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Conway PM, Burr H, Kersten N, Rose U. Work Ability and Work Nonparticipation: A Prospective Study of 2426 Participants in Germany. J Occup Environ Med 2024; 66:273-279. [PMID: 38151990 DOI: 10.1097/jom.0000000000003032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
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.
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Affiliation(s)
- Paul Maurice Conway
- From the Department of Psychology, University of Copenhagen, Copenhagen, Denmark (P.M.C.); and Federal Institute for Occupational Safety and Health, Berlin, Germany (H.B., N.K., U.R.)
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Markovic G, Bartfai A, Schult ML, Ekholm J. Rehabilitation with intensive attention training early after acquired brain injury promotes better long-term status on health-related quality of life, daily activities, work ability and return to work. J Rehabil Med 2024; 56:jrm5308. [PMID: 38214119 PMCID: PMC10802788 DOI: 10.2340/jrm.v56.5308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 10/31/2023] [Indexed: 01/13/2024] Open
Abstract
OBJECTIVE To describe long-term effects on activity, participation, and quality of life (i) at different post-injury starting time points of attention training and (ii) of two different types of rehabilitation with attention training in patients after stroke or traumatic brain injury; and to describe their functioning level. DESIGN 2 years after rehabilitation intervention, comparisons were made in one cohort receiving attention training subacute (< 4 months) or post-acute (4-12 months) and in one cohort with two different training methods, a process-based and an activity-based method respectively. PATIENTS 100 patients were recruited from our earlier RCT study. They had mild to moderate stroke or traumatic brain injury with relatively limited symptomatology, and all had moderate to severe attention impairment. METHODS A questionnaire-based interview: EuroQol 5 dimensions, Occupational Gaps Questionnaire, Work Ability Index, self-assessed work status, self-reported employment conditions, sick leave, and experienced cognitive limitations in work performance. RESULTS An advantage for patients receiving subacute attention training regarding daily activities, work ability and returning to work. CONCLUSION The results indicate that subacute rehabilitation with attention training (< 4 months) is preferable compared to post-acute intervention (4-12 months). There were only minor differences between the training methods.
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Affiliation(s)
- Gabriela Markovic
- aKarolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden.
| | - Aniko Bartfai
- Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Marie-Louise Schult
- Karolinska Institutet, Department of Clinical Sciences, Danderyd University Hospital, Stockholm, Sweden; Division of Rehabilitation Medicine, Danderyd University Hospital, Stockholm, Sweden
| | - Jan Ekholm
- Department of Clinical Sciences, Karolinska Institutet, Danderyd University Hospital, Stockholm, Sweden
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Wallius MA, Lallukka T, Leinonen T, Remes J, Ervasti J. Level of and Changes in Perceived Work Ability Among Partial Disability Pensioners and the Risk of Full Disability Pension-A Register-Linked Cohort Study. JOURNAL OF OCCUPATIONAL REHABILITATION 2023:10.1007/s10926-023-10161-z. [PMID: 38153619 DOI: 10.1007/s10926-023-10161-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/29/2023]
Abstract
PURPOSE To examine how the level of perceived work ability and its changes over time are associated with the risk of full disability pension (DP) among those receiving partial DP. METHODS We retrieved survey data on perceived work ability and covariates (sociodemographic factors and health behaviors) from a cohort study of Finnish public sector employees at two time points: 2008 and 2012 and linked them with register data on DP obtained from the Finnish Centre for Pensions up to the end of 2018. Participants had begun receiving partial DP in 2008 and responded to either the 2008 survey (n = 159) or both surveys (n = 80). We used Cox regression for the analyses. RESULTS During the follow-up, 61 (38%) of those receiving partial DP transitioned to full DP. Those with perceived poor work ability were at a higher risk of full DP (HR 1.93; 95% CI 1.11-3.38) than those with at least moderate work ability, after adjustment for covariates. During four years of receiving partial DP, perceived work ability decreased among 36% of the participants, and remained unchanged or improved among 64%. Change in work ability was not associated with a risk of full DP. CONCLUSION Among those receiving partial DP, perceived poor work ability was a risk factor for full DP. Our findings highlight the importance of monitoring the level of perceived work ability of those receiving partial DP to enable identifying individuals at an increased risk of full DP.
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Affiliation(s)
| | - Tea Lallukka
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Taina Leinonen
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jouko Remes
- Finnish Institute of Occupational Health, Helsinki, Finland
| | - Jenni Ervasti
- Finnish Institute of Occupational Health, Helsinki, Finland
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Bellagamba G, Metge H, Villa A, Lehucher-Michel MP. Permanent Unfitness for Work and Musculoskeletal Diseases: A Multicentric Cross-sectional Study of 2788 Unfit Employees. J Occup Environ Med 2023; 65:e472-e477. [PMID: 36998169 DOI: 10.1097/jom.0000000000002855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/01/2023]
Abstract
OBJECTIVE To describe the various musculoskeletal diseases resulting in work-related permanent unfitness for work. Methods: In 2017, a multicenter cross-sectional employee survey in the South of France was conducted by 323 occupational physicians. Results: Of the 359,966 employees monitored, 2788 had permanent unfitness for work. This number included 1078 for musculoskeletal diseases, which was more frequent in women (odds ratio, 1.42; confidence interval, 1.20 to 1.68) and showed an increase in women older than 55 years (odds ratio, 6.42; confidence interval, 4.4 to 6.60). Back disorder was the most common work-related disorder reported (n = 488 [45.4%]), with soft tissue conditions being (n = 237 [22.0%]). Arthropathy (n = 157 [14.6%]) had occupational origins in 282 (44.3%), 169 (26.6%), and 55 (8.6%) cases, respectively. Conclusions: Musculoskeletal disability prevention should be encouraged to avoid resultant employment attrition.
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Affiliation(s)
- Gauthier Bellagamba
- From the Groupement Interprofessionnel Médico-Social (GIMS), Marseille, France (G.B., H.M.); Aix-Marseille Univ, CEReSS, Marseille, France (G.B., A.V., M.-P.L.-M.); and APHM, Groupe Hospitalier Timone, Service de médecine et santé au travail, Marseille, France (A.V., M.-P.L.-M.)
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Vähätalo L, Siukola A, Atkins S, Reho T, Sumanen M, Viljamaa M, Sauni R. Cooperation between Public Primary Health Care and Occupational Health Care Professionals in Work Ability-Related Health Issues. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11916. [PMID: 36231222 PMCID: PMC9564539 DOI: 10.3390/ijerph191911916] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 09/16/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
Work disability creates significant expenses for nations and causes human suffering by limiting patients' lives. International studies show that to enhance recognition of and support for work disability, cooperation, mutual trust, and information exchange between public primary health care and occupational health care must be strengthened. However, little is known of how health care professionals experience this cooperation. The aim of this study was to understand how professionals experience the cooperation between public primary health care and occupational health services regarding patients' work ability. Semi-structured interviews were conducted with 29 health care professionals working in five small cities (<10,000 inhabitants) in Finland. Interviews were audio and video recorded, transcribed verbatim, and analyzed through inductive thematic analysis. Three key themes were identified from the interviews: attitudes toward the other health care sector, the exchange of information, and resources for cooperation. Professionals seem to have poor knowledge about the services available and how care is given in the other sector, appearing to lead to weak mutual trust. The public primary health care professionals especially emphasized the benefits of cooperation, but several issues were mentioned as barriers to cooperation. These results can be used when planning effective patient paths and service provisioning models.
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Affiliation(s)
- Lauri Vähätalo
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Anna Siukola
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Salla Atkins
- Health Sciences, Faculty of Social Sciences, Tampere University, 33014 Tampere, Finland
- Department of Global Public Health, Social Medicine Infectious Disease and Migration (SIM), Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Tiia Reho
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | - Markku Sumanen
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
| | | | - Riitta Sauni
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland
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6
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van de Ven D, Robroek SJ, Oude Hengel KM, van Zon SK, Brouwer S, Ots P, Burdorf A, Schuring M. Associations of within-individual changes in working conditions, health behaviour and BMI with work ability and self-rated health: a fixed effects analysis among Dutch workers. BMJ Open 2022; 12:e058574. [PMID: 35487715 PMCID: PMC9058761 DOI: 10.1136/bmjopen-2021-058574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study assessed the associations of (1) within-individual improvements and (2) within-individual deteriorations in working conditions, health behaviour and body mass index (BMI) with changes in work ability and self-rated health among workers. DESIGN Prospective cohort study. SETTING The Netherlands. PARTICIPANTS Persons in paid employment, aged 45-64 years, who participated in the Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) between 2010 and 2017, and improved or deteriorated at least once with respect to working conditions (psychological and emotional job demands, autonomy, social support, physical workload), health behaviour (moderate and vigorous physical activity, smoking status), or BMI between any of two consecutive measurements during the 7-year follow-up. PRIMARY AND SECONDARY OUTCOME MEASURES Changes in self-reported work ability on a scale from 0 to 10 (1st item of the work ability index) and self-rated health on a scale from 1 to 5 (SF-12). RESULTS Of the 21 856 STREAM participants, ultimately 14 159 workers were included in the fixed effects analyses on improvements (N=14 045) and deteriorations (N=14 066). Workers with deteriorated working conditions decreased in work ability (β's: -0.21 (95% CI: -0.25 to -0.18) to -0.28 (95% CI: -0.33 to -0.24)) and health (β's: -0.07 (95% CI: -0.09 to -0.06) to -0.10 (95% CI: -0.12 to -0.08)), whereas improvements were to a lesser extent associated with increased work ability (β's: 0.06 (95% CI: 0.02 to 0.09) to 0.11 (95% CI: 0.06 to 0.16)) and health (β's: 0.02 (95% CI: 0.00 to 0.03) to 0.04 (95% CI: 0.02 to 0.06)). Workers with increased BMI or decreased physical activity reduced in work ability and health. Likewise, decreased BMI or increased vigorous physical activity was associated with improved health. An increase in moderate or vigorous physical activity was modestly associated with a reduced work ability. Quitting smoking was associated with reduced work ability and health. CONCLUSIONS Compared with improvements, preventing deteriorations in working conditions, health behaviour and BMI, might be more beneficial for work ability and workers' health.
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Affiliation(s)
- David van de Ven
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Suzan Jw Robroek
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Karen M Oude Hengel
- Department of Work Health Technology, Netherlands Organisation for Applied Scientific Research (TNO), Leiden, The Netherlands
| | - Sander Kr van Zon
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Sandra Brouwer
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Patricia Ots
- Department of Health Sciences, Community and Occupational Medicine, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alex Burdorf
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Merel Schuring
- Department of Public Health, Erasmus University Medical Center, Rotterdam, The Netherlands
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7
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Bohman T, Holm LW, Lekander M, Hallqvist J, Skillgate E. 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. BMJ Open 2022; 12:e054512. [PMID: 35414549 PMCID: PMC9006807 DOI: 10.1136/bmjopen-2021-054512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
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.
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Affiliation(s)
- Tony Bohman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- School of Education, Health and Social Studies, Dalarna University, Falun, Dalarna, Sweden
| | - Lena W Holm
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Mats Lekander
- Stress Research Institute, Stockholm University, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Johan Hallqvist
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Eva Skillgate
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden
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Stienstra M, Edelaar MJA, Fritz B, Reneman MF. Measurement Properties of the Work Ability Score in Sick-Listed Workers with Chronic Musculoskeletal Pain. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:103-113. [PMID: 34037926 DOI: 10.1007/s10926-021-09982-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/26/2021] [Indexed: 05/26/2023]
Abstract
Purpose Chronic musculoskeletal pain can have a major impact on ability to work. The work ability score is a commonly used single-item question to assess work ability but has not been fully validated yet. The aim of the present study was to evaluate test-retest reliability, agreement, construct validity, and responsiveness of the work ability score among sick-listed workers with chronic musculoskeletal pain. Methods Data of sick-listed workers with chronic musculoskeletal pain was routinely collected at seven rehabilitation centres in the Netherlands. Assessments included a set of questionnaires, administered at admission and discharge from a fifteen-week vocational rehabilitation program. Test-retest reliability was determined with the intraclass correlation coefficient. For agreement, the standard error of measurement and smallest detectable changes were calculated. Construct validity was assessed by testing hypotheses regarding Spearman rank correlation coefficient. Area under the curve obtained from the receiver operating characteristic curve and minimal clinically important change were determined for the total sample and work ability score baseline tertile groups to assess responsiveness. Results In total, 34 workers were analyzed for reliability and agreement, 1291 workers for construct validity, and 590 responded to the responsiveness questionnaire. Reliability reached an intraclass correlation coefficient of 0.89; 95% CI 0.77-0.94, a standard error of measurement of 0.69 points, and the smallest detectable change of 1.92 points. For construct validity, six of the seven predefined hypotheses were not refuted. The area under the curve was 0.76 (95% CI 0.71-0.81) allowing for discrimination between stable and improved workers, with a minimal clinically important change of 2.0 points for the total sample. Conclusion The work ability score showed good measurement properties among sick-listed workers with chronic musculoskeletal pain.
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Affiliation(s)
- M Stienstra
- Department of Research and Development, and Institute of Vocational Assessment and Education, Heliomare Rehabilitation Center, Relweg 51, 1949, EC Wijk aan Zee, The Netherlands.
| | - M J A Edelaar
- Department of Research and Development, and Institute of Vocational Assessment and Education, Heliomare Rehabilitation Center, Relweg 51, 1949, EC Wijk aan Zee, The Netherlands
| | - B Fritz
- Department of Research and Development, and Institute of Vocational Assessment and Education, Heliomare Rehabilitation Center, Relweg 51, 1949, EC Wijk aan Zee, The Netherlands
| | - M F Reneman
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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Mateo Rodríguez I, Knox ECL, Oliver Hernández C, Daponte Codina A. Psychometric Properties of the Work Ability Index in Health Centre Workers in Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182412988. [PMID: 34948599 PMCID: PMC8700918 DOI: 10.3390/ijerph182412988] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Revised: 12/03/2021] [Accepted: 12/06/2021] [Indexed: 11/18/2022]
Abstract
The aim of the present study is to analyse the psychometric properties of the work ability index (WAI) within a sample of Spanish health centre workers. The WAI was translated into Spanish using transcultural and forward–backward translation processes and administered to 1184 Spanish health centre workers. Internal consistency, predictive validity, and discriminative ability were examined. Exploratory factor analysis, via principal components analysis and confirmatory factor analysis, determined the most appropriate questionnaire structure. All indices in relation to predictive validity and reliability were acceptable. Exploratory factor analysis supported validity of the one-factor structure, however, confirmatory factor analysis suggested better properties in relation to a two-factor structure (χ2 = 59.52; CFI = 0.98; TLI = 0.96; RMSEA = 0.06). Items 3, 4, and 5 loaded onto factor one, and items 1, 2, 6, and 7 loaded onto factor two. The two factors could be broadly described as “subjectively estimated work ability” and “ill-health-related ability”. The WAI is valid and reliable when administered to health centre workers in Spain. In contrast to that suggested by studies conducted in other countries, future research and practical application with similar respondents and settings should proceed using the two-factor structure.
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Affiliation(s)
- Inmaculada Mateo Rodríguez
- Department of Social and Organizational Psychology, Faculty of Psychology, Universidad a Distancia de Madrid (UNED), 28040 Madrid, Spain
- Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.C.L.K.); (A.D.C.);
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
- Correspondence:
| | | | - Coral Oliver Hernández
- Department of Social, Work and Differential Psychology, Faculty of Psychology, Universidad Complutense de Madrid, 28040 Madrid, Spain;
| | - Antonio Daponte Codina
- Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.C.L.K.); (A.D.C.);
- CIBER de Epidemiología y Salud Pública (CIBERESP), 28029 Madrid, Spain
| | - the esTAR Group
- Escuela Andaluza de Salud Pública, 18011 Granada, Spain; (E.C.L.K.); (A.D.C.);
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The impact of musculoskeletal pain and strenuous work on self-reported physical work ability: a cohort study of Swedish men and women. Int Arch Occup Environ Health 2021; 95:939-952. [PMID: 34825943 PMCID: PMC9203375 DOI: 10.1007/s00420-021-01816-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 11/01/2021] [Indexed: 11/18/2022]
Abstract
Objective We investigated the separate and combined effects of musculoskeletal pain (MSP) and strenuous work (heavy physical workload (PWL)/low-decision authority) on poor physical work ability (WA). Methods This study uses baseline data from the 2010 Stockholm Public Health Questionnaire (SPHQ) including 9419 workers with good physical WA. Exposure to PWL and decision authority were estimated using sex-specific job-exposure matrices linked to occupations. Exposures (high/low) were combined with the presence of MSP. Follow-up data on physical WA were taken from the 2014 SPHQ and dichotomised (the responses: “moderate”, “rather poor” and “very poor” indicated poor WA). Logistic regression models calculated sex-specific odds ratios adjusting for age, education and health and lifestyle factors. Interaction between MSP and strenuous work was examined using the synergy index (SI). Analyses were conducted using SPSS.27. Results MSP, heavy PWL and low-decision authority were separately associated with poor WA. MSP was associated with higher odds of poor WA than strenuous work for women, the opposite for men. Combinations of MSP and strenuous work often resulted in higher risks of poor WA than when adding the effects of the single exposures (e.g., MSP and heavy PWL men: AOR 4.04 95% CI 2.00–8.15, women: AOR: 3.25 95% CI 1.81–5.83). The SI was non-significant for both sexes. Conclusion Workers with MSP and strenuous work often had higher risks of poor WA than would be expected from adding the effects of the single exposures. To decrease poor WA in this group, strenuous work should be lowered, and MSP addressed in workplaces.
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11
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Onell C, Holm LW, Bohman T, Magnusson C, Lekander M, Skillgate E. Work ability and psychological distress in a working population: results from the Stockholm Public Health Cohort. Scand J Public Health 2021:14034948211033692. [PMID: 34423688 DOI: 10.1177/14034948211033692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AIMS Psychological distress is a global public health concern with individual and societal implications causing work-related disability and loss of productivity. It is less known how much work ability contributes to the development of psychological distress. This study aimed to assess the association between self-perceived physical and mental work ability in relation to job demands, and the incidence of psychological distress in a Swedish working population. METHODS Data were obtained from three subsamples of the Stockholm Public Health Cohort with baseline in 2010 and follow-up in 2014, based on a working population in Stockholm County aged 18-60 years, with no or mild psychological distress at baseline (n=29,882). Self-perceived physical and mental work ability in relation to job demands were assessed at baseline with a subscale from the Work Ability Index. Study participants scoring 4 or more on the General Health Questionnaire 12 at follow-up were classified as having developed psychological distress during the study period. Poisson log linear regression was used to calculate crude and adjusted rate ratios with 95% confidence intervals. RESULTS At follow-up, 2543 participants (12%) had developed psychological distress. Reporting poor physical and/or poor mental work ability in relation to job demands at baseline was associated with an almost doubled rate ratio of psychological distress at follow-up, compared to reporting good work ability (rate ratio 1.8; 95% confidence interval 1.6-2.0). CONCLUSIONS Poor work ability is associated with a higher incidence of future psychological distress compared to good work ability.
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Affiliation(s)
- Clara Onell
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sweden
| | - Lena W Holm
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden
| | - Tony Bohman
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden.,School of Health and Welfare, Dalarna University, Sweden
| | | | - Mats Lekander
- Department of Clinical Neuroscience, Karolinska Institutet, Sweden.,Department of Psychology, Stress Research Institute, Stockholm University, Sweden
| | - Eva Skillgate
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Sweden.,Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Sweden
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12
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Bethge M, Spanier K, Köhn S, Schlumbohm A. Self-reported work ability predicts health-related exit and absence from work, work participation, and death: longitudinal findings from a sample of German employees. Int Arch Occup Environ Health 2020; 94:591-599. [PMID: 33219840 PMCID: PMC8068707 DOI: 10.1007/s00420-020-01608-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 11/03/2020] [Indexed: 11/16/2022]
Abstract
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.
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Affiliation(s)
- Matthias Bethge
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Katja Spanier
- Institute for Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Stefanie Köhn
- Institute of Medical Sociology and Rehabilitation Science, Charité, Universitätsmedizin Berlin, Berlin, Germany
| | - Anna Schlumbohm
- Institute of Medical Sociology and Rehabilitation Science, Charité, Universitätsmedizin Berlin, Berlin, Germany
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Amiri S, Behnezhad S. Smoking and disability pension: a systematic review and meta-analysis. Public Health 2020; 186:297-303. [PMID: 32882482 DOI: 10.1016/j.puhe.2020.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 04/03/2020] [Accepted: 04/14/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVES Smoking has negative consequences on occupational health. The current meta-analysis was conducted with the aim to pool the studies about smoking and increased disability pension. STUDY DESIGN Systematic review and meta-analysis. METHODS Articles were found in the scientific literature using keywords, and searching was limited to prospective cohort studies that had been published before August 2018. Based on the inclusion and exclusion criteria, 23 prospective cohort studies were selected. The analyses were carried out on the basis of the random-effects method. Subgroup analysis was also carried out. Finally, the bias of publication was examined using Begg's test, the Egger test, the trim-and-fill method, and the funnel plot. RESULTS Twenty-three studies were included. The results showed a positive association between smoking and disability pension, with a risk ratio (RR) of 1.41 and 95% confidence interval (95% CI) of 1.30-1.53 (P < 0.001). In men, the RR was equal to 1.48 and 95% CI was equal to 1.30-1.68 (P < 0.001). In women, the RR was equal to 1.23 and 95% CI was equal to 1.09-1.37 (P = 0.001). In current smokers, the RR was equal to 1.41 and 95% CI was equal to 1.26-1.57 (P < 0.001). In former smokers, the RR was equal to 1.16 and 95% CI was equal to 1.05-1.29 (P = 0.003). Qualitative evaluation showed that the studies had a low level of selection bias, data collection bias, and withdrawal and dropout bias. CONCLUSIONS Smoking is a risk factor for increasing disability pension, and men are at higher risk of disability pension. In addition, both current and former smokers are in high risk of disability pension. Overall, it can be concluded that smoking is a risk factor for occupational health.
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Affiliation(s)
- S Amiri
- Behavioral Sciences Research Center, Lifestyle Institute, Baqiyatallah University of Medical Sciences, Tehran, Iran.
| | - S Behnezhad
- Department of Psychology, Kharazmi University, Tehran, Iran
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van Schaaijk A, Nieuwenhuijsen K, Frings-Dresen MHW. Work ability and percentage of hours worked related to limitations in patients with upper extremity musculoskeletal disorders: a cross-sectional cohort study. BMC Musculoskelet Disord 2020; 21:389. [PMID: 32552733 PMCID: PMC7304180 DOI: 10.1186/s12891-020-03387-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 06/01/2020] [Indexed: 01/10/2023] Open
Abstract
Background The aim of this study was to assess the relationship between self-reported work ability and hours worked at the current time in Upper Extremity Musculoskeletal Disorders (UEMSD) patients. To further investigate this relationship, the association of work ability and working hours with several limitations in daily and working life were explored. Methods In this cross-sectional cohort study, a questionnaire was sent out to members of the UEMSD patient organisation, containing self-reported work ability, questions on working hours and limitations in work due to UEMSD. Limitations were measured with the Disabilities of Arm Shoulder and Hand questionnaire, ShortForm-36 subscales, and common hand grasps or grips. Work ability was measured with the work ability score, while worked hours were operationalised as the percentage of hours worked compared to fulltime. The correlation between worked hours and work ability was tested with the Pearson correlation coefficient. Variance in work ability and the hours worked were explained by limitations and assessed with two linear regression analyses. Results Based on data of 794 respondents a moderate correlation was found between work ability and worked hours r = 0.46; 95% CI [0.40, 0.53]. Models including limitations explained 52 and 21% of total variance in work ability and worked hours, respectively. Variance in both can be explained by the degree of difficulties performing daily activities at work, limitations in daily activities as a consequence of health issues and the ability to perform a precision grip. Additionally, work ability can be explained by limitations at work and other daily activities due to physical health issues, while the percentage of hours can additionally be explained by the ability to grasp a large object with one hand, the ability to use a keyboard, and the subject’s gender. Conclusions The number of worked hours does not fully match the work ability. Although they share three predictors, work ability and worked hours seem to be based on different aspects. Compared to work hours, work ability is more strongly related to limitations in daily activities and work. Taking self-reported work ability into account can improve the fit between work limitations and work hours.
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Affiliation(s)
- A van Schaaijk
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, PO Box 22660, 1100, DE, Amsterdam, the Netherlands.
| | - K Nieuwenhuijsen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, PO Box 22660, 1100, DE, Amsterdam, the Netherlands
| | - M H W Frings-Dresen
- Amsterdam UMC, University of Amsterdam, Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Meibergdreef 9, PO Box 22660, 1100, DE, Amsterdam, the Netherlands
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Savinainen M, Seitsamo J, Joensuu M. The association between changes in functional capacity and work ability among unemployed individuals. Int Arch Occup Environ Health 2020; 93:503-511. [PMID: 31838734 PMCID: PMC7118035 DOI: 10.1007/s00420-019-01498-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Accepted: 11/28/2019] [Indexed: 11/24/2022]
Abstract
PURPOSE Unemployment has multidimensional effects. This study investigated how the changes in functioning are associated with the changes in perceived work ability among unemployed people. METHODS The participants were clients in projects funded by the European Social Fund (ESF) targeted for unemployed individuals. They answered a questionnaire covering work ability (Work Ability Score) and functioning (cognitive, psychological and social functioning, physical condition and everyday activities) and perceived health at the beginning and at the end of the project (mean follow-up 173 days). The study included data from unemployed respondents (N = 502) aged 19-64 years. RESULTS Overall, during the follow-up, both work ability and different aspects of functioning improved, excluding physical condition. Changes in cognitive and psychological functioning, physical condition and everyday activities were significantly associated with the changes in work ability. The physical condition had the strongest association with the changes in work ability. Short unemployment time and especially good perceived health improved WAS over time. Age, gender and follow-up time were not associated with changes in work ability. CONCLUSIONS Maintaining or improving health and functioning and shortening the length of unemployment appeared to be important issues in enhancing work ability and thus increasing re-employability potential.
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Affiliation(s)
- Minna Savinainen
- Finnish Institute of Occupational Health, 33540, Tampere, Finland.
| | - Jorma Seitsamo
- Finnish Institute of Occupational Health, 00290, Helsinki, Finland
| | - Matti Joensuu
- Finnish Institute of Occupational Health, 00290, Helsinki, Finland
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Bumann A, Niederer D, Santarossa C, Banzer W, Vogt L. How Is the Self-Perceived Work Ability Affected by the Duration of Unemployment, Heart Rate Variability and the Amount of Physical Activity in Older Long-Term Unemployed Persons? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E2039. [PMID: 32204434 PMCID: PMC7143746 DOI: 10.3390/ijerph17062039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 03/12/2020] [Accepted: 03/16/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND This study investigated whether work ability is associated with the duration of unemployment, heart rate variability (HRV), and the level of physical activity. METHODS Thirty-four unemployed persons (mean 55.7 ± standard deviation 33.3 years, 22 female, 12 male, unemployed: range 1-22.5 years) participated in the cross-sectional study. The Work Ability Index (WAI) and International Physical Activity Questionnaire (IPAQ) were applied. Short-term (five minutes) resting HRV (Low Frequency (LF), High Frequency (HF), Total Power (TP)) was collected. RESULTS Work ability was positively associated with the HRV: LF (r = 0.383; p = 0.025), HF (r = 0.412; p = 0.015) and TP (r = 0.361; p = 0.036). The WAI showed a positive linear correlation with the amount of total physical activity (r = 0.461; p = 0.006) as well as with the amount of moderate to vigorous physical activity (r = 0.413; p = 0.015). No association between the WAI and the duration of unemployment occurred. CONCLUSIONS the relation between self-perceived work ability, health-associated parameters, the HRV and the level of physical activity points out the relevance of health-care exercise and the need of stress-reducing interventions to improve perceived work ability. Our results point out the need for the further and more holistic development of healthcare for the unemployed.
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Affiliation(s)
- Anke Bumann
- Department of Sports Therapy and Exercise Physiology, Justus-Liebig-University Giessen, 35390 Giessen, Germany;
| | - Daniel Niederer
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, 60487 Frankfurt am Main, Germany; (C.S.); (L.V.)
| | - Constanze Santarossa
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, 60487 Frankfurt am Main, Germany; (C.S.); (L.V.)
| | - Winfried Banzer
- Institute for Occupational Medicine, Social Medicine and Environmental Medicine, University Hospital Frankfurt, 60596 Frankfurt am Main, Germany;
| | - Lutz Vogt
- Department of Sports Medicine and Exercise Physiology, Goethe University Frankfurt, 60487 Frankfurt am Main, Germany; (C.S.); (L.V.)
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Hult M, Lappalainen K, Saaranen TK, Räsänen K, Vanroelen C, Burdorf A. Health-improving interventions for obtaining employment in unemployed job seekers. Cochrane Database Syst Rev 2020; 1:CD013152. [PMID: 31912888 PMCID: PMC6956407 DOI: 10.1002/14651858.cd013152.pub2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Unemployment is associated with decreased health which may be a reason or a consequence of becoming unemployed. Decreased health can inhibit re-employment. OBJECTIVES To assess the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. SEARCH METHODS We searched (3 May 2018, updated 13 August 2019) the Cochrane Central Register of Controlled Trials, MEDLINE, Scopus, PsycINFO, CINAHL, SocINDEX, OSH Update, ClinicalTrials.gov, the WHO trials portal, and also reference lists of included studies and selected reviews. SELECTION CRITERIA We included randomised controlled trials (RCTs) of the effectiveness of health-improving interventions for obtaining employment in unemployed job seekers. The primary outcome was re-employment reported as the number or percentage of participants who obtained employment. Our secondary outcomes were health and work ability. DATA COLLECTION AND ANALYSIS Two authors independently screened studies, extracted outcome data, and assessed risk of bias. We pooled study results with random-effect models and reported risk ratios (RRs) with 95% confidence intervals (CIs) and assessed the overall quality of the evidence for each comparison using the GRADE approach. MAIN RESULTS We included 15 randomised controlled trials (16 interventions) with a total of 6397 unemployed participants. Eight studies evaluated therapeutic interventions such as cognitive behavioural therapy, physical exercise, and health-related advice and counselling and, in seven studies, interventions were combined using therapeutic methods and job-search training. Therapeutic interventions Therapeutic interventions compared to no intervention may increase employment at an average of 11 months follow-up but the evidence is very uncertain (RR = 1.41, 95% CI 1.07 to 1.87, n = 1142, 8 studies with 9 interventions, I² = 52%, very low-quality evidence). There is probably no difference in the effects of therapeutic interventions compared to no intervention on mental health (SMD 0.12, 95% CI -0.06 to 0.29, n = 530, 2 studies, low-quality evidence) and on general health (SMD 0.19, 95% CI -0.04 to 0.41, n = 318, 1 study, moderate-quality evidence). Combined interventions Combined interventions probably increase employment slightly compared to no intervention at an average of 10 months follow-up (RR 1.12, 95% CI 1.06 to 1.20, n = 4101, 6 studies, I² = 7%). There were no studies that measured work-ability, adverse events, or cost-effectiveness. AUTHORS' CONCLUSIONS Interventions combining therapeutic methods and job-search training probably have a small beneficial effect in increasing employment. Therapeutic interventions may have an effect on re-employment, but we are very uncertain. Therapeutic interventions may not improve health in unemployed job seekers. Large high-quality RCTs targeting short-term or long-term unemployed people are needed to increase the quality of the evidence. A cost-effectiveness assessment is needed of the small beneficial effects.
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Affiliation(s)
- Marja Hult
- University of Eastern FinlandKuopioFinland
| | | | - Terhi K Saaranen
- University of Eastern FinlandDepartment of Nursing ScienceP.O.Box 1627KuopioFinland70211
| | - Kimmo Räsänen
- University of Eastern FinlandInstitute of Public Health and Clinical Nutrition, Occupational Health UnitPO Box 1627KuopioFinland70211
| | - Christophe Vanroelen
- Vrije Universiteit BrusselInterface Demography, Department of SociologyPleinlaan 2BrusselsBelgium1050
| | - Alex Burdorf
- Erasmus Medical CenterDepartment of Public HealthPO Box 2040RotterdamNetherlands3000 CA
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Pihlajamäki M, Uitti J, Arola H, Ollikainen J, Korhonen M, Nummi T, Taimela S. Self-reported health problems and obesity predict sickness absence during a 12-month follow-up: a prospective cohort study in 21 608 employees from different industries. BMJ Open 2019; 9:e025967. [PMID: 31676640 PMCID: PMC6830705 DOI: 10.1136/bmjopen-2018-025967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
OBJECTIVES To study whether self-reported health problems predict sickness absence (SA) from work in employees from different industries. METHODS The results of a health risk appraisal (HRA) were combined with archival data of SA of 21 608 employees (59% female, 56% clerical). Exposure variables were self-reported health problems, labelled as 'work disability (WD) risk factors' in the HRA, presence of problems with occupational well-being and obesity. Age, socioeconomic grading and the number of SA days 12 months before the survey were treated as confounders. The outcome measure was accumulated SA days during 12-month follow-up. Data were analysed separately for males and females. A Hurdle model with negative binomial response was used to analyse zero-inflated count data of SA. RESULTS The HRA results predicted the number of accumulated SA days during the 12-month follow-up, regardless of occupational group and gender. The ratio of means of SA days varied between 2.7 and 4.0 among those with 'WD risk factors' and the reference category with no findings, depending on gender and occupational group. The lower limit of the 95% CI was at the lowest 2.0. In the Hurdle model, 'WD risk factors', SA days prior to the HRA and obesity were additive predictors for SA and/or the accumulated SA days in all occupational groups. CONCLUSION Self-reported health problems and obesity predict a higher total count of SA days in an additive fashion. These findings have implications for both management and the healthcare system in the prevention of WD.
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Affiliation(s)
- Minna Pihlajamäki
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Terveystalo, Helsinki, Finland
| | - Jukka Uitti
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
- Finnish Institute of Occupational Health, Tampere, Finland
| | | | - Jyrki Ollikainen
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Mikko Korhonen
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Tapio Nummi
- Faculty of Information Technology and Communication Sciences, Tampere University, Tampere, Finland
| | - Simo Taimela
- Orthopedics and Traumatology, University of Helsinki, Helsinki, Finland
- Evalua International, Helsinki, Finland
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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? BEHAVIOUR CHANGE 2019. [DOI: 10.1017/bec.2019.15] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractWork 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.
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20
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Characteristics of Claimants on Long-Term Disability Benefits a Year After Report of an Occupational Injury. J Occup Environ Med 2019; 61:511-517. [DOI: 10.1097/jom.0000000000001603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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21
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Oellingrath IM, De Bortoli MM, Svendsen MV, Fell AKM. Lifestyle and work ability in a general working population in Norway: a cross-sectional study. BMJ Open 2019; 9:e026215. [PMID: 30948597 PMCID: PMC6500250 DOI: 10.1136/bmjopen-2018-026215] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Revised: 01/18/2019] [Accepted: 01/28/2019] [Indexed: 12/28/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between multiple lifestyle-related risk factors (unhealthy diet, low leisure-time physical activity, overweight/obesity and smoking) and self-rated work ability in a general working population. SETTING Population-based cross-sectional study, in Telemark County, Norway, 2013. PARTICIPANTS A random sample of 50 000 subjects was invited to answer a self-administered questionnaire and 16 099 responded. Complete data on lifestyle and work ability were obtained for 10 355 participants aged 18-50 years all engaged in paid work during the preceding 12 months. OUTCOME MEASURE Work ability was assessed using the Work Ability Score (WAS)-the first question in the Work Ability Index. To study the association between multiple lifestyle risk factors and work ability, a lifestyle risk index was constructed and relationships examined using multiple logistic regression analysis. RESULTS Low work ability was more likely among subjects with an unhealthy diet (ORadj 1.3, 95% CI 1.02 to 1.5), inactive persons (ORadj 1.4, 95% CI 1.2 to 1.6), obese respondents (ORadj 1.5, 95% CI 1.3 to 1.7) and former and current smokers (ORadj 1.2, 95% CI 1.1 to 1.4 and 1.3, 95% CI 1.2 to 1.5, respectively). An additive relationship was observed between the lifestyle risk index and the likelihood of decreased work ability (moderate-risk score: ORadj 1.3; 95% CI 1.1 to 1.6; high-risk score: ORadj 1.9; 95% CI 1.6 to 2.2; very high risk score: ORadj 2.4; 95% CI 1.9 to 3.0). The overall population attributable fraction (PAF) of low work ability based on the overall risk index was 38%, while the PAFs of physical activity, smoking, body mass index and diet were 16%, 11%, 11% and 6%, respectively. CONCLUSIONS Lifestyle risk factors were associated with low work ability. An additive relationship was observed. The findings are considered relevant to occupational intervention programmes aimed at prevention and improvement of decreased work ability.
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Affiliation(s)
- Inger M Oellingrath
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Marit Müller De Bortoli
- Department of Nursing and Health Sciences, University of South-Eastern Norway, Porsgrunn, Norway
| | - Martin Veel Svendsen
- Department of Occupational and Environmental Medicine, Telemark Hospital, Skien, Norway
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Wittmann L, Hampel P, Peter U, Karow A, Gallinat J, Groen G. Die gruppentherapeutische Intervention „Gesund bleiben im Beruf“ zur Wiedererlangung der Arbeitsfähigkeit. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2019. [DOI: 10.1026/1616-3443/a000533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: In der psychotherapeutischen Forschung und Versorgung wurde die Wiedererlangung der Arbeitsfähigkeit bislang nur unzureichend berücksichtigt. Einige Studien weisen jedoch auf die Wirksamkeit arbeitsbezogener kognitiv-verhaltenstherapeutischer Therapieansätze hin. Fragestellung: Die vorliegende Pilotstudie soll ein neues Gruppentherapiekonzept mit dem Ziel der Verbesserung der Arbeitsfähigkeit evaluieren. Methoden: Es wurden Daten von N = 17 Teilnehmenden mit depressiven Störungen erhoben. Dafür wurden die Arbeitsfähigkeit, Arbeitsmotivation, generelle Symptombelastung und Depressivität zu drei Messzeitpunkten erfasst. Ergebnisse: Die Arbeitsfähigkeit verbesserte sich tendenziell. Teilnehmende wiesen kurz- und mittelfristig eine geringere Symptombelastung und geringere Depressivität auf. Die Aktivität und Partizipation erhöhten sich kurz- und mittelfristig. Schlussfolgerungen: Die Intervention scheint die psychische Gesundheit zu verbessern, allerdings müssen diese ersten Ergebnisse in einer randomisierten-kontrollierten Studie verifiziert werden.
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Affiliation(s)
| | | | | | | | | | - Gunter Groen
- Hochschule für Angewandte Wissenschaften Hamburg
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23
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Bethge M, Spanier K, Peters E, Michel E, Radoschewski M. Self-Reported Work Ability Predicts Rehabilitation Measures, Disability Pensions, Other Welfare Benefits, and Work Participation: Longitudinal Findings from a Sample of German Employees. JOURNAL OF OCCUPATIONAL REHABILITATION 2018; 28:495-503. [PMID: 28956225 DOI: 10.1007/s10926-017-9733-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
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.
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Affiliation(s)
- Matthias Bethge
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany.
| | - Katja Spanier
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Elke Peters
- Institute of Social Medicine and Epidemiology, University of Lübeck, Ratzeburger Allee 160, 23562, Lübeck, Germany
| | - Elliot Michel
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Michael Radoschewski
- Institute of Medical Sociology and Rehabilitation Science, Charité - Universitätsmedizin Berlin, Berlin, Germany
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Work Ability Trajectories and Retirement Pathways: A Longitudinal Analysis of Older American Workers. J Occup Environ Med 2018; 60:e343-e348. [PMID: 29727398 PMCID: PMC6075889 DOI: 10.1097/jom.0000000000001353] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Objective: To determine whether older workers who follow different work ability (WA) trajectories tend to follow different retirement pathways. Methods: Nationally representative data on Americans born between 1943 and 1948. Latent class growth modeling to estimate trajectories of work ability between ages 53–54 and 65–66. Multinomial log-linear models to assess the association between WA trajectories and retirement pathways. Results: Three WA trajectories were identified: high (74%), declining (17%), and low (9%). Low WA leads more often to an early-gradual retirement. Declining WA leads to both early-gradual and early-crisp retirements. Conclusions: Workers with low and declining WA are more at risk of unemployment, disability, and inactivity prior to retirement; workers with declining WA are also likely to make a direct transition to early retirement. Future changes to social security should consider inter-individual variation over time in WA.
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Nurmela K, Mattila A, Heikkinen V, Uitti J, Ylinen A, Virtanen P. Identification of Depression and Screening for Work Disabilities among Long-Term Unemployed People. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:E909. [PMID: 29751563 PMCID: PMC5981948 DOI: 10.3390/ijerph15050909] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 04/30/2018] [Accepted: 05/02/2018] [Indexed: 11/30/2022]
Abstract
The study explores whether clinical screening targeted at work disabilities among long-term unemployed people reveals eligible individuals for a disability pension and the importance of depression in granting the disability pensions. A total of 364 participants of the screening project were considered as eligible to apply for disability pension. Among them, 188 were diagnosed as clinically depressed. They were classified into those with earlier depression diagnosis (n = 85), those whose depression had not been diagnosed earlier (n = 103), and those without diagnosed depression (n = 176). The association of this ‘Depression identification pattern’ with being granted a disability pension was explored by logistic regression analyses. Compared to those with earlier diagnosis, those whose depression had not been diagnosed earlier were granted disability pension more commonly (72% vs. 54% OR 2.2, p = 0.012). Corresponding figures of the undepressed were 73%, OR 2.3, p = 0.002. The adjustments did not affect the results. Clinical examination of the long-term unemployed people in terms of work disability seems to be worthwhile. In particular, the examination reveals new depression diagnoses, which contribute more to the award of disability pension than depression diagnosed earlier by regular health care. Novel ways to detect depression among the unemployed should be implemented in the health and employment services.
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Affiliation(s)
- Kirsti Nurmela
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Mental Health and Substance Abuse Services, 33900 Tampere, Finland.
| | - Aino Mattila
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Department of Adult Psychiatry, Tampere University Hospital, 33521 Tampere, Finland.
| | - Virpi Heikkinen
- Department of Neurosciences and Rehabilitation, Tampere University Hospital, 33521 Tampere, Finland.
| | - Jukka Uitti
- Faculty of Medicine and Life Sciences, University of Tampere, 33521 Tampere, Finland.
- Clinic of Occupational Medicine, Tampere University Hospital, 33521 Tampere, Finland.
- Finnish Institute of Occupational Health, 33100 Tampere, Finland.
| | - Aarne Ylinen
- Department of Neurological Sciences, Faculty of Medicine, University of Helsinki, 00100 Helsinki, Finland.
- Department of Neurology, Helsinki University Central Hospital, 00260 Helsinki, Finland.
| | - Pekka Virtanen
- Faculty of Social Sciences, Health Sciences, University of Tampere, 33014 Tampere, Finland.
- Department of Public Health, Faculty of Medicine, Uppsala University, 75124 Uppsala, Sweden.
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Furu H, Sainio M, Hyvärinen HK, Kaukiainen A. Work ability score of solvent-exposed workers. Int Arch Occup Environ Health 2018; 91:559-569. [PMID: 29594340 DOI: 10.1007/s00420-018-1306-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2017] [Accepted: 03/25/2018] [Indexed: 11/25/2022]
Abstract
PURPOSE Occupational chronic solvent encephalopathy (CSE), characterized by neurocognitive dysfunction, often leads to early retirement. However, only the more severe cases are diagnosed with CSE, and little is known about the work ability of solvent-exposed workers in general. The aim was to study memory and concentration symptoms, work ability and the effect of both solvent-related and non-occupational factors on work ability, in an actively working solvent-exposed population. METHODS A questionnaire on exposure and health was sent to 3640 workers in four solvent-exposed fields, i.e. painters and floor-layers, boat builders, printers, and metal workers. The total number of responses was 1730. We determined the work ability score (WAS), a single question item of the Work Ability Index, and studied solvent exposure, demographic factors, Euroquest memory and concentration symptoms, chronic diseases, and employment status using univariate and multivariate analyses. The findings were compared to those of a corresponding national blue-collar reference population (n = 221), and a small cohort of workers with CSE (n = 18). RESULTS The proportion of workers with memory and concentration symptoms was significantly associated with solvent exposure. The WAS of solvent-exposed workers was lower than that of the national blue-collar reference group, and the difference was significant in the oldest age group (those aged over 60). Solvent-exposed worker's WAS were higher than those of workers diagnosed with CSE. The WAS were lowest among painters and floor-layers, followed by metal workers and printers, and highest among boat builders. The strongest explanatory factors for poor work ability were the number of chronic diseases, age and employment status. Solvent exposure was a weak independent risk factor for reduced WAS, comparable to a level of high alcohol consumption. CONCLUSIONS Even if memory and concentration symptoms were associated with higher solvent exposure, the effect of solvents on self-experienced work ability was relatively weak. This in line with the improved occupational hygiene and reduced solvent exposure levels in industrialized countries, thus the effect may be stronger in high-level exposure environments. As a single question, WAS is easily included, applicable, and recommendable in occupational screening questionnaires.
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Affiliation(s)
- Heidi Furu
- Finnish Institute of Occupational Health, Helsinki, Finland. .,Doctagon, Kaivokatu 6, 00100, Helsinki, Finland.
| | - Markku Sainio
- Finnish Institute of Occupational Health, Helsinki, Finland
| | | | - Ari Kaukiainen
- Finnish Institute of Occupational Health, Helsinki, Finland
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Kinnunen U, Nätti J. 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. Scand J Public Health 2017; 46:321-330. [PMID: 29212430 DOI: 10.1177/1403494817745190] [Citation(s) in RCA: 56] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
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.
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Affiliation(s)
- Ulla Kinnunen
- Faculty of Social Sciences, Psychology, Social Policy, University of Tampere, Finland
| | - Jouko Nätti
- Faculty of Social Sciences, Psychology, Social Policy, University of Tampere, Finland
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Hakkarainen P, Sund R, Arffman M, Koski S, Hänninen V, Moilanen L, Räsänen K. Working people with type 1 diabetes in the Finnish population. BMC Public Health 2017; 17:805. [PMID: 29025404 PMCID: PMC5639775 DOI: 10.1186/s12889-017-4723-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Accepted: 09/06/2017] [Indexed: 01/13/2023] Open
Abstract
Background The incidence of type 1 diabetes is increasing worldwide. Since so little is known about work life of individuals with type 1 diabetes, we examined incidence and prevalence trends of type 1 diabetes among working-aged Finns. We also investigated the employment rate and how workers with type 1 diabetes perceive their health and work ability, and their intended retirement age. Methods We analyzed changes in the incidence, prevalence, and employment rate using nationwide multi-register-based FinDM data, and estimated a Self-Rated Health, Work Ability Score, and inquired about retirement intentions of 767 working individuals with type 1 diabetes in a cross-sectional survey. All estimates were compared to the corresponding data of the Finnish general population. Results The average annual age-standardized incidence rate of type 1 diabetes among men aged 18–39 was 29 per 100,000/year; the incidence rate has increased by 33% from 1992 to 2007. Among women, the incidence remained at 16 per 100,000/year. Among working-aged (18–64) people, the age-standardized prevalence of type 1 diabetes increased by 39% among women and 33% among men. Two out of every three working aged individuals with type 1 diabetes were in the labor force; this is about 10% lower than in the Finnish population. The average age-standardized employment rate among those individuals with type 1 diabetes belonging to the labor force was 82%, compared to 84% in the general population. Working individuals with type 1 diabetes rated their health and work ability as being slightly lower than the general working population, but nonetheless, there were no significant differences in retirement intentions. Conclusions Between 1992 and 2007, the number of working-aged people and workers with type 1 diabetes increased by 35%. Most workers with type 1 diabetes manage as well at work as the general population. Special attention should be paid to workers with type 1 diabetes when they are diagnosed and/or report moderate or poor work ability. Electronic supplementary material The online version of this article (10.1186/s12889-017-4723-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Pirjo Hakkarainen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland.
| | - Reijo Sund
- Centre for Research Methods, Department of Social Research, University of Helsinki, Helsinki, Finland.,School of Medicine, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Martti Arffman
- Department of Health and Social Care Systems, National Institute for Health and Welfare, Helsinki, Finland
| | - Sari Koski
- The Finnish Diabetes Association, Tampere, Finland
| | - Vilma Hänninen
- Department of Social Sciences, University of Eastern Finland, Kuopio, Finland
| | - Leena Moilanen
- Department of Medicine, Kuopio University Hospital, Kuopio, Finland
| | - Kimmo Räsänen
- School of Medicine, Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio Campus, P.O. Box 1627, FI-70211, Kuopio, Finland
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Lundin A, Leijon O, Vaez M, Hallgren M, Torgén M. Predictive validity of the Work Ability Index and its individual items in the general population. Scand J Public Health 2017; 45:350-356. [DOI: 10.1177/1403494817702759] [Citation(s) in RCA: 60] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
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.
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Affiliation(s)
- Andreas Lundin
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Center for Epidemiology and Community Medicine, Stockholm County Council, Stockholm, Sweden
| | - Ola Leijon
- Swedish Social Insurance Inspectorate, Stockholm, Sweden
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Marjan Vaez
- Department of Clinical Neuroscience, Karolinska Institutet, Division of Insurance Medicine, Stockholm, Sweden
| | - Mats Hallgren
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Margareta Torgén
- Department of Medical Science, Uppsala University, Uppsala, Sweden
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Leijon O, Balliu N, Lundin A, Vaez M, Kjellberg K, Hemmingsson T. Effects of psychosocial work factors and psychological distress on self-assessed work ability: A 7-year follow-up in a general working population. Am J Ind Med 2017; 60:121-130. [PMID: 27779327 DOI: 10.1002/ajim.22670] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/23/2016] [Indexed: 10/20/2022]
Abstract
BACKGROUND Toinvestigate the effects of psychosocial work factors (PWF) and psychological distress (PD) on self-assessed work ability. METHODS This follow-up study included 7,810 individuals (55%women) with good work ability at baseline. PWFandPD (measured by GHQ-12) were assessed at baseline and work ability at 7-year follow-up. Effects of PWF and PD on work ability were analyzed by logistic regression, odds ratios (OR) with 95% CI, and by mediation analysisusing 4-way decomposition. RESULTS Low support was associated with poor work ability for both women and men (OR 1.78 and 1.89). For men, also low skill discretion was associated with poor work ability (OR 2.07). For both women and men, PD was associated with poor work ability (OR 3.41 and 1.84). PD did not act as an intermediate variablein the association between PWF and work ability. CONCLUSION Strategies for sustainable work ability should focus on both working conditions and health factors. Am. J. Ind. Med. 60:121-130, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ola Leijon
- Swedish Social Insurance Inspectorate; Stockholm Sweden
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
| | - Natalja Balliu
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
| | - Andreas Lundin
- Department of Public Health Sciences; Karolinska Institutet; Stockholm Sweden
| | - Marjan Vaez
- Department of Clinical Neuroscience; Karolinska Institutet; Stockholm Sweden
| | - Katarina Kjellberg
- Institute of Environmental Medicine; Karolinska Institutet; Stockholm Sweden
- Centre for Occupational and Environmental Medicine; Stockholm County Council; Stockholm Sweden
| | - Tomas Hemmingsson
- Centre for Social Research on Alcohol and Drugs (SoRAD); Stockholm University; Stockholm Sweden
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