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A note on using the workability index (WAI) to predict future earnings capacity losses in moderate to severe partial disability cases
Disability and Rehabilitation
Abstract
Purpose:
Disability experts are often called upon to analyze the economic impact of an injury. Determining future economic loss in cases of disabilities is difficult, particularly when the disabilities are considered partial in nature, and the individuals have some capacity to mitigate their future income losses. This paper examines one possible approach for examining reduced future income capacity in cases of partial disabilities, the use of the Work Ability Index (WAI) and Work Ability Scale (WAS).
Materials and methods:
Empirical data from one-hundred six cases is analyzed using a censored tobit regression to determine the relationship between scores on the WAI/WAS and verified long-term income losses for individuals who suffered disabling events.
Results:
The study found a high correlation between the scores obtained on both the WAI and WAS measures, and future economic loss. The results suggest that these scales may be very useful in analyzing reduced future income capacity in situations involving partial disabilities.
Conclusions:
This study assists the rehabilitation and disability expert to better understand the implications of a moderate to severe disability on the future income capacity of an injured person. It also provides additional support for the validity of the WAI/WAS scales.
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Purpose
To 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.
Methods
We 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.
Results
During 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.
Conclusion
Among 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.
Background: There is limited knowledge regarding the impact of rehabilitation on work ability. The aim of this study was to explore factors associated with work ability 12 months following a multidisciplinary rehabilitation program in a cohort with different diagnoses. Methods: Of 9108 potentially eligible participants for the RehabNytte research project, 3731 were eligible for the present study, and 2649 participants (mean age 48.6 years, 71% female) consented to contribute with work-related data, and were included. Self-perceived work ability was assessed by the Work Ability Score (WAS) (0–10, 10 = best), during the follow-up period using paired t-tests and logistic regression to examine associations between demographic and disease-related factors and work ability at 12-month follow-up. Results: The mean baseline WAS for the total cohort was 3.53 (SD 2.97), and increased significantly to 4.59 (SD 3.31) at 12-month follow-up. High work ability (WAS ≥ 8) at 12 months was associated with high self-perceived health at the baseline (OR 3.83, 95% CI 2.45, 5.96), while low work ability was associated with a higher number of comorbidities (OR 0.26, 95% CI 0.11, 0.61), medium pain intensity (OR 0.56, 95% CI 0.38, 0.83) and being married or cohabiting (OR 0.61, 95% CI 0.43, 0.88). There were no significant differences in work ability between participants receiving occupational and standard rehabilitation. Conclusions: Work ability increased significantly over the follow-up period. High work ability at 12-month follow-up was associated with high self-perceived health at baseline, while being married or cohabiting, having higher number of comorbidities, and experiencing medium baseline pain intensity was associated with lower work ability. Rehabilitation interventions targeting these factors may potentially enhance work ability, leading to a positive impact on work participation among people in need of rehabilitation.
Purpose:
To ascertain the feasibility and acceptability of delivering a job retention vocational rehabilitation intervention [MSVR] for people with multiple sclerosis (pwMS) in a community setting. Secondary objectives included determining whether MSVR was associated with changes in quality of life, fatigue, mood, cognition, workplace accommodations, work instability, work self-efficacy, and goal attainment.
Methods:
Single-centre mixed-methods feasibility case series.
Results:
15 pwMS and three employers received 8.36 (SD = 4.48) and 1.94 (SD = 0.38) hours of MSVR respectively over three months. The intervention predominantly addressed managing cognition, fatigue, and negotiating reasonable accommodations. Four healthcare professionals were recruited to clarify clinical information.The intervention was feasible to deliver, and there was a significant positive impact on goal attainment immediately following MSVR (t(14) = 7.44, p = .0001, d = 1.9), and at months 3 (t(13) = 4.81, p = .0001, d = 1.28), 6 (t(11) = 4.45, p = .001, d = 1.28), and 12 (t(9) = 5.15, p = .001, d = -2.56). There was no impact on quality of life, fatigue, mood, cognition, workplace accommodations, work instability, and work self-efficacy. In post-intervention interviews, participants reported that MSVR was acceptable. Four themes were derived regarding the context, employer engagement, empowerment through knowledge, and intervention components and attributes.
Conclusion:
It was feasible and acceptable to deliver MSVR. Participants better understood their MS, became more confident managing problems at work and attained their work-related goals.IMPLICATIONS FOR REHABILITATIONPeople with multiple sclerosis (MS) experience problems at work because of the interaction between symptoms and environmental factors (e.g., co-workers' attitudes).Vocational rehabilitation for people with MS and their employers should be tailored in terms of content and intensity.People with MS can be empowered at work by learning about MS and how their symptoms fluctuate over time.Understanding legal responsibilities and examples of accommodations at work can be beneficial for employers.
Introduction: Nurses are considered to be the frontline healthcare
professionals with prolonged hours of caring for ailing as well
as critically ill patients. This highly demanding work pattern can
lead them to experience Work-related Musculoskeletal Disorders
(WRMSD) and thus makes it important to study its prevalence and
its impact on workability and to develop appropriate supportive
strategies to improve their health and work efficiency.
Aim: To explore the prevalence of WRMSDs among hospital
nurses in Delhi, including the risk factors and coping strategies
adopted by them to avoid the risk of WRMSDs.
Materials and Methods: This multicentric survey, cross-sectional
study was conducted in different hospitals in Delhi, India, from October
2020 till March 2021 among 260 nurses. Data were collected using
the Nordic Musculoskeletal Questionnaire (NMQ), Perceived Stress
Scale (PSS) and Workability Index (WAI). Pearson’s product moment
correlation was used to develop correlations for continuous variables
and Biserial correlation test was used for dichotomous variables. The
level of significance was 95% (p-value
Purpose
A cross-sectional and longitudinal study was conducted to analyse construct validity, responsiveness, and Minimal Clinically Important Change (MCIC) in the Work Ability Score (WAS) and Pain Disability Index Work item (PDI-W) in patients with Chronic Low Back Pain (CLBP).
Method
Construct validity was assessed by testing predefined hypotheses. Responsiveness and MCIC were measured with an anchor-based method. The area under the receiver Operating Characteristic Curve (AUC) and the optimal cut-off point were calculated. Smallest Detectable Change (SDC) was calculated to determine measurement error.
Results
In total, 1502 patients (age 18–65 years) with CLBP were included. For validity of the WAS and PDI-W, respectively, seven and six out of 10 hypotheses were not rejected. The WAS (n = 355) was responsive to change with an AUC of 0.70. MCIC was 1.5 point, SDCindividual 4.9, and SDCgroup 0.3. MCICs were 4.5, 1.5, and − 0.5 points for, respectively, low, middle, and high scoring baseline groups. The PDI-W (n = 297) was responsive to change with an AUC of 0.80. MCIC was − 2.5 points, SDCindividual 5.2, and SDCgroup 0.3. MCICs were − 0.5, − 2.5, and − 4.5 points for, respectively, low, middle, and high scoring baseline groups.
Conclusion
Construct validity of the WAS and PDI-W was insufficient in this patient sample. The WAS and PDI-W are responsive to change. On average, improvements of 1.5 point (WAS) and − 2.5 points (PDI-W) were interpreted as clinically important. However, MCICs are also baseline dependent. Due to a risk of measurement error, at the individual level change scores should be interpreted with caution.
Purpose Chronic musculoskeletal pain can have a major impact on ability to work. The work ability score is a commonly used single-item question to assess work ability but has not been fully validated yet. The aim of the present study was to evaluate test–retest reliability, agreement, construct validity, and responsiveness of the work ability score among sick-listed workers with chronic musculoskeletal pain. Methods Data of sick-listed workers with chronic musculoskeletal pain was routinely collected at seven rehabilitation centres in the Netherlands. Assessments included a set of questionnaires, administered at admission and discharge from a fifteen-week vocational rehabilitation program. Test–retest reliability was determined with the intraclass correlation coefficient. For agreement, the standard error of measurement and smallest detectable changes were calculated. Construct validity was assessed by testing hypotheses regarding Spearman rank correlation coefficient. Area under the curve obtained from the receiver operating characteristic curve and minimal clinically important change were determined for the total sample and work ability score baseline tertile groups to assess responsiveness. Results In total, 34 workers were analyzed for reliability and agreement, 1291 workers for construct validity, and 590 responded to the responsiveness questionnaire. Reliability reached an intraclass correlation coefficient of 0.89; 95% CI 0.77–0.94, a standard error of measurement of 0.69 points, and the smallest detectable change of 1.92 points. For construct validity, six of the seven predefined hypotheses were not refuted. The area under the curve was 0.76 (95% CI 0.71–0.81) allowing for discrimination between stable and improved workers, with a minimal clinically important change of 2.0 points for the total sample. Conclusion The work ability score showed good measurement properties among sick-listed workers with chronic musculoskeletal pain.
Background
The concept of workability provides a conceptual framework and proposes measures for the evaluation of relevant actions focused on a healthy workforce. In Spain, one of the countries with the highest life expectancy, there are practically no scientific studies on workability and its associated factors.
Aims
The objective of this study is to examine the associations between workability and variables related to health and work in a sample of workers from Spanish health centres.
Methods
Cross-sectional study including 1184 health centre workers who completed a questionnaire at baseline, comprising measures of workability, health and other work-related factors. Workability has been analysed as a one-factor construct, and as a two-factor construct. Multinomial logistic regression models were used to analyse factors associated with workability.
Results
As a one-dimensional construct, workability is associated with physical and mental health, number of hours of worked, insomnia, work and family life balance, adequate training, never having had an accident and type of contract. When the two-factor measure was used, sensitivity of findings increased, and it was identified that those participants who were older, lived alone and have more years of service in their profession also show worse workability.
Conclusions
The present study identified factors associated with the workability of health centre workers. The two-factor workability index (WAI) has better psychometric properties and used in combination with the global measure of WAI, identifies important additional aspects, specifically, age and years of professional experience as additional considerations for the intervention.
Objectives
Maintenance and promotion of employees' work ability is one of the important social goals. This study is aimed at investigating psychometric properties of the Persian translation of work ability index (WAI).
Methods
A total number of 750 employees were randomly selected from car manufacturing and petrochemical industries. Reliability of the questionnaire was determined using test‐retest and Cronbach alpha coefficient. Factor analysis was used for assessing construct validity. To determine discriminant validity, the mean score of total WAI was compared between workers with high and low sick leave rate.
Results
Intraclass correlation coefficients for its seven dimensions were estimated higher than 0.7. The questionnaire showed a good internal consistency, Cronbach α = 0.78. Factor analysis showed a three‐factor structure model for Persian translation of WAI including: mental resources, self‐perceived work ability, and presence of disease and health‐related limitation. A good level of discriminant validity was observed for all WAI dimensions except the item “work ability regarding work demands.”
Discussion
The study findings indicate that the Persian version of WAI questionnaire has good psychometric properties of internal consistency and test‐retest showed a good reliability of WAI questionnaire, which is in line with those found in previous studies. Therefore, this tool can be considered as a reliable instrument for assessing work ability.
Industrial accidents cost a huge amount of money, but they also have negative consequences in many respects. We analyzed the data of the first to fourth panel study of workers’ compensation insurance (PSWCI). Repeated measures ANOVA was used to compare the annual income before and after the industrial accident, and a general linear model was used to identify changes in income due to disability ratings and participation in economic activities. The wages before the industrial accident and the annual income varied among the disabilities ratings. In addition, for affected workers, the average income during four years post-accident was lower than the average income before the accident. Regression analysis to see changes in income after the industrial accident showed that the group with a disability rating of 11–14 and no injuries had a suffered a greater income decrease than those with a disability rating of 1–3, and the unemployment group saw a greater decrease in income than the employment group. Workers who were affected by industrial accidents received lower incomes than before the accident, and even considering different disability ratings, there was a greater decrease in income among the unemployed group than in the working group.
Objectives:
We analyzed the work ability index (WAI) and its first item (work ability score, WAS) - and subsequent four-year changes thereof - as predictors of disability pension (DP).
Methods:
We linked survey responses of 5251 Finnish municipal employees, aged 44-58 years, to pension and death register data until 2009. Job content (physical, mental, or mixed) was based on observation. Baseline (1981) WAI was divided into poor (<27), moderate (28-36), and good/excellent (>37) and WAS into poor (0-5), moderate (6-7), and good/excellent (8-10). Four-year changes in these scores were classified as strong decline (<lowest 15th percentile), slight decline, and no change/improved. Cox regression and receiver operating characteristic (ROC) analysis were used.
Results:
During follow-up, 2057 subjects were granted DP. Compared to those with good/excellent WAI, the hazard ratio (HR) for DP related to moderate and poor WAI, respectively, was 2.0 (95% CI 1.8-2.2) and 5.0 (95% CI 4.4-5.6), adjusted for sociodemographic variables and job content. For WAS, the HR were 1.8 (95% CI 1.6-2.0) and 3.4 (95% 3.0-3.8). Four-year decline in WAI/WAS further increased the risk. During the first four years of follow-up, the area under the curve (AUC) for WAI at cut-off point 27 was 0.66 (sensitivity 49.2% and specificity 82.9%) and 0.64 for cut-off point 36 (sensitivity 84.2% and specificity 44.3%). For WAS at cut-off point 5, the figures were AUC 0.63 (sensitivity 41.9% and specificity 85.0%) and AUC 0.65 for cut-off point 7 (sensitivity 78.2% and specificity 52.7%).
Conclusion:
The single-item WAS can be considered a reasonable alternative to the seven-item WAI in describing the risk of DP and as a prognostic tool.
Little is known about functional trajectories of older persons in the year before and after admission to the intensive care unit (ICU) or how pre-ICU functional trajectories affect post-ICU functional trajectories and death.
To characterize functional trajectories in the year before and after ICU admission and to evaluate the associations among pre-ICU functional trajectories and post-ICU functional trajectories, short-term mortality, and long-term mortality.
Prospective cohort study of 754 community-dwelling persons 70 years or older, conducted between March 23, 1998, and December 31, 2012, in greater New Haven, Connecticut. The analytic sample included 291 participants who had at least 1 admission to an ICU through December 2011.
Functional trajectories in the year before and after an ICU admission based on 13 basic, instrumental, and mobility activities. Additional outcomes included short-term (30 day) and long-term (1 year) mortality.
The mean (SD) age of participants was 83.7 (5.5) years. Three distinct pre-ICU functional trajectories identified were minimal disability (29.6%), mild to moderate disability (44.0%), and severe disability (26.5%). Seventy participants (24.1%) experienced early death, defined as death in the hospital (50 participants [17.2%]) or death after hospital discharge but within 30 days of admission (20 participants [6.9%]). Among the remaining 221 participants, 3 distinct post-ICU functional trajectories identified were minimal disability (20.8%), mild to moderate disability (28.1%), and severe disability (51.1%). More than half of the participants (53.4%) experienced functional decline or early death after critical illness. The pre-ICU functional trajectories of mild to moderate disability and severe disability were associated with more than double (adjusted hazard ratio [HR], 2.41; 95% CI, 1.29-4.50) and triple (adjusted HR, 3.84; 95% CI, 1.84-8.03) the risk of death within 1 year of ICU admission, respectively. Other factors associated with 1-year mortality included ICU length of stay (adjusted HR, 1.03; 95% CI, 1.00-1.05), mechanical ventilation (adjusted HR, 2.89; 95% CI, 1.91-4.37), and shock (adjusted HR, 2.68; 95% CI, 1.63-4.38).
Among older persons with critical illness, more than half died within 1 month or experienced significant functional decline over the following year, with particularly poor outcomes in those who had high levels of premorbid disability. These results may help to inform discussions about prognosis and goals of care before and during critical illness.
Physicians handling workers compensation cases serve in a dual capacity not required of physicians treating non-workers compensation cases. Not only are they are asked to treat the workers' injuries and disability symp-toms, but they are also frequently asked to evaluate the extent of economic damage done to a worker via the assignment of an impairment rating to certain types of injuries. Although physicians are trained to treat traumatic injuries as well as the symptoms of cumulative trauma processes, they gen-erally receive no training in disability evaluation. The authors examine phy-sicians ' ability to carry out their latter, "lost earnings capacity" assessment, role. Their multivariate regressions indicate that physicians' impairment ratings are poor guides to subsequent wage loss; impairment ratings ex-plain no more than one-half of 1 percent of subsequent wage loss.
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.
Workers' compensation systems are typically designed to assign higher permanent disability benefits to workers with more severe disabilities. However, little or no scientific work exists to guide the design of ratings systems to properly account for the amount of earnings power lost due to disability. In this article, we examine the effectiveness of disability ratings using matched administrative data on ratings and earnings for a large, representative sample of permanent disability claimants in California. We find that while workers with higher ratings do experience larger earnings losses on average, there are large and persistent differences in average earnings losses for similarly rated impairments in different parts of the body. We then explore how adjusting permanent disability ratings to reflect cross-impairment differences in earnings losses can affect the equity of permanent disability benefits. Adjusting disability ratings to account for typical earnings losses reduces cross-impairment differences substantially. The adjusted ratings result in a more equitable distribution of disability benefits across workers with different impairments. Copyright (c) The Journal of Risk and Insurance, 2010.
A brief history Our multidisciplinary study group (occupational physiology , psychology, medicine, epidemiology and biostatis-tics) started cross-sectional studies among municipal employees in 1981. The study participants were followed for 16 years [1,2]. Since the beginning, the use of Work Ability Index (WAI) both in research and practice has widened to various countries, and the index has been translated into 24 languages.
The purpose of this article is to explore the associations of psychosocial factors at work, life style, and stressful life events on health and work ability among white-collar workers.
A cross-sectional survey was conducted among workers in commercial services (n = 1141). The main outcome variables were work ability, measured by the work ability index (WAI), and mental and physical health, measured by the Short-Form Health Survey (SF-12). Individual characteristics, psychosocial factors at work, stressful life events, and lifestyle factors were determined by a questionnaire. Maximum oxygen uptake, weight, height, and biceps strength were measured during a physical examination.
Work ability of white-collar workers in commercial services industry was strongly associated with psychosocial factors at work such as teamwork, stress handling, and self-development and, to a lesser extent, with stressful life events, lack of physical activity, and obesity. Determinants of mental health were very similar to those of work ability, whereas physical health was influenced primarily by life style factors. With respect to work ability, the influence of unhealthy life style seems more important for older workers, than for their younger colleagues.
Among white-collar workers mental and physical health were of equal importance to work ability, but only mental health and work ability shared the same determinants. The strong associations between psychosocial factors at work and mental health and work ability suggest that in this study population health promotion should address working conditions rather than individual life style factors.
Background:
While positive short-term effects from corrective exercise on neck-shoulder pain (NSP) are evident, maintenance effects after cessation of the exercise remain unknown.
Objective:
The objective of the present study was to assess the lasting effects of corrective exercise in NSP and workability after a year of detraining.
Methods:
A cohort study with 1-year follow-up was carried out in two previous training groups (n = 24) using a self-reported paper-based questionnaire, which was completed three times (baseline, 8-week exercise, and 1-year detraining). The subjects (mean±SD age: 39.0±6.4, 38.1±8.0) responded to the Visual Analogue Scale (VAS) for NSP as the primary outcome. A single validated item from the Workability Index determined workability as the secondary outcome. Between and within-group differences of the two groups were investigated using non-parametric tests, including 12 subjects in each group.
Results:
The results indicated that 8-week exercise improvements in NSP and mental and physical workability were largely maintained after one year of detraining. The lasting effects of NSP and physical and mental workability were statistically identified in 8-week and 1- year follow-ups. Nevertheless, it is noticeably warranted to adhere to the exercise program.
Conclusion:
The current study indicates that a brief 8-week exercise period once per year is sufficient to reduce pain and improve workability among workers. This knowledge can make exercise interventions more feasible and cost-effective for companies aiming to improve employee health.
Background: Literature lacks a clear description of return to work following traumatic brain injury (TBI). Aim: to describe work metrics for people with mild and moderate/severe TBI at 3, 6, and 12 months post-injury.
Methods: A retrospective cross-sectional analysis of 172 TBI participants measuring work outcomes up to 12-months post-injury. Metrics described vocational status, accommodations, satisfaction, hours, time taken to return, financial status, and responsibilities. Logistic regression identified factors indicative of complete (80% of pre-injury hours) return to work.
Results: 59/86 moderate/severely injured (68.6%) and 68/81 mildly injured (84%) people returned to work following TBI. Twenty-eight (16.3%) achieved a complete return by 12 months. The regression model was statistically significant X² (4) = 51.980, p = <.0005, suggesting that those with high health-related quality of life, anxiety and functional ability were more likely to achieve complete return to work. At 12 months, 41 participants (23.8%) had workplace accommodations. One hundredfifteen (66.9%) were less content with their job and many reported reduced working hours.
Discussion: This study highlights the heterogeneity of work post-TBI. Even people with ‘mild’ TBI fail to make a complete return to work by 12 months.
Conclusions: Further longitudinal research is needed to explore the personal and economic legacy of TBI.
Background:
The Work Ability Index (WAI) identifies non-sicklisted workers at risk of future long-term sickness absence (LTSA). The WAI is a complicated instrument and inconvenient for use in large-scale surveys. We investigated whether shortened versions of the WAI identify non-sicklisted workers at risk of LTSA.
Methods:
Prospective study including two samples of non-sicklisted workers participating in occupational health checks between 2010 and 2012. A heterogeneous development sample (N = 2899) was used to estimate logistic regression coefficients for the complete WAI, a shortened WAI version without the list of diseases, and single-item Work Ability Score (WAS). These three instruments were calibrated for predictions of different (≥2, ≥4 and ≥6 weeks) LTSA durations in a validation sample of non-sicklisted workers (N = 3049) employed at a steel mill, differentiating between manual (N = 1710) and non-manual (N = 1339) workers. The discriminative ability was investigated by receiver operating characteristic analysis.
Results:
All three instruments under-predicted the LTSA risks in both manual and non-manual workers. The complete WAI discriminated between individuals at high and low risk of LTSA ≥2, ≥4 and ≥6 weeks in manual and non-manual workers. Risk predictions and discrimination by the shortened WAI without the list of diseases were as good as the complete WAI. The WAS showed poorer discrimination in manual and non-manual workers.
Conclusions:
The WAI without the list of diseases is a good alternative to the complete WAI to identify non-sicklisted workers at risk of future LTSA durations ≥2, ≥4 and ≥6 weeks.
What impact has anti-discrimination legislation had on the careers of disabled federal employees? Gregory B. Lewis and Cheryl Lynn Allee ask that question in light of the recent passage of the Americans with Disabilities Act (1990). Disabled federal employees have had such protection since passage of the 1973 Rehabilitation Act. Using an annual sample drawn from OPM's Central Personnel Data File between 1977 and 1989, the authors focused their analysis on hiring patterns, grade level assignments, and promotions. Lewis and Allee found that disabled federal employees "made few gains in the federal work force except in their numbers." While cautious in attributing these findings to discriminatory practices, the study's authors suggest that greater attention be paid to what happens to the career paths of disabled Americans.
Aim of the present study was to evaluate the usability of the Work Ability Index (WAI) in a random sample of the Swedish working population. Totally 6637 subjects were selected randomly from the whole Swedish population of ages 25–75 years, stratified based on gender, age and place of domicile. The present study is based on responses from employed or self-employed subjects 25 to 64 years old, 1011 women (mean age 44.4 years) and 951 men (mean age 44.9). Rank correlation analyses between total WAI score and the seven subscores and factor analyses of the seven subscores were performed in relation to gender, age group, level of total WAI score.The Work Ability Index seems to be a useful tool not only among older workers but also among the entire working population, but the distortion of the distribution should be taken into consideration when evaluating WAI results in healthy groups and when planning new studies. Further evaluations of the WAI instrument are needed regarding changes in demands in present working life, workers of different ages and in relation to other instruments that measure work ability.
This article is focused on psychometric properties of Work Ability Index. The authors have undertaken this task in order to check whether WAI may be considered as a reliable, valid and universal measurement of ability to work in the nursing profession. As an empirical basis authors used the data set obtained from Nurses' Early Exit Study—coming from 10 European countries, an extensive international survey research, conducted on almost 40,000 nurses. As a measure of work ability, WAI may be treated as internally coherent, although one item seems to be meaningless and unnecessary. Additionally, WAI should be considered a very predictive and cross-nationally stable instrument.
We evaluated outcomes 12 months after trauma in terms of general health, satisfaction, and work status.
Two hundred forty-seven patients without severe neurotrauma were evaluated by interview during admission and by mailed self-report 6 and 12 months after trauma. Data were obtained from the Trauma Registry, interviews, and survey instruments. Baseline assessment was obtained with the Short Form 36 (SF36) and the Sickness Impact Profile (SIP) work scale. Outcome measures were the SF36, SIP work scale, Brief Symptom Inventory (BSI) depression scale, the Civilian Mississippi Scale for Posttraumatic Stress Disorder (PTSD), and a satisfaction questionnaire. Three regressions were determined for outcome. The dependent variables were general health and work status (linear) and satisfaction (logistic). Each regression controlled for baseline status and mental health, Injury Severity Score (ISS), and 12-month SF36 physical function before evaluating the effect of outcome mental health.
Follow-up data were available for 75% of the patients at 6 months and 51% at 12 months. The mean age of patients was 37.2 +/- 0.9 years (+/-SEM), and 73% were male. Their average ISS was 13.9 +/- 0.6. Seventy percent of injuries were blunt force, 13.5 % were penetrating, and 16.5 % were burn injuries (mean total body surface area, 13.3 +/- 1.5%). Sixty-four percent of the patients had returned to work at 12 months. Follow-up SF36 mental health was associated with the dependent outcome in each regression. After controlling for baseline status and mental health, ISS, and outcome SF36 physical function, outcome mental health was associated with outcome SF36 general health (p < 0.001), SIP work status (p = 0.017), and satisfaction with recovery (p = 0.005). Outcome SF36 mental health was related to baseline mental health, 12-month PTSD and BSI depression scores, and increased drug and alcohol use.
Twelve months after trauma, patients' work status, general health, and overall satisfaction with recovery are dependent on outcome mental health. This dependency persists despite measured baseline status, ISS, or physical recovery. The mental disease after trauma is attributable to poor mental health, the development of symptoms of PTSD and depression, and increased substance abuse. Trauma centers that fail to recognize, assess, and treat these injury-related mental health outcomes are not fully assisting their patients to return to optimal function.
Comparing the use of the short and the long disease list in the Work Ability Index Questionnaire
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Dimensions of work ability. Elaaketurvakeskus, Finland: Finnish Centre for Pensions
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- A Jarvikosko
- Ilmarinen J
Relationship between the self-assessment and clinical assessment of health status and work ability
- L Eskeline
- A Kohvakka
- T Merisalo
- Eskeline L
Workability and well-being at work among cut-to-length forest machine operators
- K Heli
- L Juha
- V Kari
- Heli K
Income changes due to disability ratings and participation in economic activities valued by industrial accidents
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- Y Lee
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