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      Lifestyle and work ability in a general working population in Norway: a cross-sectional study

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          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 (OR adj 1.3, 95% CI 1.02 to 1.5), inactive persons (OR adj 1.4, 95% CI 1.2 to 1.6), obese respondents (OR adj 1.5, 95% CI 1.3 to 1.7) and former and current smokers (OR adj 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: OR adj 1.3; 95% CI 1.1 to 1.6; high-risk score: OR adj 1.9; 95% CI 1.6 to 2.2; very high risk score: OR adj 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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          Most cited references46

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          The effects of work-related and individual factors on the Work Ability Index: a systematic review.

          T. I. J. van den Berg, L. Elders, B C H de Zwart … (2009)
          This paper systematically reviews the scientific literature on the effects of individual and work-related factors on the Work Ability Index (WAI). Studies on work ability published from 1985 to 2006 were identified through a structured search in PubMed, and Web of Science. Studies were included if the WAI was used as measure of work ability and if quantitative information was presented on determinants of work ability. In total, 20 studies were included with 14 cross-sectional studies and six longitudinal studies. Factors associated with poor work ability, as defined by WAI, were lack of leisure-time vigorous physical activity, poor musculoskeletal capacity, older age, obesity, high mental work demands, lack of autonomy, poor physical work environment, and high physical work load. The WAI is associated with individual characteristics, lifestyle, demands at work, and physical condition. This multifactorial nature of work ability should be taken into account in health promotion programmes aimed at maintaining and promoting the participation of the labour force and improvement of the performance at work.
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            The Work Ability Index (WAI)

            J Ilmarinen (2006)
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              Work ability assessment in a worker population: comparison and determinants of Work Ability Index and Work Ability score

              Mehdi El Fassi, Valéry Bocquet, Nicole Majery … (2013)
              Background Public 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). Methods Using 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). Results The 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. Conclusion The 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.
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                Author and article information

                Journal
                Journal ID (nlm-ta): BMJ Open
                Journal ID (iso-abbrev): BMJ Open
                Journal ID (hwp): bmjopen
                Journal ID (publisher-id): bmjopen
                Title: BMJ Open
                Publisher: BMJ Publishing Group (BMA House, Tavistock Square, London, WC1H 9JR )
                ISSN (Electronic): 2044-6055
                Publication date Collection: 2019
                Publication date (Electronic): 3 April 2019
                Volume: 9
                Issue: 4
                Electronic Location Identifier: e026215
                Affiliations
                [1 ] departmentDepartment of Nursing and Health Sciences , University of South-Eastern Norway , Porsgrunn, Norway
                [2 ] departmentDepartment of Occupational and Environmental Medicine , Telemark Hospital , Skien, Norway
                Author notes
                [Correspondence to ] Marit Müller De Bortoli; marit.muller@ 123456usn.no
                Author information
                http://orcid.org/0000-0002-3345-774X
                Article
                Publisher ID: bmjopen-2018-026215
                DOI: 10.1136/bmjopen-2018-026215
                PMC ID: 6500250
                PubMed ID: 30948597
                SO-VID: f5a3865a-7491-4601-8359-84a1392629ff
                Copyright © © Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.
                License:

                This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date received : 13 September 2018
                Date revision received : 18 January 2019
                Date accepted : 28 January 2019
                Categories
                Subject: Occupational and Environmental Medicine
                Subject: Research
                Subject: 1506
                Subject: 1716
                Custom metadata
                special-feature unlocked

                ScienceOpen disciplines: Medicine
                Keywords: lifestyle risk factors,work ability,general working population
                Data availability:
                ScienceOpen disciplines: Medicine
                Keywords: lifestyle risk factors, work ability, general working population

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