Promote Work Ability Research Articles

Work ability assessment in a worker population: comparison and determinants of Work Ability Index and Work Ability score

BackgroundPublic authorities in European countries are paying increasing attention to the promotion of work ability throughout working life and the best method to monitor work ability in populations of workers is becoming a significant question. The present study aims to compare the assessment of work ability based on the use of the Work Ability Index (WAI), a 7-item questionnaire, with another one based on the use of WAI’s first item, which consists in the worker’s self-assessment of his/her current work ability level as opposed to his/her lifetime best, this single question being termed “Work Ability score” (WAS).MethodsUsing a database created by an occupational health service, the study intends to answer the following questions: could the assessment of work ability be based on a single-item measure and which are the variables significantly associated with self-reported work ability among those systematically recorded by the occupational physician during health examinations? A logistic regression model was used in order to estimate the probability of observing “poor” or “moderate” WAI levels depending on age, gender, body mass index, smoking status, position held, firm size and diseases reported by the worker in a population of workers aged 40 to 65 and examined between January 2006 and June 2010 (n=12389).ResultsThe convergent validity between WAS and WAI was statistically significant (rs=0.63). In the multivariable model, age (p<0.001), reported diseases (OR=1.13, 95%CI [1.11-1.15]) and holding a position mostly characterized by physical activity (OR=1.67, 95%CI [1.49-1.87]) increased the probability of reporting moderate or poor work ability. A work position characterized by the predominance of mental activity (OR=0.71, 95%CI [0.61-0.84]) had a favourable impact on work ability. These relations were observed regardless of the work ability measurement tool used.ConclusionThe convergent validity and the similarity in results between WAI and WAS observed in a large population of employed workers should thus foster the use of WAS for systematic screening of work ability. Ageing, overweight, decline in health status, holding a mostly physical job and working in a large-sized firm increase the risk of presenting moderate or poor work ability.

Joint associations of sleep duration and insomnia symptoms with subsequent sickness absence: The Helsinki Health Study

We aimed to examine the joint associations of sleep duration and insomnia symptoms with subsequent sickness absence of various lengths while considering several covariates. Baseline surveys among 40-60-year-old employees of the City of Helsinki, Finland, (N = 6535) were prospectively linked with employer's personnel register data comprising short self-certified (1-3 days), medically-certified intermediate (4-14 days) and long (15 days or more) sickness absence spells. Average follow-up time was 4.1 years. Sleep duration, insomnia symptoms, sociodemographics, working conditions, health behaviours and health were self-reported in the surveys. Poisson regression analysis was used. Insomnia symptoms were associated with sickness absence at all levels of sleep duration. Adjusting for gender and age, U-shaped associations regarding sleep hours were found. Thus, those reporting short or long sleep and reporting insomnia symptoms had a higher risk for medically-certified intermediate and long sickness absence as compared to those reporting 7 hours of sleep without insomnia symptoms. Also, those reporting 6, 7, and 8 hours of sleep had a higher risk for such sickness absence, if they reported insomnia. Weak associations were also found for self-certified sickness absence, and for those reporting short and long sleep without insomnia. Adjustments attenuated the associations, but they mainly remained. These results suggest primacy of the effects of insomnia symptoms over sleep duration on sickness absence. Although insomnia dominated the joint association, U-shaped associations suggest that both sleep duration and insomnia symptoms need to be considered to promote work ability.

Promoting work ability in a structured national rehabilitation program in patients with musculoskeletal disorders: outcomes and predictors in a prospective cohort study.

BackgroundMusculoskeletal disorders (MSDs) are a major reason for impaired work productivity and sick leave. In 2009, a national rehabilitation program was introduced in Sweden to promote work ability, and patients with MSDs were offered multimodal rehabilitation. The aim of this study was to analyse the effect of this program on health related quality of life, function, sick leave and work ability.MethodsWe conducted a prospective, observational cohort study including 406 patients with MSDs attending multimodal rehabilitation. Changes over time and differences between groups were analysed concerning function, health related quality of life, work ability and sick leave. Regression analyses were used to study the outcome variables health related quality of life (measured with EQ-5D), and sick leave.ResultsFunctional ability and health related quality of life improved after rehabilitation. Patients with no sick leave/disability pension the year before rehabilitation, improved health related quality of life more than patients with sick leave/disability pension the year before rehabilitation (p = 0.044). During a period of −/+ four months from rehabilitation start, patients with EQ-5D ≥ 0.5 at rehabilitation start, reduced their net sick leave days with 0.5 days and patients with EQ-5D <0.5 at rehabilitation start, increased net sick leave days with 1.5 days (p = 0.019). Factors negatively associated with sick leave at follow-up were earlier episodes of sick leave/disability pension, problems with exercise tolerance functions and mobility after rehabilitation. Higher age was associated with not being on sick leave at follow-up and reaching an EQ-5D ≥ 0.5 at follow-up. Severe pain after rehabilitation, problems with exercise tolerance functions, born outside of Sweden and full-time sick leave/disability pension the year before rehabilitation were all associated with an EQ-5D level < 0.5 at follow-up.ConclusionsPatients with MSDs participating in a national work promoting rehabilitation program significantly improved their health related quality of life and functional ability, especially those with no sick leave. This shows that vocational rehabilitation programs in a primary health care setting are effective. The findings of this study can also be valuable for more appropriate patient selection for rehabilitation programs for MSDs.

Selection, optimization, and compensation in nursing: exploration of job‐specific strategies, scale development, and age‐specific associations to work ability

(1) To explore 'successful ageing' strategies in terms of selection, optimization and compensation in nursing; (2) To develop a scale that measures these strategies in nursing; (3) To investigate the association between these strategies in nursing and work ability of nurses and the moderating effects of age on this relationship. Studies indicate impaired work ability of older nurses. Research is needed to examine if 'successful ageing' strategies can promote the work ability especially in older nurses. The investigation applied a mixed method design: Study (1) Semi-structured interviews were conducted to explore selection, optimization and compensation in nursing; (Study 2) A cross-sectional survey was used to test the association between selection, optimization and compensation in nursing and work ability. Data were collected in 2010 and 2011. Study 1: 17 nurses ≥45years were interviewed; Study 2: 438 nurses (21-63years) participated. A selection, optimization and compensation-in-nursing-scale was applied that was developed on the basis of study 1. Work ability was measured with the Work Ability Index (Dimension 1). Study 1, the majority of reported ageing strategies were identified as selection, optimization and compensation in nursing. Study 2, selection, optimization, and compensation in nursing was positively related with work ability. The positive relationship was stronger for older nurses. Selection, optimization and compensation in nursing contributes positively to work ability, particularly in older nurses. This finding is relevant for the development of measures that promote work ability of nurses over the course of their professional careers.

Work Ability Index (WAI) and Its Association with Psychosocial Factors in One of the Petrochemical Industries in Iran

In recent decades, work ability index (WAI) has been a common practical tool to measure individuals' work ability in many European, Asian and South American countries. However, there is no study concerning work ability in Iran. The aim of this study was to determine the work ability index in an Iranian petrochemical job setting and to examine its relationship with psychosocial factors. A cross-sectional study was conducted among 420 male workers in various occupations. Work ability was evaluated using the WAI questionnaire developed by FIOH; the Job content questionnaire (JCQ) was used to assess psychosocial factors. The mean WAI score was 39.1 (SD=5.7) among workers in the studied petrochemical industry. Multiple linear regression analysis revealed a significant association between mean WAI score and age, job tenure, educational level, rest and sleep status and vocational education. Moreover, the results showed that skill discretion, coworker support and supervisor support were positively associated with the mean WAI score. On the other hand, it was inversely associated with job demands, job strain and job insecurity. This study was the first research to determine WAI in an important industry in Iran. Overall, work ability was in the "Good" category among the workers in the studied field. On the basis of the WAI guidelines, this level should be maintained and promoted to excellent level by providing supportive countermeasures. The WAI score was significantly associated with psychosocial factors. The results showed that even in heavy physical work, factors such as job insecurity, skill discretion, job strain and social support play an important role in maintaining work ability. A positive combination of "psychosocial characteristics" of the job with "individual resources" can promote work ability in such occupations.

Meeting the Challenges of Implementing an Intervention to Promote Work Ability and Health-Related Quality of Life at Construction Worksites

To evaluate the process of a prevention program among construction workers. The program consisted of training sessions of a physical therapist and an empowerment trainer, and a Rest-Break Tool. Data on seven process items were collected by means of questionnaires and interviews. Recruiting construction companies to participate was difficult. The therapists and trainer largely provided the training sessions as intended, but the Rest-Break Tool was poorly implemented. Construction workers (n = 171) showed high reach (84%) and moderate attendance rates (three of four sessions). Sixty-four percent of the construction workers recommended the overall program to colleagues. Company size, economic recession, engagement of the management, and intervention year influenced dose delivered and satisfaction. The study showed a successful reach, dose and fidelity, and moderate satisfaction. Furthermore, contextual factors played an important role during the implementation.

Relations between changed self-reported work factors and changed work ability among young male and female adults: a prospective cohort study

ObjectivesTo prospectively assess if a change in self-reported work factors among young male and female adults relate to a change in self-reported work ability.MethodsFrom a cohort of young Swedish people...

Work Ability Index among Finnish Dairy Farmers

Full-time farmers and particularly dairy farmers who plan to expand their production have voiced concerns about their physical and mental work ability in recent studies. The objectives of this study were to characterize the work ability of dairy farmers and to identify demographic groups at risk of disability and in greatest need of interventions to promote work ability. We conducted a postal survey using the Work Ability Index (WAI) questionnaire. The WAI of 399 dairy farmers (245 female and 154 male) was analyzed (response rate 41.5%). The mean WAI score was 36.0 among female and 39.0 among male respondents (scale: 7 = worst to 49 = best). The WAI decreased with age. The WAI was systematically better among males compared to females in all age groups, and the difference was greatest among those over 45 years of age. About one-fourth of females and one-tenth of males over 45 years of age were at an imminent risk of disability (poor WAI). The WAI of farmers in our study was similar to farmers in previous studies where entrepreneurs and salaried workers had better WAI compared to farmers. This study indicates that interventions are needed among older dairy farmers, particularly females, to help them improve their work ability. The first question (of seven) in the WAI questionnaire correlated well with the complete questionnaire-based WAI. The first question could be used in surveys as a condensed version of the WAI, if the same correlation is found in future studies. Based on this study, we recommend using the Work Ability Index questionnaire for assessing the health of those working in agriculture.

Associations between work ability, health-related quality of life, physical activity and fitness among middle-aged men

The Work ability of ageing work force is a matter of major concern in many countries. The aim of this study was to examine the relationship between perceived work ability and health-related quality of life (HRQoL), and to investigate their associations with age, physical activity and physical fitness in middle-aged men working in blue-collar occupations. The study population consisted of 196 middle-aged (aged 40–60 years) men (construction and industrial work) attending occupationally orientated early medical rehabilitation. They were mostly healthy having only symptoms of musculoskeletal or psychological strain. Perceived work ability was assessed with the work ability index (WAI) and HRQoL with the Rand, 36-item health survey (Rand-36). Information on physical activity was obtained with a structured questionnaire. Cardiorespiratory fitness was estimated with a submaximal exercise test on a cycle-ergometer. The WAI was significantly ( p<0.001) associated with the total score of Rand-36, and with all its domains. Age, physical activity and cardiorespiratory fitness were neither associated with the WAI, nor did physical activity predict any of the dimensions of Rand-36. Cardiorespiratory fitness was associated with the physical functioning dimension of the Rand-36 whilst age was positively associated with the dimensions of the energy, emotional well being and social functioning of the Rand-36. The present study on middle-aged men showed a close relationship between perceived work ability and the HRQoL. It is suggested that the promotion of work ability may have beneficial effects on quality of life.

Occupational work and quality of life in osteoarthritis patients

The ageing European population suffers from chronic diseases, including osteoarthritis (OA). The aim of this study was to investigate the work activity/ability, the quality of life and reciprocal interaction between both in OA patients. A total of 750 OA outpatients were evaluated by a questionnaire study. Work Ability Index (WAI) and General Health Questionnaire 28 (GHQ 28) were used as tools for work ability and quality of life assessment, respectively. Statistical analysis was performed by means of ANOVA tests. A total of 22.2% OA patients were still active professionally. They had decreased work ability and decreased quality of life. A worse work ability and a worse quality of life were related with a blue-collar work, multi-joint localization of OA and co-existence of other diseases. A negative correlation was found between general scores of GHQ 28 and that of WAI and five WAI components. Findings indicate a need for work ability promotion among OA working patients to maintain both, better quality of life and higher level of satisfaction with job.

International Congress Series 1280: Assessment and Promotion of Work Ability, Health and Well-Being of Ageing Workers. Edited by G. Costa, W. J. A. Goedhard and J. Ilmarinen. Published by Elsevier, 2005. ISBN 0-444-51989-0. Price: £114. viii + 435 pp.

International Congress Series 1280: Assessment and Promotion of Work Ability, Health and Well-Being of Ageing Workers. Edited by G. Costa, W. J. A. Goedhard and J. Ilmarinen. Published by Elsevier, 2005. ISBN 0-444-51989-0. Price: £114. viii + 435 pp.

Work Ability in Ageing Workers Suffering From Chronic Diseases

The aim of this study was to investigate the work ability in ageing workers suffering from osteoarthritis (OA),coronary heart disease (CHD) or hypertension (H). One hundred and sixty-six OA and 355 CHD/H outpatientswere evaluated. The Work Ability Index (WAI) served for work ability assessment. Patients ‘ results werecompared with the results of a control group of 225 healthy young workers. Statistical analysis was performedwith ANOVA tests. WAI in female and male CHD/H patients was higher than in OA patients (p < .01), betterwork ability was related to better education (p < .01), white-collar work (p < .01) and better recreation(p < .01); subjective work ability was determined mostly by the objective health status. The promotion of workability among workers suffering from advanced age-related diseases should be closely related to the promotionof health. It is indicative to improve occupational education and skills, already at an early stage of a disease.

Promotion of work ability at company level: Intention and performance, dreams and realities

The study examined how well the written policies of retaining employees at work were in accordance with the local management's attitudes, decisions, and activities. The management and employees at an ageing care centre answered a work ability questionnaire. A total of 189 of 289 participated and, among them, 67 were identified as vulnerable, which meant they had moderate or severe reduced work ability. 12 vulnerable employees were interviewed in depth to identify problems and discuss solutions to adjust work demand and individual resources. The implementation of the model was acceptable. However, the first year follow-up showed a gap between written policies and decisions, attitudes, and activities. It was partly explained by the organisational structure, lack of management competencies, and economic restrictions at the work place. The social security office did not initiate activities for work-active participants with deteriorated work ability. The lack of communication between the work place and the health care system was a barrier against comprehensive adjustment of work demand and individual resources. In the future, we recommend analyses of the current policies, attitudes, and activities as a basis for implementing changes in the organisation and for establishing routines for communications with relevant co-operators.

Promotion of work ability among French health care workers—value of the work ability index

The French HCWs who have been studied belong to the French sample of European NEXT Study. This sample consists of 55 public and private institutions in five regions. WAI has been calculated on 4306 subjects out of 5376 because of missing data. More than a third have a moderate or a poor index (29.4% and 5.2%, respectively). Half (50.6%) of the sample have a good index and only 14.9%, an excellent one. The WAI decreases with age: 19.4% of the “less than 30”, 14.6% of the 30–44 years old and 12.3% of the 45 + have an excellent WAI. But, the rate of decrease depends definitely on job demands and especially on physical load. The multivariate analysis showed that in France as well as in the other countries, work demand, uncertainty about treatments, low support from colleagues, and dissatisfaction with psychological support had high odds ratios for a low WAI. Dissatisfaction with physical working conditions and the necessity to maintain uncomfortable postures were the second group of factors with a strong influence on a low WAI. The absence of time for sports or leisure remained strongly linked with a low WAI after an adjustment to the other risk factors. The WAI enables the workplace physician to summarize data which the hospital can use to further its thinking about how to manage jobs and skills.

Method to evaluate the quality of work place health promotion in security organisations

A method for assessing the quality of workplace health promotion (WHP) in security organisations (WHP-SEC method) was developed and evaluated. It is based on the quality criteria and questionnaire for self-assessment “Healthy Employees in Healthy Organisations—Good Practice in Workplace Health Promotion in Europe” and the Finnish concept for the promotion of work ability. The current version of the WHP-SEC method seems to be valid, reproductive, and feasible. It helps the evaluation of the entire WHP process. The WHP-SEC method is anticipated to be suitable for self-evaluation, benchmarking activities and external evaluations of the quality of the WHP in security organisations.

Can age management promote work ability among older workers?

Facing an expected future labour shortage due to demographic factors, there is a growing interest in many countries, how to cope with early retirements among older workers. The Swedish government has financed two Age Management intervention programmes for the public sector. The goals for both programmes were to break the negative trends in regard to long time sick leaves as well as early retirements. The main focus was Age Management training and professional support through a mentorship programme for middle managers. The concept of work ability rather than work inability was of crucial importance to the programmes. The programmes have demonstrated that Age Management can be applied in a successful way, also in the Swedish labour market. As expected, positive results will not come easily and without hard work and a commitment from employers, employees and labour unions. To break down barriers and find new ways to develop a more age-friendly work organisation calls for a close cooperation between the social partners.

Factors associated with premature departure from working life among ageing food industry employees.

To find out how health status, work ability and job-related factors were associated with premature departure from working life in an 11 year follow-up period. The study population was composed of 126 ageing food industry employees. Baseline data were derived from medical examinations and self-completed questionnaires in 1989. The follow-up data were collected in 2000. Data analyses were performed by independent samples t-tests and Mann-Whitney and chi(2) tests. Several chronic diseases, higher degree of work impairment due to diseases, long-term sickness absence, stress symptoms, low scores in work ability index, poor subjective work ability and physical work ability, and heavy physical workload seemed to be factors associated with early departure from working life among ageing food industry employees. Identification of these factors, prevention of sickness and promotion of work ability seem to be the most important tools to reduce premature exit from working life.

Promotion of work ability, the quality of work and retirement.

In this study, the validity of a model designed to promote the work ability of aging workers was examined. The target areas of work ability promotion were searched for the characteristics that explain work ability the best. In addition, the way work ability relates to the quality of work and retirement was examined. The subjects (n = 1101) participated in the follow-up study on aging Finnish workers in 1992 and 1997. The results consistently supported the model for promoting work ability. All four areas of focus-(i) work demands and the environment; (ii) work organization and the work community; (iii) the promotion of workers' health and functional capacity; and (iv) the promotion of professional competence-proved to be strongly associated with work ability. Good work ability was associated with a high quality of work and the enjoyment of staying in one's job. It also predicted active and meaningful retirement.

Research challenges arising from changes in worklife.

Great challenges for occupational health research are set by the rapid changes in the world of work as a consequence of globalization, new technologies, demographic workforce changes, fragmentation of enterprises and work contracts, high time pressures, high demands for learning new skills, and growing worker mobility. The occupational health problems are of 2 types, the persistent and reemerging old problems of occupational injuries and diseases and new challenges from psychological stress, musculoskeletal disorders caused by computerized work, cognitive ergonomics in information-intensive work, the work ability of aging workers, and new trends in occupational allergies. The 3 roles of research, improvement of knowledge, improvement of understanding, and support of the development of work conditions in practice, all call for new initiatives in occupational health research. The new comprehensive strategy for the development and promotion of work ability has been found to respond effectively to these new needs.

Promotion of work ability during ageing.

The aging of the work force is a global phenomenon. The main reasons for this historical change are (i) the large baby boom generation born in the 1940s-1950s is entering its 50s, and (ii) the subsequent generations have been relatively small. For example, in the European Union (EU) the relative proportion of those aged 50-64 years will be about 27% of the entire work force in 2005. In 2025, this proportion will approach 35%. During the same period, the youngest part of the work force, those aged 15-24 years, will decline, and form only 17% of the EU work force. As a consequence, there will be potentially double the number of older workers as compared to younger workers in the EU over the next 25 years (Eurostat, New Cronos 1998).