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BACKGROUND: Sustainable employability (SE) has become an important factor for keeping people in the labour market and enabling the extension of working life. AIMS: We developed and validated an SE index to predict assured workability in 2 years. Additionally, we developed a scoring tool to use in practice. METHODS: A questionnaire survey of postal employees aged ≥50 years was conducted in 2016 and followed up in 2018 (n = 1102). The data were divided into training and validation sets. The outcome was defined as whether the employees had an assured workability after 2 years or not. Multivariable log-binomial regression was used to calculate the SE index. The area under the curve (AUC) was calculated to assess the discriminative power of the index. RESULTS: The probability of assured workability increased with increasing quintiles of the SE index. The highest quintiles of the SE index showed the highest observed and expected assured workability in 2 years. The predictive ability, area under the curve (AUC) for training was 0.79 (95% CI 0.75-0.83) and for validation data was 0.76 (95% CI 0.73-0.80). In the scoring tool, the self-rated health, workability, job satisfaction and perceived employment had the highest contribution to the index. CONCLUSIONS: The SE index was able to distinguish the employees based on whether they had assured workability after 2 years. The scoring method could be used to calculate the potentiality of future employability among late midlife postal employees.

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BACKGROUND: Work Ability Score (WAS) is a common instrument for assessing work ability but its validity in assessing presenteeism and productivity loss is unknown. AIMS: To validate a WAS-based measure, the Presenteeism Scale (PS), and to evaluate its accuracy as a presenteeism instrument among forestry employees. METHODS: This validation study was based on questions of perceived WAS assessed using the Work Ability-Personal Radar (WA-PR) instrument and on questions of perceived productivity loss and presenteeism assessed using a cross-sectional questionnaire survey. Pearson's correlation test was used to ascertain the associations between variables. The association of productivity loss with presenteeism was evaluated using a logistic regression model. The predictive ability of presenteeism was tested using the receiver-operating characteristic curve. RESULTS: There were 339 respondents in the cross-sectional survey, 257 in the WA-PR and 107 respondents participating in both surveys. The prevalence of presenteeism was 48%. Presenteeism was significantly (P < 0.05) higher among those reporting productivity losses. Presenteeism is extremely accurate in predicting perceived productivity loss but less accurate in predicting PS-based productivity loss. The odds ratio (OR) of self-estimated productivity loss was 77 times higher (OR 77.39, 95% confidence interval [CI] 25.36-236.12) among those with presenteeism. Correspondingly, OR of productivity loss based on the PS was three times higher (OR 3.05, 95% CI 1.16-8.04). CONCLUSIONS: The PS may be a valid tool for predicting productivity loss and may be as good as other instruments. However, further research is needed to improve its accuracy.

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BACKGROUND: We investigated the separate and joint effects of multi-site musculoskeletal pain and physical and psychosocial exposures at work on future work ability. METHODS: A survey was conducted among employees of a Finnish food industry company in 2005 (n = 1201) and a follow-up survey in 2009 (n = 734). Information on self-assessed work ability (current work ability on a scale from 0 to 10; 7 = poor work ability), multi-site musculoskeletal pain (pain in at least two anatomical areas of four), leisure-time physical activity, body mass index and physical and psychosocial exposures was obtained by questionnaire. The separate and joint effects of multi-site pain and work exposures on work ability at follow-up, among subjects with good work ability at baseline, were assessed by logistic regression, and p-values for the interaction derived. RESULTS: Compared with subjects with neither multi-site pain nor adverse work exposure, multi-site pain at baseline increased the risk of poor work ability at follow-up, allowing for age, gender, occupational class, body mass index and leisure-time physical activity. The separate effects of the work exposures on work ability were somewhat smaller than those of multi-site pain. Multi-site pain had an interactive effect with work environment and awkward postures, such that no association of multi-site pain with poor work ability was seen when work environment was poor or awkward postures present. CONCLUSIONS: The decline in work ability connected with multi-site pain was not increased by exposure to adverse physical or psychosocial factors at work.

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BACKGROUND: Multi-site pain is a common phenomenon among working-age people and it strongly increases work disability risk. Little is known about the impact of musculoskeletal pain on work ability. AIMS: To investigate whether the number of musculoskeletal pain sites predicts future poor work ability. METHODS: The study was conducted in 2005 and 2009 in a food processing company. A total of 734 workers participated in the study. The information on self-perceived work ability and musculoskeletal pain during the preceding week was obtained through a structured questionnaire distributed to employees. The risk of poor work ability at follow-up related to the number of pain sites at baseline was estimated with logistic regression. RESULTS: The proportion of poor work ability increased in 4 years from 15 to 22%, parallel to the increase in the number of pain sites. Among those with 'non-poor' work ability at baseline, one-tenth reported their work ability to be poor after 4 years. The number of pain sites predicted poor work ability after 4 years of follow-up with a dose-response manner. Those with widespread pain had almost a 3-fold risk of developing poor work ability at follow-up. The associations were stronger for younger and white-collar workers. CONCLUSIONS: The results of the present study indicate that multi-site musculoskeletal pain at baseline strongly predicts poor work ability after 4 years among industrial workers. Counting the number of concurrent pain sites may be a simple method of identifying workers with high risk of work disability in occupational health practice.

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BACKGROUND: The effects of workplace interventions on sickness absence are poorly understood, in particular in ageing workers. AIMS: To analyse the effects of a senior programme on sickness absence among blue-collar food industry workers of a food company in Finland. METHODS: We followed up 129 employees aged 55 years or older, who participated in a senior programme (intervention group), and 229 employees of the same age from the same company who did not participate (control group). Total sickness absence days and spells of 1-3, 4-7, 8-21 and >21 days were recorded for the members of the intervention group from the year before joining the programme and for the control group starting at age 54 years. Both groups were followed for up to 6 years. RESULTS: The median number of sickness absence days per person-year increased significantly from baseline in both groups during the follow-up. Compared with the control group, the intervention group had increased risk for 1-3 days spells [rate ratio 1.34 (1.21-1.48)] and 4-7 days spells [rate ratio 1.23 (1.07-1.41)], but the risk for >21 days spells was decreased [rate ratio 0.68 (0.53-0.88)] after participation in the senior programme. CONCLUSIONS: A programme to enhance individual work well-being in ageing workers may increase short-term but reduce long-term sickness absence.

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BACKGROUND: Occupational deaths are used as indicators of occupational safety worldwide. The Arkhangelsk region is among the areas with the highest burden of fatal occupational injuries (FOI) in Russia. AIMS: To describe the occurrence of FOI in the Arkhangelsk region in 1996-2007. METHODS: Data on all FOI reported in the Arkhangelsk region in 1996-2007 were obtained from the State Labour Inspection. Data on the number of employees were collected at the Regional Federal State Statistics Service. The incidence of FOI was calculated by gender, age and economic activity per 100,000 employees. Blood alcohol concentration for all victims was available from the autopsy records. RESULTS: Altogether, there were 734 occupational fatalities during the study period, 94% of them were among men. The incidence of FOI decreased from 18.6 (95% CI 14.6-23.6) in 1996 to 11.7 (95% CI 8.5-16.0) in 2007 among men and from 1.3 (95% CI 0.5-3.2) in 1996 to 0.3 (95% CI 0.1-1.7) in 2006 among women. The agriculture, hunting and forestry sector had the highest incidence of FOI, but they also showed a decrease in FOI from 43.9 (95% CI 32.3-65.3) in 1996 to 20.8 (95% CI 12.0-36.1) in 2007. The highest proportion of FOI occurred on Tuesdays (17%) and Wednesdays (18%). Thirty two of the victims had blood alcohol concentration >0.5 per thousand. CONCLUSIONS: The incidence of FOI in the Arkhangelsk region decreased from 1996 to 2007, but remains high and varies by gender, age and economic activity over time.

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The aim of the current study was to find out how the measures of chairs and desks match with the anthropometrics of schoolchildren and how schoolchildren sit during a lesson in their classroom. This paper reports the baseline measurements of an intervention study. Participants of this study were 6th and 8th grade (12 and 14 year old) schoolchildren from two comprehensive schools in Finland (N = 101, 57 girls and 44 boys). The main outcome measures were the differences between desk height and elbow-floor height, and chair height and popliteal height. Forty-three participants were randomized for sitting posture analysis by video recordings. The study showed that desks were on average 13 cm above elbow-floor height and chairs 2 cm below popliteal height. For 56% of time participants sat with their backs flexed >20 degrees and/or rotated >45 degrees . For 70% of time they sat with their necks flexed >20 degrees or rotated >45 degrees. The results indicate that there is a mismatch between school furniture and the anthropometrics of schoolchildren. Schoolchildren sit in disadvantaged postures for a substantial part of school lessons.

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BACKGROUND: While cardiovascular diseases are prevalent in aging population, associations between different factors and cardiovascular diseases are less studied or inconsistency still exists. AIM: To determine which factors measured at baseline predicted overall cardiovascular diseases and hypertension, and which factors were currently associated with these conditions. METHODS: Based on a sample of aging and retired food industry employees (N = 100, mean age 62 years) associations of health, dietary and job-related factors and mental problems with overall cardiovascular morbidity and hypertension were assessed with independent samples t-test, chi2 test and binary logistic regression analyses. Data were derived from health examinations and self-completed questionnaires in 1989 and 2000. RESULTS: Added medical findings, related to cardiovascular diseases, appeared as predictor of overall cardiovascular morbidity, while elevated blood pressure together with high systolic and diastolic pressure, dyslipidemia and elevated blood pressure together, added medical findings, and inability to enjoy daily activities predicted hypertension. According to our analyses most significant current associations with overall cardiovascular morbidity were feeling of weakness, dyspnoea, hopelessness about the future, cardiac arrhythmia, chronic mental stress and lower HDL cholesterol, and with hypertension metabolic syndrome, lower HDL cholesterol, hopelessness about the future and muscular fatigue on exertion. CONCLUSIONS: Health factors were most important predictors of hypertension during a long-term period, while health factors together with mental problems had significant current associations with overall cardiovascular morbidity including hypertension.

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METHODS: The relationship between sickness absence and job control among industrial food workers of different ages (n = 114) was studied. RESULTS: The number of absence spells, particularly short absence spells, was higher among younger workers, as expected. Using multivariate analysis, low job control was associated with an increased number of all absence spells (P < 0.02). CONCLUSIONS: Job control may be an important factor in determining sickness absence among industrial workers.

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AIM: 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. METHODS: 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. RESULTS: 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. CONCLUSION: 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.

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An organizational change among 82 postal workers was studied with the aim of evaluating the effects on the work environment, work ability, and musculoskeletal complaints. The study was undertaken in 2 suburbs of Stockholm, Sweden. Psychological work demands were estimated to be reduced at the 1-year follow-up but physical work demands had changed very little. In an observation study in a subgroup of older workers, the risk of overexertion at work and musculoskeletal complaints was reduced. In spite of that, most of the older participants (>/=35 years) had unchanged or increased musculoskeletal symptoms. This shows the need for early preventive measures.

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The objective of this follow-up study of aging workers was to determine changes in the work, life-style, health, functional capacity, and stress symptoms of Finnish municipal employees from 1981 to 1992. In addition, factors that predict improvement or decline in the ability to work were studied. With the use of this information, attempts were made to produce practical measures to decrease the work-related health risks of elderly workers and increase factors promoting work ability. Along with the stress-strain model applied in the study, the reference frame of the World Health Organization (WHO) was used. The WHO model emphasizes the interaction between work, life-style, aging, and health. Work, life-style, health, work ability, and stress symptoms were studied through the use of comprehensive questionnaire surveys in 1981, 1985 and 1992. Initially, all the subjects (N = 6257) were employed in municipal occupations. During the follow-up, the data were supplemented by information on disability to work and mortality. The changes in work, life-style, health, work ability, and stress symptoms were examined among employees who worked in the same job (N = 924) during the entire follow-up period.

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OBJECTIVE: Perceived changes in mental and physical work demands and work content were evaluated longitudinally. METHODS: Municipal workers (N = 924) in the same job from 1981 (mean age 47 years) to 1992 (mean age 58 years) in the work content groups of mental, mixed mental and physical, or physical work responded to a questionnaire in both 1981 and 1992. RESULTS: The workers reported that the physical and mental demands of their jobs had mainly increased from 1981 to 1992, especially muscular work and use of knowledge. In 1992 the women still perceived higher physical demands than the men but felt they had greater possibilities to develop. The use of knowledge had increased, especially among the women, and was on the same level for both genders. The perception of changes differed in the 3 work content groups. CONCLUSIONS: Perceived work demands increase with age. Although the 3 work content categories differ somewhat as to perceived changes over time, in general, the changes may be more connected to personal factors than work factors. Older persons seem to work at a relatively higher capacity than younger workers, and this higher work load may be a risk factor for early work disability. Work demands and stress factors should therefore be surveyed and balanced according to the capacity of the aging worker. On the other hand, workers' perception of possibilities to develop seem to increase with age. The differences between men and women may especially diminish at a later age.

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OBJECTIVES: This study evaluated perceived changes in stress symptoms and the relationship of these changes to work during an 11-year period. METHODS: The sample consisted of municipal workers in different occupational groups who had remained in the same occupation during 1981-1992 (N = 924, 350 men and 574 women, 14.8% of the original sample in 1981). The age range was 44-51 years in 1981. Changes in the physical and mental stress symptoms and changes at work were analyzed with the aid of a structured questionnaire in 1981 and 1992. RESULTS: The questionnaire surveys revealed that stress symptoms were markedly increased, especially aches and pain in the upper and lower limbs, but also respiratory and cardiovascular symptoms. Avoidance reactions, including sense of apathy in general and desire to stay at home in the morning, were the most increased psychological symptoms. The women experienced a greater increase in symptoms than the men. Changes in symptoms were associated with changes at work in that, in general, the more symptoms had increased, the more the work had also been changed. CONCLUSIONS: The results suggest that the impact of work on the functional capacity and symptoms of workers might start even earlier than the age of 45 years. This finding is of crucial importance when preventive measures and policies are being planned in regard to stress and physical and mental load at work. Results on the relationship of changes in cardiorespiratory symptoms and work tentatively suggest that, by developing job content and social support, even a positive impact on physical symptoms is possible.

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In ergonomic epidemiology exposure to local loads as well as cardiovascular load may contribute to general and local fatigue and musculoskeletal disease. Self-reported exposure is often the only feasible method in large population studies. The aim of this study was to evaluate retrospectively self-reported physical activity and perceived exertion as estimates of cardiovascular load during occupational work. The study population consisted of 39 men, representing 25 different occupations, and 58 women, representing 28 occupations. Ratings of physical exertion (RPE scale) and physical activity (Edholm scale transferred to multiples of the basal metabolic rate, METs) at the end of a work shift were correlated with the average heart rate during the same work shift. In the male population, both RPE ratings and METs correlated significantly (P < .01) with the average heart rate. No such correlation was observed in the female population.

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A study was undertaken to investigate physical work load, physical capacity, physical strain and perceived health among elderly aides in home-care service. A secondary aim was to compare the work load and strain between the two main types of home-care service available in Sweden today. Work tasks and their distribution among 20 elderly aides (aged 45-65 years), working in open home-care service (clients living in their original flats or houses) and at service apartment houses (clients living in private flats constructed for the elderly and handicapped with service functions) were observed during whole work days. Heart rate and number of steps taken were also measured continuously during the whole work day. Oxygen consumption and work postures for upper arm and back were measured during parts of the work day. The results showed that home-care work is characterised by long periods of standing and walking and that postures potentially harmful for the low back and shoulders occurred frequently. Average physiological strain measured as relative oxygen consumption and heart rate during the work day did not exceed present recommendations. Average physical work load and strain in open home-care service slightly exceeded those in service apartment houses because of more frequent cleaning and walking outdoors. Many aides in this study showed slightly reduced physical capacity, and musculoskeletal problems were common. Many elderly aides in home-care service are probably exposed at work to high risks of overexertion and impaired health as a result of high postural loads in combination with other known important factors, such as time stress and lack of equipment.

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The objective of this cross-sectional study was to determine whether habitual physical activity such as daily walking at work affects bone mineral density (BMD) in healthy premenopausal women. Thirty-one letter or newspaper carriers and 30 sedentary (non-exercising) office workers were screened out from 167 subjects working in the public post office and a private newspaper publishing company. BMD was measured with a dual-energy X-ray densitometer at the lumbar spine (L2-4), femoral neck, distal femur, patella, proximal tibia, calcaneus and distal radius. In addition, maximal isometric strength, cardiorespiratory fitness, anthropometry, 4-day dietary record and daily occupational work load were assessed. During one work shift the carriers' mean walking distance was 5926 m, with 68 flights of stairs walked, and their mean heart rate was 105 beats/min (114 beats/min during the delivery). The corresponding figures for the office workers were significantly lower: 1895 m, 10 flights and 82 beats/min, respectively. Neither the BMD values adjusted for body mass index (kg/m2) and calcium intake nor the indices of physical performance capacity showed significant differences between the groups. Consequently, habitual daily walking and stair climbing by healthy premenopausal women appeared to be insufficient exercise stimulus to increase considerably the BMD or aerobic and muscular fitness above the values found in a comparable group of sedentary office workers.

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A study was made of the appraisers' effect on the estimation of metabolic rate with the Edholm scale and a table of the ISO 7243 heat stress standard. The appraisers, five experienced and five inexperienced persons, estimated the metabolic rate of three different work tasks from videotapes. Analysis of variance indicated significant ( [Formula: see text] ) differences in the appraisers' recordings of the activities. The appraisers were grouped according to the similarity of the estimated values they gave. The groups thus contained both experienced and inexperienced appraisers, and it was not possible to classify the appraisers into experienced and inexperienced groups according to their earlier experience. The metabolic rates according to the Edholm scale were higher than according to the ISO 7243 table. The differences in metabolic rates given by the individual observers varied from 38 to 118 W/m(2). The variations in the estimation of metabolic rates were greater when the Edholm scale was used. This variation caused considerable variation also in the predicted mean vote, PMV index. It is recommended that the appraisers be selected carefully, because it is not possible to know whether a randomly selected appraiser is an 'average' or an 'extreme' appraiser without a test. Before conducting extensive field surveys where several appraisers estimate the metabolic rates, it would be useful to arrange training in order to calibrate the levels of the Edholm scale as well as ISO method among the appraisers because training clearly unified the estimation.