Abstract

Abstract Background Research on how to improve work ability and health of workers is essential for prolongation of working lives. Therefore, this study assessed the impact of 1) within-individual improvements, and 2) within-individual deteriorations in working conditions, health behavior and BMI on changes in work ability and self-rated health among workers. Methods The Dutch Study on Transitions in Employment, Ability and Motivation (STREAM) was used to identify participants whose working conditions, health behavior, and BMI improved (N = 14,045) or deteriorated (N = 14,066) at least once during 7 year follow-up (2010-2017). The impact of within-individual improvements and deteriorations in health behavior (moderate- and vigorous physical activity, smoking status), BMI, psychosocial (psychological- and emotional job demands, autonomy, social support) and physical working conditions in a given year on changes in work ability (0-10 scale) and self-rated health (1-5 scale) in the same year were analyzed with fixed-effects regression models. Results Workers with deteriorated physical or psychosocial working conditions decreased in work ability (β's:-0.21 (95%CI: -0.25;-0.18) to -0.28 (95%CI: -0.33;-0.24)) and health (β's:-0.07 (95%CI: -0.09;-0.06) to -0.10 (95%CI: -0.12;-0.08)), whereas improvements were to a lesser extent associated with increased work ability (β's: 0.06 (95%CI: 0.02;0.09) to 0.11 (95%CI: 0.06;0.16)) and health (β's: 0.02 (95%CI: 0.00;0.03) to 0.04 (95%CI: 0.02;0.06)). Decreased physical activity and increased BMI were associated with reduced work ability and health. Workers whose BMI decreased or vigorous physical activity increased improved in health, but those with increased moderate or vigorous physical activity reduced in work ability. Quitting smoking was associated with reduced work ability and health. Conclusions Preventing deteriorations in working conditions and health behavior could be of importance for sustainable employability. Key messages Modification of working conditions and health promotion might contribute to sustained employability. Preventing deteriorations in working conditions might be of particular importance for prolongation of working lives.

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