healthmedicinet

We found the prevalence of reduced work ability among technical-administrative workers
in education at Federal University of Juiz de Fora to be 13.9 %. This proportion is
similar to the reduced work ability of 11.3 % observed by Fischer and Martinez 24] among nursing professionals at a hospital in São Paulo, Brazil. By contrast, the
percentage of workers with reduced work ability determined in the present study is
lower than that reported in other Brazilian studies: 20.4 % for workers in hospital
housekeeping services 25]; 34.5 % for workers in sawmills 26]; 35.3 and 46 % for municipal school teachers 27], 28]; and 43.3 % in nurses 29].

The differences may be explained by the different sociodemographic and occupational
profile of the present study population compared with that of other groups of Brazilian
workers, especially regarding the type of employment contract. The workers who took
part in the present study had job stability; that is contrast to workers in unstable,
outsourced employment, which has grown in all industries in Brazil in recent years
and has had an impact on the working conditions of the entire population 30].

In the present study, reduced work ability was found to be associated with individual
characteristics, health conditions, life habits, and work-related factors: being of
an older age; being female; having a low level of education; having a poor self-assessed
overall health status; having signs and symptoms of depression; having a low level
of physical activity; and having low social support at work. This result is similar
to that obtained by Fischer and Martinez 24], who found that reduced work ability was associated with sex, sedentariness and social
support at work. The result is also similar to that obtained by Van den Berg et al.
7], who identified the factors associated with poor work ability to be older age, lack
of leisure time, lack of vigorous physical activity, poor musculoskeletal capacity,
obesity, high physical and psychosocial work demands, poor physical work environment,
and high physical workload 7], 24].

We found that such factors as color, self-assessed overall dental status, alcohol
addiction, network and social support, work stressors, contact with the public, and
type of work function did not continue to show a significant association after the
Poisson regression. That is possibly because other variables were more strongly associated
with work ability.

In the present study, age was observed to be one of the factors significantly associated
with work ability. Older workers aged 50 years or above displayed a greater probability
of reduced work ability. This finding is in accordance with that of Raffone and Hennington
15], who reported the prevalence of reduced work ability among nursing professionals
to be 16.8 %. Those authors also observed diminishing work ability with advancing
age. However, having a preexisting condition may exert a greater negative effect on
an individual’s work ability than age 31]. Marqueze and Moreno 32] studied college educators at a university in Santa Catarina, Brazil and found the
prevalence of reduced work ability to be 13 %, which is very similar to our own result.
However, in contrast to the present study, those authors maintained that functional
aging was not necessarily related with chronological aging: they believed that functional
aging depends on individual characteristics and on adopted lifestyles in addition
to living and working conditions 32].

We found sex to be associated with reduced work ability: women showed a greater likelihood
of reduced work ability. One possible explanation for this is the greater burden for
women. Although women have increasingly become a part of the labor market in Brazil
and achieved independence and equal rights with men in several respects, home chores
and taking care of their children and husbands is frequent still a woman’s responsibility.
Domestic demands can impose a double or even triple burden on women. Female employees
have roles that extend beyond those of work, such as those of mother and wife, which
have an impact on their health and work ability 32], 33].

In the present study, the level of education was significantly associated with the
outcomes: developing actions related to health education and encouraging people to
pursue healthier lifestyles is easier with individuals having higher levels of education,
and that contributes to improved work ability 34]. We found that the higher education level of the technical-administrative workers—over
half of them had a graduate degree—could explain the prevalence of good work ability.

Life habits and health conditions were also found to be significantly associated with
work ability. The significant association between work ability and health could be
owing to the conceptual overlap between them: question 4 of the WAI includes statements
related to diseases 1]. Studies have shown that health conditions are crucial with respect to quality of
life and work ability 35], and self-assessed health is one of the most widely used public health indicators
36]. In a study of teachers in São Paulo conducted by Vedovato and Monteiro 27], a poor self-assessment of general health was found to be associated with reduced
work ability. In their study, most of the respondents were women, with a mean age
of 41.4 years and a high level of education; the prevalence of reduced work ability
was 35.4 %. It should be noted that the results of the present study are in accordance
with those of Silva Junior et al. 37], who found a direct, significant correlation between the WAI and self-assessed health
status. The authors observed that employees with greater work ability were usually
those who had a more positive outlook on their overall health status 37].

We found that sedentariness and signs and symptoms of depression were directly associated
with a decline in work ability 15]. In 2001, severe depression was the main cause of decreased work ability, and it
ranked fourth among the top ten causes of illness worldwide 38]. According to a recent forecast by the World Health Organization 39], depression will be the most prevalent worldwide illness by 2030. Therefore, sedentary
individuals and those with depressive symptoms have a greater chance of becoming incapacitated
for work than those who exercise regularly and lack such symptoms 40].

Among occupational variables, only one retained a significant association after the
Poisson regression: social support at work was related to the interaction between
employees and managers in job cooperation 23]. We found low social support at work to be associated with poor work ability, and
it could contribute to increased worker weakness and health risks 23]. Improved work ability is strongly associated with better relationships with supervisors
and in the organizational process of work 41]. Negeliskii and Lautert 42] consider social support to be the foundation of labor relationships and a social
organization strategy in institutions. Social support would thus appear to be a way
to reduce and even prevent work stress. By valuing relationships and the work environment,
it is possible to promote the benefits to employees’ health and their work ability,
which could contribute to reduce absenteeism caused by illness and early retirement
42].

It is necessary to note that the present study could be subject to a healthy worker
bias: incapacitated workers miss work more often, are on sick leave for treatment,
or have retired. It should also be noted that this study’s cross-sectional design
provides a single snapshot of the relationships under scrutiny. Such cross-sectional
cohort studies can lead to the identification of just the survivors of the effect
under study (prevalence bias), and this could lead to underestimating the level of
risk in the assessed work process 43].

Furthermore, it is not possible with cross-sectional studies to establish the directions
of causal relationships. It is likewise not possible to determine health aspects before
the study period or forecast how those aspects will develop in the future. There is
a possibility with the present study that low work ability may have stimulated certain
life habits and healthy behaviors, such as exercising, though exercising did not have
an impact on an individual’s work ability.

Other limitations that deserve mention are the type of questionnaire used. The self-completed
questionnaire depends on an individual’s report and can be influenced by such factors
as memory, understanding capacity, and the bias of socially desirable reporting. El
Fassi et al. 44] have argued that workers who perceive their health to be declining could decide not
to complete a questionnaire or to provide incorrect details through fear of influencing
the occupational physician’s decision concerning their fitness for work.

Although this study has the above limitations, it has the benefit of expanding the
discussion about the factors associated with reduced work ability in a working population.
This discussion can form the basis for developing actions and policies to support
employees’ work ability and help the recovery of those with inadequate ability.