Determinants of work ability and its predictive value for disability.

BACKGROUND Maintaining the ability of workers to cope with physical and psychosocial demands at work becomes increasingly important in prolonging working life. AIMS To analyse the effects of work-related factors and individual characteristics on work ability and to determine the predictive value of work ability on receiving a work-related disability pension. METHODS A longitudinal study was conducted among 850 construction workers aged 40 years and older, with average follow-up period of 23 months. Disability was defined as receiving a disability pension, granted to workers unable to continue working in their regular job. Work ability was assessed using the work ability index (WAI). Associations between work-related factors and individual characteristics with work ability at baseline were evaluated using linear regression analysis, and Cox regression analysis was used to evaluate the predictive value of work ability for disability. RESULTS Work-related factors were associated with a lower work ability at baseline, but had little prognostic value for disability during follow-up. The hazard ratios for disability among workers with a moderate and poor work ability at baseline were 8 and 32, respectively. All separate scales in the WAI had predictive power for future disability with the highest influence of current work ability in relation to job demands and lowest influence of diseases diagnosed by a physician. CONCLUSION A moderate or poor work ability was highly predictive for receiving a disability pension. Preventive measures should facilitate a good balance between work performance and health in order to prevent quitting labour participation.