Perceived work ability index of public service employees in relation to ageing and gender: A comparison in three European countries

The workforce is ageing and the contribution of older workers is considerable. Their occupational health profiles differ from those of their younger (1) colleagues. Demographic changes imply an increasing number of workers with health problems and a decreasing of ability to work (2). Functional capacities, mainly physical, show a declining trend after the age of 30 years, and the trend can become critical after the next 15–20 years if the physical demands of work do not decline (3, 4, 5). Consequently, efforts to maintain the ability to work of currently and future employees are of key importance. In this context, the Finish Institute of Occupational Health (FIOH) developed a generic tool during the 1980s to monitor and assess work ability, the so-called “Work Ability Index” (WAI) in the working population on a regular basis (6). WAI considers the workers’ self assessed work ability in relation to work demands, health status and particular type of work. The WAI has since then been widely disseminated and is nowadays the most commonly used tool for measuring work ability (7). Excellent ability to work is closely related to the possibility to increase quality of work, improve quality of life and well-being among employees, thereby decreasing the likelihood of their early retirement, decreasing absenteeism, as well increasing motivation and productiveness in employees of all ages (8).

The most studied demographic factor regarding WAI was age, and some authors reported a decreased WAI with ageing (9, 10, 11). In the Finish Health 2000 survey, nearly half of young adults perceived their work ability as excellent compared to 8% of 55-64 year-olds (12). Work ability decreases with age even among the healthy (13). Work ability significantly decreased with age among the women. Also, the ageing trend of WAI is different, depending on the sector of the economy. Work ability seems to be lower in farming and agriculture, the wood industry, the metal industry and transport, as well as in social services and in some countries among teachers (public sector) (14). The present study therefore aims at examining perception of work ability and its dimensions of public service employees aged 55 and older and gender differences in three cohorts in three European countries.

Between individual characteristics of respondents the mean by standard deviation (SD) were for: age 45.06±10.90 years; length of service 20.74±11.12 years; sick leave 5.72±23.71 days; and WAI score 40.08±6.17 (Table 1).

The study sample consisted of more women 1091 (66%) than men 562. The total number of respondents aged between 18 and 54 was 1287 (78%) and between them older employees aged ≥55 were 366 (22%). The poor WAI in women being 17% compared to 9.4% in men or excellent WAI found in women 24.5% vs. 31.9% in men (P=0.001). Women were much more affected by health disorders thatinfluence their work than men (P=0.004). Women expressed much more (almost two times more) poor WA prognosis for the next two years than men, 22.6% vs. 11.6% (P=0.001). Women rarely enjoy their regular daily activities, other than men, who admit that they enjoy their daily activities (P=0.044) (Table 2).

Respondents aged ≥55 years significantly frequent attained excellent WAI and in particular good WAI compared to younger (P=0.001). Older employees more frequent perceived higher current work ability compared with lifetime best than younger respondents (P=0.002).

They had a much higher number of diagnosed illnesses (from 1 to 5) than younger employees (P=0.001), but older employees were significantly more influenced by diseases to work and work inability due to disease (Table 3).

There are significantly negative correlations between WAI dimensions’ and gender (P<0.001): health disorders influence to work (correlation=-0.080); WA prognosis for two years (correlation=-0.134); and decreased WAI score (correlation=-0.104) more in women than men; and a significantly negative correlation between mental demands of and gender among women (P<0.05; correlation=-0.059). Increased ageing positive correlated with WA dimensions ‘at the level of P<0.001: mental demands of work (correlation=0.084); health disorders influence to work (correlation=0.177); and decreased WAI score (correlation=0.076). We found a negative correlation between ageing and current work ability compared with lifetime best (correlation factor=-0.115).

Using a multilevel logistic regression model we found that the excellent work ability index was associated with the following predictors: to live in Spain or Europe Union (β=-0.185, 95%CI, -5.612- -2.576, P<0.000), higher level of education (β=0.123, 95%CI, 0.778-2.414, P<0.001), higher level of current work ability (β=0.280, 95%CI, -0.9731.421, P<0.000), lower level of physical demands of work (β=-0.084, 95%CI, -0.023- -0.046, P<0.003), lower level of mental demands of work (β=-0.048, 95%CI, -1.085- -0.084, P<0.022), sick leave during the past year (β=0.144, 95%CI, 0.323-0.073, P<0.001), and prognosis of work ability in next two years (β=0.305, 95%CI, 0.566-0.866, P<0.001) among 446 (27%) respondents.

Predictors of poor WAI were: to live in southeast Europe countries (β=0.334, 95%CI, 0.659- 1.728, P<0.000), to be divorced or widowed (β=-0.078, 95%CI, -0.527- -0.043, P<0.021), low level of education (β=-0.191, 95%CI, -0.771-0.201, P<0.001), high level of physical demands at work (β=0.452, 95%CI, 0.054-0.080, P<0.001), high level of mental demands at work (β=0.194, 95%CI, 0.561-1.151, P<0.001), high level of impairment due to disease (β=0.452, 95%CI, 0.054-0.080, P<0.001), bad prognosis of WA in next two years (β=0.331, 95%CI, 1.062-1.624, P<0.001), and decline of mental resources (β=0.097, 95%CI, 0.092-0.510, P<0.005) among 195 (12%) respondents (shown in Table 5).

The present study adds important knowledge about 1653 (1091 female) employees in the public sector of which most were employed in health care or education field of service and coming from Spain, B&H and Monte Negro at the time of progressive population aging and when extended working life is a necessity and a possibility. This survey aims to answer the following question: are individual factors, physical or mental demands of work, and health determinants of excellent or poor WAI? Twenty seven percent of the entire population based cohort reported excellent WAI and 12% perceived poor WAI.

The relations observed between WAI and individual variables generally support those reported in the literature. The authors of numerous studies suggested a strong association between ageing and the decline in work ability and demonstrated that young workers estimate their WAI at a higher level than older ones (18, 19, 20, 21, 22, 23). Ageing is related to decreasing physical work capacity (7, 8, 24). Work ability in relation to demands in working life results in increasing strain in older employees (18). Furthermore, ageing results in a higher prevalence of clinical diseases (25, 26, 27, 28). Work ability among Croatian nurses confirmed that the WAI score decreases significantly with age (29, 30). The relations observed between WAI and the individual variables generally support those reported in the literature. The authors of numerous studies suggested a strong association between ageing and a decline in work ability. They demonstrated that young workers estimate their WAI at a higher level than older ones. We found a significant correlation between aging and decreased WAI score, decreased current work ability among our participants too, but our older employees aged 55 and over 55 years had better levels (categories) of WAI than their younger colleagues.

According study results, ageing and gender did not influence work ability among our respondents (Table 5). Some prior studies also demonstrated no association between ageing and WAI (12, 31, 32), and one study found a higher risk for a poor WAI among younger workers (26). High physical workload among women working in social and health care is likely to contribute to the gender differences (31).

According to study results, ageing and gender did not influence work ability among our respondents. Predictors for poor work ability were: a high level of mental demands at work, a low level of education, health impairments during work, and bad self-prognosis for work. Our finding is in accordance with data that was reported by other authors (11, 12, 13 22, 33, 34). On the basis of assessment of protectors for excellent WAI (excellent WAI) were: a high level of education, a low level of impairment influenced to work and reduced sick leave days.

Gender and ageing wasn’t associated with low or high level of work ability among public sector employees. High mental and physical workload among women working in public sector occupations are likely to contribute to the work ability gender differences, but we didn’t found it among our respondents. As workers age, their physical, physiological and psychosocial capabilities change. Keeping older workers healthy is a key goal of the labour policy. Providing educational and career prospects can contribute to maintaining work ability during all your working life.