Changes In Work Ability Research Articles

Changes in active commuting and changes in work ability and recovery from work in 16,778 Finnish public sector employees

BackgroundPromotion of active commuting by walking and cycling presents a feasible strategy to increase physical activity levels and improve employee health and wellbeing. Increasing evidence on the health benefits of active commuting exists, but little is known about longitudinal associations between active commuting and work ability, and recovery from work. MethodsWe conducted an observational cohort study of 16,778 public sector employees who responded to the Finnish Public Sector study surveys in 2020 and 2022. Within- and between-individual associations of changes in active commuting with changes in work ability and recovery from work were examined using hybrid modelling. Analyses were adjusted for sex and age at T1 (time-invariant confounders in the between-individual part of the analyses) and socio-economic factors, body mass index, health behaviours, and job strain (time-varying confounders in both parts). ResultsAfter adjustments, an increase in active commuting equivalent to 10 km per week was associated with small within-individual (unstandardized beta (B) = 0.016, 95% confidence interval (CI) 0.004–0.028) and between-individual (B = 0.028, 95% CI 0.019–0.038) improvements in work ability. In sex-stratified analyses, the positive within-individual effect on work ability was observed only among women (B = 0.026, 95% CI 0.001–0.040). With recovery from work, only between-individual positive association was observed (B = 0.032, 95% CI = 0.018–0.045). ConclusionsIt may be possible to improve work ability by increasing active commuting. However, it appears that a change corresponding to tens of weekly kilometres of active commuting is required to achieve a small improvement in work ability. No conclusive evidence supporting that an increase in active commuting enhances recovery from work was found.

Level of and Changes in Perceived Work Ability Among Partial Disability Pensioners and the Risk of Full Disability Pension—A Register-Linked Cohort Study

PurposeTo 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.MethodsWe 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.ResultsDuring 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.ConclusionAmong 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.

Changes in active commuting and changes in work ability and recovery from work

Abstract Background Active commuting (walking or cycling) to work may be a feasible way to increase physical activity and improve health and wellbeing also at work. There is increasing evidence on the health benefits of active commuting, but little is known about longitudinal associations between active commuting and work ability, and recovery from work. Methods We conducted an observational cohort study of 16,776 public sector employees who responded to the Finnish Public Sector study in 2020 and 2022. Within- and between-individual associations of changes in active commuting with changes in self-rated work ability and recovery from work (scale from 0 to 10) were examined using hybrid modelling. The change in active commuting was assessed with a repeated self-report of weekly frequency of commuting by walking or cycling that was multiplied with the daily commuting distance. While the within-individual part of the hybrid model accounts for all time-invariant confounders, both parts of the model were adjusted for time-varying confounders including socio-economic factors, body mass index, and health behaviors, and the between individual part with sex and age (birth year) (time-invariant). Results After adjustments, a 10 km weekly increase in active commuting was associated with a slight improvement in work ability in both within- and between-individual analyses (unstandardized B = 0.02, p = 0.01; unstandardized B = 0.03, p = 0.001, respectively). Similar increase in active commuting was associated with slightly improved recovery from work in between-individual analysis (unstandardized B = 0.03, 95%, p = 0.001), but the association was not replicated in within-individual analysis. Conclusions Our findings suggest that an increase in active commuting may have some potential for improving work ability, albeit the increase needs to be rather large to achieve even a small improvement in work ability. The results for recovery from work were inconclusive. Key messages • An increase in active commuting may improve work ability. • No conclusive evidence supporting that an increase in active commuting enhances recovery from work was found.

Improvement of Work Ability After Weight Loss Surgery: Results of a Longitudinal Study of Patients Suffering from Extreme Obesity Before and 4 Years After Bariatric Surgery.

Body mass index (BMI) is directly associated with employment status. Our longitudinal prospective study is aimed at ascertaining whether work ability index (WAI) 4years after surgery remains improved, such as 1year after surgery, or changes and whether socio-demographic or psycho-social factors influence changes in work ability. 197 bariatric surgery candidates were recruited. Data on demographic and psycho-social characteristics were collected prior to surgery (t1) and at 6 (t2), 12 (t3), and 48months (t4). Change effects over time in the WAI and BMI were investigated using a repeated-measures analysis of variance (ANOVA). A hierarchical multiple regression analysis was calculated to predict socio-demographic and psychosocial characteristics at t1 on WAI at t4. Not only a significant increase in WAI was observed between t1 and t2 and between t3 and t4 but also a significant decrease between t2 and t4. BMI reduction was significant between t1 and t2 and t3 and t4, respectively. There was no significant interaction effect of BMI reduction 4years after surgery on decreased work ability from t2 to t4. The hierarchical multiple regression analysis revealed an association of WAI scores at t1 on WAI scores at t4 only. Work ability 4years after surgery remained significantly improved compared to the values at t1-t3 assessment. Since work ability was the only predictor at t1, findings might indicate the use of psycho-social measures post bariatric surgery to increase work ability. There was no association between work ability and other socio-demographic or psycho-social factors.

Psychosocial factors associated with workability after surgery in cancer survivors: An explorative study.

This study aimed to evaluate the work ability and its associated factors in patients with glioma (II, III) and breast cancer after 6 (T0) and 12 (T1) months from surgery. A total of 99 patients were evaluated with self-reported questionnaires at T0 and T1. Correlation and Mann-Whitney tests were used to investigate the association between work ability and sociodemographic, clinical, and psychosocial factors. The Wilcoxon test was used to investigate the longitudinal change in work ability. Our sample showed a decrease in work ability level between T0 and T1. Work ability was associated with emotional distress, disability, resilience, and social support in glioma III patients at T0, and with fatigue, disability, and clinical treatments in patients with breast cancer at T0 and T1. Work ability levels decreased in patients with glioma and breast cancer and were associated with different psychosocial factors after surgery. Their investigation is suggested to facilitate the return to work.

The impact of physical fitness, social life, and cognitive functions on work ability in middle-aged and older adults

ObjectiveDemographic changes encompass societies to maintain the work ability (WA) of aging workforces. The present study explored the relationship between modifiable lifestyle factors, cognitive functions, and their influence on WA, using a multi-group structural equation approach.MethodCross-sectional data from 247 middle-aged and 236 older employees from the Dortmund Vital Study were included in this analysis. We proposed a model with three exogenous variables (Physical Fitness, Cognitive Functions, and Social Life), and with WA as the endogenous variable. WA was measured with the Work Ability Index (WAI), which considers job demands and individual physical and mental resources. Multi-group analyses were based on the principles of invariance testing and conducted using robust estimation methods.ResultsResults revealed that Social Life outside work had significant positive effects on WA in both, middle-aged and older adults. Physical Fitness had a significant effect on WA only in middle-aged adult, and Cognitive Functions had no significant influence on WA in either group. In older adults, Physical Fitness correlated with Cognitive Functions, whereas in middle-aged adults, Cognitive Functions marginally correlated with Social Life.ConclusionsOur results underline the importance of an active social life outside the workplace for WA, regardless of the employees’ age. The influence of Physical Fitness on WA changes with increasing age, indicating the necessity to have a differentiated view of age effects and interacting influencing factors. Our research contributes to the knowledge of how WA could be most effectively promoted in different age groups.Clinicaltrials.gov NCT05155397; https://clinicaltrials.gov/ct2/show/NCT05155397.

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

ObjectivesThis 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...

Promoting work ability with a wearable activity tracker in working age individuals with hip and/or knee osteoarthritis: a randomized controlled trial

BackgroundPhysical activity (PA) may improve work ability and health in individuals with hip and/or knee osteoarthritis (OA). The use of wearable activity trackers (WATs) has been shown to increase PA and improve other health outcomes but little is known concerning their effect on work ability. The objectives of this study were to examine the effect of self-monitoring PA with a WAT on work ability, PA and work productivity among individuals of working age with hip and/or knee OA.MethodsIndividuals (n = 160) were included and cluster-randomized to a Supported Osteoarthritis Self-management Program (SOASP) with the addition of self-monitoring PA using a commercial WAT for 12 weeks (n = 86), or only the SOASP (n = 74). Primary outcome was self-reported work ability measured with the Work Ability Index (WAI) and secondary outcomes were self-reported PA measured with the International Physical Activity Questionnaire – Short Form (IPAQ-SF) and work productivity, measured with the Work Productivity and Activity Impairment scale: Osteoarthritis (WPAI:OA) at baseline and after 3, 6 and 12 months. Data was primarily analysed with linear mixed models.ResultsParticipants with data from baseline and at least one follow-up were included in the analyses (n = 124). Linear mixed models showed no statistically significant difference between groups regarding pattern of change in work ability or PA, from baseline to follow-ups. Also, neither group had a statistically significant difference in work ability between baseline and each follow-up.ConclusionThe SOASP together with self-monitoring PA with a WAT did not have any effect on the primary outcome variable work ability. Participants already at baseline had good work ability and were physically active, which could have reduced the possibility for improvements. Future interventions should target a population with lower work ability and PA-level.Trial registrationClinicalTrials.gov, NCT03354091. Registered 15/11/2017.

Age-Differentiated Leadership and Healthy Aging at Work: Evidence from the Early Stages of the COVID-19 Pandemic.

Little is known about the relative influence of age-differentiated leadership on healthy aging at work. Likewise, the age-conditional influence of age-differentiated leadership is understudied, and especially so in the context of the COVID-19 pandemic. Using a three-wave longitudinal study, we examined the role that age-differentiated leadership plays in the prediction of work ability, as measured three times over six months (n = 1130) during the early stages of the COVID-19 pandemic in Germany (i.e., December 2019, March 2020, and June 2020). The results suggest that although there were no systematic changes in work ability on average, there was notable within-person variability in work ability over time. Additionally, we find that a balanced approach to age-differentiated leadership that considers the needs of both older and younger employees matters most and complements the positive influence of leader–member exchange for predicting within-person variability in work ability. We also find that older employees’ work ability benefits from an approach to age-differentiated leadership that considers older employee’s needs, whereas younger employees’ work ability especially benefits from leader–member exchange and a balanced approach to age-differentiated leadership. Overall, these results provide initial support for the idea that an age-differentiated approach to leadership is important when considering healthy aging at work.

Changes in Work Ability after Weight-Loss Surgery: Results of a Longitudinal Study of Persons with Morbid Obesity before and after Bariatric Surgery

Introduction: Bariatric surgery is a life-changing treatment, but knowledge of its influence on changes in work ability is still limited. We hypothesized that self-reported work ability improves in response to surgery-induced weight loss and sociodemographical variables (e.g., age, sex, and marital status), and that psychosocial characteristics (e.g., depressive symptoms and dysfunctional eating) may have predictive value as to patients’ work ability. Methods: A total of 200 participants scheduled for bariatric surgery were recruited between September 2015 and June 2018. They completed several self-report measures at the preoperative examination (t1) and at 6- (t2) and 12 months (t3) after bariatric surgery. A repeated-measures analysis of variance was calculated to detect any changes in the work ability and body mass index (BMI) among the 3 time points. Further, a hierarchical multiple regression analysis was used to determine whether any demographical and psychosocial characteristics at (t1) would predict work ability at (t3). Results: Participants (82% of whom were women) were middle-aged and showed a BMI of nearly 46 at the preoperative medical examination. Excess weight loss at (t2) and at (t3) was 49 and 66%, respectively. Work ability increased toward a moderate level after weight-loss surgery. Work ability and dysfunctional eating at (t1) showed significant predictive value with respect to work ability at (t3). Discussion: The results suggest that weight-loss surgery has a positive impact on work ability, and indicate a predictive value for the extent of weight loss and dysfunctional eating behavior. Against our hypothesis and in contrast to former research, a predictive value for depressive symptoms and age was not revealed. Further research must show how interventions can support and maintain improvements in work ability after bariatric surgery, in order to reduce sick leave and unemployment in patients with preoperative morbid obesity.

The impact of changes in working conditions, health behavior and BMI on work ability and health

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.

Physical and psychosocial working conditions as predictors of 5-year changes in work ability among 2078 employees in Germany

ObjectiveTo examine 5-year prospective associations between working conditions and work ability among employees in Germany.MethodsA cohort study (2011/2012–2017), based on a random sample of employees in employments subject to payment of social contributions aged 31–60 years (Study on Mental Health at Work; S-MGA; N = 2,078), included data on physical and quantitative demands, control (influence, possibilities for development, control over working time), relations (role clarity and leadership quality) and work ability (Work Ability Index, WAI; subscale ‘subjective work ability and resources’). Data were analysed using linear regression.ResultsPhysical demands and control were associated with small 5-year changes in work ability (ΔR2 = 1%). Among the subgroup of employees with ≥ 25 sickness days, possibilities for development, control and quality of leadership were associated with changes in work ability (ΔR2 = 8%).ConclusionsThe impact of working conditions on long term changes in work ability seems to be negligible. However, in vulnerable subpopulations experiencing poor health, working conditions may be associated to a larger extent to work ability over this time span.

Predicting improvement of work ability in modalities of short- and long-term psychotherapy: The differential impact of reflective ability and other aspects of patient suitability.

We investigated how patients' psychological capacities to engage in psychotherapy predict changes in work ability in short- and long-term psychotherapy. A cohort study of 326 patients, aged 20-46 years and suffering from mood and anxiety disorders, treated by short-term solution-focused, short-term psychodynamic, or long-term psychodynamic psychotherapy, followed-up for 5 years. The Suitability for Psychotherapy Scale, assessed at baseline, was the predictor. Outcomes were assessed at baseline and at six follow-up occasions using the Work Ability Index as the primary indicator. Patients with good pretreatment psychological suitability for psychotherapy, good reflective ability in particular, improved more than patients with poor suitability in short-term psychodynamic psychotherapy. Comparisons between therapy groups showed poorer suitability to predict more improvement in solution-focused and in long-term psychodynamic psychotherapy than in short-term psychodynamic psychotherapy. Patients' psychological suitability for psychotherapy has a different impact on work ability in different therapy modalities and durations.

The association of musculoskeletal complaints and individual and work-related factors with work ability in Chilean white-collar and blue-collar workers

Objective. The maintenance of good work ability has proven to have a positive effect on health, quality of work and productivity. There is little evidence regarding the association between musculoskeletal complaints, individual and work-related factors, and work ability in blue-collar and white-collar workers. Methods. A cross-sectional study of hospital and university workers (n = 360) was performed to determine the association between musculoskeletal complaints, individual and work-related factors, and work ability; two multiple linear regression models were created. Results. In white-collar workers, musculoskeletal complaints of the dorsal/lumbar region (β = −0.259) and the wrist/hand segment (β = −0.151) were significantly associated with reduced work ability. A higher body mass index (β = −0.227) was also negatively associated with the dependent variable. In blue-collar workers, musculoskeletal complaints of the dorsal/lumbar region (β = −0.317) and the elbow/forearm segment (β = −0.171) were significantly associated with lower work ability. Increased age (β = −0.204) was associated with reduced work ability in this group. No significant correlations were found between work-related factors and work ability. Conclusions. Musculoskeletal complaints and individual factors, but not work-related factors, are associated with work ability in Chilean blue-collar and white-collar workers. Nevertheless, the variables that explain the change in work ability are different between these groups.

Menopause, multisite pain and work ability among municipal workers

Abstract Background A rising number of women will go through menopause while working. We aimed to examine the association of menopausal status with multisite pain and pain interfering with work ability. Methods We analysed cross sectional data collected in the Helsinki Health Study. Female full-time municipal employees aged 45, 50, 55 or 60 years and of at least normal weight were studied. Premenopausal group included 2420 and postmenopausal group 1364 participants. First, we examined the associations between menopausal status and multisite pain. Second, among those with pain (n = 1481), the association between menopausal status and change in work ability due to pain was studied. Age, health behaviour (including the use of hormone replacement therapy) and work-related factors were controlled for. Results Postmenopause was associated with multisite pain (OR 1,44; 95 % CI 1,11 − 1,87) as compared with premenopause. Postmenopause was also associated with a large change in self¬-perceived work ability caused by pain (OR 1,53; 95 % CI 1,01 − 2,32). Conclusions The results underline the importance of menopause to the experience of multisite pain and its contribution to the change in self¬-perceived work ability. Key messages This study adds evidence to the underresearched topic of menopause and work. Support for women in menopause and further attention in work issues of women in midlife are necessary.

Work Loss in Relation to Pharmacological and Surgical Treatment for Crohn's Disease: A Population-Based Cohort Study.

PurposePatients with Crohn’s disease have increased work loss. We aimed to describe changes in work ability in relation to pharmacological and surgical treatments.Patients and MethodsWe linked data from the Swedish National Patient Register, The Swedish Quality Register for Inflammatory Bowel Disease SWIBREG, The Prescribed Drug Register, The Longitudinal Integrated Database for Health Insurance and Labour Market Studies, and the Social Insurance Database. We identified working-age (19–59 years) patients with incident Crohn’s disease 2006–2013 and population comparator subjects matched by sex, birth year, region, and education level. We assessed the number of lost workdays due to sick leave and disability pension before and after treatments.ResultsOf 3956 patients (median age 34 years, 51% women), 39% were treated with aminosalicylates, 52% with immunomodulators, 22% with TNF inhibitors, and 18% with intestinal surgery during a median follow-up of 5.3 years. Most patients had no work loss during the study period (median=0 days). For all treatments, the mean number of lost workdays increased during the months before treatment initiation, peaked during the first month of treatment and decreased thereafter, and was heavily influenced by sociodemographic factors and amount of work loss before first Crohn’s disease diagnosis. The mean increase in work loss days compared to pre-therapeutic level was ~3 days during the first month of treatment for all pharmacological therapies and 11 days for intestinal surgery. Three months after treatment initiation, 88% of patients treated surgically and 90–92% of patients treated pharmacologically had the same amount of work loss as before treatment start. Median time to return to work was 2 months for all treatments.ConclusionIn this regular clinical setting, patients treated surgically had more lost workdays than patients treated pharmacologically, but return to work was similar between all treatments.

The association between changes in functional capacity and work ability among unemployed individuals

PurposeUnemployment has multidimensional effects. This study investigated how the changes in functioning are associated with the changes in perceived work ability among unemployed people.MethodsThe 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.ResultsOverall, 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.ConclusionsMaintaining 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.

Preferences regarding the way of use and design of a work ability prognosis support tool: a focus group study among professionals

Purpose To explore the preferable way of use and design of a work ability prognosis support tool for insurance physicians (IPs) and labour experts (LEs), based on a prediction model for future changes in work ability among individuals applying for a work disability benefit. Methods We conducted three focus groups with professionals of the Dutch Social Security Institute (17 IPs and 7 LEs). Data were audio recorded and qualitatively analysed according to the main principles of thematic analysis. Results Clarity and ease of use were mentioned as important features of the tool. Most professionals preferred to make their own judgement during the work disability assessment interview with the claimant and afterwards verify their evaluation with the tool. Concerning preferences on the design of the tool, dividing work disability claimants into categories based on the outcome of the prediction model was experienced as the most straightforward and clear way of presenting the results. Professionals expected that this encourages them to use the tool and act accordingly. Conclusions The tool should be easy to access and interpret, to increase the chance that professionals will use it. This way it can optimally help professionals making accurate prognoses of future changes in work ability. Implications for rehabilitation A work ability prognosis support tool based on a prediction model for changes in work ability at one-year follow-up can help occupational health professionals in making accurate prognosis of individuals applying for a work disability benefit. To be used in occupational health practice, these tools should have a simple and easy-to-use design. Graphical risk presentation can be used to provide intuitive meaning to numerical information and support users’ understanding. Taking professionals’ preferences into account when developing these tools encourages professionals to use the tools and act accordingly.

Monitoring Work Ability Index During a Two-Year Period Among Portuguese Municipality Workers.

In Portugal, little is known about the work ability profiles of municipal workers and their changes during working life. In order to characterize and understand the changes in work ability among municipal workers, a prospective study was designed to begin in 2015 in the municipality of Sintra, in the surroundings of Lisbon, and to collect data every two years. The present paper aims at characterizing the changes in the work ability of those workers between 2015 and 2017 and to identify the main predictors. Data collection was based on a questionnaire that encompassed socio-demographic data, the Copenhagen Psychosocial Questionnaire II (COPSOQ II), the Nordic questionnaire adapted, and the Work Ability Index (WAI). In this two-year period, the work ability of municipal workers decreased and the main predictive factors were age, lower-back pain, negative health perception, the presence of burnout, and making manual efforts. Still, there were factors that act as positive predictors of an excellent work ability, such as having training in the previous two years, a good sense of community at work, and a favorable meaning of work. In summary, the intervention strategies in the work field should take into consideration the main predictors of work ability that are relevant for each organization.

Self-reported work ability in breast cancer survivors; a prospective cohort study in the Netherlands

PurposeTo evaluate patient-reported work ability of breast cancer patients, to compare scores with the Dutch general population, and to identify determinants of reduced work ability in breast cancer patients. MethodsIn a prospective cohort study, we identified 939 patients <67 years. Employed patients filled out the Work Ability Index (WAI) questionnaire before the start of radiotherapy treatment (baseline) and at 6, 18, and 30 months. Work ability was compared with a matched Dutch cancer-free population (n=3,641). The association between (clinical) characteristics and work ability over time was assessed using mixed-effects models. ResultsAt baseline, 68% (n=641) of the respondents were employed and 64% (n=203) were employed at 30 months. Moderate or poor work ability was reported by 71% of patients at baseline, by 24% of the patients at 30 months and by 14% of the general population. Axillary lymph node dissection, (neo)adjuvant chemotherapy and locoregional radiotherapy were associated with reduced work ability. After 30 months, 18% of employed patients reported to have reduced their working hours, made substantial modifications to their work or were unable to work. ConclusionPatient-reported work ability is strongly reduced during breast cancer treatment. Thirty months after treatment the proportion of women reporting poor or moderate work ability remains higher compared to the general population. Even though the proportion of women with paid employment is rather stable over time, substantial amendments in work are needed in 18% of patients. These findings emphasize the importance of informing patients on potential changes in work ability to allow shared decision making.