may help to reach sustainable employability of older workers.

Evidence of Workplace Interventions-A Systematic Review of Systematic Reviews

Work environment factors are highly correlated with employees' health and well-being. Our aim was to sum up current evidence of health promotion interventions in the workplace, focusing on interventions for the prevention of musculoskeletal disorders, psychological and behavioral disorders as well as interventions for older employees and economic evaluations. We conducted a comprehensive literature search including systematic reviews published from April 2012 to October 2017 in electronic databases and search engines, websites of relevant organizations and institutions. It consisted of simple and specific terms and word combinations related to workplace health promotion based on the search strategy of a previous review. After full-text screening, 74 references met the eligibility criteria. Using the same search strategy, there was a higher proportion of relevant high-quality studies as compared with the earlier review. The heterogeneity of health promotion interventions regarding intervention components, settings and study populations still limits the comparability of studies. Future studies should also address the societal and insurer perspective, including costs to the worker such as lost income and lost time at work of family members due to caregiving activities. To this end, more high-quality evidence is needed.

Effectiveness of Interventions to Promote Sustainable Employability: A Systematic Review

Background: Despite growing interest in sustainable employability (SE), studies on the effectiveness of interventions aimed at employees’ SE are scarce. In this review, SE is defined by four core components: health, productivity, valuable work, and long-term perspective. The aim of this review is to summarize the effectiveness of employer-initiated SE interventions and to analyze whether their content and outcome measures addressed these SE components. Methods: A systematic search was performed in six databases for the period January 1997 to June 2018. The methodological quality of each included study was assessed. A customized form was used to extract data and categorize interventions according to SE components. Results: The initial search identified 596 articles and 7 studies were included. Methodological quality ranged from moderate to weak. All interventions addressed the components ‘health’ and ‘valuable work’. Positive effects were found for ‘valuable work’ outcomes. Conclusions: The quality of evidence was moderate to weak. The ‘valuable work’ component appeared essential for the effectiveness of SE interventions. Higher-quality evaluation studies are needed, as are interventions that effectively integrate all SE core components in their content.

Work-related stress in the banking sector: a study on an Italian aged population of over 2,000 workers

INTRODUCTION

In the European Union, the employment rate for the population in the age group 55-64 years has greatly increased in the last two decades. Companies, especially in sectors such as banking, are looking for new strategies to improve the productivity of workers in this age group.

OBJECTIVES

This study was conceived with the purpose of exploring the associations between job characteristics that could influence stress and certain organizational aspects in a large population of banking workers.

METHODS

More than 2,000 workers over 50 years of age of an Italian banking group participated in the study. Work-related stress was measured with the Stress Questionnaire (SQ). Organizational aspects of work were measured with a dedicated scale included in the SQ. Demographic aspects were detected by specific questions. Structural equation modelling was used and correlation coefficients were calculated.

RESULTS

The results from the structural equation modeling supported the theoretical model. Organizational policies are associated with both stress correlated factors (β=0.468) and perceptions of supervisor support and social support (β=0.710). The perception of both parameters is associated with stress outcomes (β=0.365). The proposed model offered better results than a competitive model, on which a total mediation was tested, rather than a partial one (p<0.001).

CONCLUSIONS

The results highlight the importance of an integrated assessment of the effects of organizational aspects of work and stress factors to implement the protection of physical and mental health. Further research will help to understand more thoroughly if the issues emerged are effectively related to age. This can be assessed through a case-control study that also includes younger workers.

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.

Can the work ability model provide a useful explanatory framework to understand sustainable employability amongst general practitioners: a qualitative study

BACKGROUND

Work ability (WA) is an indication of how well someone's health, skills and experience match current job demands. The aim of this study was to ascertain whether the work ability model can provide a useful explanatory framework to understand some elements of sustainable employability (SE) amongst GPs.

METHODS

A thematic analysis of 19 in-depth interviews with GPs in the Northern Rivers region of NSW, Australia, was conducted and formed the basis for a qualitative validation of the work ability model.

RESULTS

In order to provide a more comprehensive reflection on the factors and dynamics found to underpin work ability amongst ageing GPs required the creation of specific subcategories within the WA model. Additionally, new themes relevant to general practice also emerged from the data. The analyses revealed a set of important, new factors and relationships that required additions and refinements to the original model, in order to fully explain sustainable employability in this GP sample. These new emerging themes that required model extension were 'Work-life balance and lifestyle', 'Extended social community' and 'Impact of gender'.

CONCLUSION

While the WA model provides a basic explanatory framework for understanding some elements of sustainable employability amongst GPs, a revision of the current model has been proposed to sufficiently describe the factors impinging on sustainable employability in this group. The extended model can potentially be used for addressing workforce planning issues and to assist in programme design to promote sustainable employability amongst GPs and could potentially be translated to other health professional groups.

Occupational physical and emotional fitness

Sports medicine is a wide field of knowledge with a focus on the physical and psychological aspects of individuals; unfortunately, it is not well-known among occupational therapy practitioners. If at all, it is focused on exercise therapy for physical injuries and pain. We agree there are many types of physical pain and injuries among workers in different occupations, but not all that pain is related to physical overuse. Recently, new recommendations were presented by the American College of Sports Medicine highlighting particularly the psychological aspects of occupational emotional fitness. However, there is very little research about the concurrent effects of cost-effective packages of therapy for occupational emotional and physical fitness. Accordingly, this commentary reviews the occupational physical and emotional fitness aspects of sports medicine. In addition, this work makes suggestions to examine packages and protocols of physical and emotional fitness, with therapeutic targets for occupational cultures in different societies for employees and employers.

Effectiveness and Cost-benefit Evaluation of a Comprehensive Workers' Health Surveillance Program for Sustainable Employability of Meat Processing Workers

Objective To evaluate the effectiveness of a comprehensive workers' health surveillance (WHS) program on aspects of sustainable employability and cost-benefit. Methods A cluster randomized stepped wedge trial was performed in a Dutch meat processing company from february 2012 until march 2015. In total 305 workers participated in the trial. Outcomes were retrieved during a WHS program, by multiple questionnaires, and from company registries. Primary outcomes were sickness absence, work ability, and productivity. Secondary outcomes were health, vitality, and psychosocial workload. Data were analyzed with linear and logistic multilevel models. Cost-benefit analyses from the employer's perspective were performed as well. Results Primary outcomes sickness absence (OR = 1.40), work ability (B = -0.63) and productivity (OR = 0.71) were better in the control condition. Secondary outcomes did not or minimally differ between conditions. Of the 12 secondary outcomes, the only outcome that scored better in the experimental condition was meaning of work (B = 0.18). Controlling for confounders did not or minimally change the results. However, our stepped wedge design did not enable adjustment for confounding in the last two periods of the trial. The WHS program resulted in higher costs for the employer on the short and middle term. Conclusions Primary outcomes did not improve after program implementation and secondary outcomes remained equal after implementation. The program was not cost-beneficial after 1-3 year follow-up. Main limitation that may have contributed to absence of positive effects may be program failure, because interventions were not deployed as intended.

Healthy ageing at work- Efficacy of group interventions on the mental health of nurses aged 45 and older: Results of a randomised, controlled trial

Objective

This multicentre, randomised controlled trial (RCT) aimed to evaluate the efficacy of a small-group intervention promoting successful ageing at work in older nurses (aged ≥45).

Method

A sample of 115 nurses aged ≥45 from 4 trial sites in Germany were randomly assigned to either the intervention group (IG), that received a small-group intervention of seven weekly sessions of 120 min with a booster session after six weeks or to a wait-list control condition (WLC). Outcomes were measured via validated self-report questionnaires at baseline (T1) and at post-treatment (T2).

Primary outcomes were mental health-related well-being and mental health-related quality of life (QOL). The secondary outcomes included mental health-related and work-related measures.

Results

The intention to treat (ITT) analysis showed significant positive effects of the intervention on mental health. A significant small effect (d = 0.3) in favour of the IG was found for psychological health-related quality of life. Positive small effects (d = 0.24 to d = 0.31) were also found for work related mental strain.

Conclusions

Our small-group intervention based on a theory of successful ageing for nurses aged ≥45 was found to be effective with regard to improvements of psychological health related quality of life and other mental health-related outcomes. Thus, our study shows that the ageing workforce can be reached through specifically designed preventive interventions. The components of our intervention could be easily adapted to the belongings of other professions. Our results suggest that these components should be evaluated in various settings outside the healthcare sector.

Integrating participatory ergonomic management in non-weight-bearing exercise and progressive resistance exercise on self-care and functional ability in aged farmers with knee osteoarthritis: a clustered randomized controlled trial

Background

Ergonomic hazards are the most important cause of knee osteoarthritis (OA) in aged para rubber farmers. Ergonomic management comprising improvement of working conditions and muscle-strengthening exercise has been well documented in terms of workers' health benefit. However, those interventions were not adequate to sustain the advantage. Few studies have demonstrated the effect of integrating participatory ergonomic management (PEM) in non-weight-bearing exercise (NWE) and progressive resistance exercise (PRE), and none has focused on aged para rubber farmers with knee OA.

Purpose

This study investigated the effect of PEM-NWE, PEM-PRE, and standard treatment (ST) on self-care and functional ability in the aged population.

Materials and methods

A single-blinded, clustered randomized controlled trial was carried out. Participants (n=75) from three different communities in southern Thailand were randomly assigned to PEM-NWE, PEM-PRE, and ST. Self-care and functional ability (pain, stiffness, and physical function) were examined at baseline (B), during the intervention at Week 5 (W5), and after its completion at Week 9 (W9). Mean comparison of those outcomes over time was made using Generalized Linear Mixed Models (GLMMs).

Results

Compared to the standard treatment, the means of both groups, PEM-NWE and PEM-PRE, were significantly increased in self-care and functional ability. However, no significant difference between PEM-NWE and PEM-PRE was found.

Conclusion

Either or both interventions should be incorporated into nursing practice in order to promote occupational health and enhance quality of work life for Thai aged farmers. Further study on their cost-effectiveness is highly recommended.

The impact of work-related and personal resources on older workers' fatigue, work enjoyment and retirement intentions over time

This study aims to examine the impact of work-related and personal resources on older workers' retirement intentions by studying the pathways (fatigue and work enjoyment) from resources to retirement intentions, the buffering role of resources for psychological job demands, in a cross-sectional and longitudinal timeframe. Longitudinal results on a subsample of full-time, older workers (n = 1642) from the Maastricht Cohort Study suggest that over four years of follow-up personal resources like personal mastery and perceived health related to less (prolonged) fatigue and more work enjoyment. Personal mastery also related to later retirement intentions. A work-related resource like decision authority related to less prolonged fatigue. (Prolonged) fatigue related to earlier retirement intentions, suggesting that fatigue may be a pathway to early retirement. Finally, little evidence was found for effect modification by resources. This prospective study indicates that work-related and personal resources may be useful for prolonging working careers. Practitioner Summary: To date, the impact of work-related and personal resources on older workers' retirement intentions is rarely studied. As this prospective study shows that resources may impact older workers' (prolonged) fatigue, work enjoyment and retirement intentions, the monitoring and fostering of resources is of importance for prolonging their working careers.

Within-person fluctuations in wellbeing and task-specific work ability

Purpose

To research within-person fluctuations in occupational health, work ability and wellbeing, we need new measurement strategies. We studied absolute agreement for weekly measurements of task-specific work ability and relationships between wellbeing, work demands and personal factors and task-specific work ability over time.

Methods

Forty-eight Dutch academic researchers answered questions during 12 consecutive weeks. Physical and mental work demands, indicators of wellbeing and task-specific work ability in each week were measured. Intra-class correlation coefficients (ICC) for absolute agreement between task-specific work ability measures were calculated. For application in individual workers, an ICC > 0.90 was regarded as suitable. Multilevel models were used to relate both time-invariant and time-varying predictors to task-specific work ability.

Results

Multiple measurements increased the reliability. Absolute agreement, however, did not reach the optimal level, except for the task ‘ability to conduct data analyses’ which had an ICC value of 0.95 (95% CI 0.91–0.98). Individuals’ leisure time physical activity (p = 0.03) and relational (p = 0.02) and social (p = 0.02) wellbeing were related to their average task-specific work ability. Weekly physical demands (p = 0.01) and personal (p = 0.04) and general wellbeing (p = 0.03) were related to weekly fluctuations in work ability.

Conclusions

We demonstrated intra-individual variability in repeated assessments of task-specific work ability, pointing to the need for multiple measurements when characterizing work ability. The finding that some time-invariant and time-varying predictors can be related to the estimate of aspects of task-specific work ability and its fluctuations is helpful in understanding the dynamics of this concept.

Stressors influence work ability in different age groups of nursing professionals: 2-year follow-up

Work stressors influence work ability - WA - and increasing age is associated with functional aging. We sought to establish whether work stressors differentially influence WA in young and aging nursing professionals. A cohort (2009-2011) composed of 304 workers at a hospital in Sao Paulo responded questionnaires Effort-Reward Imbalance (ERI), Job Stress Scale (JSS), Work-Related Activities That May Contribute To Job-Related Pain and/or Injury (WRAPI) and Work Ability Index (WAI). Changes in perceived exposure to stressors in each age group (< 45 and ≥ 45 years old) were compared to delta-WAI (difference between initial and final WAI score) by means of the Mann-Whitney test. There was a worsening in WAI (p = 0.609) without difference between the groups. WA impairment was associated with intensification of stressors ERI (p = 0.004), overcommitment (p = 0.002), social support (p = 0.014) and WRAPI (p = 0.004) among the younger workers, but with poorer ERI (p = 0.047) only among the older ones. While among the younger workers WA was influenced by the intensification of various stressors, in the case of the older ones it was influenced by effort-reward imbalance only, indicating that interventions should be differentiated according to age groups.

Work-related determinants of multi-site musculoskeletal pain among employees in the health care sector

BACKGROUND

Work-related musculoskeletal pain is a major occupational problem. Those with pain in multiple sites usually report worse health outcomes than those with pain in one site.

OBJECTIVE

This study explored prevalence and associated predictors of multi-site pain in health care sector employees.

METHOD

Survey responses from 1348 health care sector employees across three organisations (37% response rate) collected data on job satisfaction, work life balance, psychosocial and physical hazards, general health and work ability. Musculoskeletal discomfort was measured across 5 body regions with pain in ≥ 2 sites defined as multi-site pain. Generalized linear models were used to identify relationships between work-related factors and multi-site pain.

RESULTS

Over 52% of the employees reported pain in multiple body sites and 19% reported pain in one site. Poor work life balance (PRR = 2.33, 95% CI = 1.06-5.14). physical (PRR = 7.58, 95% CI = 4.89-11.77) and psychosocial (PRR = 1.59, 95% CI = 1.00-2.57) hazard variables were related to multi-site pain (after controlling for age, gender, health and work ability. Older employees and females were more likely to report multi-site pain.

CONCLUSION

Effective risk management of work related multi-site pain must include identification and control of psychosocial and physical hazards.

Qualidade de vida no trabalho: avaliação de estudos de intervenção

RESUMO Objetivo: analisar a produção de conhecimento sobre intervenções em qualidade de vida no trabalho. Método: estudo de revisão integrativa. Para seleção dos estudos, utilizou-se as bases de dados: SciELO, Medline e PubMed. Resultados: a amostra incluiu 25 artigos nacionais e internacionais que descreveram programas e maneiras de adquirir hábitos saudáveis no ambiente laboral e amenizar as demandas mentais decorrentes do mesmo. Conclusão: diante da quantidade de empresas em todo o mundo, verifica-se número inexpressivo de programas voltados para a saúde e bem-estar dos trabalhadores, e a implantação de políticas eficientes nas instituições poderia minimizar tal situação.

Barriers and facilitators to extended working lives in Europe: a gender focus

BACKGROUND

There is a global imperative to respond to the challenge of a growing 'old-age dependency ratio' by ensuring the workforce is healthy enough to remain in work for longer. Currently more than half of older workers leave before the default retirement age, and in some countries (e.g. the UK), the time spent in retirement is increasing. At the same time across Europe, there is a gender employment gap, with 14.5% fewer female workers between 55-64 years old, and a large variation in the participation of older women in the workforce (ranging from 30-75%). As older women are under-represented in the workforce, increasing employment in this group has the propensity to go some way towards reducing the old-age dependency ratio to ensure continued economic growth.

OBJECTIVES

This review explores the barriers and facilitators to extended working lives in Europe, particularly those that impact on women.

METHODS

A systematic mapping review process was undertaken using four electronic databases, MEDLINE, PsychoINFO, PsychEXTRA via Ovid and AgeLine via EBSCO, using the terms, 'work', 'ageing', 'retirement', 'pension', 'old', 'barrier', 'extended working life', 'gender' and 'health and well-being'. Hand searching was also carried out in the International Journal of Aging and Human Development and the International Journal of Aging and Society.

RESULTS

The search resulted in 15 English language studies published from 1st January 2005 to the current date that met the inclusion criteria.

KEY FINDINGS

The key factors that influenced decisions to retire or extend working lives in Europe were health, social factors, workplace factors, and financial security and pension arrangements.

CONCLUSIONS AND IMPLICATIONS OF THE KEY FINDINGS

Health was found to be the most commonly cited barrier to extended working lives in Europe, and a number of social inequalities to work exist by gender. Structural factors exist, such as the gender pay gap, which disadvantages women, while the nature of work itself differs by gender and can have a negative impact on health. Currently, women tend to exit the labour market earlier than men; however, changes in the state pension age are resulting in women being required to work for as long as men, in most countries. For women to remain healthy at work, workplaces need to consider a range of interventions, including flexible arrangements to both work and retirement to enable women to balance the demands of work with domestic and caring responsibilities that particularly impact on them.

Association between midlife health behaviours and transitions out of employment from midlife to early old age: Whitehall II cohort study

Background

It is important to determine whether unhealthy behaviours might influence transitions out of employment from midlife to old age, given the anticipated need for adults to work for longer. Our aim was to determine the association between repeated assessments of cigarette smoking, heavy/problem alcohol drinking, low physical activity and poor diet at midlife, in relation to work exit from midlife to old age.

Methods

Data from 7704 participants (5392 men) from the Whitehall II cohort study in employment at midlife were used to evaluate the association between unhealthy behaviours and a subsequent transition out of work during 22 years follow-up, using logistic regression models.

Results

Men who smoked cigarettes, consistently drank alcohol heavily, or reported problem drinking, were more likely to leave employment over follow-up. Women with a consistently poor diet were more likely to leave employment. Associations were stronger when the reason for leaving was health grounds, and stronger among those with persistently unhealthy behaviours over follow-up. The size of the effects were broadly equivalent to one advancing year of age on employment. Physical health functioning over follow-up only partly accounted for the associations with work exit, whereas physical and mental functioning accounted for most of the associations with work exit on health grounds.

Conclusions

Unhealthy behaviours in midlife are associated with transitions out of employment into old age. Promoting healthy behaviours at midlife might support current policy initiatives aimed at extending working life. Future research should consider possible mechanisms that link behaviours to transitions out of employment, and consider sex differences in larger cohorts.

Electronic supplementary material

The online version of this article (doi:10.1186/s12889-016-3970-4) contains supplementary material, which is available to authorized users.

Do workplace interventions reduce disability rates?

BACKGROUND

Increasing life expectancy and decreasing fertility have led to a shift in the workforce age structure towards older age groups. Deteriorating health and reduced work capacity are among the challenges to retaining older workers in the labour force.

AIMS

To examine whether workplace interventions to facilitate work among employees with health problems or reduced work capacity affect disability rates among employees aged 50 years and older.

METHODS

Data from a survey of Norwegian companies (n = 713) were linked with registry data on their employees aged 50-61 years (n = 30771). By means of a difference-in-differences approach, we compared change in likelihood of receiving a full disability pension among employees in companies with and without workplace interventions.

RESULTS

Employees in companies reporting to have workplace interventions in 2005 had a higher risk of receiving full disability pension during the period 2001-03 compared with employees in companies without such interventions [odds ratio (OR) 1.25, 95% confidence interval (CI) 1.07-1.45]. During the period 2005-07, there was an overall reduction in disability rates (OR 0.83, 95% CI 0.71-0.96) in both the intervention and control group. However, employees in companies reporting to have interventions in 2005 experienced an additional reduction in an employee's likelihood of receiving a full disability pension (OR 0.80, 95% CI 0.64-0.99) compared with employees in companies without interventions.

CONCLUSIONS

Interventions to facilitate work among employees with health problems or reduced work capacity have reduced disability rates among employees aged 50-61. This suggests that companies' preventive interventions are an effective means to retain older workers with deteriorating health.

Workplace health promotion for older workers: a systematic literature review

BACKGROUND

Aging of the workforce is a growing problem. As workers age, their physical, physiological and psychosocial capabilities change. Keeping older workers healthy and productive is a key goal of European labor policy and health promotion is a key to achieve this result. Previous studies about workplace health promotion (WHP) programs are usually focused on the entire workforce or to a specific topic. Within the framework of the EU-CHAFEA ProHealth65+ project, this paper aims to systematically review the literature on WHP interventions specifically targeted to older workers (OWs).

METHODS

This systematic review was conducted by making a comprehensive search of MEDLINE, ISI Web of Science, SCOPUS, The Cochrane Library, CINAHL and PsychINFO databases. Search terms included ageing (and synonyms), worker (and synonyms), intervention (and synonyms), and health (and synonyms). The search was limited to papers in English or Italian published between January, 1(st) 2000 and May, 31(st) 2015. Relevant references in the selected articles were also analyzed.

RESULTS

Of the 299 articles initially identified as relating to the topic, 18 articles met the inclusion criteria. The type, methods and outcome of interventions in the WHP programs retrieved were heterogenous, as was the definition of the age at which a worker is considered to be 'older'. Most of the available studies had been conducted on small samples for a limited period of time.

CONCLUSION

Our review shows that, although this issue is of great importance, studies addressing WHP actions for OWs are few and generally of poor quality. Current evidence fails to show that WHP programs improve the work ability, productivity or job retention of older workers. In addition, there is limited evidence that WHP programs are effective in improving lifestyles and concur to maintain the health and well-being of older workers. There is a need for future WHP programs to be well-designed so that the effectiveness and cost-benefit of workplace interventions can be properly investigated.