title: The influence of chronic health problems on work ability and productivity at work: a longitudinal study among older employees.
abstract: OBJECTIVE
  This study aimed to assess the influence of chronic health problems on work ability and productivity at work among older employees using different methodological approaches in the analysis of longitudinal studies.
  
  
  METHODS
  Data from employees, aged 45-64, of the longitudinal Study on Transitions in Employment, Ability and Motivation was used (N=8411). Using three annual online questionnaires, we assessed the presence of seven chronic health problems, work ability (scale 0-10), and productivity at work (scale 0-10). Three linear regression generalized estimating equations were used. The time-lag model analyzed the relation of health problems with work ability and productivity at work after one year; the autoregressive model adjusted for work ability and productivity in the preceding year; and the third model assessed the relation of incidence and recovery with changes in work ability and productivity at work within the same year.
  
  
  RESULTS
  Workers with health problems had lower work ability at one-year follow-up than workers without these health problems, varying from a 2.0% reduction with diabetes mellitus to a 9.5% reduction with psychological health problems relative to the overall mean (time-lag). Work ability of persons with health problems decreased slightly more during one-year follow-up than that of persons without these health problems, ranging from 1.4% with circulatory to 5.9% with psychological health problems (autoregressive). Incidence related to larger decreases in work ability, from 0.6% with diabetes mellitus to 19.0% with psychological health problems, than recovery related to changes in work ability, from a 1.8% decrease with circulatory to an 8.5% increase with psychological health problems (incidence-recovery). Only workers with musculoskeletal and psychological health problems had lower productivity at work at one-year follow-up than workers without those health problems (1.2% and 5.6%, respectively, time-lag).
  
  
  CONCLUSIONS
  All methodological approaches indicated that chronic health problems were associated with decreased work ability and, to a much lesser extent, lower productivity at work. The choice for a particular methodological approach considerably influenced the strength of the associations, with the incidence of health problems resulting in the largest decreases in work ability and productivity at work.
authors: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. a.burdorf@erasmusmc.nl.
authors: Fenna R M
authors: FR
authors: Leijten
authors: Swenne G
authors: SG
authors: van den Heuvel
authors: Jan Fekke
authors: JF
authors: Ybema
authors: Allard J
authors: AJ
authors: van der Beek
authors: Suzan J W
authors: SJ
authors: Robroek
authors: Alex
authors: A
authors: Burdorf
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology*; D003920:Diabetes Mellitus / Q000453:epidemiology; D004066:Digestive System Diseases / Q000453:epidemiology; D004526:Efficiency; D004651:Employment; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology; D008875:Middle Aged; D008881:Migraine Disorders / Q000453:epidemiology; D008962:Models, Theoretical; D009140:Musculoskeletal Diseases / Q000453:epidemiology; D009426:Netherlands; D015995:Prevalence; D012008:Recurrence; D012140:Respiratory Tract Diseases / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014938:Work Capacity Evaluation