The impact of Raynaud's phenomenon on work ability - a longitudinal study.

PurposeWe aimed to investigate which changes in the explanatory factors that were associated with positive change in the work ability score (WAS) and degree of work participation (DWP) for participants in a new 1-year vocational rehabilitation (VR) program for people on or at risk of sick leave due to obesity or obesity-related problems.Patients and MethodsThis prospective observational study included 95 participants with a body mass index (BMI) above 30 kg/m2. The 1-year multidisciplinary VR program with an integrated work and lifestyle intervention included 4 weeks of inpatient stay followed-up by five meetings. Differences between baseline and 12-month follow-up data were analyzed for the change in explanatory variables WAS, DWP, health-related quality of life (HRQoL), BMI, and return-to-work self-efficacy (RTWSE). The primary outcome was measured by multiple linear regression for predicting WAS and DWP.ResultsWe found significant changes in WAS (1.51, 95% CI: 0.83 to 2.20, p<0.001), DWP (18.69, 95% CI: 8.35 to 29.02, p<0.001), HRQoL (2.57, 95% CI: 1.35 to 3.79, p<0.001), BMI (−2.33, 95% CI: −3.10 to −1.56, p<0.001), and in RTWSE (15.89, 95% CI: 4.07 to 27.71, p = 0.009). Regression analysis yielded a strong association between WAS at 12-month follow-up with an increase in HRQoL (β=0.27, 95% CI: 0.16 to 0.38, p<0.001) and WAS baseline (β=0.49, 95% CI: 0.28 to 0.71, p<0.001). Further, regression analysis demonstrated a strong association between DWP at 12-month follow-up with return-to-work expectancy (RTWEXP) (β=−10.62, 95% CI: −15.25 to −6.03, p<0.001).ConclusionThe results indicate positive changes in WAS, DWP, HRQoL, BMI, and RTWSE from baseline to 12-month follow-up. For people with BMI above 30 kg/m2, changes in HRQoL are important for an increase in WAS, and a high RTWEXP is essential to achieve work participation. Future studies examining VR programs with lifestyle interventions for people with obesity are recommended.

BackgroundAt the beginning of the COVID-19 pandemic, some workers had the opportunity to work from home, while others remained in on-site work. The aim of the present study was to compare the psychosocial work aspects, work ability, mental health conditions and SARS-CoV-2 infection rates of Brazilian workers in remote and on-site work through a longitudinal study with quarterly follow-up assessments over a 12-month period.MethodA convenience sample of 1,211 workers from different economic sectors participated in the study, 897 of whom (74.1%) worked from home and 314 (25.9%) remained in on-site work. Psychosocial work aspects were assessed using the Copenhagen Psychosocial Questionnaire (COPSOQ). Work ability was assessed using the Work Ability Index (WAI) and the Work Ability Score (WAS). Mental health conditions and SARS-CoV-2 infection rate were recorded based on self-reported medical diagnoses. Online questionnaires were answered from June 2020 to September 2021, involving two waves of the COVID-19 pandemic. The groups were compared using chi-square tests, t-tests, and two-way ANOVA.ResultsIn the first wave of the pandemic, remote workers reported more quantitative demands and work-family conflicts, whereas on-site workers reported more emotional demands, low development of new skills, low commitment, low predictability, low recognition, and low satisfaction. They also reported greater occurrences of unwanted sexual attention, threats of violence, and physical violence. In the second wave, the remote group continued to report high work-family conflicts, whereas the on-site group reported – in addition to the results of the 1st wave – low influence at work, low quality of leadership, and burnout. No significant difference was found between groups with regards to the WAI in either wave. A significant difference was found for the WAS between the 3rd and 12th months (P < 0.01) in both groups. No significant differences were found between groups for the prevalence of anxiety, depression, burnout/stress, insomnia, panic syndrome, and eating disorders, except for the prevalence of insomnia at the 12-month follow-up, with higher rates in the remote group (P = 0.03). SARS-CoV-2 infection was significantly lower in the remote group (11.3%) compared to the on- site (16.9%) group (P < 0.01).ConclusionsPsychosocial work aspects differed between remote and on-site workers. Work ability and mental health conditions were similar between groups. Remote work might have played a role in limiting the spread of the virus in Brazil had it been more widely available.

Obesity and high physical workload are both associated with poor work ability, but the interaction between obesity and high physical workload on work ability is not yet fully understood. Obesity and high physical workload may share a common mechanical pathway, possibly leading to a synergistic negative effect on work ability. The purpose of this study was to investigate the effect of obesity on work ability in workers with high versus low physical work load. A longitudinal study was conducted among 36,435 Dutch construction workers who participated in at least two periodic medical examinations during the years 2008-2015. Logistic regression analyses were used to investigate the effect of manual material handling and strenuous work postures in sports on the association between obesity and work ability. Work ability was measured using the self-reported Work Ability Index consisting of seven dimensions. Confounding effects were tested for age, educational level, smoking, vigorous physical activity, psychosocial work demands, and working hours. Additive interaction between obesity and physical workload on work ability was tested using the relative excess risk due to interaction (RERI). Construction workers with overweight (OR = 1.09; 95% CI 1.02-1.16) or obesity (OR = 1.27; 95% CI 1.17-1.38) had an increased risk of poor/moderate work ability. Exposure to manual material handling (OR = 1.58; 95% CI 1.49-1.68) or strenuous work postures (OR = 1.80; 95% CI 1.70-1.90) also increased the risk of poor/moderate work ability. The effect of the combination of obesity with high physical workload was greater than the sum of the individual effects (strenuous work postures: RERI = 0.39; 95% CI 0.10-0.67; manual material handling: RERI = 0.26; 95% CI 0.02-0.51). Obesity and high physical workload were associated with poor work ability and had a synergistic, negative effect on work ability. Interventions that prevent obesity and high physical workload might have a beneficial effect on work ability.

Objective: To study the long-term effects of a workplace intervention in addition to structured physiotherapy regarding self-reported measures in patients with acute/subacute neck and/or back pain.Design: WorkUp – a cluster-randomised controlled trial in 32 primary care centers in Sweden, from January 2013 through December 2014 (ClinicalTrials.gov ID: NCT02609750).Intervention: Structured physiotherapy with the workplace dialogue ‘Convergence Dialogue Meeting’ (CDM), conducted by the treating physiotherapist as an add-on. Reference group received structured physiotherapy.Subjects: Adults, 18–67 years (mean 43.7, standard deviation (SD) 12.2), 65.3% women with acute/subacute neck and/or back pain who had worked ≥4 weeks past year, considered at risk of sick leave or were on short-term sick leave (≤60 days) were included (n = 352).Outcome measures: Self-reported function, functional rating index (FRI), health-related quality of life (EQ-5D-3L) and work ability (Work Ability Score, WAS) at 12 months follow-up.Results: The mean differences in outcomes between intervention and reference group were; −0.76 (95% confidence interval (CI): −2.39, 0.88; FRI), 0.02 (95% CI: −0.04, 0.08; EQ-5D-3L) and −0.05 (95% CI: −0.63, 0.53; WAS). From baseline to 12 months, the intervention group improved function from 46.5 (SD 19.7) to 10.5 (SD 7.3) on FRI; health-related quality of life from 0.53 (SD 0.29) to 0.74 (SD 0.20) on EQ-5D and work ability from 5.7 (SD 2.6) to 7.6 (SD 2.1) on WAS.Conclusion: Despite a clinically relevant improvement over time, there were no significant differences in improvement between groups, thus we conclude that CDM had no effect on self-reported measures in this study.Key pointsIn earlier analysis of the primary outcome (work ability measured by absenteeism) in this trial, a positive effect was found when the workplace intervention ‘Convergence Dialogue Meeting’ (CDM) was added to structured physiotherapy for patients with neck or back pain.By contrast, in this new analysis of secondary outcomes (self-reported function, health and perceived work ability), there was no added effect of CDM above structured physiotherapy alone, although patients in both the intervention and reference group improved over time.The addition of CDM to physiotherapy is therefore justified by its specific effect on behavior (work absence) rather than any effect on clinical outcomes.

THU0577 Do raynaud phenomenon negative juvenile systemic scleroderma patients have a different pattern of organ involvement as raynaud phenomenon positive patients?

Objective: The aim of this study was to evaluate work ability (WA) after radical prostatectomy (RP) in prostate cancer survivors, in relation to post-RP urinary leakage (UL) and adjuvant or salvage pelvic radiation therapy (RT) and/or hormone therapy (HT). Methods: Patients for this cross-sectional study were selected from two surveys on post-RP adverse effects and WA. All participated in the workforce. Using EPIC-50/26, UL was defined as daily use of at least one pad. Data on RT were obtained from the Cancer Registry of Norway. WA, measured by the Work Ability Score (WAS), was categorized into “excellent”, “good” or “moderate/poor”. Multinomial logistic regression analyses assessed associations between WA and selected variables. p values below 0.05 were considered statistically significant. Results: Of 563 patients, 18% had received post-RP RT and/or HT. Compared to the “excellent” WAS category, such treatment was significantly associated with belonging to the “good” or “moderate/poor” category. Patients with UL (30%) were more than twice as likely to report a “moderate/poor” WAS than those without UL. Age above 65 years, less than 3 years since RP and co-morbidity were additional factors associated with increased risk of reporting a lower WAS. Half of the patients rated their current WA as “very good” with respect to the physical or mental demands of their work. Conclusion: Increasing age, UL, co-morbidity and time since RP are associated with decreasing post-RP WA. Without specifying the individual therapy, post-RP oncological treatment seems to have an additional negative effect, warranting consideration of patients’ work plans when considering post-RP oncological treatment.

SAT0601 RELATIONSHIP BETWEEN BODY MASS INDEX AND NAILFOLD CAPILLAROSCOPY IN PRIMARY AND SECONDARY RAYNAUD'S PHENOMENON

COVID-19 can have a large impact on people's participation in work. The purpose of this article is to gain insight in characteristics of persons with COVID-19 at the time of infection, and their work ability and work limitations one year after inclusion in the allied health recovery care study (ParaCov study). A cross-sectional observational study approaching participants in the ParaCov cohort with paid work at cohort inclusion, who completed the 12-month assessment (n = 681). They received additional work-related questionnaires on work characteristics, Work Ability Score (WAS), and Work Limitations Questionnaire (WLQ). Descriptive statistics summarized participant and work characteristics, reporting categorical variables as numbers and percentages and continuous variables as medians with interquartile ranges (IQR) or means with standard deviations (SD). One year after inclusion in the Paracov cohort, 385 out of 681 (57%) persons gave permission to participate; 273 (71%) responded to one or more of the additional questionnaires. Mean age was 49 years (SD 10), 64% was female, 79% was not admitted to hospital for COVID-19, 76% had experienced mild to moderate symptoms and 61% reported no comorbidities. Participants had a mean employment contract for 29 (SD 10) hours per week, and 35% worked full time. The mean WAS score was 6.4 (SD 2.3), with 34% of the persons reporting good or excellent work ability, 40% moderate and 26% poor work ability. The mean WLQ index was 12.1, corresponding with 11% productivity loss. On average, 26% of time persons were limited in the physical job demands, 48% of time in time demands, 42% of time in mental-interpersonal demands, and 45% of time in output demands. Twelve months after initiating allied healthcare after COVID-19, 66% of persons experienced moderate to poor work ability, substantial productivity losses, and work limitations, especially regarding mental-interpersonal demands, time- and output demands. Clinicaltrials.gov (NCT04735744) First posted 2021-02-03.

Work ability of teachers associated with voice disorders, stress, and the indoor environment: A questionnaire study in Finland

IntroductionOccupational chronic solvent encephalopathy (CSE) often leads to early retirement. However, little is known about work ability in solvent exposed workers in general. The aim was to study the effect...

A main goal during the return to work (RTW) process after a long-term sickness absence due to common mental disorders (CMDs), is to restore and maintain employees' work ability to enable their sustained work participation. This study jointly examined employees' work ability ratings and experiences during their RTW process with CMDs. In a mixed methods follow-up study of N = 286 participants, work ability was quantitatively assessed with the Work Ability Score (WAS, range 0-10) at baseline (week before clinical discharge) and after 6, 12, 18, and 30months. In a sub-sample, the qualitative work ability experiences of N = 32 participants were analysed at 6 and 12months, and were jointly evaluated with the quantitative data. The mean WAS increased during the first 18months of follow-up. Three groups of qualitative work ability experiences emerged: Employees with (1) poor work ability (WAS 0-3), who did not RTW yet and described great difficulties in coping with everyday life, (2) moderate work ability (WAS 4-6), who mainly did RTW, but still showed a certain level of fragility, and (3) good to very good work ability (WAS 7-10), who mainly returned to work and reported many individual and work accommodations to maintain their work ability. The present study provides new insights into different aspects of work ability experiences, especially during the later RTW phases, where restoring and maintaining work ability is essential for a sustained work participation. This knowledge may help RTW stakeholders to better tailor support during the RTW process.

Objectives Weighted regression procedures can be an efficient solution for cohort studies that involve rare events or diseases, which can be difficult to predict, allowing for more accurate prediction of cases of interest. The aims of this study were to (i) predict changes in work ability at one year after approval of the work disability benefit and (ii) explore whether weighted regression procedures could improve the accuracy of predicting claimants with the highest probability of experiencing a relevant change in work ability. Methods The study population consisted of 944 individuals who were granted a work disability benefit. Self-reported questionnaire data measured at baseline were linked with administrative data from Dutch Social Security Institute databases. Standard and weighted multinomial logit models were fitted to predict changes in the work ability score (WAS) at one-year follow-up. McNemar's test was used to assess the difference between these models. Results A total of 208 (22%) claimants experienced an improvement in WAS. The standard multinomial logit model predicted a relevant improvement in WAS for only 9% of the claimants [positive predictive value (PPV) 62%]. The weighted model predicted significantly more cases, 14% (PPV 63%). Predictive variables were several physical and mental functioning factors, work status, wage loss, and WAS at baseline. Conclusion This study showed that there are indications that weighted regression procedures can correctly identify more individuals who experience a relevant change in WAS compared to standard multinomial logit models. Our findings suggest that weighted analysis could be an effective method in epidemiology when predicting rare events or diseases.

The association between worksite temperature and perceived work ability (WA) in various educational classes remains unknown. Therefore, we interviewed 286 poultry industry workers in Thailand about their WA and linked their responses to worksite temperature. WA was based on the self-assessment of current work ability compared with their lifetime best ability (scores 0–10). Education was classified as high (university or vocational school) or low (less education). Temperature was classified as cold (−22–10°C) or warm (10–23°C). WA and the occurrence of a low WA were regressed on worksite temperature, education, and their interaction with the adjustment for sex, age, job category, physical work strain, moving between cold and warm sites, thermal insulation of clothing, relative humidity, and air velocity. The average worksite temperature was 10°C for high- and 1°C for low-educated workers. The average WA score was 8.32 (SD, 1.33; range, 4–10) and classified as low (<8) in 23% of the workers. In highly-educated workers, the adjusted mean WA decreased from 9.11 in the warm areas to 8.02 in the cold areas and the prevalence of a low WA increased from 11 to 30%, while no significant change was observed in less-educated workers. The WA score was estimated to decline by 10% more (95% CI, 4–16%) in the cold areas for the more vs. less-educated workers and the prevalence of a poor WA was estimated to increase 3.09 times (95% CI, 1.43–5.45) more. Highly-educated workers in this industry are a risk group that should be given customized advice.

BackgroundAlthough asthma and obesity are each associated with adverse respiratory outcomes, a possible interaction between them is less studied. This study assessed the extent to which asthma and overweight/obese status...

ObjectivesThis study aimed to analyse and compare differences in occupational stress, depressive symptoms, work ability and working environment among residents working in various medical specialties.Methods435 German hospital residents in medical...