Lundin A, Kjellberg K, Leijon O, Punnett L, Hemmingsson T
Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Solnavägen 4, 113 65, Stockholm, Sweden.
Centre for Occupational and Environmental Medicine, Stockholm County Council, Stockholm, Sweden.
J Occup Rehabil. 2016 Jun;26(2):195-203. doi: 10.1007/s10926-015-9603-4.
Purpose Work ability is commonly measured with self-assessments, in the form of indices or single items. The validity of these assessments lies in their predictive ability. Prospective studies have reported associations between work ability and sickness absence and disability pension, but few examined why these associations exist. Several correlates of work ability have been reported, but their mechanistic role is largely unknown. This study aims to investigate to what extent individual's own prognosis of work ability predicts labor market participation and whether this was due to individual characteristics and/or working conditions. Methods Self-assessed prognosis of work ability, 2 years from "now," in the Stockholm Public Health Questionnaire (2002-2003) was linked to national registers on sickness absence, disability pension and unemployment up to year 2010. Effects were studied with Cox regression models. Results Of a total of 12,064 individuals 1466 reported poor work ability. There were 299 cases of disability pension, 1466 long-term sickness absence cases and 765 long-term unemployed during follow-up. Poor work ability increased the risk of long-term sickness absence (HR 2.25, CI 95 % 1.97-2.56), disability pension (HR 5.19, CI 95 % 4.07-6.62), and long-term unemployment (HR 2.18, CI 95 % 1.83-2.60). These associations were partially explained by baseline health conditions, physical and (less strongly) psychosocial aspects of working conditions. Conclusions Self-assessed poor ability predicted future long-term sickness absence, disability pension and long-term unemployment. Self-assessed poor work ability seems to be an indicator of future labor market exclusion of different kinds, and can be used in public health monitoring.
目的 工作能力通常通过自我评估来衡量，形式为指数或单项指标。这些评估的有效性在于其预测能力。前瞻性研究报告了工作能力与病假缺勤和残疾抚恤金之间的关联，但很少研究这些关联存在的原因。已报告了一些工作能力的相关因素，但其作用机制大多未知。本研究旨在调查个人对工作能力的自我预后在多大程度上预测劳动力市场参与情况，以及这是否归因于个人特征和/或工作条件。方法 将斯德哥尔摩公共卫生调查问卷（2002 - 2003年）中从“现在”起2年的工作能力自我评估预后与截至2010年的全国病假缺勤、残疾抚恤金和失业登记数据相联系。使用Cox回归模型研究影响因素。结果 在总共12,064名个体中，1466人报告工作能力较差。随访期间有299例残疾抚恤金案例、1466例长期病假缺勤案例和765例长期失业案例。工作能力差会增加长期病假缺勤（风险比2.25，95%置信区间1.97 - 2.56）、残疾抚恤金（风险比5.19，95%置信区间4.07 - 6.62）和长期失业（风险比2.18，95%置信区间1.83 - 2.60）的风险。这些关联部分可由基线健康状况、工作条件的身体和（较弱的）心理社会方面来解释。结论 自我评估的能力差可预测未来的长期病假缺勤、残疾抚恤金和长期失业。自我评估的工作能力差似乎是未来不同类型劳动力市场排斥的一个指标，可用于公共卫生监测。
