Relation between diseases and work ability according to

Determining the effect of diseases on the work ability of the workforce is espe-cially relevant for succeeding in attempts to increase the employment rate. In endeavouring to reduce early retirement, we must place special emphasis on the prevention, treatment, and relief of the consequences of diseases that limit the work ability of employed and unemployed people.

Table 5.6 shows the relationship between the diseases that reduced the work ability of all 30- to 64-year-olds the most and the work ability score of those em-ployed, those unemem-ployed, and those on a disability pension. The information on employment status was based on the interview. From the table it is evident that the prevalence of almost all of the diseases was highest among those on a dis-ability pension and lowest among those employed, with the unemployed located between these two groups. The same order was maintained for work ability. The average work ability score was highest for those employed and lowest for those on a disability pension. (See also Section 4.4.)

There was a strong association between diseases and work ability among those employed. For most of the diseases, the work ability score of those who reported the disease was considerably lower than that of those who did not have the disease. For the unemployed, the difference in the work ability score of those who were ill and those who were not ill was at least as large as that found for the employed for nearly all diseases listed in Table 5.6, but some differences were not statistically significant because of the small number of cases.

Table 5.6. Relationship between the work ability score and the occurrence of different diseases among 30- to 64-year-olds, according to employment status.¹

Women Men

n=1,856 n=336 n=204 n=1,844 n=270 n=246

Coronary heart

Prevalence of disease 23 29 29 26 30 33

Work ability score

Prevalence of disease 8 10 16 5 5 12

Work ability score

Without disease 8.6 7.8 5.1 8.5 7.4 4.5

With disease 8.6 7.0 4.3 8.4 (5.3)** 4.0

Osteoarthritis of the knee

Prevalence of disease 5 10 10 5 7 11

Work ability score

Without disease 8.6 7.9 4.9 8.6 7.4 4.5

With disease 7.9** 6.6*** 5.1 8.0*** 6.8 4.4

Back disorder

Prevalence of disease 27 30 40 31 35 33

Work ability score

Without disease 8.7 7.9 4.9 8.7 7.7 4.5

With disease 8.3*** 7.3* 5.1 8.1*** 6.7** 4.3

Depression

Prevalence of disease 8 18 35 5 16 19

Work ability score

Without disease 8.7 7.9 5.4 8.6 7.6 4.6

With disease 7.7*** 6.9*** 4.2*** 7.6*** 6.0*** 3.7*

Disturbing allergy

Prevalence of disease 23 25 31 15 14 23

Work ability score

Without disease 8.6 7.9 5.3 8.5 7.4 4.6

With disease 8.5* 7.3* 4.9 8.5 7.1 3.6*

1 Age adjustment was made for men and women separately. Statistical difference in the mean work ability score between those with and without a disease: *p<0.05, **p<0.01, ***p<0.001.

( ) Size of the study population at risk 6–19.

The relation between a specific disease and work ability was weak among those on a disability pension. The work ability of those with and without a disease did not differ significantly. This result may be due to the fact that all people on a disability pension have some disease that limits work ability. Those who did not have the disease in question were afflicted with another disease that limited their work ability.

Depression had a particularly strong impact on self-reported work ability. This finding was evident in each group, including those on a disability pension. Among employed men, also coronary heart disease, arterial hypertension, diabetes, oste-oarthritis of the knee, and back disorders affected work ability. Of these illnesses, back disorders seemed to be the most important reason for limited work ability among employed men. The relation between diagnosed diseases and self-reported work ability was weaker among employed women than among employed men.

The difference between the work ability scores of those ill and those not ill was generally smaller among women than among men. In a comparison between dif-ferent diseases, depression and back disorders seemed to have the largest impact on work ability among employed women and men.

5.1.8 Relation between diseases and work ability according to physical work load

Table 5.7 shows the relation between the diseases that limited the study popula-tion’s work ability the most and the work ability score in three groups formed on the basis of physical work load. The analysis includes those who had been working at some point during the 12 months prior to the interview. More than 90 per cent of these persons were still employed at the time of the study, about 5 per cent were unemployed, and 3 per cent had retired.

Even though it is probable that the sickest workers in physically demanding jobs had already retired before the study took place, all diseases listed in Table 5.7, were more prevalent among those whose work was physically demanding than among those with physically lighter occupations. However, coronary heart dis-ease for women and asthma and disturbing allergies for men were less prevalent among those with lighter occupations.

Table 5.7. Relationship between the work ability score and different diseases among employed 30- to 64-year-olds, according to physical work load.¹

Women Men

n=774 n=609 n=598 n=729 n=423 n=739

Coronary heart disease

Prevalence of disease 21 19 26 25 24 25

Work ability score

Prevalence of disease 26 24 30 26 30 36

Work ability score

Prevalence of disease 22 21 25 18 16 14

Work ability score

Without disease 8.8 8.7 8.5 8.8 8.6 8.3

With disease 8.8 8.6 8.2* 8.8 8.3 8.3

1 Age adjustment was made for men and women separately. Statistical difference in the mean work ability score between those with and without a disease: *p<0.05, **p<0.01, ***p<0.001.

2 Physically light work = sedentary work; physically fairly light work = work that requires fairly much walk-ing; physically demanding work = work that requires climbing stairs, lifting or carrying, or other physically demanding work.

– Size of the study population at risk 0–5.

( ) Size of the study population at risk 6–19.

The detrimental effect of diseases on work ability was the most evident in the group of workers with physically demanding jobs. All of the diseases except heart diseases, as well as asthma for women and allergies for men, decreased work ability statistically significantly. Especially those with physically demanding work who suffered from depression estimated their work ability to be poor. The work ability of those with fairly light work was most limited by back disorders.

In addition, depression and osteoarthritis of the knee among women and heart diseases, hypertension, and diabetes among men had a statistically significant relationship with limited work ability. The only diseases listed in Table 5.7 that statistically significantly affected the work ability of those with physically light work were back disorders and depression, and among men also heart disease and hypertension.