Promotion of Work Ability towards Productive Aging: Selected papers of the 3rd International Symposium on Work Ability, Hanoi, Vietnam, 22-24 October 2007

PROMOTION OF WORK ABILITY TOWARDS PRODUCTIVE AGING

PROMOTION OF WORK ABILITY TOWARDS PRODUCTIVE AGING Selected papers of the 3rd International Symposium on Work Ability, Hanoi, Vietnam, 22–24 October 2007 Editor

Masaharu Kumashiro Department of Ergonomics, University of Occupational and Environmental Health, Kitakyushu, Japan

Taylor & Francis is an imprint of the Taylor & Francis Group, an informa business © 2009 Taylor & Francis Group, London, UK Typeset by Charon Tec Ltd (A Macmillan Company), Chennai, India Printed and bound in Great Britain by Antony Rowe (A CPI-group Company), Chippenham, Wiltshire All rights reserved. No part of this publication or the information contained herein may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, by photocopying, recording or otherwise, without written prior permission from the publishers. Although all care is taken to ensure integrity and the quality of this publication and the information herein, no responsibility is assumed by the publishers nor the author for any damage to the property or persons as a result of operation or use of this publication and/or the information contained herein. Published by:

CRC Press/Balkema P.O. Box 447, 2300 AK Leiden, The Netherlands e-mail: [email protected] www.crcpress.com – www.taylorandfrancis.co.uk – www.balkema.nl

ISBN: 978-0-415-48590-6 (Hbk) ISBN: 978-0-203-88251-1 (eBook)

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Table of Contents

Preface

IX

Chapter 1 Overview Achievements in Aging and Work “period 1989–2007; Challenges after 2007” W.J. Goedhard Measures for the aging workforce in Japan from the perspective of the occupational health, safety and ergonomics M. Kumashiro

3

9

The effects of work-related and individual factors on work ability: A systematic review T.I.J. van den Berg, L.A.M. Elders & A. Burdorf

15

Systematic review for assessing job demands and physical work capacity in safety jobs A. Ropponen, J. Smolander & V. Louhevaara

19

Chapter 2 Work Ability Index The place of age in organisational policymaking: Evidence from an Australian qualitative survey L. Brooke, P. Healy, J. Jiang & P. Taylor Establishment of a Work Ability Index network in Germany H.M. Hasselhorn, B.H. Müller, R. Tielsch, B. Gauggel, G. Freude & J. Tempel WAI among workers in SMEs at Wholesale, Fruits, Vegetables and Flower Market in Brazil – from research to action I. Monteiro, K. Tuomi, J. Ilmarinen, J. Seitsamo, E. Tuominen & H.R. Corrêa-Filho Factors associated to the work ability among Brazilian teachers T.G. Vedovato & I. Monteiro Factors that predict work ability: Incorporating a measure of organisational values towards ageing J. Palermo, L. Webber, K. Smith & A. Khor

27 33

37 41

45

Effect of Japanese employment system on Work Ability Index M. Tokuhiro, H. Izumi, J.-L. Malo, N. Uehara & M. Kumashiro

59

Study on work ability of Vietnamese workers in selected industries D.K. Van & N.N. Nga

65

WAI among young employees in Brazil with new scores I. Monteiro, J. Ilmarinen, K. Tuomi, J. Seitsamo, E.P. Goes, A.P. Fernandes & E.P. Hodge

71

V

Verifying of the theoretical model of perceived work ability in the field of teaching V. Louhevaaral & S. Järvelin

75

An assessment of the Work Ability Index (WAI) and its usefulness in predicting and promoting continued work in staff employed by a major UK Charity T. Reilly, A. Rees & M. Tipton

83

Individual and work related determinants of work ability in white-collar workers T.I.J. van den Berg, S.M. Alavinia, F.J. Bredt, D. Lindeboom, L.A.M. Elders & A. Burdorf

89

Workplace trauma exposure, emotional imbalance and work ability G.P. Fichera, L. Neri, S. Sartori & G. Costa

93

Work ability and all cause mortality: A 25-year longitudinal study among Finnish municipal workers J. Seitsamo & R. Martikainen

101

Impacts from occupational risk factors on self reported reduced work ability among Danish wage earners L. Sell, A. Faber & K. Søgaard

105

Work ability and work quality as indicators for a longer and more productive working life M. Melon, P. Cocco & G. Costa

113

Disabled people at work and work ability: A study in a Brazilian company E.P. Hodge & I. Monteiro

117

Work ability of a population of 40+ in Luxembourg N. Majery

121

Chapter 3 Staying at Work Older worker career plateau: Issues and remedies P. McCarthy & S. Moore

127

Can organisations influence employees’ intentions to retire? J. Oakman & Y. Wells

133

Extending the working life R.G. Goedhard & W.J.A. Goedhard

139

Pension preferences and work environment M. Stattin

143

Younger managers and considerably older subordinates I. Johansson

155

Training older workers and long-term development: Needs and obstacles J.-C. Marquié & L.R. Duarte

161

Chapter 4 Promotion of Health and Work Ability Promoting health and workability in Vattenfall AB Nordic, Sweden R.J. Mykletun & T. Furunes VI

169

Managers’ decision making latitudes in relation to managing ageing workers T. Furunes & R.J. Mykletun The DRUVAN-project: A major increase in Occupational Health Service based on the Metal Age method in a Finnish municipality improved the work ability and gave significant financial return O. Näsman & G. Ahonen

177

183

A study on effects of support systems for KAIZEN in casting production of non-ferrous alloy by aged foundry workers Y. Mizuno, N. Motegi, M. Sugiura, F. Matsuda, T. Yoshikawa, K. Sakai & T. Misawa

191

Discovering the treasure: The use of the Work Ability Concept and the WAI in a bus company within a workplace health promotion process J. Tempel & J. Schramm

195

Prolonging working life in intellectual work Ü. Kristjuhan

209

Ergonomic and safe design of railway vehicles for elderly and handicapped people M. Rentzsch & D. Seliger

213

Female workers’ superior peculiarity and consideration for aging for the activation of “super-advanced age and fewer children” society K. Mikami, K. Iida & M. Kumashiro

219

Usability research on the older person’s ability for Web browsing D. Kobayashi & S. Yamamoto

227

Chapter 5 Age Affected Functions Impact of psychosocial work environment factors measured by the COPSOQ on the need for recovery after work in aging workers. Preliminary results P. Kiss & M. De Meester Age differences in mental workload while performing visual search task M. Takahara, T. Miura, K. Shinohara & T. Kimura A study of clinical assessment of Unilateral Spatial Neglect using a Head Mounted Display system (HMD) for elderly stroke patients in a virtual reality technology T. Tanaka, S. Ino, T. Ifukube, S. Sugihara, S. Shirogane, Y. Oyama & Y. Maeda Postural control using a vibratory feedback system for balance training in the elderly T. Tanaka, S. Ino, T. Ifukube, S. Shirogane, Y. Maeda, Y. Oyama, S. Sugihara & T. Izumi A study of static and dynamic balance abilities in the elderly Y. Maeda, T. Tanaka, S. Ino, T. Ifukube, S. Shirogane & Y. Oyama Differences of visual information processing between younger and aged person K. Yamanaka, Y. Nakanishi & M. Kawakami VII

239 247

253

263 271

275

Chapter 6 Nurse Effects of disturbed sleep on work ability and well-being among European nurses D. Camerino, P.M. Conway, S. Sartori & G. Costa

283

Physical/mental recovery and work ability of nurses in Japan C. Miyamoto, Y. Suenaga, M. Ando, N. Noda, Y. Okui & M. Hashimoto

293

Relationship between depersonalization syndrome and medical malpractice among Japanese nurses M. Sugiura, M. Hirosawa, Y. Yamada, Y. Nishi, S. Tanaka & M. Mizuno

299

Effect of continuous exercise on job stress among Japanese nurses Y. Kawata, Y. Yamada, M. Sugiura, Y. Nishi, M. Mizuno, M. Hirosawa & S. Tanaka

303

Relation between Typus Melancholicus and burnout among Japanese nurses Y. Yamada, M. Hirosawa, M. Sugiura, Y. Nishi, S. Tanaka & M. Mizuno

307

Relationship between depression and depersonalization among Japanese nurses S. Tanaka, M. Sugiura, M. Hirosawa, Y. Yamada, Y. Nishi & M. Mizuno

311

Effect of obsessive personality traits and impulsiveness on obsessive-compulsive disorder and eating disorders among hospital nurses Y. Nishi, M. Hirosawa, M. Sugiura, Y. Yamada, S. Tanaka & M. Mizuno Work-family balance and stressors among Japanese administrative nurses M. Mizuno, Y. Yamada, M. Hirosawa, M. Sugiura, Y. Nishi, Y. Kawata & S. Tanaka

315 319

Chapter 7 Others Time constraints and age: Health impact on musculoskeletal problems and perceived health B. Norma, S. Rosa & S. Francesco

325

Age-related differences in insurance claim rates for work-related injuries and diseases for different occupations and industry sectors K. Munk, P. Congdon & W. Macdonald

331

Age-related differences in patterns of return to work and compensation costs following work-related injury or illness K. Munk, P. Congdon & W. Macdonald

343

Keyword Index

355

Author Index

357

VIII

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Preface

This publication is a collection of selected papers from the 3rd International Symposium on Work Ability—Promotion of Work Ability Towards a Productive Aging, which is an international conference that was held for three days from Monday, October 22 to Wednesday, October 24, 2007. This conference was planned by the ICOH Scientific Committee for Aging and Work (ICOH SC for Aging and Work) and was jointly sponsored with the IEA Technical Committee for Aging, Vietnam Association of Occupational Health, and Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health (UOEH), Japan. The ICOH SC for Aging and Work was founded in 1989. Since its founding the ICOH SC for Aging and Work has held two international conferences. The first was the International Conference on Aging and Work. The first Conference was held in The Hague in 19901 ), the second one was held in Helsingor, Denmark2 ) in 1998, the third in Kitakyushu, Japan3 ) in 2001, and the fourth in Krakow, Poland in 2002. The other was the International Symposium on Work Ability. The first Symposium on Work Ability was organized in Tampere, Finland in September 20014 ). The second Symposium on Work Ability was organized in Verona, Italy in October 20015 ), and irregularly held workshops on aging workforces have also been held For example,6 ). With the exception of the conference in Krakow, the proceedings of all ICOH SC for Aging and Work conferences have been published to propose measures for aging workforce societies from the standpoint of occupational health and ergonomics and other areas of the social sciences. The first ICOH SC for Aging and Work chairman is W. J. Goedhard. The first paper in this publication, Achievements in Aging and Work “Period 1989-2007; challenges after 2007”, uses the history of this conference to introduce readers to challenge of an aging workforce from an occupational health perspective. The aging workforce issues addressed by the occupational health and ergonomics fields are of particular interest to the well developed regions. Many of these areas are European countries in Northern Europe, and in Asia it is Japan that is actively working on these issues. In view of this, Vietnam in Southeast Asia was selected as the conference location for the ICOH SC for Aging and Work. There was a reason for holding the conference in Vietnam. The reason is that it is forecast that in the near future Asia will be unable to avoid the issue of aging workforces. The problems related to an aging workforce differ among countries. For example, Japan is dealing with an aging society with a low birthrate, which is reducing the working population and increasing the ratio of aging workers in the productive age population. This demographic distortion is impacting the foundation of the pension system. In response, the labor administration is working to create an employment environment where people work until age 70. In particular, Japan is working to improve the workplace. Europe, on the other hand, is concentrating on human resources and work ability evaluation methods for their extension. Differences can also be seen in “work ability”, which was used in the title of this publication, between Japan and Europe in how the evaluation results are used. This publication addresses in a major way the Work Ability Index (WAI) as an index for evaluating work ability. This was developed by the Finnish Institute of Occupational Health as a tool for evaluating work ability of workers. The ICOH SC for Aging and Work has promoted the use of this index through international conferences, publications and other means and construction of an international database based on this index. As a result, today the WAI is used in 25 languages. WAI is becoming an international and multi-cultural technique. However, to advance the promotion of work ability, which is the subtitle of this publication, how to use work ability evaluations and how to achieve the sought after productive aging must be studied. Currently, unfortunately, there is a major gap between Japan and Europe regarding how the evaluation obtained from WAI is used. Europe appears to be using this index to say, “You have this much work ability, so please continue IX

working instead of retiring early.” On the other hand, Japan is using this index to allow workers to say, “I have this much work ability, so please allow me to continue working without making me retire because of my calendar age.” This publication is a collection of papers that discuss from a variety of angles the goal of developing a truly international standard tool that can be used in common internationally taking into account differences in circumstances among countries. It is our hope that soon there will be a common guideline that exceeds national and regional boundaries that can be used for the diagnostic evaluation of work ability and employability. In conclusion, I wish to thank Mr. Jean-Luc Malo for the great effort he demonstrated in editing this publication. The majority of the time he spent as an assistant professor in my department was devoted to the work of holding this conferences and editing the corresponding papers. This publication is the result of his efforts. I also wish to thank Mr. Osami Hagiwara, president of Alphacom, for picking up where Mr. Jean-Luc Malo left off and assisting in the organization and editing of the transcripts for this publication. References: Materials issued by the ICOH SC for Aging and Work 1. AGING AND WORK, Willem J.A. Goedhard, 1992, ICOH Scientific Committee “Aging and Work”, Den Haag, ISBN 90-9005032-9 2. Experimental Aging Research, Jeffrey W. Elias, Vol.25, No.4, 1999, Taylor & Francis, USA, ISSN 0361-073X 3. AGING AND WORK, Masaharu Kumashiro, 2003, London: Taylor & Francis, ISBN 0-41527478-8 4. Past, Present and Future of Work Ability, -Proceedings of the 1st International Symposium on Work Ability- , Juhani Ilmarinen, Suvi Lehtinen, 2004, Finnish Institute of Occupational Health, Helsinki, ISBN 951-802-581-9 5. Assessment and Promotion of Work Ability, Health and Well-being of Ageing Workers, Proceedings of the 2nd International Symposium on Work Ability held in Verona, Italy between 18 and 20 October 2004-, Giovanni Costa, Willem J.A. Goedhard, Juhani Ilmarinen, 2005, Elsevier, The Netherlands, ISBN 0-444-51989-0 6. AGING AND WORK 4, -Healthy and Productive Aging of Older Employees-, Willem J.A. Goedhard, 2000, ICOH Scientific Committee “Aging and Work”, The Netherlands, ISBN 90803145-3-6 Masaharu Kumashiro, PhD, Professor of University of Occupational and Environmental Health (UOEH), Japan Chairman of ICOH Scientific Committee for Aging and Work

X

Chapter 1 Overview

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Achievements in Aging and Work “period 1989–2007; Challenges after 2007” Willem J. Goedhard The Netherlands Foundation of Occupational Health and Aging, Middelburg, The Netherlands

ABSTRACT: The Scientific Committee “Aging and Work” of The Int. Commission on Occupational Health (ICOH) was raised in 1989. Since the beginning the activities of the committee and its members have been growing resulting in many fruitful workshops, symposiums and a series of conference proceedings. The following officers of the committee were nominated by the Board of ICOH: Prof. (em.) Willem J.A. Goedhard (Middelburg, The Netherlands) as chairman and Prof. Juhani Ilmarinen (Helsinki, Finland) as secretary. In 2005 these officers were succeeded by Prof. Masaharu Kumashiro (Kitakyushu, Japan) as chaiman and Prof. Clas-Håkan Nygård (Tampere, Finland) as secretary. Aim of the committee: To preserve health and work ability of aging employees. The committee focuses on: • Older Employees • Studies on the relationship of Work Environment and the Aging Process of employees • Studies about the changes in Work Ability of aging employees Early developments: In the period before the start of the committee attention for older employees, for example during ICOH congresses was relatively small. This is possibly an indication that ageassociated changes of worker’s health were considered of little importance. Research concerning aging or age associated topics in occupational health was usually aimed at physiological changes in work capacity. From the beginning of the work of the committee research was more directed towards the challenges that were emerging from foreseeable aging of the workforces. This implied attention for prevention aspects of diseases, the importance of the aging process on the performance of aging workers and the relation between aging and mental capacity. Furthermore much research was dedicated towards aspects of (early) retirement. Also aspects of work stress in relation to worker’s age were receiving closer attention. It became clear that research concerning aging workers was explained rather differently in many countries possibly due to the different problems prevailing in these countries. Work ability and aging: A major break-through was the development and gradual implementation of the work ability index (WAI) by the Finnish Institute of Occupational Health in Helsinki. This questionnaire was translated in many languages and very soon study results emerged in which the WAI had been applied. The various study results among different cultures showed that the WAI was a valuable instrument to determine a worker’s ability to perform his/her job. Cross-sectional studies with the WAI showed negative trends of WAI scores in relation to age. However it became obvious that the work ability rate with age is relatively small explaining only about 5–10% of the variance of WAI. It can therefore be concluded that other variables, such as endurance capacity, are contributing considerably more to the level of work ability than calendar age. The scatter of WAI scores increases with advancing age. 3

Challenges after 2007: With a greater number of older participants in tomorrow’s workforces much knowledge about aging will be needed among Occupational Health (OH) physicians and OH personnel. Special programs aimed at older workers will have to be developed. No doubt the WAI will be a helpful instrument. Main activities will have to be directed towards age management. Then, it will be important to control prevention of chronic diseases which usually have detrimental effects on work ability. Last but not least control of excess job stress will be required since work stress may negatively affect aging and work ability. 1 ICOH SCIENTIFIC COMMITTEE “AGING AND WORK” FROM 1989 TO 2007 During the 20th century life expectancy increased considerably, not only at birth but also life expectancies at advanced ages (Fries, 1983). Improved living and working conditions theoretically allowed longer and more productive work lives. However, opposite developments were observed in many developed countries. Instead of retirement at 65 years, the retirement age that was already established during the 19th century; in the 70s and 80s of the 20th century shrinking of manpower in many industrialized countries was observed. Much unemployment followed and with financial aid of governments workers were entitled to early retirement around the age of 60 or even earlier (RedayMulvay, 2005). These developments were leading to the paradox of increased and improved life expectancies and health the percentages of people working beyond 60 years decreased considerably. Yet it could be foreseen that these developments had to reach a limit since another important development was observed, i.e. decreased birth rates in many countries. This would no doubt lead in the near future to shortages of manpower and the return of older workers in the workforces. This was more or less the situation in the beginning of the 1980s. An illustration of the situation is minimal attention for age-associated aspects of occupational health at that time (e.g. at the ICOH congress in 1984 in Dublin) only a few papers were dealing with topics pertaining to the aging process of workers: There was only one session on Aging, chaired by Prof. Asa Kilbom (Sweden) that comprised two papers related to aging (one from Finland by Ilmarinen et al. and one from the Netherlands by Goedhard et al.). In 1987 I wrote a letter to the late Professor Murray the president of the ICOH in which I suggested to raise a scientific committee that would concentrate on matters of aging in the working population. Professor Murray wrote 27th August 1987 “. . . My own personnel interest in the subject derives from the fact that I believe it is very useful to continue working as you get older. It is those who do not have a consuming interest, either in their work or in equally important leisure activity who die early. I can recognize that older people some times have to step aside to allow younger people to be promoted, but in many cases a life time of experience is wasted if they are merely given a retirement pension”. The board of ICOH responded positively and in 1989 the scientific committee “Aging and Work” was raised and officially started in Helsinki by prof. Sven Hernberg, president of ICOH. Nominated as officers of the committee were: myself as chairman and Prof. Juhani Ilmarinen (Finland) has secretary. The aim of the committee was to preserve health and work ability of aging employees. I am much obliged to my colleague Juhani Ilmarinen with whom I was able to work together for many years. We had many stimulating discussions and were able to organize a series of international workshops and conferences (see Table 1). The committee focuses on: Health of Older Employees, Studies on the relationship of Work Environment and the Aging Process (bridging the gap between occupational health and gerontology), and Studies about changes in Work Ability of older employees. Aging of the population – Some consequences of population aging are: (1) Aging of the workforce (2) Changes in retirement policies (3) Increased numbers of disabled workers Is aging of the workforce a problem? – (J-F. Caillard, former President of ICOH, 1994) wrote “. . . the survival of greater numbers of people into old age has great consequences for the health of the 4

Table 1.

1990 1992 1994 1994 1996 1998 1999 2001 2001 2002 2004 2007

List of venues of workshops and conferences under the auspices of the ICOH scientific committee “Aging and Work” between 1989 and 2007 The Hague (Netherlands) Haikko (Finland) Wijk aan Zee (Netherlands) Kitakyushu (Japan) Stockholm (Sweden) Helsingor (Denmark) The Hague (Netherlands) Tampere (Finland) Kitakyushu (Japan) Krakow (Poland) Verona (Italy) Hanoi (Vietnam)

Aging and Work Aging and Work Aging and Work Paths to Productive Aging Work after 45? Aging and Work Aging and Work Work Ability Aging and Work Aging and Work Work Ability Work Ability

labor force, as many remain in employment with the deficiencies and disabilities that accompany ageing”. Early developments – The start of the new ICOH committee: “Aging and Work” in 1989 was certainly not the beginning of research interests in older workers’ problems. In social gerontology much earlier than 1989 researchers were interested in topics concerning older workers. An example is the publication of a book in 1970: by professor Harold Sheppard (USA): He was White House counselor on aging in the Carter Administration (end of the 70s). In 1970 he edited and published a book “Towards an industrial gerontology, an introduction to a new field of applied research & service”: This book was considered of particular use for personnel management. A balance should be maintained between exertion of capabilities and performance (Sheppard, 1970). An important conclusion was: “it may someday be proven (or convincingly argued) that continued activity in some form of work (compensated or not) is an important way in which to slow down the process of aging”. In the Netherlands important research on aging workers was done by Dirken and co-workers (1972). They concentrated on physiological aspects of aging which led to the concept of functional age that may differ from calendar age in many people. Johan Dirken (Netherlands): 1970: Publication of his book “Functional Age of Industrial Workers: Functional age: i.e. measurable characteristics of an individual vs. his functioning in a physically or socially determined (work) environment (Dirken, 1972). Finally, in Jan Baart (1973) wrote a thesis about older dock workers. One of his conclusions was “Older dock laborers should be allowed to adjust their work speed. What is an older worker? – The committee focuses on older workers. The question arises what is an older worker? Without giving some exact definition it is mores sensible to provide some characteristics of an older worker. It is now generally accepted that the following characteristics are appropriate: • Older than 45 years [1996: congress in Stockholm: theme: “Work after 45?”, At this congress Hjort (1997) proposed an official retirement age of 70 years]. • In the final third of professional career. • Age-associated changes which may affect work ability. • Increasing risk of chronic diseases. • Aging of professional skills and knowledge. • More experienced. 2 HIGHLIGHTS FROM CONFERENCES AND WORKSHOPS Below I will shortly refer to some highlights of conferences and Workshops as indicated in Table 1. The selection of papers is very much subjective. 5

WorkAbility Index (WAI) – This questionnaire which was developed and introduced in Finland by researchers of the Finnish Institute of Occupational Health can be considered an important breakthrough in the international research on aging workers. (1992: Haikko) Ilmarinen and Tuomi (1993): • Work Ability Index for Aging Workers: Report on a longitudinal study that started 1981 on 6,257 workers (45–58 years). • It took some more years before WAI was introduced in other countries. • The presentation of the WAI was followed by the launch of the concept of “age management”. These developments allowed the study of aging workers in different countries with the application of a standardized instrument. In the meantime this has been proven a very useful development. The WAI has been translated in many languages and is used in many countries. The results of studies with WAI have given rise to the organization of several international conferences, like Tampere (2001); Verona (2004) and Hanoi (2007). Age Management – It has clearly been demonstrated by Ilmarinen (1999) that good age management is a very useful tool in order to maintain employability of aging workers. Age Management implies promotion of Work Ability. It is one of the main objectives of the committee Aging and Work to disseminate this view among employers and employees. Is this necessary? The answer is Yes, because: • In the EU it was decided: [EU summit conferences in Barcelona 2002, Stockholm 2001] to the 2010 objectives: i.e. • More than 50% of the 55–64 yr old population should be active in the workforces. • Reduction of early retirement policies. • Age of retirement to be increased to 65 years in all EU countries. It is rather questionable whether the EU targets will be realized. In the Netherlands it was found that employees and employers are not in favor of extending the working life (van Dalen et al., 2005). Most employees expect to work till 62 years. Most employers consider extending the working life of their employees to 65 years as undesirable. The central issue here is the question whether older workers will be able to continue working. At the conference in Stockholm (1996) an important contribution to this discussion was presented by Salthouse: “Implications of adult age differences in cognition for Work Performance needed” (1997). There is little relation between age and measures of work performance. This conclusion is consonant with Dirken (1972). The good news is: Increased age is not a liability in most employment situations. However the “bad news” is: age-related decline in cognitive abilities is to be expected. An important aspect of Age management is the maintenance of knowledge and professional skills. This requires continuous learning which may become difficult in case of reduced cognitive abilities. An important contribution at the conference in Helsingor 1998 was by Näsman & Ilmarinen (1999): “Metal-Age: A process for improving well being and productivity. Methods for starting interventions in enterprises e.g. improvement of the work organization: The important key words are: participatory planning, i.e. finding solutions together. This method derives to get more attention. It is applied to find the most crucial development targets of well-being at work. This is comprehensively discussed in the publication: “Well-being creates productivity” (Rissa, 2007). The problems of aging workforces are not limited to Europe or the USA. Also Asian countries have to deal with reduced birth rates and subsequently aging workforces. For example in Japan the age group 55–64 year old workers was estimated to increase from 15.5% of the population in 1990 to 20.8% in 2010. Kumashiro described a strategy to retain productive aging. Key aspects in this strategy are: estimation of functional age, maintenance of Work Ability and an optimum work motivation (Kumashiro, 1999). Winn (1999) pleaded for a more efficient use of older workers in the United States. He indicated that social minorities are more likely than non-minorities to retire 6

early because of poor health. Yet many work longer than the normal retirement age in order to maintain their living standards. Vitality – Vitality is not a usual biological concept. In many Gerontology textbooks the word is often not indexed. The word expresses something like energy or “vital force” (i.e. the power to live or go on living. At a conference in The Netherlands in 2006 (Wijffels, 2003) stated that that modern societies should invest in vitality of elderly people and the community. Elderly people should be enabled to participate actively and enjoy a high quality of life. This will imply that there should not be any age limit to education. Work Ability of men and women – Application of the WAI in several countries has resulted in numerous studies among workers in many countries. Differences between workers in different professions were visualized. Also gender differences in work ability can become clear. In an evaluation of functional working capacity by the WAI in Italian workers it was found that female workers have lower WAI scores than men and workers under stress (strain) are more prone to decrease in fitness and work ability (Costa et al., 1999). An important comprehensive study is the NEXT study (nurses early exit study). This study that was setup in nine European countries among 40,000 nurses and provided better understanding of the variables contributing to work ability scores. Camerino et al. (2005) showed that stress factors like harassment at work (uncertainty about treatment), low job control, and high job demands, tend to give low WAI scores and job alienation. 3 CHALLENGES AFTER 2007 It can be reasoned that in many industrialized countries more older workers (60–65 + yrs) will re-enter the workforces. Extending the working life is an important challenge for occupational health physicians in the future. They will have to deal more than in the recent past with increases of age-associated disorders (risk of disability). Disability rates will possibly increase. It will become more difficult to maintain skills and knowledge of these aging workers. It must also be realized that age-associated declines in cognitive abilities (Salthouse, 1997) may affect the possibilities of workers to keep up with new developments in their profession. The key-item is employability. This is preceded by promotion of work ability (Ilmarinen, 1999). An other important aspect of work in modern societies is the level of perceived stress. It is therefore essential to realize that on-going work ability control and on-going stress control are warranted in order to maintain employability of older workers. Variability in work ability – Work ability has the tendency to decrease with advancing age. In cross-sectional studies usually negative trends are observed in WAI scores of the studied population (Goedhard, 2004). The scatter in observed WAI scores also changes over time resulting in increased 50 45 40 35 30 25 20 15 10 5 0

WAI
47.9  0,14  age R2
0,91 (p.01)

Variance
0,84  age  9,6 R2
0,71 (p.05) 0

10

20

30 40 Age (years)

Figure 1. WAI-score mean and variance per 5-years age-group

7

50

60

70

variances of WAI scores (see Figure 1). This implies that differences between workers increase with advancing age. Work stress control and age – Based on earlier observations the preliminary conclusion was reached that perceived work stress increases with age. Will older workers be able to cope with these stresses? What could be the negative outcomes of work stress? An other conclusion was that baroreflex function is possibly affected by work stress (Goedhard, 1993). Recently it was found that prolonged stress affected telomere length in caregivers. Women with the highest levels of perceived stress have telomeres shorter on average by the equivalent of at least one decade of additional aging compared to low stress women (Epel et al., 2004). These findings have implications for understanding how, at the cellular level, stress may promote earlier onset of age-related diseases. Such findings illustrate the serious effects of work stresses on important biological systems. REFERENCES Baart, J., (1973). De oudere havenwerker (the older dock worker) (Dutch). Thesis, Erasmus University, Rotterdam Caillard, J.F., (1995). In: Cox, R.A.F. et al. (eds) Fitness for Work. Oxford University Press, Oxford, Foreword, pp. iv–v Costa, G. et al., (2000). Evaluation of functional working capacity by the work ability index in Italian workers. In : Goedhard, W.J.A. (editor), Aging and Work 4, ICOH SC Aging and Work, printed: Pasmans, The Hague, pp. 53–61 Dirken, J.M. (editor), (1972). Functional Age of Industrial Workers. Wolters-Noordhoff, Groningen, Netherlands Epel, E.S. et al., (2004). Accelerated telomere shortening in response to life stress. Proceedings National Academy of Sciences; 101/49: pp. 17312–17315 Fries, J.F., (1983). Compression of morbidity. The Milbank memorial fund Quarterly 61/3: pp. 397–419 Goedhard, W.J.A., (1993). Work stress and the aging process. 24th Int. Congress ICOH, Nice, France, Book of Abstract, pp. 67 Goedhard, W.J.A., (2004). WAI scores and its different items in relation to age: a study in two industrial companies in the Netherlands. In: Ilmarinen, j. and Lehtinen, S. (editors). Past, Present and Future of Work Ability, FIOH, Helsinki, Research Reports 65: pp. 26–40 Hjort, P.F., (1997). Age and Work-good or bad for whom? In: Kilbom, Å et al. (editors), Work after 45? Arbete och Hälsa, 29: pp. 3–13 Ilmarinen, J., and Tuomi, K., (1993). Work ability index fora ging workers. In: Ilmarinen, J. (editor), Aging and Work, Finn. Inst. Occup. Health, Helsinki, pp. 142–151 Ilmarinen, J., (1999). Ageing workers in the European Union. Status and promotion of work ability, employability and employment, Finn. Inst. Occupational Health, Helsinki. Kumashiro, M., (1999). Strategy and actions for achieving productive aging in Japan. Experimental Aging Research, 25/4: pp. 461–470, 379–384 Näsman, O., and Ilmarinen, J., (1999). Metal-Age: A process for improving well being and productivity. Experimental Aging Research, 25/4: pp. 379–384 Reday-Mulvey, (2005). Working beyond 60. Key policies and Practices in Europe, Palgrave MacMillan, New York Rissa, K., (2007). Well-being creates productivity (the Druvan model). Centre for Occupational Safety, Helsinki, pp. 80. ISBN: 978-951-810-340-3 (PDF) http://www.tsr.fi/files/Julkaisut2007/wellbeing productivity. pdf (valid fev. 2007) Sheppard, H.L. (editor), (1970). Towards an Industrial Gerontology. Schenkma Publ., Cambridge, Mass. Salthouse, T.M., (1997). Implications of adult age differences in cognition for work performance. In: Kilbom, Å et al. Work after 45? Arbete och Hälsa, 29: pp. 15–28 Van Dalen, H.P. et al., (2005). The double standard in attitudes toward retirement- the case in the Netherlands. The Geneva Papers, Palgrave MacMillan, 30/4: pp. 693–710 Wijffels, H., (2006). Investeer in de vitaliteit van mensen en de samenleving (Dutch). In: Tielen, G. and Dortland, B (editors). Van Nazorg naar voorzorg, Kon. Holl. Maatsch. Der Wtrenschappen, Haarlem, Netherlands, pp. 19–28 Winn, F., (1999). Structural impediments to the efficient use of older workers in the United States. Experimental Aging Research, 25/4: pp. 451–459

8

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Measures for the aging workforce in Japan from the perspective of the occupational health, safety and ergonomics Masaharu Kumashiro Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu, Japan

ABSTRACT: The aging of population has major repercussions on the workforce population. The basic issues of such an aging workforce society that must considered from the perspective of the occupational health, safety and ergonomics are (1) enhancing the health resources of the citizenry, (2) human resources management that includes setting wages and benefits based on objective evaluation of workability and employability, and (3) work and working environment management focusing on job design that takes aging workers into account. To resolve these issues requires making an employment environment in which employer and employees can work comfortably without being conscious of calendar age while maintaining the high labor productivity that can be thus created. This is to create a so-called “age free” workplace. The core strategy for creating an age free workplace is to avoid as much as possible mismatches between work ability and the job requirements placed on the workers. To do this, how work ability is evaluated and the factors that hinder maintaining and increasing work ability must be identified. At the same time, working conditions and working environment that allow the work ability acquired by workers to be fully utilized must be created (set). In this paper, the former is positioned as a strategy at the company level. In particular, the difference from the West of the work ethic held by Japan has given birth to employability that is unique to Japan. An evaluation for the Japanese style work ability that is the source for this must be considered. On the other hand, the later is positioned as a strategy at the workplace level, and it can be used to weigh the actual condition of Japanese company KAIZEN activities. This will also serve as a reference for strategies that support future workplaces.

1 JAPAN AND THE AGING WORKFORCE SOCIETY The average lifespan for Japanese people announced in 2005 was 78.53 years for men and 85.49 years for women. For men, this figure is second to that of Iceland, while women live longer in Japan than anywhere else. Compared to the figures for 1950 (58 and 61.5, respectively), the average lifespan has lengthened by more than 20 years for both men and women. Meanwhile, the productive-age population peaked in 1995, after which the trend has been toward decline. According to projected population statistics released in 2002, the productive-age population comprised 66.4% of the total Japanese population in 2005. This is estimated to fall to 58.5% in 2030. Focusing on middle-aged and older workers aged 45 and over, the percentage has increased since 1990, and in particular, a dramatic increase is foreseen for 2015 and after. Japan has truly entered the era of an aging society with a low birthrate. One can relate to the negative aspects of this phenomenon when observing it from the viewpoint of maintaining a productive-age population. This means that 4.1 million people between the ages of 60 and 64, or about 2/3 of that age group, will have to be working in 2010 in order to maintain a productive-age population between ages 15 and 60 comparable to that in 1998 (58.7 million). Similarly, by 2015, everyone up to age 64 and 10% of the over-65 population will have to be working. In 1973, the Japanese government set the target retirement age at 60, and subsequently examined legislating this target, which in 1994 became law. The next step was the start in 1999 of a campaign 9

to promote model businesses in which people could work until age 65, and then seven years later in April 2006 the Revised Law for the Stabilization of Employment for the Aged came into force. As a result, businesses are under pressure to prepare for introducing a continuing employment system up to age 65. In spite of the fact that the law came into effect after a preparation period lasting 33 years, any negative judgments made by employers regarding employment up to age 65 relate to skepticism about the health, physical capabilities, motivation to work and the like of aging workers. The aging phenomenon is unavoidable as long as human beings are animals. The fact that aging brings about diminished fluid ability can be felt in daily life. As a result, there is a general tendency to dismiss aging workers as being out of the running. This tendency results in a vicious circle by creating an unhealthy aging society that has lost its motivation toward life and work. Meanwhile, according to a survey of aging people (25,224 randomly selected people between ages 55 and 69) regarding their employment status conducted by the Ministry of Health, Labor and Welfare in 2004, 71.5% of the men and 45.6% of the women were gainfully employed in September 2004. By age group, these figures were 68.8% for men aged 60–64, 49.5% for men aged 65–69, 42.3% for women aged 60–64, and 28.5% for women aged 65–69. It is unclear as to whether these percentages indicate people who were forced to work to support themselves, or those who consider that work gives them something to live for. However, it can be easily seen that a large number of aging people are seeking work. This means that the role of occupational health and safety is to provide lifestyle and health guidance to enable aging people to lead reasonable working lives, and to supply the know-how required to avoid mismatches between their working capabilities and the job requirements. Thus, the basic issues that occupational health and safety specialists will have to consider from now on are (1) enhancing the health resources of the citizenry; (2) human resources management that includes setting wages and benefits based on objective evaluation of workability and employability; and (3) work and working environment management focusing on job design that takes aging workers into account. The fundamental concept for resolving these issues is the building of a company that has a healthy workforce regardless of age or gender. This means making an employment environment in which employer and employees can work comfortably without being conscious of calendar age, and maintaining the high labour productivity that can thus be created.

2 PERCEPTIONS OF WORKABILITY IN JAPAN In looking at measures for aging workers in Europe, and particularly in the northern European countries, lively research is ongoing in the area of human resources and workability. In northern Europe, human resources research is viewed from the perspective of the natural sciences, starting with physiology and medicine. For Japan, where human resources and labour management is carried out from the viewpoint of social sciences, this dimension is probably as great a shock as the coming of Commodore Perry’s Black Ships in 1853. Japan also has focused on the relationship between unavoidable human aging and fluid ability. But diminished workability that accompanies aging has always been perceived visually. Specifically, the emphasis has been on developing and preparing support systems (working conditions, working environment, etc.) to compensate for decline that can be confirmed with the eyes, such as diminished muscular strength, failing stamina, fading vision and the like. Why has Japan not perceived this human aspect biologically, and evaluated human resources objectively on that basis? Perhaps they were working on the basis of Japan’s organizational operation and the labor management practice of “protecting one another” – for example: “I know you’re having a hard time. So am I. So let’s try together”. The “protect one another” concept resulted in the creation not only of bonding, arising from the life wisdom of agricultural people, but also in the concept of ostracism. Perhaps this encouraged the development of organizations that are oblivious of the distorted nature of this method of ability evaluation. Moreover, the “protect one another” concept covers up potential problems. The introduction of support equipment and tools may aggravate this aspect. So this is probably why an equation for evaluating the workability of aging workers has not been created outside the arena of calendar age. If a competitive society had resulted in a “pep talk” concept among the Japanese people, such as “If it’s so tough, you can stop. 10

If you stop, it’ll be easier for you, and it will mean one fewer competitor for me, so it will be easier for me to win”, then Japan might have turned to objective human resource evaluation based on biological thinking. 3 THE TIME HAS COME TO DEVELOP JAPANESE-STYLE WORKABILITY In order for individual human beings to maintain workability, they must first enhance the skills, experience, knowledge, interpersonal relationship building capabilities and the like that are required in their current jobs. Once a certain level of ability is achieved, then it is important to increase their capabilities to cope with peripheral work and gradually expand their work scope. Workability fostered in this way must eventually be carried forward into employability that can be utilized in the external labour market, not just within the company of the current employer. At the same time, companies as part of their role should be proactive in providing educational and training systems for the purposes of improving the quality of employee workability and expanding its applicable scope. Basically, companies must be aware that they are each a member of the single organization “Japan Inc.”, which is becoming an aging society with a low birthrate. And they must work together as one to improve and educate Japan’s human resources. Companies must become aware of the fact that unless they eradicate the insularity exemplified by the phrase “our own employees”, the deed will come back upon them when they end up with “only our own employees” having low workability. Essentially, Japan appears to have the grounding for developing workability into employability. In other words, employees in Japan usually spend their entire working life in the same company, in contrast to other countries. However, within that same company they move about from sales to production to office work, for example, in order to gain a variety of experiences. If this grounding could be exploited, this environment of changing workplaces within one company need only be standardized for application to employment in other companies. As described above, a wide range of employability becomes possible when one possesses workability in relation to various individual jobs. The issue for Japan going forward is whether or not the individual work abilities cultivated within just one company can be applied outside that company. In other words, the standardization of workability will be a crucial labor policy issue for the future. The three sources of workability are health, motivation and skill. Among these three sources, the most basic is the health of the individual. Health is composed of mental and physical capacity, an awareness of its role in social lifestyle including work and daily life, and the functions carried out. Then, the source of the required workability is motivation to work. This means the attitude to one’s work. The final aspect is technical skills, which is what many companies are most concerned about. These can be expressed in terms of a combination of knowledge, experience and technology (in terms of blue collar workers), or a combination of specialized abilities, adaptability to environmental change, and management abilities (in terms of white collar workers and managers). 4 OCCUPATIONAL HEALTH AND SAFETY STRATEGIES IN THE ERA OF AN AGING WORKFORCE SOCIETY WITH A LOW BIRTHRATE Many different measures are put forward when discussing how occupational health and safety should intervene in Japan’s aging workforce society with a low birthrate. From the perspective of occupational health, safety and ergonomics, the following four strategies can be proposed. The characteristic of strategies in occupational health, safety and ergonomics is that they can be developed at all levels, from the individual to the state level. (1) Strategies at individual level Examples: Ensuring health, rejuvenating the physical age (preventing reduction in life functions) (2) Strategies at workplace level Examples: Workplace improvement (KAIZEN) activities (including job re-design), developing support equipment and tools 11

(3) Strategies at company level Examples: Evaluating workability and building workability-based wage and benefit systems, horizontal development of success stories (among workplaces) (4) Strategies at state and regional administration levels Examples: Creating database of company success stories, publicizing the database, establishing a certified employability evaluation system

5 STRATEGIES AT WORKPLACE LEVEL WORKPLACE IMPROVEMENT (KAIZEN) – A CHARACTERISTIC AGING WORKFORCE MEASURE IN JAPAN Tables 1–3 illustrate the results of aging workforce measures as classified and arranged by the author, based on the joint research reports (April 1986–March 2007) published by the Japan Organization for Employment of the Elderly and Persons with Disabilities (JEED). Table 1 gives an interesting glimpse of the kinds of issues that concern Japanese companies in terms of aging workforce measures. This joint research system is broadly divided into four categories (job re-design, health care, human resources/wages, and capability development). Looking at the joint research results for the past 21 years, job re-design at 55.9% was most often cited, followed by capability development at 20.5%, human resources/wages at 15.3% and health care at 8.3%. This indicates that Japanese companies have shown great interest in workplace improvement activities carried out under the slogan of job re-design.

Table 1. Japan Organization for Employment of the Elderly and Persons with Disabilities Joint Research Reports (April 1986–March 2007) No. of cases Job re-design Health care Human resources/wages Capability development Participating companies

194 29 53 71 234

In fact, most companies encourage workplace improvement from the bottom up, under such names as KAIZEN Dojo, karakuri KAIZEN activities and the like. In Table 2, the focus is on measures taken by Japanese companies to lighten the workload on their own employees who are aging workers, in particular the number of times job re-design was implemented. The result shows that the issue of greatest concern is the load on the musculoskeletal system, at almost 60%.

Table 2.

KAIZEN activities in Japanese companies as measures for aging workers (April 1986–March 2007)

Vital function

KAIZEN cases (%)

Musculoskeletal functions Sensory organs Judgment functions Other (including unclassifiable) Total

470 (59.4%) 74 (9.3%) 50 (6.3%) 198 (25.0%) 791 (100%)

12

Note: The figures given in Table 1 relate to multiple joint research topics and thus represent combined totals. Also, even if improvement measures related to an individual function, they were classified under “Other” if the function was not a main target of improvement. Next, Table 3 focuses on this issue of greatest concern, the musculoskeletal system, and shows the elements that cause the load and the status of countermeasures taken. The first preventive countermeasure against musculoskeletal system disorders taken on the front line was improving defective work posture (36.1%), followed by transport of heavy objects (29.4%), and improved methods of lifting of heavy objects (27.6%). To summarize, the main concerns of Japanese companies in terms of aging worker measures are improving defective working posture and handling of heavy objects. Table 3.

Musculoskeletal system disorder preventive activities in Japanese companies as measures for aging workers (April 1986–March 2003)

KAIZEN target work

KAIZEN cases (%)

Lifting of heavy objects Transport of heavy objects Defective working posture Walking and ascending/descending staircases Isometric exertion Total

132 (27.6%) 141 (29.4%) 173 (36.1%) 21 (4.4%) 12 (2.5%) 479 (100%)

Further, one other keyword that can be found in Table 2, and indicated in almost 10% of KAIZEN activities, is dealing with sensory organ changes. Specifically, this means KAIZEN activities relating to age-induced reduction in visual functions such as near-point adjustment, night vision and dynamic visual acuity. In addition, a characteristic change in KAIZEN activities in Japanese companies is that they have started to be adapted to training and handing down of job know-how. Thus, some KAIZEN targets are no longer demanding the optimum KAIZEN results. This type of trend makes it increasingly difficult to fit corporate results from the past two to three years into the categories of Table 2 and Table 3. In any case, in Japanese companies all of these activities are carried out at the workplace level, by front line workers and managers. The most elementary and common KAIZEN activity carried out in Japan’s workplaces is the development and introduction of support equipment and tools from the production technology aspect. Next, workplace groups that have advanced one level further have acquired production control knowledge and skills, and are working on KAIZEN activities that incorporate method improvement, process improvement and other IE (Industrial Engineering) concepts. The procedure actually followed by mature KAIZEN teams is first to test low-cost method improvements, then to introduce equipment and tools. Meanwhile, recently not only are improvement measures being introduced for current work, but KAIZEN tools are also being developed. One of these that is often used is the application of the ergonomics checklist. In most of these cases, a checklist most suited to the workplace in question is created based on a sample of a general ergonomics checklist. For example, a formula is woven whereby the focus of the checks is divided into safety, human aging characteristics, product quality, and production efficiency, with scores allocated for each, and the KAIZEN priority is obtained from total scores. Finally, a formula has been developed whereby KAIZEN priority is determined according to the degree of workload.

6 CONCLUSION Measures for aging workers in Japan mix two types of tactics – those to be proud of and impoverished ones. Those in which to take pride exist as strategy at the workplace level. In other words, workplace 13

level tactics include the frequent utilization of workplace improvement and job design. Japanese companies excel at these tactics. Even on a global level, Japan’s level of knowledge, technique and experience for KAIZEN activities cannot be approached by any other country. Furthermore, Japan has training programs that allow this to be entrusted to the front line workers. In contrast, in terms of corporate level tactics, Japan is not very good at workability evaluation, which must be utilized proactively from now on. This is a tactic at which European countries excel, in particular northern European countries. In observing aging worker measures in northern Europe, one sees lively practical research being carried out in relation to human resources and workability in the field of occupational health and safety. Northern Europe perceives human resources research from the viewpoint of the natural sciences, starting with physiology and medicine. This clearly differs from Japan, which has carried out human resources research from the social sciences perspective. The background to this is the clear difference in thinking on workability and employability in Japan as compared to Europe. For Japan, with its seniority system and lifelong employment, evaluating workability using figures was difficult. Turning to the thinking on employability, as evidenced by the Japan Economic Federation in 1999, there is resistance to equating employability with the ability to make a career change. Employability could be defined as the ability fully to utilize one’s workability within the current employer and thus remain capable of continuing to be employed. In such an environment it is difficult to create standards such as those that exist in the West, for capability evaluation and development targets for the external labor market. However, it would appear that the very issue that Japanese companies must deal with urgently as they confront a rapidly aging society with a low birthrate is that of developing a workability evaluation method that incorporates the occupational health and safety perspective, and creating a workability bank that contributes to employability standardization. REFERENCES Joint Research Report (April 1986–March 2007), Japan Organization for Employment of the Elderly and Persons with disabilities, – This report is published annually in Japanese Juhani Ilmarinen, Aging workers in the European Union – Status and promotion of work ability, employability and employment, Finnish Institute of Occupational Health, Finland, 1999 Juhani Ilmarinen, Tuomi K, Past, present and future of work ability, Proceedings of the 1st International Symposium on Work Ability, Finnish Institute of Occupational Health, Finland, 2004 Juhani Ilmarinen, Towards a Longer worklife! – Aging and the quality of worklife in the European Union, Finland, 2005 Kumashiro, M., Strategy and Actions for Achieving Productive Aging in Japan, Experimental Aging Research, Vol. 25, No. 4, p. 461–470, 1999 Kumashiro, M., Japanese Initiatives on Aging and Work: An Occupational Ergonomics Approach to Solving this Complex Problem, “AGING AND WORK”, p. 1–8, Taylor & Francis, U.K., 2003 Population Statistics of Japan 2006 by PDF, National Institute of Population and Social Security Research Population Projects for Japan 2001–2050, National Institute of Population and Social Security Research, January 2002

14

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

The effects of work-related and individual factors on work ability: A systematic review Tilja I.J. van den Berg, Leo A.M. Elders & Alex Burdorf Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands

ABSTRACT: Objectives – This paper systematically reviews the scientific literature on the effects of individual and work related factors on work ability. Methods – Studies on work ability published from 1985 to 2006 were identified through a structured search in PubMed, and Web of Science. Studies were included if the Work Ability Index was used as measure of work ability and if quantitative information was presented on determinants of work ability. Results – In total, 20 studies were included. Important factors for a decreased work ability were lack of leisure-time vigorous physical activity, poor musculoskeletal capacity, older age, obesity, and high physical and psychosocial work demands. Conclusion – Work ability is influenced by individual characteristics, life style, demands at work and health status.

1 INTRODUCTION Aging of the working population increases the importance of physical and mental capacities of workers. In order to prolong the working life among older workers the concept of work ability has been developed in the early 1980s in Finland, and later adopted in various other European and Asian countries. The Work Ability Index (WAI) (Tuomi, 1998) is by far the most used, and well-accepted instrument to measure work ability. Although several studies in different occupational settings have been conducted, there is a need for a systematic evaluation of the relative importance of important determinants of work ability. The aim of this systematic review is to identify the individual and work-related determinants of a poor work ability in the workforce. 2 METHODS 2.1 Identification of the studies Relevant articles were identified by means of a computerized search of the bibliographical databases PubMed January 1985–December 2006, and Web of Science January 1988–December 2006. The following search string was used: “work ability”. The search was restricted to studies published in the English language. The literature search identified 337 abstracts with 124 abstracts in both databases, resulting in 213 unique abstracts. 2.2 Selection Studies were excluded when (1) not using the work ability index to describe work ability in an occupational population, and (2) not presenting quantitative information on associations between 15

individual and work-related factors and work ability. There remained 17 publications that met our selection criteria (Aittomaki et al., 2003, Eskelinen et al., 1991, Fischer et al., 2006, Goedhard et al., 1998, Kaleta et al., 2006, Laitinen et al., 2005, Monteiro et al., 2006, Nygard et al., 1991, Pohjonen 2001, Pohjonen 2001, Pranjic et al., 2006, Punakallio et al., 2004, Sjogren-Ronka et al., 2002, and Tuomi et al., 1991, 2001, 1997, and 2004). One publication was included after an additional search in personal archives of the authors (Martinez and Latorre Mdo, 2006). Since two publications reported results of both a cross-sectional study and a follow-up study, in total 20 studies were included. 3 RESULTS 3.1 Individual characteristics The demographic factor most studied was age (seven studies). Four out of seven studies (57%) reported a decreased WAI with older age (Goedhard et al., 1998, Monteiro et al., 2006, Pohjonen, 2001, and Tuomi et al., 1991), two studies (29%) demonstrated no association (Martinez and Latorre Mdo, 2006, and Tuomi et al., 1997) and one study found a higher risk for a poor WAI among younger workers (Fischer et al., 2006). All four studies on poor musculoskeletal capacity reported a significant association with a poor WAI with risk estimates varying from 6.4 to 9.1 (Eskelinen et al., 1991, Nygard et al., 1991, Pohjonen, 2001, and Sjogren-Ronka et al., 2002). One out of three studies found a positive association for a poor cardio respiratory fitness expressed by maximum oxygen uptake (VO2 max) (Goedhard et al., 1998). Poor functional balance in home care workers was associated with poor WAI (Pohjonen, 2001), whereas this association was not observed among fire fighters (Punakallio et al., 2004). Both studies on cognitive performance showed no significant associations (Eskelinen et al., 1991, and Nygard et al., 1991). Lack of leisure-time physical activity was associated with a lower WAI in four out of five studies. Overweight was positively associated with a poor WAI in four out of six studies. In one study smoking was associated with lower WAI (Tuomi et al., 1991), whereas in two studies no significant association was found (Kaleta et al., 2006, and Tuomi et al., 2001). 3.2 Work-related characteristics A large variety of psychosocial factors at work were addressed, varying from poor management to satisfaction with supervisor. Five out of seven studies (71%) reported a positive association between high mental work demands and a poor WAI (Pranjic et al., 2006, Sjogren-Ronka et al., 2002, and Tuomi et al., 1991, 2001 and 2004). Regarding autonomy (i.e. poor possibilities of job control, lack of freedom in work tempo) three out of four (75%) studies reported an increased risk for poor WAI with lack of autonomy (Tuomi et al., 2001, 1997 and 2004). High physical demands, such as increased muscular work, and poor work postures were positively associated with a lower WAI in four out of seven (57%) studies (Pohjonen, 2001, and Tuomi et al., 1991, 1997 and 2004). Three out of seven studies (43%) could not find any association between high physical work demands and poor WAI (Aittomaki et al., 2003, Fischer et al., 2006, and Tuomi et al., 2001). Regarding the physical work environment, two out of four (50%) studies reported a lower WAI with thermal discomfort and poor physical climate (Tuomi et al., 1991, and 2001), whereas another two studies did not find any association (Fischer et al., 2006, and Tuomi et al., 1997). 4 DISCUSSION Important factors for a decreased work ability were lack of leisure-time vigorous physical activity, poor musculoskeletal capacity, older age, overweight, and high physical and psychosocial work demands. 16

For individual determinants the range in magnitude of associations was larger in cross-sectional studies than in longitudinal studies. A cross-sectional study design is more sensitive to bias, which may explain the larger differences in risk estimates. For some determinants the available number of studies was too small to draw meaningful conclusions; gender (two studies), education (two studies), mental performance (two studies). Despite the large differences in definition of the determinant and the validity of the measurement techniques applied, the studies showed a consistency in important determinants for WAI high mental work demands, poor autonomy, and high physical work demands. All work related determinants were measured by means of self-report. This assessment technique may lead to some spurious results because subjects with a poor WAI may overestimate their physical and mental work load in the workplace relative to those with an excellent WAI. It is unclear if an objective measurement of the work demands would show similar results.

5 CONCLUDING REMARKS Research on work ability is strongly focused on risk factors for poor work ability and more often on individual than work related factors. Important factors for health promotion in aging workers would be increasing leisure-time physical activity, prevention of overweight, increasing musculoskeletal capacity and decrease of physical and psychosocial work load. REFERENCES Aittomaki, A., Lahelma, E., and Roos, E., (2003). Work conditions and socioeconomic inequalities in work ability. Scandinavian Journal of Work Environment & Health 29: pp. 159–165 Eskelinen, L., Kohvakka, A., Merisalo, T., Hurri, H., and Wagar, G., (1991). Relationship between the SelfAssessment and Clinical-Assessment of Health-Status and Work Ability. Scandinavian Journal of Work Environment & Health 17: pp. 40–47 Fischer, F.M., Borges, F.N., Rotenberg, L., Latorre Mdo, R., Soares, N.S., Rosa, P.L., Teixeira, L.R., Nagai, R., Steluti, J., and Landsbergis, P., (2006). Work ability of health care shift workers: What matters? Chronobiology International 23: pp. 1165–1179 Goedhard, W.J., Rijpstra, T.S., and Puttiger, P.H., (1998). Age, absenteeism and physical fitness in relation to work ability. Stud Health Technol Inform 48: pp. 254–257 Kaleta, D., Makowiec-Dabrowska, T., and Jegier, A., (2006). Lifestyle index and work ability. International Journal of Occupational Medicine and Environmental Health 19: pp. 170–177 Laitinen, J., Nayha, S., and Kujala, V., (2005). Body mass index and weight change from adolescence into adulthood, waist-to-hip ratio and perceived work ability among young adults. International Journal of Obesity 29: pp. 697–702 Martinez, M.C., and Latorre Mdo, R., (2006). Health and work ability among office workers. Revista Saude Publica 40: pp. 851–858 Monteiro, M.S., Ilmarinen, J., and Corraa Filho, H.R., (2006). Work ability of workers in different age groups in a public health institution in Brazil. International Journal of Occupational Safety and Ergonomics 12: pp. 417–427 Nygard, C.H., Eskelinen, L., Suvanto, S., Tuomi, K., and Ilmarinen, J., (1991). Associations between Functional-Capacity and Work Ability among Elderly Municipal Employees. Scandinavian Journal of Work Environment & Health 17: pp. 122–127 Pohjonen, T., (2001). Age-related physical fitness and the predictive values of fitness tests for work ability in home care work. Journal of Occupational and Environmental Medicine 43: pp. 723–730 Pohjonen, T., (2001). Perceived work ability of home care workers in relation to individual and work-related factors in different age groups. Occupational Medicine-Oxford 51: pp. 209–217 Pranjic, N., Males-Bilic, L., Beganlic, A., and Mustajbegovic, J., (2006). Mobbing, stress, and work ability index among physicians in Bosnia and Herzegovina: Survey study. Croatian Medical Journal 47: pp. 750–758 Punakallio, A., Lusa, S., and Luukkonen, R., (2004). Functional, postural and perceived balance for predicting the work ability of firefighters. Int. Arch. of Occup. & Env. Health 77: pp. 482–490

17

Sjogren-Ronka, T., Ojanen, M.T., Leskinen, E.K., Mustalampi, S.T., and Malkia, E.A., (2002). Physical and psychosocial prerequisites of functioning in relation to work ability and general subjective well-being among office workers. Scan. J. of Work Environment & Health 28: pp. 184–190 Tuomi, K., Eskelinen, L., Toikkanen, J., Jarvinen, E., Ilmarinen, J., and Klockars, M., (1991). Work Load and Individual Factors Affecting Work Ability among Aging Municipal Employees. Scandinavian Journal of Work Environment & Health 17: pp. 128–134 Tuomi, K., Huuhtanen, P., Nykyri, E., and Ilmarinen, J., (2001). Promotion of work ability, the quality of work and retirement. Occupational Medicine-Oxford 51: pp. 318–324 Tuomi, K., Ilmarinen, J., Martikainen, R., Aalto, L., and Klockars, M., (1997). Aging, work, life-style and work ability among Finnish municipal workers in 1981–1992. Scandinavian Journal of Work Environment & Health 23: pp. 58–65 Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L., and Tulkki, A., (1998). Work ability index. In: Health, F. I. o. O., (Ed.), Helsinki. Tuomi, K., Vanhala, S., Nykyri, E., and Janhonen, M., (2004). Organizational practices, work demands and the well-being of employees: a follow-up study in the metal industry and retail trade. Occupational Medicine-Oxford 54: pp. 115–121

18

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Systematic review for assessing job demands and physical work capacity in safety jobs Annina Ropponen Institute of Biomedicine, Physiology/Ergonomics, University of Kuopio, Kuopio, Finland

Juhani Smolander ORTON Research Institute and ORTON Orthopaedic Hospital, Helsinki, Finland

Veikko Louhevaara Finnish Institute of Occupational Health, Kuopio, Finland

ABSTRACT: Introduction – A number of physical demanding jobs include unavoidable health and safety risks. The aim of this review is to consider worker selection and the assessment by the job-related tests for the prerequisites of physical work capacity in safety jobs. Material and methods – The literature search identified references from Medline, and ISI Web of Science databases. First the titles were assessed for relevance and then abstracts by one of the authors. Then the articles were evaluated for the assessment of physical work demands in safety jobs. There were 41 articles fulfilling the selection criteria of fire fighter and security guard jobs and 11 of the articles had relevance and quality to be presented this paper. Conclusions – The selection of safety workers based on physical performance and job-related tests seems to guarantee an acceptable level of physical fitness up to middle-age. Both individual and societal measures are needed to keep the physical work capacity at the acceptable level for the age of 55–60 years. The discrimination of the tests due to gender and age could be avoided in physically demanding high-risk jobs if the tests are relevant and valid with respect to the actual job demands.

1 INTRODUCTION There are a number of jobs such a fire fighter, a paramedic worker, a police officer, and a security guard whose physical demands include unavoidable health and safety risks. Physically demanding safety jobs often require heavy dynamic muscle work, manual handling of materials and static muscle work in poor or dangerous work environment. Typically also the intensity of the jobs may reach near maximal or maximal levels in an unpredictable manner (Lusa, 1994). In these high-risk safety jobs a worker with a low physical work capacity is considered to have a high individual risk (Taylor and Groeller, 2003). Therefore, the workers need to have capacities to control or cope with the risks in order to avoid overstrain and to improve safety at work for themselves and others (Shephard and Bonneau, 2002). The necessity of the tests for the assessment of the prerequisites of physical work capacity is commonly agreed, and the use of tests has been required by employers, workers and civil right organization (Jackson, 1994, Shephard and Bonneau, 2002, and Taylor and Groeller, 2003). Matching the work to the worker needs to be based on reliable and accurate analysis of the critical and important elements of work. There is, thus, a need to investigate if the published studies can provide the basis for methods of assessment of job demands and physical work capacity. 19

The aim of this review is to consider worker selection and the assessment by the job-related tests for the prerequisites of physical work capacity in safety jobs. The focus is on the selection of healthy individuals with various capacity and/or job-related tests, which assess physical performance or various dimensions of physical work capacity. The examples of safety jobs include a fire fighter and a security guard.

2 METHODS A systematic review was made including studies published until March 2006. The literature search identified a total of 573 references from Medline, and ISI Web of Science databases. First the titles were assessed for relevance for assessing job demands and physical work capacity in safety jobs and then abstracts by one of the authors (AR). Based on the relevance of the abstracts, fulltext articles were gathered and 81 articles were identified of safety jobs including jobs of fire fighters, paramedic workers, police officers and security guards. The articles were evaluated for the worker selection and the assessment by the job-related tests for the prerequisites of physical work capacity in these four different safety jobs. Particularly, the selection of healthy individuals with various capacity and/or job-related tests by assessing physical performance or various dimensions of physical work capacity was evaluated for the selection of the articles. There were 41 articles fulfilling these selection criteria of fire fighter and security guard jobs which are presented as an example in this paper. In respect with the 41 articles of fire fighters and security guards, 11 articles were determined having relevance and quality to be included in this paper.

3 RESULTS 3.1 Job demands of fire fighters Fire fighters meet high physical and psychological demands in operative tasks. In different firefighting and rescue operations with fire protective clothing and a self-contained breathing apparatus (SCBA) such as smoke-diving, fire-suppression, ladder climbing, rescuing a victim, dragging a hose, and raising a ladder, the mean oxygen consumption levels were 2.1–2.8 l/min (Louhevaara, 1985, Lusa, 1994, and Holmér and Gavhed, 2007). During peak loads the mean oxygen consumption was 3.6–3.8 l/min and heart rate 179–180 beats/min in young and healthy fire fighters (Lusa, 1994, and Holmér and Gavhed, 2007). While the aerobic demands of fire fighting tasks are well documented, the strength and motor coordination demands are less well quantified. The biomechanical features were studies in a simulated rescue-clearing task requiring the lifting of a 9-kg power saw (Lusa et al., 1991). In the task the mean dynamic compression force at the disc of L5/S1 was 6228 N. The mean peak torque for the back extension was 242 Nm and for knee extension 120 Nm. The peak values corresponded to over 90% of their maximal isokinetic muscle strengths. The results showed that lifting and handling of a heavy power saw produced a high load on musculoskeletal system. Other typical fire fighting tasks having high demands on muscle strength and endurance are carrying, pulling, pushing and dragging. Regarding to motor coordination of fire fighting tasks, Punakallio et al. (2003) showed that the use of fire-protective clothing and SCBA in particular, significantly impaired both postural and functional balance, and more negatively the balance of older fire fighters than that of younger ones. The authors recommended that valid balance tests should be developed for fire fighters. 3.2 Tests of physical work capacity for fire fighters Several studies have recommended that a fire fighter should have a maximal oxygen consumption of 2.7–3.0 l/min and/or 34–45 ml/min per kilogram of the body mass (Lemon & Hermiston, 1977, 20

Table 1. Tests and their classification for assessing male and female fire fighters’ cardiorespiratory\fitness and muscular performance. Classification Test

Poor

Moderate

Good

Excellent

VO2 maxa (l/min) ml/min/kg Bench press (45 kg) (reps/60 s) Sit-up (reps/60 s) Squatting (45 kg) (reps/60 s) Pull-up (max reps)

2.4 29 9 20 9 2

2.5–2.9 30–35 10–17 21–28 10–17 3–4

3.0–3.9 36 18–29 29–40 18–26 5–9

4.0 50 30 41 37 10

a

Bicycle-ergometer or treadmill test, Maximal oxygen consumption = VO2 max.

Louhevaara et al., 1994, and Holmér & Gavhed, 2007). In Finland, the Guide for Smoke-diving (1991, 2002) gives a recommendation for a four-stage scale to classify fire fighters’ maximal oxygen consumption (Table 1). Male and female fire fighters at the age range of 20–63 years are considered to have a sufficient cardiorespiratory capacity for smoke-diving tasks when they attain a result of 3.0 l/min and/or 36 ml/min/kg in the tests for the maximal oxygen consumption (Lusa, 1994, and Holmér & Gavhed, 2007). The demands of fire fighting and rescue tasks on muscle strength and endurance have not been quantified adequately. The tests of muscular performance in Table 1 have mainly designed to followup the fire fighters’ physical work capacity in Finland. These tests are also used for the selection of applicants for the training courses of the Emergency Service Institute of Finland. In the selection of applicants for basic training courses, the required minimum level has been between “good” and “excellent” in each test. A job-related test drill has been developed for Finnish fire fighters (Louhevaara et al., 1994). It simulates the physiologically heaviest work activities often required by smoke-diving operations, and the purpose is to assess the circulatory strain during the tasks with heart rate measurements. The test drill with fixed maximal working time of 14.5 min consists of five activities (walking and carrying, climbing/ascending stairs, hammering, moving over and under bars, and hose rolling) done with full personal protective clothing and SCBA of 25.5 kg. The test drill is instructed to be carried out using a habitual work pace within the fixed time. This is exceptional as compared to other job-related tests or test drills that are advised to perform as fast as possible (e.g., Shephard and Bonneau, 2002). 3.3 Job demands of private guards There are no scientific reports available in ergonomics or work physiology literature about the job demands and physical work capacity of security guards. In Finland, the number of security guards is about 7,000, and every fourth of them is a woman. Usually security guards are young, and their length of the career often remains quite short. However, the guards meet risks and dangers in the street such violent clients usually due to abuse of drugs, unpredictable and poor work conditions and situations, shift work and night work as well as shortcomings in their protective equipment and weapons. During the work shifts the most common operative tasks of security guards are the catching of a client by running and controlling him or her by using arms and trunk. (Laine et al., 2004). In the job of the security guards there are demands for muscle strength and endurance, cardiorespiratory capacity, and dynamic balance of the body (Laine et al., 2004). 3.4 Tests of physical work capacity for private guards There are no commonly approved health or physical capacity qualifications for the security guards. Laine et al. (2004) suggested that the assessment of the security guards’ physical work capacity 21

would include two job-related tests. Firstly, a 1.5-mile walking-running test with the work clothing and equipment of 7 kg that consists of light protective clothing, a bullet vest, a weapon belt and protective boots. The performance time and heart rate are registered in the test. According to the time and heart rate the average and maximal oxygen consumption is estimated and related to mass of the body and equipment. The performance is accepted when the estimated maximal oxygen consumption is at least 36 ml/min/kg, which is also used as the qualified criteria for fire fighters’ smoke-diving operations (Lusa, 1994). The second job-related test is a functional (dynamic) balance test (Punakallio et al., 2003). According to Laine et al. (2004) suitable physical work capacity tests for evaluating security guards’ muscle strength and endurance are the sit-up test and the pull-up test The time limit is 60 s, and the accepted performance requires at least 38 sit-ups/min. The pull-up test is done with a reverse grip without the time limit. The acceptable performance requires at least 6 pull-ups. The minimum limits require “good” performance according to the classification for fire fighters (Lusa, 1994).

4 DISCUSSION The selection of safety workers based on physical performance and job-related tests seems to guarantee an acceptable level of physical fitness up to middle-age. Both individual and societal measures are needed to keep the physical work capacity at the acceptable level for the age of 55–60 years. The discrimination of the tests due to gender and age could be avoided in physically demanding high-risk jobs if the tests are relevant and valid with respect to the actual job demands. The fire fighters’ job demands on physical work ability are occasionally very high during the entire occupational career. Their cardiorespiratory and muscular fitness should be tested regularly for guaranteeing adequate work capacity for physically extreme operations. The use of fitness tests is necessary in the planning and carrying out preventive measures for maintaining health and work ability of fire fighters. A number of valid test batteries are available for the assessment of fire fighters’ physical work capacity (Lusa, 1994). According to Laine et al. (2004) the test battery developed for assessing the security guards’ physical work capacity is relevant and feasible both in the pre-employment screening and in the follow-up of the physical work capacity. The set “acceptable” limits of the tests are very strict and are needed to be modified when older (over 30 years) and female guards are evaluated. The tests have been used for two years in a small enterprise of security guards and the obtained results and experiences have been positive. When the physical performance or job-related tests are relevant they should guarantee an acceptable work performance in physically demanding jobs that are equal for men and women with all ages. This leads on the situation that the passing of tests is easier for men than women, and for younger than older individuals. For instance, about a half of the Finnish fire fighters aged over 50 years have serious problems to pass all physical fitness tests, and presently only one female fire fighter is carrying out operative fire and rescue tasks. On the other hand, there are many female security guards that carry out operative tasks in the street.

5 CONCLUSIONS The selection of safety workers based on physical performance and job-related tests seems to guarantee an acceptable level of physical fitness up to the age of 40 years. After that there should be alternative respectable career paths for older workers who could not pass the tests. The reasons for the negative test outcome usually relate to various disorders and diseases, which prevent regular physical exercise needed for maintaining sufficient physical fitness in the middle-aged and older safety workers. Intensive and regular fitness training alleviates the evident decline of cardiorespiratory and muscular fitness due to age, and may maintain the physical work capacity at the acceptable 22

level for the age of 55–60 years. After that most of the safety workers have problems to meet the high physical job demands in operative tasks. REFERENCES Guide for Smoke-Diving, (1991, 2002). Finnish Ministry of Internal Affairs. Helsinki Holmér, I. and Gavhed, D., (2007). Classification of metabolic and respiratory demands in fire fighting activity with extreme workloads. Applied Ergonomics, 38: pp. 45–52 Jackson, A., (1994). Pre-employment physical evaluation. Exercise and Sports Science Reviews, 22: pp. 53–90 Laine, K., Kolehmainen, M. and Louhevaara, V., (2004). Development of the promotion of work ability in an enterprise of security guards. In: Action program for safety occupations, edited by Lusa, S. and Louhevaara, V. (Helsinki, Finnish Institute of Occupational Health), pp. 33–44 (in Finnish) Lemon, P.W. and Hermiston, R.T., (1977). Physiological profile of professional fire fighters, Journal of Occupational Medicine, 19: pp. 337–340 Louhevaara, V., Soukainen, J., Lusa, S., Tulppo, M., Tuomi, P. and Kajaste, T., (1994). Development and evaluation of a test drill for assessing physical work capacity of fire fighters, International Journal of Industrial Ergonomics, 13: pp. 139–146 Lusa, S., Louhevaara, V., Smolander, J., Kinnunen, K., Korhonen, O. and Soukainen, J., (1991). Biomechanical evaluation of heavy tool-handling in two age groups of firemen. Ergonomics, 34: pp. 1429–1432 Lusa, S., (1994). Job demands and assessment of physical work capacity of fire fighters, University of Jyväskylä, Studies in sport, physical education and health, Jyväskylä (doctoral dissertation) Punakallio, A., Lusa, S. and Luukkonen, R., (2003). Protective equipment affects balance abilities differently in younger and older firefighters, Aviation Space and Environmental Medicine, 74: pp. 1151–1156 Shephard, R. and Bonneau, J., (2002). Assuring gender equity in recruitment standards for police officers. Canadian Journal of Applied Physiology, 27: pp. 263–295 Taylor, N. and Groeller, H., (2003). Work-based physiological assessment of physically-demanding trades: a methodological overview. Journal of PhysiologicalAnthropology andApplied Human Science, 22: pp. 73–81

23

Chapter 2 Work Ability Index

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

The place of age in organisational policymaking: Evidence from an Australian qualitative survey Libby Brooke, Patricia Healy, Joyce Jiang & Philip Taylor Business Work and Ageing Centre for Research, Swinburne University of Technology, Victoria, Australia

ABSTRACT: This report presents findings of qualitative research in four case study organizations as part of a larger study, Redesigning Work for an Ageing Society (RW4AS) Project, being undertaken by Business Work and Ageing Centre for Research, Swinburne University. The study will identify factors transforming the nature of work and posing risks to the work ability of an ageing workforce, examine existing policies and practice in managing workforce ageing in public and private organizations and test the applicability of the Work Ability model to Australian circumstances. The research found that changes engendered by globalization shaped the organization of work and the pressures experienced by individual workers. All the organizations function in a globalised, highly competitive market, are adopting new technologies and are increasingly reliant on work intensification and casualisation of labour. They had not come to terms with the need to retain their ageing workers as manifested by short term policy responses rather than proactive strategies. The areas in which ageing workers experienced difficulties, such as their competence with new technologies, changing work structures and occupational health risks indicate alignments between work ability domains and managing the vulnerabilities of ageing Australian workers in changing organizational environments.

1 INTRODUCTION The Redesigning Work for an Ageing Society (RW4AS) Project aims to adapt the Work Ability model to the Australian context within an Australian Research Council funded demonstration project carried out in four case study organisations. The project is conducted by the Business Work and Ageing Centre for Research, Swinburne University of Technology, in collaboration with industry partners, including public and private sector case study organisations and three government agencies interested in workforce ageing and work ability. The project aims to identify factors transforming the nature of work and posing risks to the work ability of an ageing workforce, examine existing policies and practice in managing workforce ageing in public and private organisations, and test the applicability of the work ability model to Australian circumstances. The demonstration project will also design, implement and evaluate workplace interventions to promote work ability and support the continued employment of older workers. This paper reports findings of a qualitative survey of key informants in the case study organisations.

2 METHOD In the initial stages of the RW4AS Project, a qualitative survey of company-selected key informants was conducted in the four case study organisations – the freight handling division of a large airline, a manufacturing firm, the roadside assistance division of a motoring organisation and a national 27

university. All have a large proportion of older workers with many years of employment in the company. The sample of 59 informants comprised senior and operational managers, specialist OH&S, human relations and training staff, employee representatives and six patrol staff from the motoring organisation. Interviews generally lasted 40–60 minutes and used a structured questionnaire to explore perceptions of the impact of workforce ageing on the company’s capacity to meet productivity challenges and opportunities, the company’s responses to the identified risks of employing ageing workers, and attitudes towards older workers. Interviews were transcribed and analysed using NVivo7.

3 FINDINGS This paper focuses on changes in work organisation in the four case study organisations. As a result of new globally driven dynamics these organisations are undergoing change processes which present ongoing risks to their ageing workforces. In each case the organisation of work and the pressures experienced by individual workers are shaped by globalisation. Interrelated processes involve shifts towards more intensive work practices and new forms of work organisation, particularly to casualised workforces. At the same time the organisations have retained ageing workforces which are more vulnerable to certain kinds of risk, including physical and psychosocial stress. 3.1 Case study organisations Case study 1 – Airline freight terminals: The two international air freight terminals have an ageing permanent full-time workforce (average 44 years) of 380 (220 warehouse and 160 clerical staff), with long tenure (average 10–15 years), and very low staff turnover (2%) despite a series of redundancies over the last 10 years. Warehouse employees are all male, work in small teams and rotate tasks. The permanent full-time workforce is supplemented by casual, part-time employees working five hour shifts at peak times. Base salary rates are relatively low but supplemented by overtime and shift penalty rates, which form a significant part of take-home pay. The mainly female clerical workforce, includes permanent full-time and part-time staff supplemented by casual employees as required. Senior managements are expected to work long hours, including extended periods on-call (up to 24/7). The workforce is strongly unionised – with around 90% union membership. Production extends over 24 hours as the company operates across global working time zones. Most employees work rotating 8-hour shifts on rosters dictated by international airline schedules – with often considerable overtime when there are unscheduled delays. Shift rosters are designed to minimise fatigue but are often changed to accommodate personal needs and unexpected work demands and there is no cap on overtime. Although much of the work is mechanised, using cranes, forklifts and motorised trollies, there is a lot of manual handling involved in packing and loading freight in accord with strict safety and quarantine regulations and aircraft requirements. As a consequence, manual handling related injuries are the most common. Older and less physically able permanent employees are given preference for lighter manual work and plant operation, with the heavier work more frequently allocated to casual staff. The firm is in transition between industrial era work practices and changing human performance criteria to improve competitiveness in global markets. Management practices have changed significantly since the company was privatised in the mid-1990s, with introduction of measures such as merit based promotion, performance management, more external recruiting and increasing management awareness of the need for career management over the life course and managing ageing workers’ injuries and health. Appropriate management of people resources was frequently identified as a continuing key organisational challenge within a context of pressures to contain costs and improve customer service in order to maintain position in a dynamic and highly competitive global market. 28

Case study 2 – Manufacturing company: Over the last decade this long established company has been through a series of takeovers, mergers and acquisitions and is now part of an international firm with interests across New Zealand and Australia. It manufactures building materials and components and sells on the domestic market and exports to Asian manufacturers of home and commercial componentry – much of which returns as cheap imports to supply the Australian market. In the domestic market the company is a major supplier to small manufacturers of home and commercial fittings, which are increasingly challenged by the same cheap imports. The company places high value on its ascendancy in the local marketplace which is becoming increasingly insecure and particularly open to challenge by global firms practicing vertical product integration which cut across its componentry. In response to these challenges it is repositioning its market role and adapting its production and marketing of products and services. The company has an Australian workforce of over 2,000, predominantly male, in 13 production plants and multiple distribution centres, many in rural areas. Employees have an average age of 42 years and over 10 years employment with the company. Most employees work rotating shifts of 8–12 hours on 24/7 or 24/5 rosters. The 12 hour shifts are unlikely to change, despite management opposition, due to workers’ preference for working fewer days. There is a high performance culture throughout the company with a strong emphasis on staff training and career development and commitment at all levels to good OH&S practice. Overall the company was seeking to maintain its competitive advantage though lean staffing and high performance utilisation of its workforce, and was concerned that its ageing workforce could potentially constrain this broader agenda. Workforce risks which applied particularly to ageing workers were identified as long hours of work, manual handling injuries, exposure to hazardous substances and injuries related to plant operation. Case study 3 – Motoring organisation: The roadside assistance service has been a major part of the motoring organisation for over 100 years but now faces declining demand for services due to the improved design and reliability of vehicles. The organisation is restructuring its workforce through attrition and by shifting to contractors, who are flexibly employed to decrease workforce down time. There are currently 119 male, patrol staff – a 19% reduction over two years due to retirement, voluntary redundancy and replacement by subcontractors, who now provide 60% of roadside assistance services. All are trained mechanics with an average age of 49 years and an average 16 years employment with the organisation. The job requires both the technical skills to diagnose and fix problems in a large range of vehicles and well-developed communication and people management skills to negotiate with people in often difficult and stressful roadside situations. The job involves eight or nine hour rotating shifts on an 18/7 roster (06.00 h – midnight). The work is largely sedentary (long in-vehicle periods of driving and waiting for jobs) but interspersed with tasks involving high physical demands (lifting, applying force, bending, static postural loading) performed in variable and often poor working environments (bad weather, poor lighting, hazardous roadside locations) and with limited access to assistance. This creates high risk of musculoskeletal injuries. As all work communications are via computer, staff are also socially isolated with little opportunity for interaction with colleagues. The shift to maintaining a “balance” of contract staff with a “stable core” of permanent staff – no permanent patrol staff have been recruited for over eight years – suggests that management had not resolved problems connected with the ageing of its workforce. These include physical risks and demands, the changing composition of the job and the transition to more autonomous work structures with lower supervision and peer group support as it moves from core staff to subcontractors. Case study 4 – Multi-campus university: The university was established in the early 1990s with several small campuses and a focus on teaching, particularly in the areas of education and nursing. It has approximately 13,000 students and a workforce of around 1200 (70% female), including 950 permanent staff and a fluctuating number of casual staff which has been steadily increasing over the last decade. The increasing reliance on a casual/sessional workforce is largely a cost containment strategy in response to the decline in government funding, on which the university is heavily reliant. 29

The average age of staff is 47 years, with over 80% of academic staff and 50% of general staff older than 45 years and 50% of new recruits over 50 years. Changes in priorities for government funding and student demand are now forcing the university to rapidly adopt a stronger research focus and to increase on-line courses and teaching. This requires the established teaching staff to take on new, additional research roles and adopt new teaching methods while maintaining their existing workloads. The conflicting task priorities and intensification of work places increasing demands on the ageing workforce. A major organisational issue identified by respondents was the tension between retention of the ageing workforce and recruitment of younger academics more attuned to the new teaching and research environment. Whilst the university has introduced a program of phased retirement to encourage retention of older staff, it is not well supported by programs to preserve their health and wellbeing and manage the stress resulting from their high workload and conflicting work priorities of research and teaching. The combination of an increasingly casualised workforce structure, more conflicting work priorities and increasing workloads, has increased stress and insecurity, particularly amongst older staff. 3.2 Common issues Although they are located in different sectors with different risk profiles, the four case study organisations share characteristics that exemplify the contemporary workplace and increasingly drive labour requirements in ways that generate significant risks for the work ability of all workers, particularly older workers. All function in a globalised, highly competitive and changing market, and have developed a strong emphasis on growing productivity and rapidly adapting to changing market demands. They are all actively responding to and adopting new technology and are increasingly reliant on work intensification and casualisation of labour to maintain productivity, reduce labour costs and increase workforce flexibility. In all four organizations, global market demands and new technology are directly driving changes in work practices. For example, the working hours and shift rosters at the international air freight terminals are directly influenced by the speed necessary to keep pace with global freight and logistics operations. Similarly, in response to increased competition from cheaper Asian and European imports, the manufacturer is repositioning its market role – moving up the supply chain, developing new products and automating production – and in the process restructuring workforce deployment. An interrelated process of workforce restructuring, is also leading to more casualisation. The university is increasingly relying on casual staff to introduce skills needed to meet increased student demand for on-line courses deliverable globally. And new vehicle technology has reduced demand and changed the working conditions of roadside patrol staff. As a result of these combined pressures the organisations’ workers are functioning in a moreor-less constantly changing environment where long-established work practices are reshaped, and traditionally valued competencies and skills are becoming outmoded. There is increased pressure to work longer and more flexible hours, update competencies and learn new skills – often in employees’ own time. At the same time traditional job security is being undermined by a growing reliance on contingent workers to provide a cheap and flexible workforce better able to meet immediate production needs, while outsourcing labour costs and risks. This combination of dislocation, work intensification and job insecurity is both creating new OH&S risks and exacerbating old ones – particularly for older workers. 3.3 Perception of older workers The majority of respondents claimed a marked dissonance or mismatch between company labour requirements and the capacities and skills of older workers. Although there was considerable uncertainty about the immediate and future implications of workforce ageing, all respondents gave a predominantly negative assessment of older workers. Older workers were stereotyped as having a negative impact on the organisation’s capacity to meet new challenges and opportunities. Older workers were also perceived to be more expensive – engendering higher risks and costs – and less productive because of their reduced functional capacity and inability or reluctance to develop new 30

skills and adapt to new working conditions. The increased costs and risks were largely attributed to greater vulnerability to injury, more workers compensation claims and payouts, longer and more difficult rehabilitation after injury or illness, and increased sick leave. Yet there was also some acknowledgement that older workers had lower turnover rates and were generally regarded as more reliable with greater experience, knowledge and life-skills, and as holding valuable corporate knowledge. Several respondents also noted that older workers’increased sick leave was frequently planned and therefore less disruptive that the unplanned one-day ‘sickies’ more prevalent among younger workers – particularly when shift work is involved. Generational differences in attitudes to work were also noted by several respondents, with younger workers characterised as more demanding and less committed and reliable. 3.4 Responses to workforce ageing Perceptions of older workers reflected many commonly held negative stereotypes – although many stressed the effect of individual differences and referred to positive exceptions. Nevertheless, in part their views reflected existing problems which were poorly addressed at company level and managed mainly at local or operational level and often in a relatively ad hoc manner. A central theme was that the companies perceive and respond to workforce ageing as essentially an issue of better managing the exit of older workers – not as part of a more comprehensive workforce planning strategy. Generally responses are reactive rather than proactive, fragmented rather than systematic. For example, despite clear identification of risk factors for older workers, there were no age-specific OH&S policies or programs in place to avoid injuries and maintain their functional capacity. Similarly, retirement programs do not include formal arrangements for transfer or handover of skills and corporate knowledge and succession planning at other than senior levels is largely dependent on the initiatives of local operational managers. In large part the companies address the mismatch or misalignment between their current ageing workforce and their labour requirements in ways that meet their immediate needs – mainly through use of overtime or casual/contract labour to fill the gaps. There is relatively little effort to retrain and redeploy older workers except at operational level, where reasonable accommodation is frequently made on an ad hoc basis, particularly for older workers with long employment, but only as long as it does not significantly reduce productivity. 4 CONCLUSION The findings indicate both the need for and a lack of comprehensive, structurally based interventions, focusing on all the work ability domains, to cope with pervasive changes in work environments. In all the case study organizations there is considerable uncertainty about the implications and appropriate responses to workforce ageing yet respondents identified many issues requiring responses. In all four organizations the work environment is changing in ways creating ongoing misalignments with ageing workforces and indicating the need for long-term career management across the life course to ensure a continuing supply of workers with competencies appropriate to new technologies and restructured workplaces. Yet management responses currently tend towards the short-term, with increasing reliance on work intensification and casual labour to maintain productivity in the face of growing shortages of skilled labour. As yet there are no age-specific programs or policies in place to address the identified risks and better manage health and injuries across traditional OH&S boundaries. REFERENCES NVivo7. QSR International Pty Ltd, 2nd Floor, 651 Doncaster Road, Doncaster Victoria 3108 Australia. National Occupational Health and Safety Commission 2005. Surveillance Alert. OHS and the Ageing Workforce.

31

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Establishment of a Work Ability Index network in Germany Hans Martin Hasselhorn, Bernd H. Müller, Rainer Tielsch & Benita Gauggel University of Wuppertal, Wuppertal, Germany

Gabriele Freude Federal Institute for Occupational Safety and Health, Berlin, Germany

Jürgen Tempel Occupational Health Practice, Hamburg, Germany

ABSTRACT: In times of an ageing work force sustaining the work ability becomes increasingly important for a society. In 2003, the German Federal Authorities have therefore initiated the development of a National Work Ability Index (WAI) network with the aim to promote the use of the WAI in Germany. The article describes design, tasks and performance of the German WAI network. Main tasks are the development of (i) a network of WAI users, (ii) a WAI data base, and (iii) a WAI user software. In a critical review of the past 5 years of network performance, the authors identify a range of success- and non-success factors. While, for example, the strong increase of public interest in the WAI belongs to the success factors, the identification of a wide spread misconception of the WAI instrument (misunderstood as indicator for ‘health’) leads to substantial future challenges for the network.

1 INTRODUCTION In times of an ageing working population sustaining the work ability becomes increasingly relevant and can even be vital for a healthy society. Here, the Work Ability Index questionnaire (WAI) can play a central role in work place health promotion by: • promoting the discussion of “work & age”, • identifying risk factors, risk groups and individuals at risk, and • evaluating the effect of interventions. The question is, whether and how the use of the WAI can be promoted in a large country. The German Federal Authorities (Federal Institute for Occupational Safety and Health, Berlin) have therefore assigned this task to a research group which has founded a national WAI-Network. In this contribution, tasks, process and results of the WAI-Network are discussed. 2 DEVELOPMENT AND PERFORMANCE OF THE WAI-NETWORK The German WAI-Network was set up in 2003/4 by the “Work Group Empirical Work Research” (“Arbeitsgruppe Empirische Arbeitsforschung”, AEA) at the University of Wuppertal. Several additional organisations and individuals were included in a project council for sharing expertise. The WAI-Network has set three aims: • to develop a network of WAI users, • to collect a WAI data base, and • to develop a WAI user software. 33

2.1 WAI user network Having the limitation of own financial resources in mind, the organisers of the network understood their role as one initiating knowledge exchange between the participants rather than steering communication. As of October 2007, the German WAI-Network has 171 members, almost half of them representing enterprises (occupational health physicians, ergonomists, and work organisation psychologists). About 20% of the members are scientists and 10% work in health- or occupational health insurances. Membership is free of charge. The degree to which within group communication occurred is not easy to determine, but it may be estimated to be low in relation to the large amount of communication with the network organisers which turned out to occur in the coming years. In the course of the project the interest in the WAI and the use of the instrument has increased substantially. Interest in the WAI-Network was dependent on the degree of networks’ dissemination activities which have been high in the course of the project and included oral and poster presentation at conferences, numerous WAI presentations, teachings, seminars and workshops and the edition of 14 articles. Regular newsletters have kept the network informed about activities and the website has provided the public with access to the WAI instrument, the underlying concept, information material and an online WAI assessment possibility. Soon after the start of the project it became evident that a mere translation of the WAI reference publication (Tuomi et al., 1998) did not suffice for the use of the WAI in Germany. This has resulted in a more detailed guide book (Hasselhorn and Freude, 2007). In addition, the request for practical examples was met by the publication of a booklet with 16 detailed examples from Germany, Austria and Switzerland (BAuA, 2007).

2.2 WAI data base The aim of a national WAI data base is to provide the users (individuals and enterprises) with valid reference scores. Valid reference scores are regarded to be of high relevance for the practical use of the WAI. Since no representative assessment of the German working population could be made, the network organisers had to collect as many (anonymous) WAI data as possible from different groups assessing WAI in Germany. As of October 2007, the network has collected cross sectional WAI data of about 8500 individuals. This data base has an uneven distribution of professions (esp. too few manual workers) and is therefore far from being representative for the German working population. Each group submitting a WAI data base receives a feedback of own results in relation to those of relevant occupational groups stratified by age (Figure 1).

45

Metal workers (low qualif.) Safety engineers

42 WAI mean

Leaders (metal industry) Nurses

39

Nursing aids

36

Rescue workers Teachers

33

NEW data: teachers Priests

30

Figure 1.

30

45 45 Age groups (years)

Example for feedback of WAI results to a group submitting new teacher WAI data.

34

2.3 WAI user software The network has developed a “WAI software” for the use in enterprises (Figure 2). It has the following features: • • • • •

WAI data entry (long and short version). WAI analysis (for individuals and for groups). Results feedback (individuals and groups). WAI benchmarking (individuals and groups). WAI longitudinal assessment (individuals and groups), and WAI data export.

The software is free for all members of the network. Since 2007 an English version is available. 3 CRTITICAL REVIEW At the end of the first project phase (2003–2006) the German WAI-Network has been evaluated very positively. Positive aspects may have been the following: • the large degree of dissemination activities initiated and performed by the network, • the substantial increase in public awareness and interest in the WAI in Germany, • the collection of profound expertise in the network core group resulting in teachings and in consultation of medium sized and large companies (free of commercial interests). • the development of the WAI software, and • the activation of further research and prevention activities adjacent to the work ability (e.g. the validation of the short WAI version, the initiation of the development of an equivalent assessment instrument for unemployed).

Figure 2. WAI software, version 2.3.1.

35

Another positive aspect has been a very controversial public debate about usefulness, limits and risks of the use of the WAI in Germany. Whereas the Germany unions have had a central role in promoting the WAI in Germany, a high ranked group of the German metal workers’ union (IG Metall) has had some major concerns about the instrument, questioning its’ validity, confidential use and worrying about the potential for misuse. The resulting debate has forced the WAI network organisers to in detail review the instrument and its’ use in Germany. This process has provided the organisers with an even more differentiated view on the instrument, considering both strengths and weaknesses and preventing the network from an undifferentiated “marketing” of an assessment instrument. Below, some problems of the network performance are listed: • Data collection of external WAI data was rather difficult. Joint efforts to perform a central WAI assessment of a representative sample of the working population may be more efficient. • Currently, the network does not have a good overview of the use of the WAI in Germany. • There is a lack of experience and knowledge about WAI in intervention studies in Germany. • It turned out a half academic post (with student support) was not adequate for keeping up the networks activities. • It may be difficult for scientists heading a WAI network to keep a scientific distance to the instrument and the topic. 4 OUTLOOK The network activities have been extended until 2009. It was considered that a continued support and guiding of the public use of the WAI was necessary. As it has turned out in the past years, the shortness and simplicity of this screening instrument is misleading. Many users believe to assess “health” or “physical or mental capacity”, instead it needs to be emphasised that “work ability” represents another concept based on the individual, his/her work and the interaction of both (this view in turn has implications for preventive action). In addition it may be necessary to – to higher degree – encourage the users to not only focus on the WAI instrument but to emphasise the underlying WAI concept which provides insight in starting points for preventive action. Another future activity of high necessity will be to promote research in the use of the WAI in intervention studies and in adjacent areas such as in rehabilitation and for long term unemployed. It is another future aim of the network is to promote international cooperation and to internationally address some validity questions. Many validation studies origin from older samples in Finland, additional new validation findings from other countries may be useful in the future. The most challenging aim will be to make the network independent of external funding by the year 2009. Since paid teaching and consultation activities (e.g. insurances, Occupational Health Services) are increasing, this aim may be realistic. ACKNOWLEDGEMENT The first phase of the German WAI Network (2003–2006) was funded by the Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, BAuA. The current activities are funded by the Initiative Neue Qualität der Arbeit, INQA, by the German Ministry of Labor. REFERENCES BAuA (Eds), (2007). Why WAI? – Der Work Ability Index im Einsatz für Arbeitsfähigkeit und Prävention – Erfahrungsberichte aus der Praxis. (BAuA, Dortmund, Berlin, Dresden) Hasselhorn, H.M., and Freude, G., (2007). Der Work Ability Index – ein Leitfaden, Schriftenreihe der Bundesanstalt für Arbeitsschutz und Arbeitsmedizin, (NW Verlag Bremerhaven). Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L., and Tulkki, A. Work Ability Index (2nd ed.). Helsinki: Finnish Institute of Occupational Health 1998.

36

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

WAI among workers in SMEs at Wholesale, Fruits, Vegetables and Flower Market in Brazil – from research to action Inês Monteiro Faculty of Medical Sciences, State University of Campinas – UNICAMP, Campinas, Brazil

Kaija Tuomi, Juhani Ilmarinen, Jorma Seitsamo, Eva Tuominen & Heleno Rodrigues Corrêa-Filho Finnish Institute of Occupational Health, Helsinki, Finland

ABSTRACT: The objective of this study was to evaluate the worker’s work ability, work characteristics and life style, which lead of towards the comprehension of certain consequences for health and well being related to the work environment. A cross-sectional study was carried out in Wholesale and Flower Market area with around 1,000 micro and small sized companies, including shops, inspection and cleaning services, administrative sector and autonomous porters. A questionnaire containing socio-demographic data, life-style, health and work aspects, living and work conditions and the Work Ability Index was administered. The sample included 1,006 workers. The male population represented 86.9% of the workers (range from 15 to 73 years old), and the mean age was 33.5 years (SD = 12.1). Young women had poor work ability than young men, while the opposite result was found in relation to older women and men. Work breaks had a positive correlation and “to have a work accident during the last year” and related risks/hazards at work (lifting and transporting heavy weight, time pressure, tiredness and stressful job) were negatively correlated with work ability. In the life style model, leisure time, physical activities, number of hours of sleep and “sleeping well” were correlated with work ability. The study indicated that work conditions are quite important in relation to work ability and should be considered when planning workplace health promotion and intervention actions. Keywords: Work Ability Index, SMEs, work conditions.

1 INTRODUCTION The International Labour Organization presents a positive perspective regarding the potential generation of decent jobs in small and medium businesses (ILO, 2003). Small and micro sized companies had been playing an important role in the economic development in many countries. In the late nineties, there were about 2.7 billions workers, with one billion employed in small businesses and one million self-employed in agriculture, as reported by Rantanen (1999). The businesses productivity became a fundamental factor in in the survival of many countries, directly affecting their market competitiveness. This has been a basic concern in some countries such as in Scandinavia and Europe, where short, medium and long-term actions have been developed. The costs of sick leave, precocious retirement due to invalidity, and work accident are important not only for the institution and the workers, but also for the country, as they interfere with the productivity, increase health expenses and interfere with workers’ lives outside of work (Monteiro-Cocco, 2003). The worker health system is structured only for the formal market, whose contingent has decreased, thus creating a gap on the provision of health care services for workers. 37

The Constitution and Brazilian law obligate the State assure this right. However, the existent service structure is not designed to comply with it. The issue is even more aggravated when dealing with large workplaces controlled by private companies, such as the Wholesale and Flower Market (Ceasa Campinas) in Brazilian cities, including the one located in Campinas, a large city in São Paulo State. What is the main issue regarding work ability and the ageing workforce in developing countries? Ilmarinen (2006) reported that the main problem concerned to the maintenance of the work ability, is due to the fact that sometimes workers begin working before legal age and, depending on the work sector are subjected to difficult situations related to work conditions and work environment. The country has a young workforce and the challenge is how to maintain workers in good conditions until the age of retirement, and at the same time, take care of older workers. The objective of the study was to evaluate the work ability, work characteristics and life style among workers from small and medium sized enterprises.

2 METHODS This study is part of a large public policies research project entitled “Basis for the implementation of worker’s health public service in informal work and SMEs of Wholesale and Flower Market in São Paulo State- Brazil” (Monteiro, 2005). A cross-sectional study was carried out in a large wholesale produce and flower market area consisting of around 1,000 micro and small sized companies, including shops, inspection and cleaning services, administrative sector and autonomous porters. A questionnaire with socio-demographic, life-style, health and work aspects, living and work conditions (Monteiro, 1996) and the Work Ability Index (Tuomi et al., 1997) was administered. The random sample included 1,006 workers and the response rate was 85%. Statistical analysis was performed in SAS 9.1 with general linear models. The research was approved by the Ethics Committee of the Faculty of Medical Sciences – State University of Campinas – UNICAMP.

3 RESULTS AND DISCUSSION The male population represented 86.9% of the workers (range from 15 to 73 years old), and the mean age was 33.5 years (SD = 12.1). The majority was married (58.4%) and 37.4% were engaged in physically, 35.8% mixed (physically and mentally) and 26.8% mentally demanding work. Women presented higher frequencies in the poor/moderate work ability categories (2.3 and 9.9% respectively) than men (0.6 and 7.6% respectively), using the chi-square test (p-value = 0.0002). Figure 1 shows decreased work ability of women aged down 40 years, when compared with men of the same age; and within the men’s group, work ability was lower for older workers. Figure 2 shows the work ability categories among men, women and all workers. The poor category was more frequent among young women and for young and old men. The mean WAI for women was 40.9 points (SD = 4.7) and mean age was 32.8 years (SD = 11.0), and for men, the mean WAI was 42.6 points (SD = 4.4) and mean age was 33.6 years (SD = 12.2). The gender difference was similar to found by Torgen (2005) in her research. Although difference were found in relation to age brackets and gender, with good results for older women and poor results for older men, it is important to consider the healthy worker effect described by Checkoway et al. (2004). Work breaks were positively correlated with work ability. Having a work accident during the last year and related risks/hazards at work (lifting and/or transporting heavy weigh, time pressure, tiredness and stressful job) had negative correlation with work ability in the general linear model. In the life style model, leisure time activities, physical activities, number of hours of sleep, and sleeping well were correlated with work ability in the general linear model. 38

WAI

44 43 42 41 40 39 37 36 35 34

Men 20

20–29

30–39

Women 40–49 Age

50–59

All 60–69


70

Figure 1. WAI scores by age groups at Wholesale vegetables, fruits and flower market. WAI by age group and sex

All all

Age and sex

Men

Women

Poor Moderate Good Excellent

50 or  40–49 30–39 20–29 20 All 50 or  40–49 30–39 20–29 20 All 0%

20%

40%

60%

80%

100%

WAI categories

Figure 2. WAI categories by age group and gender.

The results give support to design and to initiate intervention actions in the wholesale, fruits vegetables and flower market.

4 CONCLUSIONS The study showed that work conditions were quite important in relation to work ability and should be considered when planning workplace health promotion and intervention actions. Actions related to intervention should ongoing in the workplace related to basic information of health and safety aspects (ergonomic issues, sleep counselling, and nutrition). REFERENCES Checkoway, H., Pearce, N., and Kriebel, D., (2004). Research methods in occupational epidemiology. 2nd. (New York: Oxford). Ilmarinen, J., (2006). The ageing workforce – challenges for occupational health. Occupational Medicine, 6: pp. 362–364.

39

International Labour Office. ILO, (2003). Infocus Programme Boosting Employment through Small Enterprise Development – SEED. [Accessed in 2003 Oct 01]. Available on: . Monteiro-Cocco, M.I., (2002). Capacidade para o trabalho entre trabalhadores de uma empresa de tecnologia da informação. [Livre Docência]. Campinas (SP): Universidade Estadual de Campinas – UNICAMP. [Work ability among information technology workers]. Monteiro, M. I., (1996). revisado em 2004. Instrumento para coleta de dados sociodemográficos, trabalho, saúde e estilo de vida. [Socio-demographic, lifestyle, work and health questionnaire]. (Campinas: Universidade Estadual de Campinas). Monteiro, M. I., (2005). Basis for the implementation of worker’s health public service in informal work and SMEs of Wholesale and Flower Market in Sao Paulo State- Brazil. Public Policy Research Project – Phase II. (Campinas: State University of Campinas). Rantanen, J., (1999). Future perspectives in developing high-quality occupational health services for all. In: Good occupational practice and evaluation of occupational health services, edited by Lehtinen, L., (Helsinque: FIOH), pp. 32–45. Torgen, M., (2005). Experiences of WAI in random sample of the Swedish working population. In: Assessment and promotion of work ability, health and well-being of ageing workers, edited by Costa,G, Goedhard, W. J. A., Ilmarinen, J., (Amsterdam: Elsevier, International Congress series 1280), pp. 328–332. Tuomi, K., Ilmarinen, J., and Jahakola, A. et al., (1997). Índice de capacidade para o trabalho. [Work Ability Index]. (Helsinki: Finnish Institute of Occupational Health).

40

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Factors associated to the work ability among Brazilian teachers ∗ Tatiana Giovanelli Vedovato & Inês Monteiro Faculty of Medical Sciences, State University of Campinas – UNICAMP, Campinas, Brazil

ABSTRACT: The aim of this research was to evaluate the work ability of school teachers and its relation to health, individual characteristics and working conditions. A cross-sectional study with a sample of 258 teachers (fundamental education and high school) from nine public schools was performed in two cities of Sao Paulo state. A standardized self-applied instrument in order to assess work ability and social- demographic data, life style and work status questionnaire and the Work Ability Index was utilized. Statistical analysis was performed with SAS® and tested associations for logistic regression unvaried models and logistic multivariate. Sample was composed in the majority by females (81.8%), with age ranging from 20 and 65 years (Mean 41.9 SD = 9.4) and most of them with university level (95.7%). Work ability was considered as good by less than half (42.6%) of them and as moderate/poor by 35.3%. The most significant factors correlated with WAI moderate/poor categories were: female gender (p = 0.0481), health comparison to other people at the same age as being worse or equal (p < .0001), medication use (p = 0.0013), sleep less than six hours per night (p = 0.0341), bad sleep at night (p < .0001) and total working time as teacher or more then equal to 20 years (p = 0.0153). These data point the need of improvements in the working conditions of the teachers aiming at to the recovery and maintenance of the ability with respect to the work of these professionals. Keywords: Work Ability Index, teachers, health.

1 INTRODUCTION The teachers’ professions were really important for the development and culture of each country. Finish study showed that teachers had decreased work ability correlated with high mental demand at school, with time pressure, to take care of students leading towards psychosomatic diseases as reported by Parkatti, Kinnunen and Rasku (1999). The goal of this article is to evaluate the work ability of public school teachers and correlated with health, individual profile and work conditions. 2 METHOD A cross-sectional study was carried out in was realized in two cities – Campinas and São José do Rio Pardo in nine fundamental level school and/or high school. The random sample was composed by 258 teachers and data collection was performed from August until December in 2005. The research was approved by the Ethics Committee of the Faculty of Medical Sciences – State University of Campinas – UNICAMP, and all data was obtained with the agreement of the workers and school management. ∗ Grant

from CAPES and CNPq – Brazilian Federal Research Agencies

41

Female

Sex

Male Age bracket 30 (years) 30-49 50 and Marital status

 Married Single Divorced Widower

Kids

Yes No 0

10

20

30

40

50

60

70

80

90

%

Figure 1.

Distribution of teachers in relation to socio-demographic characteristics, 2005.

The Work Ability Index (Tuomi, Ilmarinen, and Jahakola et al., 1997) and socio-demographic questionnaire (Monteiro, 2002) was utilized for data collection. For statistical analysis the SAS® – 8.02 was performed and the significance level adopted was p < 0.05.

3 RESULTS The female population represented 81.8% of the workers and the mean age of all workers was 41.4 years (SD 9.4). Figure 1 shows the socio-demographic characteristics distribution among the subjects. The overwhelming majority teachers had university graduation course’s (95.7%), and 15.1% had post-graduation course (specialization, master degree or doctorate). The WAI average among teachers was 38.6 points (SD = 5.8), and women had poor values of WAI – 38.2 points (SD = 5.2) when compared with men 40.3 points (SD = 5.6) (Mann-Whitney test p = 0.0481). Figure 2 shows the work ability categories distribution. When compared WAI and self-perception about health compared with people with the same age 40.7% of the teachers that considered their health rather poor or very poor they had moderate work ability (chi-square test p < 0.0001). In relation to life style 93.4% had at least one leisure time activity and 56.6% did physical exercise regularly; and alcohol intake was referred by 27.5% of the teachers. Work conditions as noisy environment, repetitive movement was considered by the workers as tiredness and source of stress. Pain during the last six months was related by 62.1% of the teachers, pain during the last week by 51.6% and medicine use by 50.8%. Teachers that use medicine had poor WAI value when compared with no users (Mann-Whitney test p < .0001). Diseases with physician’s diagnosis was related by 82.2% and in own opinion by 71.3% of the teachers. The women double journey’s (tasks at school and at home) probably reduce time available to take care of yourself (leisure activities, to sleep). 42

Work ability among teachers Poor Moderate Good Excellent 0

10

20

30

40

50

%

Figure 2.

Distribution of work ability categories among teachers, 2005.

Perhaps the decreasing in WAI was associated with psychosocial factors, stress and musculoskeletal diseases as related in German research with teachers as reported by Freude, Seibt, Pech and Ullsperger (2005).

4 CONCLUSION The study limitation was correlated to cross-sectional design. Teachers that were in sick leave related to diseases didn’t participate on the research. The majority of teachers were women, working more then 15 years in this profession. A gender difference was in relation to work ability with poor values among women when compared to men. The authors found that work ability decrease among older teachers and with more time working as teachers. Is fundamental to improve and restore the work ability of teachers intervening on work environment, work conditions and life style. REFERENCES Checkoway, H., Pearce, N., and Crawford-Brown, D. J., (1989). Research methods in occupational epidemiology. New York: Oxford University Press. Freude, G., Seibt, R., Pech, E., and Ullsperger, P., (2005). Assesment of work ability and vitality – a study of teachers of different age groups. Anais International Congress Series 1280: pp. 270–74 Monteiro-Cocco, M. I., (2002). Capacidade para o trabalho entre trabalhadores de uma empresa de tecnologia da informação. Campinas, [tese – Livre Docência]. Campinas, SP, Universidade Estadual de Campinas. [Work ability among information technology company workers – Free docence thesis] Parkatti, T, Kinnunen, U., and Rasku, A., (1999). Work, well-being and health among ageing teachers. In: J. Ilmarinen, V. Louhevaara. (Ed.). Finn Age. Respect for the ageing. Helsinki: FIOH, pp. 163–171 Tuomi, K., Ilmarinen, J., and Jahakola, A. et al., (1997). Índice de capacidade para o trabalho. [Work Ability Index]. (Helsinki: Finnish Institute of Occupational Health).

43

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Factors that predict work ability: Incorporating a measure of organisational values towards ageing Josephine Palermo, Lynne Webber, Kaye Smith & Anne Khor School of Psychology, Deakin University, Melbourne, Australia

ABSTRACT: This research conducted in an Australian public sector organisation aimed to identify the main factors that predict work ability for employees. According to Ilmarinen’s (1999) model of work ability, an individual’s work ability is influenced by their general health, attitudes, values and motivation interacting with workplace and other environmental demands. However what is unknown is the influence of value incongruence (i.e. the lack of fit between individual and organisational values), particularly when that incongruence results in age discrimination. This is important in an Australian context where youth and symbols of youth are over-valued in business environments and where older workers themselves perceive age discrimination as the single most important cause of early exit from the labour force. 109 participants completed a survey about work ability. Differences between work ability and health were not found between older and younger workers suggesting that strategies for improving work ability could be targeted at all employees rather than just older employees. However there were significant differences found between older and younger workers on reasons that would influence employees to stay longer in the organisation. Older workers tended to be more influenced by the provision of less demanding work, and positive attitudes towards older workers. Younger workers tended to be more influenced by opportunities to be employed in another section of the organisation, skills training opportunities and career advancement opportunities. Results from hierarchical regression analyses suggested that good physical and mental health, and low occupational stress related to workplace culture were significant predictors of increased work ability. Results also suggested that occupational stress is likely to decrease with: high work ability and work satisfaction; and high value congruence. Implications for wellbeing programs to include the development of targeted organisational values are discussed.

1 INTRODUCTION It is well known that the Australian population is ageing (Kryger, 2005). Indeed, due to falling mortality and fertility rates, Australia was one of the world’s most rapidly ageing workforce. This is especially true for the female workforce (ABS, 2004). In addition, Australia has a relatively high incidence of “involuntary” early retirement with 46 percent of people in the 50–64 age group unemployed and 33 percent of 50–64 year olds relying on some form of social security payment (Sheen, 2001). Kryger (2005) predicts that unless older workers are encouraged to stay in the labour force longer, labour shortages will occur. He suggests that this could have a slowing effect for the economy along with a decline in productivity. The Council on Ageing (Sheen, May 2001) supports this view suggesting that Australian living standards could be adversely affected without appropriate public policy interventions addressing solutions to the ageing workforce. Organisations may be required to re-examine their human resources policies and working environments to facilitate and 45

accommodate the increased participation of older workers in the workforce (The Economist 2006; Rappaport et al., 2003) and to address the negative stereotypes that appear to hinder older workers (The Economist, 2006). Negative stereotypes surrounding older workers have been well documented (Taylor and Walker, 1998; Platman and Tinker, 1998; Chiu et al., 2001; Brooke, 2002). However, despite the fact that most reviews of the relevant literature have concluded that there is little or no relation between age and psychological resources and competencies (Sneed and Whitbourne, 2005), they remain ingrained in modern Australian society (McGregor and Gray, 2002; Platman, 2003). Sneed and Whitbourne suggested that researchers should shift their focus away from loss and decline in ageing to an approach focussed on growth and gain in later life. In line with this view, attention has turned to a focus on understanding and improving older workers’ “work ability” (Ilmarinen, 2001). Work ability refers to ones subjective or objective assessment of the ability to do the work that needs to be done. There is evidence that improving work ability in older workers can help to keep workers in the workplace and reduce levels of early retirement (de Boer, van Beek, Durinck, Verbeek & van Dijk, 2004; Pohjonen, 2001; Tuomi, Huuhtanen, and Nykyri and Ilmarinen, 2001). 1.1 Factors affecting work ability Research conducted in Finland, shows that work ability is multidimensional with complex interactions between the dimensions of work, lifestyle, aging and health (Tuomi et al., 1997). The Finnish Institute of Occupational Health coined work ability as a process of resources in relation to work (Ilmarinen, 2004). They defined the individual’s human resources as comprising: health and functional capacities (physical, mental and social); education and competencies; values and attitudes; and motivation. According to Ilmarinen and colleagues these variables interact with a complex set of organisational factors involving: the work demands (physical and mental); the work community and management; and the work environment. The model predicts that work ability is dependent on both the organisational factors and the individual’s human resources, including: (1) rating of current ability to do the work compared to lifetime best; (2) ability to do the work in relation to the physical and mental demands of the work to be done; (3) number of current diseases; (4) estimated work impairment due to diseases; (5) sick leave during last 12 months; (6) own estimate of work ability in two years time; and (7) mental resources available. As can be seen there is a heavy reliance on physical health (diseases, work impairment due to diseases and sick leave) rather than on psychological health and wellbeing (e.g., coping strategies, optimism). Although work ability has traditionally been measured by data from experts (e.g., occupational therapists), more recently the Finnish Institute of Occupational Health (FIOH) (1998) found that self-perceptions of work ability and own estimate of work ability in two years time are valid measures of work ability. Age and work ability. There is considerable evidence that work ability declines with age. Ilmarinen (2001) found that work ability especially in relation to perceived functional and mental capacity, can begin to decline after the age of 45 years. Age declines are commonly found for employees in physically demanding work such as cleaning. For example, Pohjonen (2001) found significant age-related declines in work ability at 35 years with a second larger decline at 55 years of age in a group of home care workers. Not surprisingly, health related factors such as chronic health issues (de Boer, 2004); workers’ health; and functional capacity, including physical, mental and social capacity (Chan et al., 2000) have all been found to be related to work ability. Self-rated work ability has been found to be predictive of the duration of sick leave (Reiso, Nygård, Brage, Gulbrandsen and Tellnes, 2001). As expected poor health, physical work demands and lack of control over work all predict poor work ability (Pohjonen, 2001; Hopsu, Lepanen, and Ranta & Louhevaara, 2005). In contrast, a ‘healthy’ lifestyle such as physical activity has also been found to be positively related to work ability (Seitsamo & Ilmarinen, 1997). Good work ability has been found to be related to good quality of work and job satisfaction (Tuomi et al., 2001). In addition, Webber, Smith and Scott (2006) found that job satisfaction and organisational satisfaction were related to self-rated work ability. It is not clear whether job satisfactions leads to higher work ability 46

or higher work ability leads to better job satisfaction. Work ability has been found to be important for predicting early retirement or failure to return to work after a prolonged illness (de Boer et al., 2004). Webber et al. (2006) found that self-rated work ability was a better predictor of plans to leave than age or job and organisational satisfaction. Factors that promote work ability. There is evidence that even older workers can improve their work ability by increasing physical activity and their positive social relationships at work (Tuomi, Ilmarinen, Martikainen, and Aalto and Klockars, 1997). Other factors that appear to be related to work ability are socio-economic status (Aittomaki et al., 2002; the level of professional competence; and work environment factors such as type of work, work satisfaction and work conditions (Tuomi et al., 2001; de Boer et al., 2004). Work ability may be mediated by physical and psychological stress. Salonen et al. (2003) found a strong correlation between stressors, chronic disease, stress symptoms and work ability. Stress outcomes are an imbalance between demand perceived load versus perceived capability (Lazarus & Folkman, 1984). Perceived demand also includes the anticipation of adverse consequences arising from failure to cope with demand. Cotton (1996) argued that the reporting of stress is an outcome of a more interactive and dynamic system of variables that cannot be reduced to the linear model. Taken together the research on stress suggests that stress is multidimensional with its effects influenced by individual differences. Factors requiring consideration in a model of occupational stress include personality style, occurrence of events, perceived support, concurrent personal pressures and other organisational factors (Cotton, 1996). Folkman and Lazarus (1984) also suggested that antecedent conditions such as motivation (for example values, commitment, goals) and beliefs about self are important factors. More recently research on stress has incorporated these variables in multidimensional designs (see Hart, Wearing, and Griffin, 1996; Code and Langan-Fox, 2001). Much of the stress literature, while emphasising individual personality and organisational characteristics as being determinants of stress, relate these only to characteristics that are associated with ‘work’. Mitchell (1996) argued that employment is more than ‘work’, and therefore the individual’s deeper levels of psychological functioning should be incorporated in models of stress. He argued that an individual’s value structure, unconscious processes, sense of meaning (and therefore self-concept), are also important factors. According to Code and Langan-Fox (2001), evidence suggests that organisational constraints that prevent goal attainment have a negative impact on individual well being, thereby adversely impacting on stress vulnerability. Therefore, congruence between goals and behaviour, and motives and behaviour may be fundamental to the experience of occupational stress. Code and Langan-Fox (2001) suggest a personality integration model of stress with dual emphasis on goal progress and attainability, and unconscious need fulfilment. This involves implicit-explicit congruence whereby stressors increase with increased discordance between implicit and explicit motives. These tenets can be applied to individual-organisational motives, extending traditional person-environment (P-E) fit theories to levels of individual and organisational system dynamics. Edwards (1996) advocates a supply value model of stress that accommodates these differences. Stress is viewed as a mis-fit between an individual’s personal values and the environmental contingencies or supplies available to fulfil those values. It follows then that congruence between the structure and organisation of personality at the individual level, and culture at the organisational level, may also be important. This may explain why reporting of stress is more likely to occur when psychological distress is higher than usual and when morale is lower than usual (Cotton, 1996). Following this argument, the extent to which the organisational culture is perceived to value older workers may be an important determinant of stress as well. 1.2 Expanding the work ability model As the previous review has shown, work ability is influenced by individuals’ general health, attitudes, values and motivation interacting with workplace and other environmental demands. However what is generally unknown is the influence of organisational cultural processes. This may be particularly important in an Australian context where youth and symbols of youth are 47

over-valued in business environments (Sheen, May 2001). According to research conducted by the Council on Ageing (Sheen, 2001), older workers themselves perceive age discrimination as the single most important cause of early exit from the labour force. Age discrimination denotes a system of entrenched beliefs and practices include: stereotyping of mature age people as less adaptive and productive than young people; marketing images concentrated on youth; and industry restructuring targeting mature workers as soft targets for redundancy and retrenchment (Sheen, 2001). Evidence has been found that people use double standards when assessing employees for promotion (Smith and Webber, 2005) and when evaluating job candidates (Richardson, Webber, Smith and Webb, 2006). In both cases older adults were judged more harshly than younger adults. Furthermore, evidence of age discrimination in various areas of employment has been found in both blue and white-collar sectors of a diverse range of organisations, and data supporting its existence has been found in numerous developed countries (Adams 2002; McGregor cited in McGregor and Gray 2002; Cant et al., 2001; Henkens 2000; Platman and Tinker 1998; Still and Timms 1998; Boerlijst, 1994). Negative attitudes and age discrimination not only render older adults vulnerable and susceptible to redundancy if the company changes direction (Boerlijst, 1994), but also perpetuate the myth that older workers lack the required motivation and ability to participate in training (Taylor and Walker, 1998). A quantitative study conducted in New Zealand found evidence of discriminatory practices in relation to training (McGregor, 2001 cited in McGregor and Gray, 2002). Negative stereotypes regarding the inability of older adults to adapt to technological change were found to be particularly pervasive. If older workers are not encouraged or afforded the opportunities to participate in training and skill development they eventually become de-motivated and lack the enthusiasm required not only to inspire younger workers but also maintain their value and relevance within their respective organisations (Boerlijst, 1994). Although motivation and values has been incorporated into the workability model (Ilmainen and Rantanen, 1999), further contributions could be made by including a measurement of value congruence (between personal and organisational values). Palermo (2005) found that congruence based on values associated with gender tolerance to be a determinant of job satisfaction and occupational stress. It is therefore likely that similar patterns may be ascertained by an investigation of ‘fit’ between individuals and their organisation on values related to age tolerance and/or discrimination, especially for older workers. This study aimed to examine the influence of individual and organisational factors that impact on work ability. More specifically it also aimed to test the following hypothesis: Lack of fit or incongruence between individual and organisational values will significantly predict work ability and occupational stress.

2 METHOD 2.1 Participants A total of 109 participants completed the survey, 66 percent were women and 34 percent were men. The majority of participants were Australian (71%), with 25 percent identifying with European ethnicities, and another 4 percent identifying with South Asian ethnicities. The sample had an average chronological age of 47 years. However, most participants felt younger than their chronological age. To analyse differences between younger and older workers, the sample was split into two groups: participants 44 and younger and those participants 45 and older. This age grouping was chosen because it is consistent with most other research. Participants in the younger age group comprised 36 percent of the total sample, with 64 percent being in the older age group. The mean tenure for participants was 8 years of service with the Council, and 10 years of service in their current job. Whilst on average, participants indicated that they were planning to leave in 7.7 years, there were no significant differences between older and younger workers on their plans to leave the Council. 48

2.2 Measures A seven-page questionnaire was designed in consultation with the industry partner to measure self-rated work ability, health and well-being. The questionnaire comprised six main sections as described below. 1. Work ability, health and emotional well-being: comprised self report items from the Work Ability Index (WAI) (adapted from Finish Institute of Occupational Health 1998). A work ability score was derived by aggregating scores on responses about participants’ current work ability to do physical and mental demands of their work and projected work ability in two years time. A combined score comprised of: mean responses to Q1 of the WAI (1 = workability at it’s worst; 10 = workability at its best) weighted according to whether their job was physically demanding, mentally demanding, or both; and mean responses obtained from the question ‘in terms of your current health will you be able to you current job (1 = unlikely, 2 = not certain, 3 = relatively certain). Health and emotional well-being was assessed using five of the seven items on the SF-12 (Medical Outcomes Trust, 2002). This survey is a standard health survey uses to assess mental and physical health over a four-week recall period. It has been extensively validated across a number of research studies. Self Efficacy was measured using items the General Self Efficacy Scale Sherer, et al., 1982), based on Bandura’s (1977) theory was used to assess general expectancies of self-efficacy. The scale consisted of 15 items rated on a 7-point likert scale where high scores indicate high selfefficacy. Sample items included: ‘when I set important goals for myself, I achieve them’ and ‘when I decide to do something I go right to work on it’. High internal consistency (α = .86) and criterion validity has been reported (Sherer et al., 1982; Long, 1989). The scale had similar internal consistent in this study (α = .86): 2. Work satisfaction. Participants were asked a series of questions relating to satisfaction with their work and job. These included items about satisfaction with: opportunities for career advancement, supervisors and co-workers, work tasks and job role, and level of autonomy and appreciation received. After analyses that showed that these items were highly correlated, a Work Satisfaction score was calculated with every participant receiving a score that was the average across all items. One item, “the way my job provides steady employment” was not included in the scale because scale reliability statistics showed it was not reliable. 3. Occupational Stress. Sources of occupational stress were assessed using 19 items adapted from Occupational Stress Indicator (OSI) scales (Cooper, Sloan and Williams, 1988). Three scales were produced: • Workplace Culture: characterised by lack of encouragement and guidance from supervisors; Lack of social support by people at work; Favoritism and Covert discrimination; Inadequate or poor quality of training; Staff shortages and unsettling turnover rates; and Lack of power and influence. (Cronbach’s alpha = 0.91, 10 items) • Work/Life Balance: characterised by demands of work in private, social and family life; having too much work to do and mundane administrative tasks. (Cronbach’s alpha = 0.82, six items) • Role Anxiety: characterised by over promotion; Keeping up with new technologies, ideas, technology, innovations and difficulty coping with stress. (Cronbach’s alpha = 0.64, three items) 4. Personal and organizational values. Participants were asked to rate their personal values and those of their respective organisation (items were adapted from Palermo 2005). The individual values were examined to identify any clusters. Analyses revealed that three clusters emerged (respect and Support, collective achievement and independent achievement). • Value Scale 1: Respect and Support (Cronbach’s alpha = 0.91, four items): characterised by being treated respectfully, fair treatment of staff, valuing employees; and support when needed. • Value Scale 2: Collective Achievement (Cronbach’s alpha = 0.88, seven items):characterised by values such as honesty, accountability, compassion, taking responsibility, and integrity. 49

• Value Scale 3: Independent Achievement (Cronbach’s alpha = 0.89, four items):characterised by creativity, ambition, independence, and recognition of good performance. Importance ratings for personal values and organisation values were added to produce personal and organisational scales. The scales were then rescored to a 0–100 scale to enable ease of interpretation. A difference score was then computed (P-E: Personal scale score value – Organisational value scale score) 5. Reasons to stay with current employer. Participants’ were asked to rate the characteristics they believed would facilitate staying with their current employer. Individual items that appeared to correlate were clustered into the following scales. • Reason to Stay 1: Career Opportunities (Cronbach’s alpha = 0.81, five items):characterised by opportunities for employment in another section and pay increases; skills training and career advancement opportunities; and more demanding work. • Reason to Stay 2: Employee assistance and flexibility (Cronbach’s alpha = 0.75, six items): characterised by a work environments with positive attitudes to older workers; health activities at work; retirement planning; part-time work and other flexible options; and less demanding work. • Reason to Stay 3: Management (Cronbach’s alpha = 0.90, five items):characterised by having employer’s respect; a good job match; positive supervisor – employee relations and personal support from management. 6. Demographic information. Participants provided some personal details (e.g., gender, age, and ethnicity). They were also asked about their plans for retirement and what kinds of activities they would like their organisation to provide that would enhance their general health and well-being (e.g., massage). 2.3 Procedure Over 600 participants were invited to complete the questionnaire from a municipal city council with 18 percent participation rate achieved. Each participant was provided with a paper-based copy of the questionnaire, a plain language statement and a reply paid envelope for return to Deakin University. Participants were requested to complete the questionnaire within two weeks from the date of receipt. Participation in the study was voluntary and anonymous.

3 RESULTS 3.1 Work ability Table 1 shows work ability scores for males and females and younger and older workers. There were no significant differences according to sex or age group.

Table 1. Work ability mean scores for males and females, younger and older workers and the total sample. Age Group

Sex

Mean

Std. Deviation

N

44 years and under

Male Female Total Male Female Total

11.50 11.73 11.68 11.07 11.33 11.22

1.69 1.48 1.51 2.09 1.49 1.76

8 30 38 28 39 67

45 years and older

50

Participants were asked to indicate the level of certainty (on a scale from 1 = uncertain to 3 = very certain) they had in maintaining their work ability two, five and 10 years from now. Projections of work ability were very high within a two year time frame, but tended to decline as the time frame increased (Mean Work ability: two yrs from now = 2.87, SD = 0.33; five yrs from now = 2.68, SD = 0.61; 10 yrs from now = 2.43, SD = 0.74). Older participants appeared to be less certain about their ability to work at current levels in 5 years from now (F(1,97) = 9.67, MSE = 0.35, p < .05) and 10 years from now (F(1,97) = 24.55, MSE = 0.46, p < .05). There were also significant differences between males and females on estimates of work ability 10 years from now, with males being less certain than females about their ability to maintain work at an optimum after 10 years (F(1,101) = 7.86, MSE = 0.52, p < .05). 3.2 Individual factors Participants answered a number of questions related to their physical and mental health, and self efficacy. Independent t-tests showed that there were no differences in health related measures between younger and older workers, with the exception of physical activity. Older workers indicated that on average they were involved in twice as many hours of physical activity in one week than younger workers. 3.3 Organisational factors Participants were asked to indicate which factors would influence intention to stay on in their workplace. Overall, most of the factors appeared to resonate with participants as important considerations in relation to their intention to stay with the Council. Employees’ top five reasons to stay included: positive relationships with supervisor, a good work environment, employer’s respect, a good job match, good physical health and a positive organisational cultural attitude to older workers. In contrast, a change in the type of work (more demanding or less demanding) and a change in manager did not appear to influence decision to stay. There were no differences between men and women in relation to factors that influence their intention to stay for most items. However there were differences between younger and older workers on some items. Table 2 reveals that older workers tended to be less influenced by the provision of less demanding work (F(1,94) = 7.31, MSE = 1.22, p < .02), and more by positive attitudes towards older workers than younger workers (F(1,94) = 13.39, MSE = .75, p < .02. Younger workers tended to be more influenced by skills training opportunities (F(1,94) = 4.96, MSE = 1.01, p < .05) and career advancement opportunities (F(1,94) = 5.63, MSE = 1.09, p < .05) than older workers. 3.4 Work satisfaction and occupational stress Mean scores of older and younger workers on work satisfaction were investigated. Overall, all employees agreed they were satisfied. There were no differences between different work areas.

Table 2.

Participants’ responses on health related measures.

Age Group

Skill training opportunities

Career advancement opportunities

Positive attitude to older workers

Less demanding work

44 yrs and under (N = 36)

Mean SD

4.25 0.97

4.14 1.05

3.69 0.98

2.33 1.01

45 yrs and older (N = 65)

Mean SD

3.77 1.03

3.64 1.04

4.35 0.80

2.95 1.15

51

There were no differences between males and females or between younger and older adults on job satisfaction. Analyses were conducted to ascertain whether there were any differences between older and younger male and female workers on occupational stress scores. There were no differences between males and females or between younger and older adults on any of the occupational stress scales (Stress – Workplace Culture: M = 2.33, SD = .84; Work/Life Balance: M = 2.43, SD = .85; Role Anxiety: M = 2.30, SD = .79). 3.5 Personal and organisational values congruence Participants were asked to rate the importance of a list of values, for themselves and for their organisation. There were significant differences between personal and organisational value scale scores found. Paired sample t-tests displayed in Table 3 showed that participants experienced some level of values incongruence, in that they tended to ascribe importance to a greater extent to themselves than to their organisation. Significant differences on value incongruence scales were also found between older and younger males and females (F(sex)(3, 99) = 6.27, η2 = 0.16, p < .05; F(agegroup)(3, 99) = 2.92, η2 = 0.08, p < .05;). Univariate statistics showed that significant differences were evident for incongruence related to Independent Achievement between older and younger workers (F(1,101) = 4.95, MSE = 0.19, p < .05), and between males and females (F(1,101) = 4.38, MSE = 0.17, p < .05). Means are displayed in Table 4. Younger workers, especially males indicated more incongruence. These results suggest that for younger males in particular, personal values associated with creativity, ambition, independence and recognition of good performance were rated as more important for self than for the organisation. 3.6 Factors that influence work ability A correlation matrix was produced to explore the relationships between work ability and factors related to individual antecedents and organisational outcomes. Table 5 shows that workability was Table 3. Paired sample t-tests between personal and organisational value scales.

Values Scales

Mean (N = 109)

Std. Dev

Std. Error Mean

Pair 1

Personal: Independent Achievement Org: Independent Achievement

83.57 67.78

13.07 21.60

1.25 2.07

8.08

Pair 2

Personal: Collective Achievement Org: Collective Achievement

89.16 79.18

12.67 16.92

1.21 1.62

6.56

Pair 3

Personal: Respect and Support Org: Respect and Support

90.07 76.93

13.34 21.07

1.28 2.02

6.44

Table 4.

t (df = 108)

Mean scores on Independent Achievement value incongruence (P-E) for older and younger males and females.

Age Group

Sex

Mean

Std. Dev.

N

44 years and under

Male Female Total

1.68 1.54 1.57

0.16 0.20 0.20

8 30 38

45 years and older

Male Female Total

1.53 1.48 1.50

0.19 0.20 0.20

28 39 67

52

53

1.00 −0.27∗ 0.36∗ −0.45∗ 0.33∗ −0.43∗ 0.29∗ 0.25∗ 0.14 0.28∗ 0.17 0.26∗ 0.17 −0.11 −0.18∗ −0.16

1.00 −0.09 −0.24∗ −0.20∗ 0.10 −0.05 −0.05 −0.21∗ −0.09 −0.28∗ −0.01 −0.27∗ −0.88 −0.02 0.02

B

Note: ∗ p < .05 A Work Ability B Psychological Age C Self Efficacy D Physical Health E Mental Health

A B C D E F H I J K L M N 0 P Q

A

F H I J K L

1.00 0.00 0.25∗ −0.32∗ 0.39∗ 0.25∗ 0.31∗ 0.24∗ 0.33∗ 0.25∗ 0.18 −0.12 0.01 −0.06

C

1.00 −0.30∗ 0.36∗ 0.21∗ 0.11 0.22 0.17 0.22∗ 0.14 −0.20∗ −0.16 −0.21

E

1.00 −0.55∗ −0.42∗ −0.11 −0.43∗ −0.06 −0.49∗ −0.10 0.44∗ 0.45∗ 0.41∗

F

1.00 0.52∗ 0.21∗ 0.50∗ 0.21∗ 0.47∗ 0.18 −0.43∗ −0.43∗ −0.55∗

H

1.00 0.39∗ 0.75∗ 0.20∗ 0.66∗ 0.10 −0.59∗ −0.62∗ −0.78∗

I

J

1.00 0.40∗ 0.64∗ 0.26∗ 0.66∗ 0.04 0.03 0.08

Stress – Workplace Practice and Culture Work Satisfaction Organisational Values Ratings: Independent Achievement Personal Values Ratings: Independent Achievement Organisational Values Ratings: Collective Achievement Personal Values Ratings: Collective Achievement

1.00 −0.15 −0.12 0.10 0.15 0.12 0.14 0.09 0.14 0.13 −0.10 −0.07 −0.13

D

Table 5. Correlation Matrix of workability, occupational stress, and individual and organisational factors.

N M O P Q

1.00 0.45∗ 0.85∗ 0.38∗ −0.67∗ −0.74∗ −0.63∗

K

1.00 0.30∗ −0.85∗ −0.67∗ −0.58∗

M

1.00 0.12 0.10 0.13

N

1.00 0.77∗ 0.73∗

O

1.00 0.75∗

P

1.00

Q

Personal Values Ratings: Respect and Support Organisational Values Ratings: Respect and Support Value Incongruence: Respect and Support (P-E) Value Incongruence: Collective Achievement (P-E) Value Incongruence: Indep. Achievement, (P-E)

1.00 0.34∗ 0.80∗ 0.00 0.17 0.03

L

Table 6.

Hierarchical multiple regression resultant model: Self efficacy, health, value incongruence, work satisfaction and occupational stress as predictors of work ability.

Psychological Age Self Efficacy Physical Health Mental Health Organisational Values Ratings: Collective Achievement Stress – Workplace Practice and Culture Work Satisfaction

B

St. Beta

sr

−0.00 −0.01 0.00 0.00 0.00

−0.06 −0.23∗ −0.45∗ −0.28∗ −0.02

0.21 −0.42 −0.25 −0.01 −0.20

0.01 −0.00

0.25∗ −0.09

0.07 −0.06

Note: Workability score was transformed to address negative skew and increase normality by reversing scores and taking the log10.

negatively and significantly correlated with psychological age rather than chronological age. It was also positively correlated with self efficacy, health measures, occupational stress related to workplace culture and work satisfaction. Ratings of organisational values were significantly and positively correlated with work ability rather than personal values. Value incongruence related to collective achievement was also significantly correlated with workability. Organisational variables rather than personal factors appeared to be significantly correlated with occupational stress related to work culture. In particular work satisfaction, organisational values and value incongruence measures were moderately to highly correlated with occupational stress. Variables that were correlated with dependent variables of interest were included in hierarchal regression analyses conducted. However limitations in sample size limited the amount of predictor variables able to be included. In addition the possibility of multicollinerarity was high due to high correlations between value incongruence measures and organisational ratings. Therefore only the significant organisational values ratings were included in the analyses. Given that participants had uniformly rated personal values as more important to themselves than to their organisation, organisational values ratings appeared to be proxies of value incongruence in this study. In order to investigate how factors of work ability may work together to predict work ability, a hierarchical regression equation was produced. Demographic characteristics were entered on the first step, organisational factors were entered on the second step and individual health factors on the last step. Table 6 displays significant predictors of workability at each step of building the model. In step 1, psychological age, self efficacy and individual health measures were all significant predictors of work ability (F(4,108) = 20.03, MSE = .00, p < .05). When organisational factors were included in the model, the shared variance attributable to psychological age was diluted with occupational stress related to Workplace Culture appearing to be a significant predictor of work ability (F(5,108) = 16.12, MSE = .00, p < .05). Overall the resultant model displayed in Table 6 explained 48 percent of the variance in work ability. It suggested that work ability is increased with (in order of importance): increased physical and mental health, decreased occupational stress related to workplace culture, and increased self efficacy (F(7,108) = 13.30, MSE = .00, p < .05). Due to the importance of occupational stress as an organisational predictor of work ability, a hierarchical regression model was conducted to investigate predictors of occupational stress related to workplace culture. In the first step self efficacy and mental health were significant negative predictors of occupational stress (F(2,108) = 9.47, MSE = .61, p < .05). In the second step mental health and self efficacy were no longer significant predictors, with Organisational values (Respect and Support) appearing to moderate their relationship with occupational stress (F(3,108) = 15.14, MSE = .51, p < .05). The resultant model displayed in Table 7 explained 46 percent of the variance in occupational stress (F(6,108) = 14.83, MSE = .40, p < .05) and suggested that decreased occupational stress is likely to be predicted by (in order of important): increased work satisfaction, increased work ability, 54

Table 7.

Hierarchical multiple regression resultant model: Value incongruence, work satisfaction, work ability and reasons to stay as predictors of occupational stress related to work culture.

Mental Health Self Efficacy Organisational Values: Respect and Support Work Satisfaction Work Ability Stay – Employee Asst Flex

B

Beta

s2

0.00 −0.11 −0.01

0.00 −0.07 −0.25∗

0.00 −0.06 −0.22

−0.36 −0.11 0.24

−0.32∗ −0.23∗ 0.20∗

−0.26 −0.20 0.20

Note: ∗ p < .05.

increased organisational values related to Respect and Support (i.e. less value incongruence) and decreased Reasons to Stay related to Employee Assistance and Flexibility. Taken together these regression analyses suggest that self efficacy and health along with occupational stress related to work culture appear to predict work ability for these Council workers. However whilst self efficacy remains a significant predictor of occupational stress, organisational factors rather than individual factors appear to better explain the variance attributable to occupational stress. More specifically, work satisfaction, work ability, organisational values related to respect and Support and employee assistance mechanisms appear to predict nearly 50 percent of the variance found in occupational stress.

4 DISCUSSION This exploration study aimed to examine the impact of individual and organisational values on work ability and occupational stress. Council staff who participated in this study indicated a reasonably high level of work ability; that is, on average they judged their ability to do their work was good. Whilst there were no differences between older and younger grouped workers on levels of work ability, these levels tended to decline as workers attempted to predict their work ability into the future that comprised a longer timeframe. Regression analyses revealed that individual factors, namely self efficacy and physical health, appeared to be important predictors of work ability. Findings suggested that as these resources increase, so too will work ability. This finding is consistent with previous studies that have shown similar relationships between psychological resources, mental health, physical health and workability (Chan et al., 2000; Pohjonen, 2001; Hopsu et al., 2005; Seitsamo and Ilmarinen, 1997). In relation to self efficacy and health measures, there were no differences between older and younger workers suggesting that this finding is equally important of workers across the lifespan. Two of the most important support provisions for self-efficacy are information that an individual is valued and accepted, and guidance and information that assist an individual in dealing with different situations. Perceptions of having relationships where competencies, skills, and value as persons are recognised (reassurances of worth) have been found to be conducive to building self-efficacy (Delongis, Folkman, and Lazarus, 1988). Whilst correlations suggested that increased work ability may be associated with more congruence between personal and organisational values (related to collective displays of honesty, compassion, integrity, taking responsibility etc.) this effect was mediated by occupational stress and work satisfaction in the equation. Findings suggested that increased work satisfaction increases and decreased occupational stress may be related to increased work ability, confirming previous research (e.g. Tuomi et al., 2001; Webber et al., 2006; Salonen et al., 2003). Given the importance of occupational stress as an organisational predictor of work ability, findings suggested that organisational factors rather than individual factors were important antecedents 55

of occupational stress for these workers. Again organisational values rather than personal values were important predictors, particularly those associated with values of respect and Support. In fact, reduced value incongruence with increased work satisfaction and decreased importance of employee assistance programs appeared to mediate the effects of self efficacy and mental health on decreased occupational stress. The finding that increased importance of employee assistance programs appeared to predict increased occupational stress at first appears unintuitive. It suggests that participants who indicated that employee assistance programs were more important to them, (including the presence of more positive attitudes to older workers), would also experience more occupational stress. It may be the case that these workers may have had unmet expectations in relation to these factors and therefore this may have been contributing to increased occupational stress. The presence of organisational values related to respect and Support as a negative predictor of occupational stress also seems to support this proposition. It indicates that unmet expectations may be working together with value incongruence to contribute to increased stress. This may be exacerbated by people using double standards (Richardson et al., 2006) and age discrimination (Adams, 2002; McGregor, 2002; Henkens, 2000; Boerlijst, 1994) when assessing older workers. This finding may have specific implications for older workers. They indicated that positive attitude towards older workers work was more important for them than did younger workers as a reason to prolong work. These results should be interpreted cautiously. Given the specific organisational sample used, it may be difficult to generalise results to populations of workers in general, particularly those in different sectors or industries. In addition, sample size restricted more complex analysis that may have further explored the relationships between value incongruence, occupational stress and work ability. Further research is warranted that includes these variables as potential mediators of individual level factors as direct and indirect predictors of workability. Within the constraints of these limitations, the results of this study suggest that organisational and individual factors are important when considering interventions that may address organisational problems relating to an ageing workforce. This study, whilst exploratory, also suggests that organisational value incongruence may indirectly affect work ability through a direct effect on occupational stress related to work culture. That is, as organisational values (especially those related to respect and support) work together with work satisfaction and work ability they reduce occupational stress related to work culture. In turn, as occupational stress decreases, health and work ability increases. Implications of these findings for the participating organisation are in recommending strategies for promoting workability of all workers, and not just ageing workers. Findings suggest that older and younger workers may require different strategies to prevent early exit from work with programs focussed on: career advancement and skill development for younger workers; work flexibility and cultural change to attitudes to older workers for older workers; and strategies related to decreasing occupational stress related to workplace culture such as reducing value incongruence related to respect and support for the individual, and a sense of collective honesty, integrity and compassion for all workers. Throughout this report we investigated differences between older and younger workers on work ability and measures that relate to work ability. Overwhelmingly there were more similarities between these groups than differences. Therefore findings also suggest that strategies would be best geared to increasing and strengthening work ability for all staff across the lifespan, and not just older workers.

REFERENCES ABS, (2004). Mature age persons statistical profile: Labour force. CAT 4905.0.55.001, Canberra, ACT: Australian Bureau of Statistics Adams, S.J., (2002). Passed over for promotion because of age: An empirical analysis of the consequences. Journal of Labour Research, vol. 23 (3): pp. 447–461

56

Aittomaki, A., Lahelma & Roos, E., (2002). Working conditions and socio-economic inequalities in work ability. European Journal of Public Health, vol. 12 (4): pp. 35 Barnes-Farrell, JL., Rumery, SM., and Swody, CA., (2002). How do concepts of age relate to work and off-thejob stresses and strains? A field study of health care workers in five nations. Experimental Aging Research, vol. 28 (1): pp. 87–98 Boerlijst, J.G., (1994). The neglect of growth and development of employees aged over 40: A managerial and training problem. In J Snel & R Kremer (Eds), Work and ageing: A European perspective. Taylor and Francis: London Brooke, L., (2002). Human resource costs and benefits of maintaining a mature-age workforce. International Journal of Manpower, vol. 24 (3): pp. 260–283 Cant, R., O’Loughlin, K., and Legge, V., (2001). Sick leave – Cushion or entitlement? A study of age cohorts’ attitudes and practices in two Australian workplaces. Work: Journal of Prevention Assessment and Rehabilitation, vol. 17 (1): pp. 39–48 Chan, G, Tan, V, and Koh, D., (2000). Ageing and fitness to work. Occupational Medicine-Oxford, vol. 50 (7): pp. 483–491 Chiu, W.C.K., Chan, A.W., Snape, E., and Redman, T., (2001). Age stereotypes and discriminatory attitudes towards older workers: An East-West comparison. Human Relations, vol. 54 (5): pp. 629–661 Code, S., and Langan-Fox, J., (2001). Motivation, cognitions and traits: predicting occupational health, well-being and performance. Stress and Health, vol. 17: pp. 159–174 Cotton, P., (1996). Impediments to achieving best practice in managing work stress. Paper presented at the National Occupational Stress Conference: Health and Well-being in a Changing Work Environment, Brisbane de Boer, A.G.E.M., van Beek, J.C., Durinck, J., Verbeek, J.H.A.M., and van Dijk, F.J.H., (2004). An occupational health intervention programme for workers at risk for early retirement; a randomised controlled trial. Occup. & Environmental Medicine, vol. 61 (11): pp. 924–929 Delongis, A., Folkman, S., and Lazarus, R. S., (1988). The impact of daily stressors on health and mood: Psychological and social measures as mediators. J. of Personality & Social Psychology, 54: pp. 486–495 Edwards, J. R., (1996). An examination of competing versions of the person-environment fir approach to stress. Academy of Management Journal, vol. 39 (2): pp. 292–339 Finish Institute of Occupational Health, 1998, Work Ability Index. (2nd ed.) Fischer, F.M., Bellusci, S.M., Teixeira, L.R., Borges, F.N.S., Ferreira, R.M., Goncalves, M.B.L., Martins, S.E., and Christoffolete, M.A., (2002). Unveiling factors that contribute to functional aging among health care shiftworkers in Sao Paulo, Brazil. Exp. Aging Research, vol. 28 (1): pp. 73–86 Hart, P. M., Wearing, A. J., and Griffin, M. A., (1996). Personality, coping and organisational climate: Where should the intervention dollar be spent. Paper presented at the National Occupational Stress Conference: Health and Well-being in a Changing Work Environment. Brisbane: Australian Academic Press Henkens, K. and van Solinge, H., (2002). Spousal influences on the decisions to retire. International Journal of Sociology, vol. 32 (2): pp. 55–74 Hopsu, L., Leppanen, A., Ranta, R., and Louhevaara, V., (2005). Perceived work ability and individual characteristics as predictors for early exit from working life in professional cleaners. In G. Costa, W.J.A. Goedhart and J. Ilmarinen (Eds.), International Congress Series (vol. 1280), (pp. 84–88). Amsterdam: Elsevier Ilmarinen. J., (1999). Ageing workers in the European Union-Status and promotion of work ability, employability and employment. Helsinki: Finnish Institute of Occupational Health, Ministry of Social Affairs and health, Ministry of Labour Ilmarinen J., (2001). Ageing Workers in Finland and in the European Union: Their Situation and the Promotion of their Working Ability, Employability and Employment. The Geneva Papers, vol. 26 (4): pp. 623–641. Blackwell Publishing Ilmarinen J., (2004). Assessment and promotion of work ability, health and well-being of ageing workers in Giovanni Costa, Willem J. A. Goedhard, and Juhani Ilmarinen, (Eds). Proceedings of the 2nd International Symposium on Work ability, Verona, Italy 18 and 20 October Ilmarinen, J., and Rantanen, J., (1999). Promotion of work ability during ageing. American Journal of industrial medicine supplement, 1: pp. 21–23 Kryger, T., (2005). Australia’s Ageing Workforce. www.aph.gov.au/library/pubs/rn/2004-05/05rn35.htm Lazarus, R. S., and S. Folkman, (1984). Stress, Appraisal and Coping. New York, Springer McGregor, J. and Gray, L., (2002). Stereotypes and older workers: The New Zealand experience. Social Policy Journal of New Zealand, issue 18: pp. 163–177, Accessed 10 March 2004, www.msd.govt.nz./publications/journal/18-june-2002/index.html

57

Medical OutcomesTrust, (2002). SF-12 Health Survey (Version 2). Lincoln, USA: Quality Metric Incorporated. Mitchell, J., (1996). Stressing organisational culture. Health and Well-Being in a Changing Work Environment. Brisbane, Australian Academic Press. National Occupational Stress Conference. Brisbane. Australian Academic Press Palermo, G., (2005). Gender and Organisational Culture: Relationships Between Marginality And Women’s Career Success. Unpublished PhD thesis, Victoria University, Melbourne Platman, K., (2003). The self-designed career in later life: A study of older portfolio workers in the United Kingdom. Ageing and Society, vol. 23 (3): pp. 281–302. Platman, K., and Tinker, A., (1998). Getting on in the BBC: A case study of older workers. Ageing and Society, vol. 18 (5): pp. 513–535 Pohjonen T., (2001). Perceived work ability of home care workers in relation to individual and work-related factors in different age groups. Occupational Medicine 51: pp. 209–217 Rappaport, A., Bancroft, E., and Okum, L., (2003). The aging workforce raises new talent management issues for employers. Journal of organizational excellence, vol. 23 (1): pp. 55–66 Reiso H, Nygard JF, Brage S, Gulbrandsen P, and Tellnes G., (2001). Work ability and duration of certified sickness absence. Scandinavian Journal of Public Health. Sep. 29 (3): pp. 218–25 Richardson, B., Webber, L., Smith, K., and Webb, J., (2006). Age Matters: the effect of job applicant age on hiring decisions. Proceedings (refereed) of the Joint Conference of the Australian Psychological Society and the New Zealand Psychological Society, Auckland, N.Z. (pp. 345–349). September 2006. Australian Psychological Society: Melbourne. Salonen, P, Arola, H, Nygard, CH, Huhtala, H, and Koivisto, M., (2003). Factors associated with premature departure from working life among ageing food industry employees. Occupational Medicine-Oxford, vol. 53 (1): pp. 65–68 Seitsamo, J. and Ilmarinen, J., (1997). Life-style, aging and work ability among active Finnish workers in 1981–1992. Scandinavian J. of Work Environment & Health, vol. 23 (1): pp. 20–26 Sheen, V., (2001). Challenging Convention Australia’s ageing workforce – the challenge for human resource management.http://www.cota.org.au/ahrispeech.htm#top Sherer, M., Maddoux, J. E., Mercandante, G., Prentice-Dunn, S., Jacobs, B., and Rogers, R. W., (1982). The Self-Efficacy Scale: Construction and validation. Psychological Reports, 51: pp. 663–671 Smith, K, and Webber, L., (2005). Promotion: Age matters. In G. Costa, W.J.A. Goedhart and J. Ilmarinen (Eds.), International Congress Series (Vol. 1280) Assessment and Promotion of Work Ability, Health and Well-being of Ageing Workers (pp. 403–408). Elsevier: Amsterdam Still, L., and Timms, W., (1998). Career barriers and the older woman manager. Women in Management Review, vol. 13 (4): pp. 43–155 Sutherland, L. F., G. J. Fogarty, and Puthers, (1995). Congruence as a predictor of occupational stress. Journal of Vocational Behavior vol. 46: pp. 292–309 Taylor, P. and Walker, A., (1998). Employers and older workers: Attitudes and employment practices. Ageing and Society, vol. 18 (6): pp. 641–658 The Economist, (2006). The ageing workforce: Turning boomers in boomerangs. The Economist, vol. February 18th: pp. 61, 62 and 64 Tuomi, K, Ilmarinen, J, Klockars, M, Nygard, CH, Seitsamo, J, Huuhtanen, P, and Martikainen, R., (1997). Finnish research project on aging workers in 1981–1992. Scandinavian Journal of Work Environment & Health, vol. 23 (1): pp. 7–11 Tuomi, K., Huuhtanen, P., Nykyri, E., and Ilmarinen, J., (2001). Promotion of work ability, the quality of work and retirement. Occupational Medicine-Oxford, vol. 51 (5): pp. 318–324 Webber, L., Smith, K., and Scott, K., (2006). Age, work ability and plans to leave work. Proceedings (refereed) of the Joint Conference of the Australian Psychological Society & the New Zealand Psychological Society, Auckland, N.Z. (pp. 479–483) September 2006. Australian Psychological Society: Melbourne.

58

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Effect of Japanese employment system on Work Ability Index Masaya Tokuhiro, Hiroyuki Izumi & Jean-Luc Malo Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu, Japan

Naomi Uehara Hitachi Metals Wakamatsu, Ltd, Kitakyushu, Japan

Masaharu Kumashiro Department of Ergonomics, Institute of Industrial Ecological Sciences, University of Occupational and Environmental Health, Kitakyusyu, Japan

ABSTRACT: In the near future, Japanese companies will have to consider enforcing an older retirement age to satisfy their employment needs in light of a decrease in the workforce due to a rapidly aging population and extremely low birth-rates. The Work Ability Index (WAI) is a potential tool to facilitate this change. However, according to our previous preliminary studies, the WAI is influenced by the work environment of Japan, including the permanent employment system and the seniority-based system. This cross-sectional survey was conducted with 499 workers. Results from the WAI questionnaires were compared with results from the effort reward imbalance model, showing the importance of job stability on WAI scores. The WAI scores of Japanese workers are much lower than the European reference values and decrease less steeply with age. Our results suggest the need to analyze the WAI score differently in the Japanese population.

1 INTRODUCTION In the near future, innovative changes will have to be brought to the employment format of the Japanese society, mainly because of a decrease in the workforce caused by a rapidly aging population, one of the lowest birth-rate in the world (1.32 per couple according to the Japanese Ministry of Health, Labour and Welfare, 2006) and the retirement of a large number of baby boomers. In Japanese companies, the burdens of the labour shortage combined with the increasing cost of the social security system have taken their toll. Some solutions have been explored such as encouraging the employment of aged workers as well as an extension of the retirement age from 60 to 65 years old in 2025 (according to the Japanese Ministry of Health, Labour and Welfare, 2006). An increased participation of female workers has been suggested, but factories remain shy in their employment policies. Finally, procedures to integrate foreign labour to Japanese companies exist but remain marginal. Consequently, Japanese companies increasingly have to rely on an aging workforce, thus intensifying the need to develop management solutions to maintain and reemploy older workers. Such methods may include considerations for the effective assignment of elderly workers and appropriate reward based on their work ability. The Work Ability Index (WAI) is an effective method to document the balance between the working environment and the health conditions of the workers. However, results from our preliminary studies suggested that the response pattern of Japanese workers differs from that of Europeans and that adjustments might be required in order to make a correct interpretation of the results gathered 59

using this tool. Three factors are thought to influence results when compared to the European standard. The distinctive Japanese work culture is the first of these. It combines a lifelong employment system (employment is guaranteed until the retirement age as long as the company doesn’t face serious financial drawbacks), a seniority system (salary and rank increase with age and years of service rather than with efficiency or other factors) and the low migration of employees between companies. Other particularities that include dedication to the company and long working hours make up the second factor. As such, while Japanese labour laws limit the maximum amount of over-time, it is common for employees to exceed this amount using their personal time. Finally, Japanese “kenson” similar to the concept of modesty is expected to generate an underestimation of self-reported capacity or ability (Yamaguchi et al., 2007, and Furnham et al., 2002), affecting WAI results. This study aims to clarify the interpretation of the WAI in the light of Japanese culture and employment system. To attain this goal, a cross-sectional survey was conducted with 499 workers from a home electric appliances factory using the WAI and the Effort-Reward Imbalance (ERI) model questionnaire. 1.1 Effort-Reward Imbalance The Effort-Reward Imbalance model by Dr Siegrist (1996), a German sociologist, “posits that effort at work is spent as part of a socially organized exchange process to which society at large contributes in terms of occupational rewards. Rewards are distributed to employees by three transmitter systems: money, esteem and security/career opportunity. The ERI Model claims that lack of reciprocity between ‘cost’ and ‘gains’ may cause a state of emotional distress…” (from de Jonge et al., 2000) The psychometric qualities of the questionnaire were assessed with Japanese workers by Tsutsumi et al. (2001, 2002). 2 METHODS This study was conducted in a medium size steel manufacturing company. In the company, field workers are required to participate in the melting and processing of raw metal to produce different parts (including: pillars for bridges, big components for industrial cutting tool and rollers). The seniority system and the lifelong employment system were implemented before the 1960’s. The survey was distributed by the occupational health physician to supervisors and later distributed to all employees during a period of two weeks in June 2007. The survey included questions about personal characteristics (name, age, length of service, job title, etc.), the short version of the Work Ability Index (Ilmarinen et al., 1996) and the effort-reward imbalance questionnaire (Tsutsumi et al., 2001). Statistical analysis were made using SPSS2. 3 RESULTS 3.1 Participants The 499 respondents (471 men and 28 women) correspond to over 99% of the total work force from the Melting and Processing department of the studied company (biggest department in this company). Of these, 92% performed physical work and 8% performed other administrative or managerial functions. None of the surveyed workers refused participation although the survey was completed on a voluntary basis. Such a high response rate is typical of surveys distributed by occupational health doctors in Japanese companies. It is partially explained by the legal power of the occupational health doctor and the job stability provided by the permanent employment system. The participants’ average age was 43.2 years (SD: 12.5, Median: 40.2) and the average length of service 19.4 years (SD: 13.6, Median: 16.8) for men and 44.9 years (SD: 11.7, Median: 42.3) and 14.2 years (SD: 10.1, Median: 15.0) for women respectively. 60

45

WAI score

35

25

15

5 10

Figure 1. 100%

20

30

40 Age

50

60

70

Distribution of WAI according to the age of the respondents. 0 4.44

0 5.2

0 6.2

0 8.2

12.5 18.4 26.1

46.6

25

52.4

71.9

65.2 71.9

Excellent

51 80.8

80.8

50%

Good

43.9 37.5

Moderate Poor

40.9 41.3 21.7 26.5

30.4

30.6

22.9 6.3

1.6 0

0%

Company Reference value 20–29

Figure 2.

25 11.3

13

11

8.3

1.2

0 Company

Reference value

30–39

Company

Reference value

40–49

Company

Reference value

50–59

Company

Reference value

60–64

Percentage of worker in each WAI score categories in comparison to data from Ilmarinen et al. (1997).

3.2 Work Ability Index results In all age groups, the average WAI scores (30.68) were lower than values from European studies where the averages are almost exclusively contained between 35 and 43 depending on the age group and occupational sector (Costa et al., 2007, and Ilmarinen et al., 1997). Figure 1 shows the WAI score distribution according to the age of the respondents. The linear regression slope shows a soft descent (r = −0.11). European studies have usually gotten steeper regression slopes (r = −0.27, example from Tobia et al., 2005), and higher scores. Figure 2, allows us to appreciate the difference in the WAI score distribution amongst the typical four classifications compared to values reference values by Ilmarinen and collaborators (1997). The absence of results in the “Excellent” group and the very limited percentage in the “Good” 61

Table 1.

Contribution of each Item of the WAI to the total score for the studied population.

Items

Scale

Average (SD)

% of max score lost

1. Subjective estimation of present Work Ability compared with the lifetime best 2. Subjective Work Ability in relation to both physical and mental demands of work 3. Number of diagnosed diseases 4. Subjective estimation of work impairment due to disease 5. Sickness absence during part year 6. Own prognosis of Work Ability after two years 7. Psychological resources

1–10

7.30 (1.90)

27.0

2–10

7.16 (1.60)

28.4

1–7 1–6 1–5 1, 4, 7 1–4

5.53 (1.65) 5.60 (0.83) 4.42 (0.79) 5.56 (1.82) 1.42 (0.48)

21.1 6.6 11.6 20.6 64.5

category leads to two hypothesis. That the population of this particular study is in poor health or that the answering patterns differ due to cultural reasons. We cannot accept the first postulate as a valid explanation to this discrepancy as these low scores are consistent with our ongoing longitudinal study in another larger factory. Furthermore, this study’s population does not show any other symptom of ill health, with the company having a normal productivity, health and safety records, and health check records. The Japanese workforce also tends to remain highly employed until a later age. In 2004, the unemployment rate was of 8.6% for the 15–24 years old; 6.2% for the 25–34; 4.5% for the 55–64; 4.2% for the 35–44; 3.9% for the 45–54 and of only 2.7% for the 65 years old and over according to the Japanese Ministry of Health, Labour and Welfare in a report published in 2005. The second hypothesis where the reason lies in a difference in answering patterns related to cultural characteristics appears more probable. Japanese modesty, or Kenson, might be responsible for these low scores. Cross cultural studies have already reported a tendency of Japanese people to underestimate their self-esteem (Yamaguchi et al., 2007) and personal skills (Furnham et al., 2002; Akimoto et al., 1999). This tendency probably contributed strongly to the low WAI score, but more studies will be needed to clarify how to interpret Japanese WAI scores and to create potential new categories of WAI results. Finally, it is interesting to notice that the highest proportion of Good WAI Score is found in the 60+ group, supporting a possible healthy worker effect as reported in some recent WAI studies. It could alternatively be related to an age related discrepancy in answering patterns. The Table 1 describes the average WAI score divided among its seven items. Item 7, psychological resources, presented low scores (average 1.42 on a 1–4 scale), and a proportionally low standard deviation. This could either be related to specific characteristics of this study’s workplace, but could more probably, be related to Japanese culture. Understanding of this question by Japanese workers should be investigated. 3.3 Results from the Effort-Reward Imbalance model Average results by age groups of the ERI questionnaire are comparable to reference values from (Seigrist et al., 2004) and are coherent to studies with Japanese workers (Tsutsumi et al., 2001, 2002). The Table 2 describes the Correlations between ERI results and WAI categories. Results from the ERI showed few correlations with higher or lower than average WAI scores. The Factor 3 related to job and position stability was the only one presenting significant relationship with the WAI level. In this population, a higher WAI score was linked to stability of job and position. It suggests that even if a Japanese worker suffers from a disease, he maintains a strong motivation and/or desire to remain in the same workplace. This might be taken into account by the employer when managing duties. 62

Table 2.

Correlations between ERI results and WAI categories.

Age ERI score Effort Factor 3 (Job & position stability)

Age 20–44

Age 45-65 WAI below average

Age 45–65 WAI above average

−0.160** −0.159** −0.315** −0.484**

−0.012 −0.190** −0.277** −0.610*

−0.045 −0.210** −0.251** −0.551*

*p < 0.05, **p > 0.01

4 DISCUSSION This research examined results from the WAI questionnaire and the ERI questionnaire in the context of the seniority system, the lifelong employment system, and Japanese cultural characteristics. The WAI results presented in the current study will prove useful for comparative purposes with other Japanese studies, but at this moment there appears to be no calibration method available to compare these results with foreign studies. The Average WAI score shows limited changes according to different age groups (Figure 1 and Figure 2). The older workers did not obtain low WAI scores. Possible explanations include: • Healthy worker effect: unhealthy workers retire prematurely, keeping the average WAI score high. This, however does not seem to be the case for workers under 65 according to preliminary retirement statistics analysis, • Aged workers are in good shape or working in a facilitating environment, • Different answering patterns of older generations: possibly related to cultural differences or beliefs; Therefore, the WAI might not be a sensitive cross-sectional evaluation tool in the Japanese context. The cultural differences in WAI responses suggest that scores and categories cannot be compared directly, stressing the interest of comparing relationships between WAI scores and other factors rather than using WAI scores directly. This is especially problematic since cultural differences can exist even between companies in the same country. Confounding factors could include: local context, company policies and disproportional representation of subgroups such as generation, gender and cultural or ethnic backgrounds. These considerations are not as important during longitudinal or intervention studies as long as the population is relatively stable, between the pretest and post-test evaluation. Therefore, we surmise that the international potential of the WAI index could reside in its ability to evaluate the impact of changes in occupational settings, rather than as a cross-sectional health evaluation tool. However, our hypotheses need to be compared with other types of jobs and employment systems, to study their influence on WAI. Also, better understanding of the effect of modesty on survey responses should be investigated to facilitate the adaptation of foreign questionnaires to the Japanese context. Finally, in order for the discrepancy between real work capacity and reported WAI scores, if there is any, to be documented, objective measurement of a worker’s capacity could be explored to set a gold standard and eventually understand the cultural bias of Japanese culture on WAI. REFERENCES Costa, G., and Sartori, S., (2007). Ageing, working hours and work ability. Ergonomics, 50:11: pp. 1914–1930 de Jonge, J., Bosma, H., Peter, P., and Siegrist, J., (2000). Job Strain, Effort-reward Imbalance and Employee Wellbeing: a Large-scale Cross-sectional study. Social Science & Medecine, 50: pp. 1317–1327

63

Furnham, A., Hosoeb, T., and Li-Ping Tang, T., (2002). Male hubris and female humility? A crosscultural study of ratings of self, parental, and sibling multiple intelligence in America, Britain, and Japan, Intelligence, 30(1): pp. 101–115 Ilmarinen, J., Tuomi, K., and Klockars, M., (1997). Changes in the work ability of active employees over an 11-year period. Scan J Work Environ Health, 23(1): pp. 49–57 Ministry of Health, Labour and Welfare, 2006 Siegrist, J., (1996). Adverse health effects of high-effort/low-reward conditions. Journal of Occupational Health Psychology, 1(1): pp. 27–41 Siegrist, J., Starke, D., Chandola, T., Godin, I., Marmot, M., Niedhammer, I., and Peter, R., (2004). The Measurement of Effort-Reward Imbalance at Work: European Comparisons. Social Science & Medicine, 58: pp. 1483–1499 Tsutsumi, A., Ishitake, T., Peter, R., Siegrist, J., and Matoba, T., (2001). The Japanese version of the EffortReward Imbalance Questionnaire: a study in dental technicians. Work and Stress, 15(1): pp. 86–96 Tsutsumi, A., Kayaba, K., Nagami, M., Miki, A., Kawano,Y., Ohya,Y., Odagiri,Y., and Shimomitsu, T., (2002). The effort-reward imbalance model: experience in Japanese working population. Journal of Occupational Health, 44: pp. 398–407 Yamaguchi, S., Greenwald, A. G., Banaji, M.R., Murrakami, F., Chen, D., and Shiomura, K. et al., (2007). Apparent Universality of Positive Implicite Self-Esteem. Psychological Science, 18(6): pp. 498–500

64

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Study on work ability of Vietnamese workers in selected industries Duong Khanh Van National Institute of Occupational and Environmental Health, Hanoi, Vietnam

Nguyen Ngoc Nga Vietnam Association of Occupational Health, Hanoi, Vietnam

ABSTRACT: Objectives – This study was aimed at adapting the Work Ability Index (WAI) to the Vietnamese setting and to start an investigation of the work ability of Vietnamese workers from different industries and different age groups. Methods – This descriptive cross-sectional study investigated a population of 2,833 Vietnamese workers (1,527 men and 1,306 women) at different ages from five job groups (fishermen, foundry workers, health care workers, pharmaceutical workers, cement factory workers). The Work Ability Index (WAI) questionnaire was used to assess their work ability. The WAI scores were calculated according to instructions provided by the Finnish Institute of Occupational Health. Age, gender and type of industry were taken into account in order to establish their relationship with WAI scores. The data was analyzed with SPSS 13.0. Results – In average, the 20–30 age group scored highest (44 ± 5 in men and 45 ± 4) on the WAI scale. Workers above 41 years old reported significantly lower rates of excellent WAI scores. However, in the age group of 51–60, 53.3% of workers still reported good and excellent scores. We also found that evolution of WAI scores through age was dependant on workers job categories. In this study, throughout their working lives, the WAI score of men decreased by 18% and the WAI score of women decreased by 15%. At the age of 60 years and over, the mean WAI score of men and women were not different. Conclusions – The WAI can be applied for Vietnamese people with only slight modifications. Recommendations were made for further studies and for the application of the WAI in monitoring workers’ health.

1 INTRODUCTION One of the main targets of occupational health services is to maintain and to promote workers’ work ability; therefore it is necessary to possess a valid tool to measure work ability. So far, in Vietnam, PWCmax (Maximum Physical Work Capacity) and PWC170 (Physical Work Capacity at a heart rate of 170) were used in researching physical work. But these indexes are better adapted to laboratory research and smaller samples, rather than to workplaces, and show limits in measuring work ability in technical and mental work. After its introduction in Vietnam by Prof. Kumashiro and Dr. Kurrpa, the WAI was translated into Vietnamese. After a pilot study in 2001, the translation was adjusted for the first large scale work ability investigation study in Vietnam, aiming at studying Vietnamese workers’ work ability in some selected industries. 65

2 METHOD In this descriptive cross-sectional study, the sample was comprised of 2,833 Vietnamese workers (1,527 men and 1,306 women) at different ages from five different industries (agriculture, fishery, foundry, health service, cement manufacture). The WorkAbility Index (WAI) questionnaire was used to assess their work ability. The WAI scores were calculated according to the standard method provided by the Finnish Institute of Occupational Health (Tuomi et al., 1998). Age, gender and type of industry were taken into account in order to establish their relationship with WAI scores. The resulting data was analyzed with SPSS 13.0.

3 RESULTS Table 1 shows the mean WAI score and WAI category of all the studied workers. The mean WAI score in this study was lower than that found by Goedhard (2004). In this study, 42.1% of the workers scored excellent in the WAI. Furthermore, the percentage of workers who scored excellent in this study was lower than that of Goedhard’s research but higher than that of Costa et al. research (2004). 5.8% of the workers had poor WAI score. This rate was much higher than that found in the research on Europeans. Table 2 compares the mean WAI score of workers by gender and age groups. The mean score decreased for men from 44 (in the 21–30 years age group) to 27 (in the 60 years and older age group). In women, it decreased from 45 to 27. In both men and women, the WAI score of the 20 years and younger age group was lower than that of the 21–30 years age group. This could be related to the experience and skills at work.

Table 1. WAI score and category. Parameters Average WAI score WAI category (%)

Excellent Good Moderate Poor

n

Results

2,833 1,193 960 516 164

40.5 ± 7 42.1 33.9 18.2 5.8

Table 2. WAI score of workers by gender and age groups. Men

Women

Age group

n

WAI score

n

WAI score

≤20 21–30 31–40 41–50 51–60 51–55 56–60 >60

35 252 453 486 218 149 69 72

43 ± 5 44 ± 5 42 ± 6 40 ± 7 37 ± 8 37 ± 8 37 ± 7 27 ± 8

31 255 312 475 166 123 43 56

44 ± 4 45 ± 4 42 ± 5 41 ± 6 37 ± 7 38 ± 7 35 ± 7 27 ± 8

66

In Vietnam, the age for retirement is of 60 years old for men and 55 years old for women. In the course of their working life, men’s WAI scores decreased by 18% while the WAI scores of women decreased by only 15%. AS was also reported in some other studies on WAI, we did not find a later increase of WAI score for older workers. At the age of 60 years and older, the mean WAI scores did not differ between men and women. The standard deviation (SD) of the WAI score increased from 5 (in men) and 4 (in women) in the youngest group to 8 (in men) and 7 (in women) in the oldest group. This indicated an increase in individual differences related to aging and work ability. The inter-individual differences of WAI score in women was smaller than in men. Table 3 shows the percentage of workers’ WAI category in different age groups. The rate of workers with excellent and good WAI decreased as they aged, while it was noted that the rate of workers with poor WAI increased, especially after 50 years old. Under 60 years old the rate of women with poor WAI tended to be lower than that of men, but 50% of women aged 60 years and older had poor WAI, while the rate in men was of only 44.5%. Table 4 details the WAI scores of workers in different job groups. The highest WAI score was found in pharmaceutical workers followed by health workers. The fishers and farmers respectively had the lowest WAI score. However, in this study, the population was not distributed evenly among jobs. The number of fishers and farmers involved in this study was greater than that of other jobs, and also the number of elderly workers in fishery and farming was also greater than that of other job categories. This may have somewhat influenced the results. 55 50 45

Men Women

40 35 30 25 20
20

21–30

31–40

41–50

51–60

51–55

56–60

 60

Figure 1. Age trend of WAI score. Table 3. WAI category of workers in different age groups. Excellent

Good

Moderate

Poor

Age group

Men

Women

Men

Women

Men

Women

Men

Women

n ≤20 21–30 31–40 41–50 51–55 55–60 51–60 >60 All age

605 42.9 62.2 48.6 32.3 20.8 20.6 20.7 1.4 39.6

587 64.5 74.2 46.2 39.4 25.4 14.0 22.4 3.6 45.0

542 45.7 27.5 32.8 42.2 36.6 33.8 33.6 8.3 35.5

417 32.3 22.7 37.5 37.3 34.1 23.3 30.9 5.4 32.0

278 11.4 8.4 11.3 19.8 32.2 35.3 33.3 45.8 18.2

238 3.2 2.0 15.4 21.5 32.5 44.2 35.8 41.1 18.2

101 0 2.0 2.0 5.8 13.4 10.3 12.4 44.5 6.6

62 0 1.2 1.0 1.9 8.1 18.6 10.9 50.0 4.8

67

100% 80%

Poor Moderate

60%

Good 40%

Excellent

20% 0%
20

21–30

31–40

41–50

51–55

55–60

51–60

 60

Figure 2. WAI categories of male workers according to age groups. 100% 80%

Poor Moderate

60%

Good 40%

Excellent

20% 0%
20

20–30

31–40

41–50

51–55

55–60

51–60

 60

Figure 3. WAI categories of female workers according to age groups.

Table 4. Average WAI score of aging workers in different jobs. WAI all ages

51–55

55–60

>60

Job

n

X ± SD

n

X ± SD

n

X ± SD

n

X ± SD

Foundry workers Health workers Farmers Cement workers Fishers Mechanicals Pharmaceutical workers Others

108 386 881 182 834 162 199 75

42 ± 6 45 ± 4 38 ± 8 44 ± 3 38 ± 7 42 ± 4 47 ± 3 43 ± 5

3 25 113 3 95 9 20 5

37 ± 6 42 ± 5 36 ± 7 40 ± 11 36 ± 7 40 ± 4 44 ± 3 36 ± 6

– – 44 – 48 – 6 –

– – 34 ± 8 – 36 ± 7 – 43 ± 5 –

6 – 75 – 45 – – –

21 ± 8 – 26 ± 8 – 29 ± 9 – – –

Table 5 shows the WAI category of workers with different jobs. The highest rate of excellent and good WAI was found in pharmaceutical workers, followed by health workers while the lowest scores were found in fishers and farmers. This may be somewhat explained by their working and living conditions. Education and employee selection could also be an explanation for this difference. Farming and fishery were two jobs with low education requirement compared to the other jobs. Farmers and fishermen were usually work free (self-employed) and therefore had fewer chances of having a good health care and health education than the other professions in this list. 68

Table 5. WAI category in different jobs. Job

n

Excellent

Good

Moderate

Poor

Foundry workers Health workers Farmers Cement workers Fishermen Mechanicals Pharmaceutical workers Others

108 386 881 182 834 162 199 75

43.5 75.4 24.7 72.0 25.5 37.7 91.0 62.7

43.5 18.9 39.0 25.8 39.1 56.2 7.5 21.3

8.3 5.2 25.4 1.6 28.2 5.6 1.5 16.0

4.6 0.5 10.8 0.5 7.2 0.6 0 0

Table 6. WAI score and its item. Item

Range

Excellent

Good

Moderate

Poor

1. Present work 2. WA related to WD 3. Disease 4. Impairment 5. Sick absent 6. Prognosis WA 7. Resource

0–10 2–10 1–7 1–6 1–5 1–7 1–4

9±1 9±1 6.6 ± 1 6±1 5±0 7±0 4±1

8±1 7.5 ± 1 6±1 5±1 4±1 6.7 ± 1 3±1

6±1 6±1 5±1 4±1 4±1 5±1 3±1

5±2 4±2 4±1 3±1 2±1 2±1 2±1

The score of all items reduced from excellent WAI group to poor WAI group. We found a strong correlation between self-evaluation of work ability and the final score category. 4 CONCLUSIONS The average work ability index score was different across different occupational sectors, with lower scores for traditional sectors (fishing and farming) and higher scores in more modern work environments (pharmaceutical, health and cement sector). The general age trend of WAI scores is found to decrease with age, with the exception of younger workers (under 20 years old) having slightly lower scores than the 21 to 30 age group. This might raise some concerns, but this difference is probably related to the difficulties associated with learning and the lack of experience. In this study, the men’s WAI score decreased by 18% and by 15% for women when comparing the scores starting from the 21–30 age group to the 60+ age group. Across all age groups, the scores for men and women seemed similar and at the age of 60 years and older, the mean WAI score of men and female was not different The WAI can be applied for Vietnamese people with only slight modifications in wording (which will be discussed in another article). In order to have a better view of WA of Vietnamese workers, further studies with larger population samples and more different industries are needed. The focus might be placed on a more elderly population in informal sectors which accounts for a large proportion of the labour force in Vietnam. Besides, the set-up of a data bank on WAI could prove to be very useful in monitoring workers’ health. REFERENCES Abstracts 10-year activity of the National Institute of Occupational and Environmental Health, Hanoi

69

Costa G, Antonacci G, Olivato D, Bertoldo B, and Ciuffa V., (2004). Ageing and Work Ability Index in Italian workers. Proceedings of the 1st International Symposium on Work Ability. People and Work Research Report 65, Finnish Institute of Occupational Heath, Helsinki: pp. 33–40 Duong Khanh Van, N.N.Nga, L.G. Khai, and T.T. Binh, (1994). Reasearch on changing some physiological parameters of young men and women in experimental physical work. Goedhard WJA., (2004). WAI scores and its different items in relation to age: a study in two industrial companies in the Netherlands. Proceedings of the 1st International Symposium on Work Ability. People and Work Research Report 65, Finnish Institute of Occupational Heath, Helsinki: pp. 26–32 Tuomi K, Ilmarinen J, Jahkola A, Katajarinne L, and Tulkki A., (1998). Work Ability Index. Finnish Institute of Occupational Health, Helsinki, 2nd revised edition.

70

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

WAI among young employees in Brazil with new scores Inês Monteiro Faculty of Medical Sciences, State University of Campinas – UNICAMP, Campinas, Brazil

Juhani Ilmarinen, Kaija Tuomi & Jorma Seitsamo Finnish Institute of Occupational Health. Helsinki, Finland

Eliane P. Goes, Angela Puzzi Fernandes & Eloísa Petruci Hodge Work and Health Research Group, Faculty of Medical Sciences, State University Campinas – UNICAMP, Campinas, Brazil

ABSTRACT: The purpose of this study was to evaluate work ability, using the Work Ability Index – WAI – among young workers employed in different sectors of the economy, using the WAI scores proposed by Kujala et al. A cross-sectional study was conducted of workers under 30 years of age employed is a variety of sectors, and the Tuomi et al. and Kujala et al. criteria for cut-off points were utilized. It is important to consider the new cut-off points for young workers – less than 30 years old in developing countries – to prevent problems in relation to work ability. Keywords: Work Ability Index, young employees, reference values

1 INTRODUCTION In developing countries workers sometimes begin working at an early age in many sectors, such as agriculture and other sectors characterized by physically demanding jobs; and workers in such jobs often have low levels of schooling (less then nine years). The promotion of work ability of young workers, from the time they begin working is very important for the proper maintenance of their health, skills and performance at work until the retirement age in good conditions. The WAI was developed in Finland by Tuomi et al. (1997) based on a study of workers aged 45 to 58 years old. Kujala et al. (2005) proposed, in an article published in 2005, and before that in a presentation at the 2003 ICOH Congress in Iguassu Falls, new criteria for WAI cut-off points for young workers, that included the following categories: poor (7–36 points), moderate (37–40 points), good (41–44 points) and excellent (45–49 points). The criteria proposed by Tuomi et al. (1997) for WAI cut-off points were: poor (7–27 points, moderate (28–36 points), good (37–43 points) and excellent (44–49 points). As reported by Kujala et al. (2005) “for young employees having impaired job performance, however, the use of this reference limit may resulting in an overestimation of work ability”.

2 METHOD The study is a part of a large study about work ability in different sectors in Brazil that was initiated in 2000. 71

A cross-sectional study was carried out in companies from different sectors of the economy, such as like as pharmaceutical industries, an information technology and telecommunication company; poultry industry; wholesale vegetables, fruits and flower market. The data collection was carried out in 2003–2006. The companies are located in two Brazilian States: Paraná, in the south, and São Paulo State, in the southeastern region. A questionnaire with socio-demographic data and the Work Ability Index were applied. The random sample included 1881 young workers. The research was approved by the Ethics Committee of the Faculty of Medical Sciences – State University of Campinas. The criteria suggested by Kujala et al. (2005) in relation to WAI categories cut-off points was used in the Work and Health Research Group, at State University of Campinas – Brazil, for workers who were less then 30 years old, since 2004.

3 RESULTS AND DISCUSSION The male population represented 61.2% of the workers (range from 14 to 29 years old), and the mean age was 23.5 years (SD = 3.4). The majority of workers was single (63.3%), and without children (70.8%). In relation to work demand 54.7% engaged in physically; 24.8% mixed (physically and mentally) and 20.5% mentally demanding work. The WAI scores range from 17–49 points and the average was 42.4 points (SD = 4.5). The distribution categories using Kujala et al. criteria were: poor – 10.1%; moderate – 19.6%; good – 33.0% and excellent – 37.4%. The mean current work ability was 8.5 (SD = 1.5) points. The WAI distribution categories with Tuomi et al. criteria were: poor – 0.5%; moderate – 9.3%; good – 42.7% and excellent – 47.2%. Statistical analysis was performed in SAS 9.1. The figures below shows the WAI values with two different cut-off points (Figures 1 and 2).

WAI – Kujala et al.(2005) criteria Poor Moderate Good Excellent

Figure 1.

Distribution of WAI categories among young workers with Kujala et al. (1997) cut-off points criteria. WAI – Tuomi et al.(1997) criteria Poor Moderate Good Excellent

Figure 2.

Distribution of WAI categories among young workers with Tuomi et al. (1997) cut-off points criteria.

72

4 CONCLUSION In special conditions such as those found in some areas in Brazil, it is important to think about health promotion and prevention at work. Thus the use of the new criteria for WAI cut-off points is important to anticipate problems concerned with work ability of young workers. The results give support to analysis related to workplace health promotion and the importance of instruments that closely measure work ability. Based on the new criteria, 29.7% of the young workers need some sort of measure to restore or improve their work ability. REFERENCES Kujala, V., Remes, J., and Ek, E et al. (2005). Classification of Work Ability Index among young employees. Occupational Medicine, 55: pp. 399–401. Tuomi, K., Ilmarinen, J., and Jahakola, A. et al. (1997). Índice de capacidade para o trabalho. [Work Ability Index]. (Helsinki: Finnish Institute of Occupational Health).

73

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Verifying of the theoretical model of perceived work ability in the field of teaching Veikko Louhevaara University of Kuopio and Finnish Institute of Occupational Health, Kuopio, Finland

Susanna Järvelin Institute of Biomedicine, University of Kuopio, Kuopio, Finland

ABSTRACT: The objective of this study was to assess the work-related and individual predictors of perceived work ability in the field of teaching, and to consider the predictors in the framework of the Work ability house. The subjects were 44 teachers and superiors with the mean age of 50 years. They were compared in age- and gender-matched pairs. Several significant work-related and individual predictors were observed for perceived work ability assessed with the Work Ability Index (WAI). The most novel finding was the incomplete recovery of the subjects with the reduced WAI from stress during sleep. In the near future the main challenge will be to support the work ability, health and wellbeing of older workers by improving ergonomics and individual resources needed at work.

1 INTRODUCTION Work ability is associated with work capacity and work performance. The terms are often quite confusing, and there is no consensus on the definition. Work performance and work capacity mainly reflect individual factors such as a worker’s physical and mental fitness, attitudes and behaviour, and his or her satisfaction and motivation for work (Robertson and Tracy, 1998, and Shephard, 2000). The work ability is characterized by the balance between a worker’s individual resources and demands of the work incorporating environment and work organisation. The principal individual resources include health, capacities, competence and values. The theoretical framework of the work ability can be described as a construction with four floors applying so called Work ability house (Figure 1). In the framework, health and physical, psychological and social capacity are the basic first floor elements of individual work ability. The second floor of the Work ability house reflects professional competence referring to knowledge and skills. The competence has also the dimension for developing own work and acting in different work communities. Values, attitudes and motivation are in the third floor, and they regulate the balance between individual resources and work as well as between work and leisure time. The fourth floor is dedicated to work and its various environmental exposures and psycho-physiological and social load factors. The organization of the work, functioning of the work community and management are multidimensional issues and difficult to conceptualize and evaluate (Ilmarinen, 2006). Ergonomics or occupational ergonomics is close to the concept of work ability because ergonomics can be defined as a multidisciplinary scientific field that is based on physiology, psychology and technical sciences. It considers and develops the interaction between a worker and his or her work. In ergonomics, a worker’s individual capabilities, needs and limitations are compared with respect to the demands of technical and organisational work systems. Ergonomic design and improvements are carried out to accommodate human factors and work demands (Louhevaara, 1999, and Sillanpää, 2007). 75

Society

Family

Close community

Work ability

Values Attitudes

Motivation

Professional competence

Occupational safety

Occupational health care

Work Work conditions Work content and demands Work community and organization Supervisory work and management

Health, functional capacity

Figure 1. The Work ability house (Ilmarinen, 2006).

The Work Ability Index (WAI) is a prevalent method to assess perceived work ability (Ilmarinen et al., 1997, and Tuomi et al., 1998). The WAI is affected by several ergonomics (work-related) and individual factors (Ilmarinen et al., 1997). Recently Hopsu et al. (2005) reported that the reduced WAI and overweight were powerful predictors for the early exit from working life in female professional cleaners during the 12-year follow-up. Physical fitness decreases due to age which is one of the most significant predictors for the WAI (Ilmarinen, 2001, and Robertson and Tracy, 1998). In order to have good results in the promotion of work ability it is important to define all factors affecting work ability in different occupational contexts, especially, when the impact of the age can be controlled. The objective of this study was to assess the work-related and individual predictors of perceived work ability in the field of teaching, and to consider the predictors in the framework of the Work ability house.

2 METHODS 2.1 Subjects The subjects were 44 teachers and superiors (18 men and 26 women). Their mean age was 50 (range 35–63) years. The subjects were compared in pairs derived from two age- and gendermatched groups according to their WAI: the group A having the excellent WAI with the mean of 45.8 (SD = 1.9) points and the group B having the reduced WAI with the mean of 34.7 (SD = 2.0) points. 76

2.2 Questionnaires Perceived work ability was assessed with the WAI which covered the following seven items: (1) Subjective estimation of current work ability compared with lifetime best (0–10 points), (2) Subjective work ability in relation to both physical and mental demands of work (2–10 points), (3) Number of diagnosed diseases (1–7 points), (4) Subjective estimation of work impairment due to diseases (1–6 points), (5) Sickness absenteeism during the past year (1–5 points), (6) Own prognosis of work ability after two years (1, 4 or 7 points), and (7) Psychological resources (enjoying daily tasks, activity and life spirit, optimistic about the future) (1–4 points). The score of the WAI ranges from 7 to 49, and is divided into four categories as follows: poor (7–27 points), moderate (28–36 points), good (37–43 points), and excellent (44–49 points) (Tuomi et al., 1998). Subjective burn-out and work-related stress were assessed with the Bergen Burnout Indicator (BBI) and the Occupational Stress Questionnaire (SQ), respectively (Näätänen et al., 2003, and Elo et al., 1992). Work motivation, professional competence, organizing of the work and functionality of the work community were assessed using a questionnaire items with the scale from 0 to 10, having the endpoints of “totally disagree” and “totally agree”, respectively. The medication, drinking and smoking habits were also inquired by the questionnaire. 2.3 Resting values The resting values of cardiorespiratory system were recorded in a supine position in the laboratory. Heart rate (HR) was recorded using the Suunto Smart Belt equipment (www.suunto.com). Diastolic blood pressure (DBP) and systolic blood pressure (SBP) were measured with the Omron M4 automatic device (www.europe.omron.com). 2.4 Physical capacity The flexibility of the lumbar spine was assessed with the modified Schober test (Gill et al., 1988). The body balance was tested with the functional balance test (Punakallio et al., 1997). Muscle strength of the trunk flexors was measured with the repetitive sit-up test (Pollock and Willmore, 1990). The assessments of the anthropometrics and body composition preceded the tests. The measurements were carried out in the laboratory. The aerobic capacity was assessed with the 2-km walking test (Laukkanen et al., 2000) on an indoor track of 400 m. 2.5 Heart rate and heart rate variability HR and heart rate variability (HRV) were recorded with the Suunto Smart Belt equipment. The 24-hour recording period consisted of a work shift, leisure time and sleep. The subjects were instructed to work in their habitual manner and to maintain their normal leisure activities. The data were analysed using the Wellness Software developed by Firstbeat Technologies Ltd. (www.firstbeattechnologies.com). 2.6 Statistical methods Descriptive statistics included the calculation of frequencies, means, standard deviations and ranges. The group differences were tested with the χ2 test or the t-test with paired samples. The level of significance was set at p < 0.05.

3 RESULTS The perceived BBI and SQ scores of the group A with the excellent WAI were significantly lower than those of the group B with the reduced WAI (p = 0.013 and p = 0.003, respectively). In the 77

Table 1. The questionnaire based results of the study: Bergen Burnout Indicator (BBI), Occupational Stress Questionnaire (SQ), medication and drinking and smoking habits. Group A (n = 22)

Group B (n = 21–22)

n

%

n

BBI No burnout symptoms Mild burnout symptoms Fair burnout symptoms Severe burnout symptoms

19 0 2 1

86 0 9 5

6 6 8 2

27 27 36 9

SQ No stress Fairly little stress Somewhat stress Fairly much stress Very much stress

3 10 6 2 1

14 46 27 9 5

1 4 5 7 5

5 18 23 32 23

Medication No medication Regular medication

17 5

77 23

7 14

32 64

Drinking No drinking Weekly Occasionally

1 7 14

5 32 64

0 12 9

0 56 41

Smoking No smoking Daily Occasionally

20 0 2

91 0 9

19 1 1

86 5 5

%

pa 0.013

0.003

0.001

0.184

0.513

a χ2 -test

Table 2. The results of the questionnaires about work motivation, professional competence, organisation of the work and the functionality of the work community with the scale of 0–10 (m = mean, sd = standard deviation).

Motivation Professional competence Organisation of the work Functionality of the work community a t-test

Group A (n = 22) m ± sd (range)

Group B (n = 22) m ± sd (range)

pa

8.2 ± 1.0 (5.3–9.6) 7.7 ± 1.2 (5.2–9.6) 7.5 ± 1.3 (5.2–9.7) 7.9 ± 1.0 (5.3–9.6)

7.3 ± 1.3 (4.3–9.3) 6.5 ± 1.8 (3.0–9.5) 6.2 ± 2.0 (2.0–8.6) 7.0 ± 1.6 (2.8–9.4)

0.014 0.060 0.036 0.041

with paired samples

group A, 23% of the subjects used medication regularly whereas the corresponding value was 64% for the group B (p = 0.001) (Table 1). The group A had a better motivation to work (p = 0.014) and work organization (p = 0.036) and they were more satisfied with the functionality of the work community (p = 0.041) compared to the group B. There was also a strong trend that the group A perceived to have a better professional competence (p = 0.060) than that of the group B (Table 2). There was a significant difference between the groups in the Body mass index (p = 0.016) and the percentage of fat (p = 0.014). In the variables of physical capacity a significant difference 78

Table 3. The resting values of heart rate (HR), diastolic blood pressure (DBP), systolic blood pressure (SBP), anthropometrics (Body mass index = BMI) as well as the values characterising physical capacity (Lumbar spine mobility = L-spine mobility) in the group A with the excellent WAI and the group B with the reduced WAI (m = mean, sd = standard deviation). Group A

HR (beats/min) DBP (mmHg) SBP (mmHg) BMI (kg/m2 ) Percentage of fat (%) 2-km walking test (index) Sit up (max rep.) L-spine mobility (cm) Functional balance (s) a

Group B

n

m ± sd (range)

n

m ± sd (range)

pa

19 22 22 18 18 15 19 18 18

67 ± 12 (46–89) 88 ± 13 (72–127) 136 ± 21 (116–200) 25.1 ± 3.7 (20.4–34.7) 25.3 ± 6.5 (15–49) 104 ± 11 (81–120) 36 ± 14 (6–50) 6.7 ± 0.9 (4.5–8.0) 16.9 ± 4.5 (11.2–31.6)

19 22 22 18 18 15 19 18 18

74 ± 11 (57–94) 87 ± 11 (69–106) 137 ± 16 (110–166) 28.2 ± 4.7 (22.4–37.3) 30.3 ± 7.9 (17–47) 85 ± 24 (39–119) 28 ± 12 (4–50) 7.1 ± 0.9 (5.8–9.0) 17.5 ± 6.6 (10.4–38.5)

0.102 0.805 0.854 0.016 0.014 0.003 0.048 0.155 0.767

t-test with paired samples

between the groups was detected in the index of the walking test and strength of the trunk flexors (p = 0.003 and p = 0.048, respectively) (Table 3). During sleep the group A with the excellent WAI seemed to recover from stress more completely than the group B with the reduced WAI according to their HRV (p = 0.051). No significant differences were observed between the groups in stress at work or stress during leisure time. The variables with significant differences between the group A and B were observed in all floors of the Work ability house (Figure 2). The variables can be considered relevant predictors of the perceived work ability, and they also supported the validity of the theoretical framework of the Work ability house.

4 DISCUSSION In spite of the small number of the teachers and superiors in this study, several significant both ergonomics i.e., work-related and individual predictors of perceived work ability assessed with the WAI were observed. The incomplete recovery of the teachers and superiors with the reduced WAI from stress during sleep was a novel finding. The increasing demands of work emphasize the need of the adequate recovery because a worker should be productive, creative and innovative in the current 24-hour society. The long-term incomplete recovery may impair health, work ability and wellbeing. Interesting findings were also the significance of overweight and walking capability related to the reduced WAI. Recently the overweight related to the reduced WAI was indicated to be a powerful predictor for the early exit from the working life (Hopsu et al., 2005). Therefore, the importance of the overweight should not be underestimated, because it seems to affect work ability in multiple ways. The promotion of health, work ability and wellbeing should include the information on nutrition and physical activity in all phases of the work career. The present results supported the theoretical framework of work ability i.e., the Work ability house developed and reported by Ilmarinen (2006) although the WAI evaluates perceived individual work ability and focuses on health oriented items. Furthermore, the strict categorization of variables to ergonomics or work-related or individual ones is sometimes difficult regarding, for instance, to professional competence. The workforce is ageing rapidly. In Finland, in the next 15 years approximately 900,000 workers, about 40% of workforce, will exit from the working life (Ilmarinen, 2006). In the near future the main challenge will be to keep older people at work. This requires much effort to promote health, 79

Society Family

Close community Work Ability Index (WAI) Work Organizing of the work (p
0.036) Functionality of the work (p
0.041)

Motivation (p
0.14) Professional competence (p
0.060) Health and functional capacity Medication (p
0.001) 2-km walking test (index) (p
0.003) WSQ (p
0.010) BBI (p
0.013) Fat% (p
0.014) BMI (p
0.016) Muscle strength of trunk flexors (p
0.048) Stress during sleep (p
0.051)

Occupational safety

Occupational health care

Values

Figure 2. The significant predictors of the perceived work ability assessed with the Work ability index (WAI) in the framework of the Work ability house (Ilmarinen, 2006).

work ability and wellbeing by improving ergonomics and individual determinants of the work ability. More studies on work ability and, particularly, on recovery are necessary. REFERENCES Elo, A-L., Leppänen, A., Lindström, K., and Ropponen, T., (1992). Occupational Stress Questionnaire: User’s Instructions, Reviews, Vol. 19. Finnish Institute of Occupational Health, Press of Vammala, Helsinki, Finland. Gill, K., Krag, M.H., Johnson, G.B., Haugh, L.D., and Pope, M.H., (1988). Repeatability of four clinical methods for assessment of lumbar spinal motion. Spine 13(1): pp. 50–53. Hopsu, L., Leppänen, A., Ranta. R., and Louhevaara, V., (2005). Perceived work ability and individual characteristics as predictors for early exit from working life in professional cleaners. In: Costa, G., Goedhard, W.J.A., and Ilmarinen, J. (eds) Proceedings of the 2nd International Symposium on Work Ability. Verona, Italy, pp. 84–88. Ilmarinen, J., Tuomi, K., and Klockars, M., (1997). Changes in the work ability of active employees over an 11-year period. Scan. J. of Work, Environment & Health 23; Suppl 1: pp. 49–57. Ilmarinen, J., (2001). Aging workers. Occupational and Environmental Medicine 58: pp. 546–552. Ilmarinen, J., (2006). Towards a longer worklife. Ageing and the quality of worklife on the European Union. Jyväskylä. Finnish Institute oh Occupational Health. Gummerus, Helsinki, Finland.

80

Laukkanen, R.M., Kukkonen-Harjula, T.K., Oja, P., Pasanen, M.E., and Vuori, I.M., (2000). Prediction of change in maximal aerobic power by the 2-km walk test after walking training in middle-aged adults. International Journal of Sports Medicine 21(2): pp. 113–116. Louhevaara, V., (1999). Participatory ergonomics as a measure for maintaining work ability. In: Ilmarinen, I. and Louhevaara, V. (eds), FinnAge – respect for the aging: Action programme to promote health, work ability and well-being of aging workers in 1990–1996. People and Work. Research reports 26. Finnish Institute of Occupational Health, Helsinki, Finland. Näätänen, P., Aro, A., Matthiesen, S.B., and Salmela-Aro, K., (2003). Bergen burnout indicator 15. Edita, Helsinki. Finland. Pollock, M.L., and Willmore, J.H., (1990). Exercise in health and disease. Evaluation and prescription for prevention and rehabilitation. WB Sauders Co. Philadelphia, USA. Punakallio, A., (2004). Trial-to-trial reproducibility and test-retest stability of two dynamic balance tests among male firefighters. International Journal of Sports Medicine 25: pp. 163–169. Robertson, A. and Tracy, C.S., (1998). Health and productivity of older workers. Scandinavian Journal of Work, Environment & Health 24 (2): pp. 85–97. Shephard, R., (2000). Aging and productivity: some physiological issues. Int. J. of Industrial Ergonomics 25: pp. 535–545. Sillanpää, J., (2007). Electromyography for assessing muscular strain in the workplace. People and Work Research Reports 79. Finnish Institute of Occupational Health, University Press of Tampere, Helsinki, Finland. Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L., and Tulkki, A., (1998). Work ability index. Finnish Institute of Occupational Health, Press of Vammala, Helsinki, Finland. www.europe.omron.com (15 June 2007). www.firstbeattechnologies.com (15 June 2007). www.suunto.com (15 June 2007).

81

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

An assessment of the Work Ability Index (WAI) and its usefulness in predicting and promoting continued work in staff employed by a major UK Charity Tara Reilly, A. Rees & M. Tipton Department of Sport & Exercise Science, Institute of Biomedical & Bio-molecular Sciences, University of Portsmouth, Hampshire, United Kingdom

ABSTRACT: Objective – The aim of this project was to evaluate the work ability index (WAI) through feedback from the users, and compare the WAI score with job satisfaction and retirement intentions. Methods – All questionnaires were completed online by participants (N = 98) employed at the Headquarters of a major national charity in the South of England. Relationships between measured variables were examined by correlation coefficients (P < 0.05). Results – A mean WAI score of 40.6 reflected good workability, though it was noted that workability relating to the mental demands of work was lower than that of physical demands. No significant associations were found between workability and age, level of educational attainment, or occupational task. Employees were asked to rate their job satisfaction, to report a “desirable” retirement age and to estimate ‘likely’ retirement age. The WAI score did not correlate with their responses. The user’s evaluation of the WAI led to the conclusion that the instrument was not too technical, personal, irrelevant or vague. However the participants felt that a measurement of “work stress” should be included in the WAI. Conclusion – A more explicit question on job satisfaction should be incorporated into the WAI for similar working groups. The major factor determining the poor/moderate workability in this cohort was health. The WAI was not able to predict intention to retire in this population. Keywords:

workability, workability index (WAI), occupation, job satisfaction, health, retirement

1 INTRODUCTION “Workability”, as the name suggests, is about the capability of an individual to do work. It is a concept that has already gained favor in Scandinavia and elsewhere in Europe, but to date has not been extensively used or critically evaluated in the UK. Indeed, the only group to use the WAI in the UK and publish in the open literature is the National Health Service (Nachiappan and Harrison, 2005). In the past decade there has been a trend towards a lower average retirement age in the Western world, and this has been shown to result in a higher cost to society in order to support these retirees (Kilbom, 1999). Attempts to prolong working life have included a number of interventions notably a reduction in early retirement benefits, changes in normal retirement age, voluntary delayed retirement, and the introduction of policies to prevent age discrimination in employment (Kilbom, 1999). It has been estimated that 70% of people in the UK retire before reaching the age of 60 (Mein et al., 2000). 83

The changing demographic towards an ageing population, the financial implications of premature exit from the workforce, and the ability and desire to continue working, have provoked the introduction of EU legislation against ageism. Attention is now focused on initiatives which aim to enable and encourage older workers to continue working if they desire. These have included studies into the physiology of ageing, and the socio-economic benefits of extending working life. The present study was concerned with the measurement of workability and in particular, focused on the utility of the questionnaire-based Workability Index (WAI). It has been argued that the WAI may be beneficial as an aid to maintain workability; a tool to inform occupational health care; and a predictor of work-related disability and retirement intention (Tuomi et al., 1998). Thus, the WAI may be a potentially useful tool in the overall assessment of work-related health and performance. The WAI is a questionnaire-based tool designed to present an overall picture of “workability”. The WAI has been defined as “an instrument to be used in occupational health care. It reveals how well a worker is able to perform his or her work” (Tuomi et al., 1998). The authors of the WAI argue that the instrument should be deployed as one of the methods for assessing workability in health examinations and workplace surveys. Ilmarinen et al. (1991) state that the WAI can be used as a tool to determine which workers need the support of occupational health care. They claim that the WAI can predict the threat of disability and retirement, and help in the prescription of appropriate occupational health interventions aimed at extending working life. This in itself suggests that the WAI alone is not sufficient to fully assess workability and that supplementary health and work place surveys must be performed. The aims of the present study were to employ the WAI with a working group and obtain feedback on the Index in order to identify its limitations and strengths. The WAI was also administered simultaneously with a job satisfaction question and questions regarding the intention to retire. The relationship between these measures was examined. It was hypothesized that the WAI was capable of predicting the future work intentions and job satisfaction of current employees working for a major UK Charity.

2 METHODS All participants were volunteers and the protocol received ethical approval from the University of Portsmouth. The WAI was initially piloted with employees in the Department of Sport and Exercise Science at Portsmouth University to determine initial opinions of the questionnaire. The pilot study resulted in the administration of 26 WAI questionnaires distributed as a hard copy and returned in a confidential manner. Of these, 18 were returned (69% response rate). The respondents consisted of 12 academics, four technicians, and two administrative staff. The mean WAI score (46) for this sample was positioned within the good-excellent (40–48) range (Tuomi et al., 1998). Individual structured interviews with respondents in the pilot study were undertaken with the aim of further evaluating the usability of the WAI index. Most individuals expressed concern regarding anonymity with hard copy, paper questionnaires. They felt these may be traceable and therefore could not be totally honest in their responses. Consequently, an online version of the WAI was developed to protect anonymity and to facilitate completion. The finalized e-questionnaire consisted of four elements: informed consent – without this the volunteer could not proceed to the questionnaire; a background to the study – adapted from the workability questionnaire; the WAI questionnaire itself; and an evaluation of the WAI questionnaire. The evaluation component included items designed to determine whether the WAI had overlooked any critical elements of working life. It also included two questions regarding current retirement intentions (Moline, 2005). Finally, there was a question on job satisfaction (Dolbier et al., 2005) “how do you feel about your job as a whole” rated on a 1–7 scale (extremely dissatisfied – extremely satisfied). The second phase of the study was to administer the e-questionnaire version of the WAI to employees working for at the Head Quarters of a major UK Charity based in the South of England. 84

WAI (7 poor–49 excellent)

55

y
0.518x  38.569 R2
0.0259

50 45 40 35 30 25 0

1

2

Extremely Dis-satisfied

3

4

5

Job satisfaction

6

7

8

Extremely satisfied

Figure 1. The relationship between job satisfaction and WAI scores (N = 83).

This company was largely administration based with job roles ranging from operations, funding, communication, technical, finance, corporate, and human resources. The website was available for approximately 400 employees to complete the questionnaires at their discretion between July and September 2006. Employees were informed of the questionnaire website, password and the aim of the project by an “all-staff ” email from the company. Descriptive and correlation statistics were then used in the analyses of the data. Significance was accepted at P < 0.05.

3 RESULTS In total, 122 questionnaires were returned with 98 completed WAI questionnaires (30% response rate). The group (N = 98) produced a mean WAI result of 40.6 and 85% were primarily engaged in mental work. Mean workability in this cohort appears to be low for 50–55 year olds but higher for those aged 55–60 compared to normative data. However, there was no significant relationship between age (19–57 years) and WAI results. There did not appear to be any relationship between role at work or level of educational attainment (secondary-doctorate) and measured work ability index scores. The WAI was also compared with job satisfaction. The relationship between the WAI results and job satisfaction resulted in an R = 0.16, R2 = 0.03 (NS, P = 0.146) (Figure 1). Finally, the study examined the ability of the WAI to predict retirement intentions. In particular, participants were asked when they would ideally like to retire (R = −0.084, NS; P = 0.456) (Figure 2) and when they actually saw themselves retiring in reality (R = 0.183, NS; P = 0.098) (Figure 3). The WAI did not reveal a significant correlation with either of these factors, and thus was not predictive of either desirable or likely age of retirement.

4 DISCUSSION In their recommendations for prolonging a healthy working life, Illmarinen et al. (1991) suggested that work demands should change with age and that workability should be regularly monitored by various mechanisms including the WAI, indicating that the WAI can predict the threat of disability and retirement. For practical application of the WAI, it is important to identify employees with low workability and explore the underlying reasons for these observations. Ideally it would have been attractive to identify these subjects and interview them in order to establish if they are actually functioning poorly at work, and therefore at risk of early exit from work. This opportunity was 85

52 48

WAI (7–49)

44 40 36 32 28 24 20 45–50

50–55

55–60

60–65

65–70

When would you like to retire (years)

Figure 2. The relationship between “when you would like to retire” and WAI scores, demonstrated as (N = 81). The vertical lines shown here represent the boundary for each of the five year categories. 55 50

WAI (7–49)

45 40 35 30 25 20 50–55

55–60

60–65

65–70 75

When do you see your self retiring (years)

Figure 3. The relationship between “when do you see yourself retiring” and WAI scores, demonstrated as NS (N = 83). The vertical lines shown here represent the boundary for each of the five year categories.

precluded by the need to maintain confidentiality. However, to further explore the problems of those with low workability, further analyses were conducted on the data. Individuals with poor/moderate WAI self rated their workability at approximately seven out of 10, which is still reasonably high. Mental resources were also rated high relative to job demands in this group and therefore, and it may be speculated that the major factor in determining workability in this cohort was the reporting of poor health. Self-rated workability accounts for 15% of the variation in the overall scoring (49 points) in the workability index. This indicates that the WAI tends to be disproportionately influenced as a result of perceived workability rather than by more objective measures. These results also suggest that individuals may not be capable of accurately perceiving their WAI score. 86

Workability did not significantly correlate with age, occupational type or level of educational attainment for this working group. The observation that self rated mental workability was lower than physical self-rated workability indicates that those with more physically demanding jobs were better matched, or at least perceived themselves as more capable at performing their daily occupational tasks. However, physical endeavors, as well as monotonous work and repetitive movements, have been shown to increase the risk of early retirement among those below 45 years of age (Kilbom, 1999), and it may therefore be expected that physical jobs result in lower WAI scores. This was not found in this study, although the physicality of the roles in this cohort may not be compatible with those studied elsewhere. Dolbier et al. (2005) measured job satisfaction with the question (“taking everything in to account how do you feel about your job as a whole”) in a cohort (N = 745) of public sector employees working for the Texas Department of Human Services. The jobs assessed were mostly professional (63%) but also included administrative, technical and administrative support, much like the work roles within the present study. The responses obtain from this working group indicated that this population was very satisfied in their work (Figure 1). These results suggest that for these employees, the WAI does not predict job satisfaction and therefore strengthens the argument that perhaps a more explicit question on job satisfaction should be incorporated into the WAI.

5 CONCLUSION The hypothesis that the WAI was capable of predicting the future work intentions of current employees working for a major UK Charity is not supported. The hypothesis that the WAI was a function of job satisfaction was also not supported. This may be unsurprising given that the decision to retire early has been found to be multi-factorial and depends on issues such as employment grade, state of heath, and level of job satisfaction (Mein et al., 2000). Not all of these factors are captured in the WAI. The authors recognise that the cross-sectional nature of this study confers limitations, particularly in relation to generalisation. Notwithstanding these limitations, it is felt that the study provides additional insight in to the utility of the WAI and confirms that the complexities of the concept of workability provides significant methodological and measurement challenges. REFERENCES Dolbier, C., Webster, C., McCalister, K., Mallon, M., and Steinhardt, M., (2005). Reliability and validity of a one-item measure of job satisfaction. American Journal of Health Promotion, 19: pp. 194–198 Ilmarinen, J., Tuomi, K., Eskelinen, L., Nygard, C., Huuhtanen, P., and Klockars, M., (1991). Summary and recommendations of a project involving cross-sectional and follow-up studies on the aging worker in Finnish municipal occupations (1981–1985). Scand Journal of Work Environmental Health, 17(suppl 1): pp. 135–141 Kilbom, A., (1999). Evidence-based programs for the prevention of early exit from work. Experimental Aging Research, 25: pp. 291–199 Mein, G., Martikainen, P., Stansfeld, S., Brunner, E., Fuhrer, R., and Marmot, M., (2000). Predictors of early retirement in British civil servants. Age and Ageing, 29: pp. 529–536 Molinie, A., (2005). Feeling capable of remaining in the same job until retirement. International Congress series on work ability, 1280: pp. 112–117 Nachiappan, N., and Harrison, J., (2005). Work ability among health care workers in the United Kingdom. International Congress series on work ability, 1280: pp. 286–291 Tuomi, K., Ilmarinen, J., Jahkola, A., Katajarinne, L., and Tulkki, A., (1998). Work Ability Index. 2nd revised edition, edited by Rautoja, S and Pietilainen R (Finland, FIOH).

87

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Individual and work related determinants of work ability in white-collar workers T.I.J. van den Berg & S.M. Alavinia Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands

F.J. Bredt & D. Lindeboom Lifeguard, Utrecht, The Netherlands

L.A.M. Elders & A. Burdorf Department of Public Health, Erasmus MC, University Medical Center Rotterdam, The Netherlands

ABSTRACT: Objectives – The purpose of this article is to explore the associations of psychosocial factors at work, life style, and stressful life events on work ability among white-collar workers in commercial services. Methods – A questionnaire was used to assess psychosocial factors at work and stressful life events and in an examination the physical condition was measured among 1,141 workers. Linear regression analysis was conducted on the work ability index score (WAI). Results – Work ability was strongly associated with psychosocial factors at work such as teamwork, stress handling, and self-development and, to a lesser extent, with stressful life events, and lack of physical activity in leisure time. Conclusion – The strong associations between psychosocial factors at work and work ability suggest that in this study population health promotion should address working conditions rather than individual life style factors.

1 INTRODUCTION With the aging of the European work population, the prevalence of work-relevant symptoms and diseases will increase. Therefore, the role of (functional) health in working life becomes more important. Within this framework, the concept of work ability has been developed as an important tool. The work ability concept is based on the assumption that work ability is determined by an individual’s perception of the demands at work and the ability to cope with them. Former research focused mainly on physically demanding occupations. Therefore, it remains unclear whether in mentally demanding jobs the relative importance of personal and work-related factors is similar to their well-known contribution in physically demanding jobs. The purpose of this study is to explore the associations of psychosocial factors at work, stressful life events, and life style on work ability among white-collar workers. 2 METHODS Subjects – In the period between 2003-2007, a total of 2,666 white-collar workers in commercial services were invited for a health examination. Complete data sets were obtained for 1,141 (42.8%) subjects. 89

Table 1.

Results regression analysis: univariate and multivariate effects of individual and work related factors on work ability in commercial services (n = 1,141). WA Univariate model

Individual characteristics Age Male Psychosocial factors at work High teamwork Intermediate teamwork Low teamwork High stress-handling Intermediate stress-handling Low stress-handling High self-development Intermediate self-development Low self-development Stressful life events Low life change score Intermediate life change score High life change score Life style Lack of moderate physical activity Lack of vigorous physical activity Current smoker Problematic alcohol use Physical examination Normal body weight (BMI 65). Here it is obvious that aspects related to work were of great importance. Almost nine out of ten stated that work gave their life meaning, and almost as many said that they liked their work. The social importance of work colleagues was 147

Table 1.

Percentages of respondents giving the three most common reasons for a preference for early exit 30; 31–50; and 51+ for years 2005 and 2007. (N = 7,072 for 2005, and 7,801 for 2007 populations). (The “uncertain” responders are not included in the table). Yes

No

Selected work environment dimensions from “My Opinion”

Year

>30

31–50

51+

>30

31–50

51+

My manager is actively interested in my personal development

2005 2007

66 65

68 71

68 68

26 27

24 22

22 20

Manager’s feedback helps me improving my achievements

2005 2007

50 50

57 63

69 64

39 35

34 27

31 24

I am often feeling work pressure

2005 2007

53 52

40 38

40 40

45 44

58 58

55 55

Work interferes with my private life

2005 2007

70 67

55 57

55 56

27 29

42 38

40 37

I have access to relevant training in my work

2005 2007

73 73

74 76

77 78

23 20

22 19

16 15

My colleagues go out of their way to help each others

2005 2007

88 90

88 89

88 89

11 7

10 8

8 7

My work gives me personal satisfaction

2005 2007

77 78

83 83

86 84

21 35

15 27

12 30

I have no intention to leave Vattenfall

2005 2007

20 23

13 19

8 13

59 57

69 61

79 73

relevant training, and experiencing pressure from work and imbalance between work and family life. Also they reported finding satisfaction in their work to a higher extent than their younger colleagues.

4 CONCLUSIONS Vattenfall implemented their Ageing Workforce Management Program in April 2001 and intensified it with new activities from 2003. Increases in average retirement ages have been observed accordingly, and sick leave rates were lower for the 80-90-100 schedule group than for Vattenfall total. Workers aged 51+ held as positive views on their work, the work environment and their interactions with managers as their younger colleagues. The program was well received by the 174

workforce and was generally accepted by managers. Positive external media support enhanced its direct effects, and the company was declared “Employer of the year” in 2006. However, the program had not fully penetrated the organisation in 2007. Some managers and units found it hard to implement, and a significant portion of managers reported lack of decision latitude for implementing age management strategies. A substantial minority of managers still held negative views on mature workers’ capabilities, and indication of age discrimination practices were reported. The competence transfer has not been accelerated and time may run out as the increase in number of retirements is sharp. 100 managers only have been in the special leadership training for Ageing Workforce Management. Thus the case study inform us that implementing an Age Management program trough a management structure is time consuming and requires several integrated approaches (Ilmarinen, J., and Huuhtanen, P. et al., 1999). After all, leadership is a complex process materialised through several organisational and behavioural channels like: delegation, written procedures, organisational cultures and face-to-face interaction (Yukl, 2006), and a significant force of worker’s self-management (Sims, and Lorenzi, 1992) should be accounted for in retirement decisions. The moderate penetration of the program may be traced back to weaknesses in or inconsistencies between these systems, where one may counteract another. Persistency in program continuation may lead to a better organisational penetration in near future, and the total leadership systems may profit from examinations with regards to the implementation of the Ageing Workforce management Program. At present the program may become an important tool to prolong workforce careers while also contributing to a strong external image for Vattenfall. REFERENCES Furunes, T., Mykletun, R. J., and Solem, P. E., (2006). Age Management in the Public Sector: Managers’ Decision Latitude. (Subm). Furunes, T., Solem, P. E. and Mykletun, R. J., (2007). Age Discrimination as a Barrier to Employment of Older Workers. (Subm). Henkens, K., Remery, C. and Schippers, J., (2005). Recruiting Personnel in a Tight Labour Market: an Analysis of Employers’ Behaviour. International Journal of Manpower, 26(5): pp. 421–433 Ilmarinen, J., Huuhtanen, P. and Louhevaara, V., (1999). Developing and Testing Models and Concepts to Promote Work Ability During Ageing. In: FinnAge - Respect for the Aging: Action Program to Promote Health, Work Ability and Well-being of Aging Workers in 1990-99 edited by Ilmarinen, J. and Louhevaara, V. (Helsinki: Finnish Institute of Occupational Health. People and Work. Research Reports 26), pp. 263–267 Ilmarinen, J. and Louhevaara, V., (1999). FinnAge - Respect for the Aging: Action Program to Promote Health, Work Ability and Well-being of Aging Workers in 1990–96. (Helsinki: Finnish Institute of Occupational Health. People and Work. Research Reports 26). Ilmarinen, J., (2003). Promotion of Work Ability during Aging. In: Aging and Work, edited by Kumashiro, M. (London: Tylor and Francis) pp. 23–35 Ilmarinen, J., (2004). Finnish National Program on Ageing Workers (FINPAW) 1998–2002. Paper presented at the Third International Course on Age Management in the Information Society. Ilmarinen, J., Tuomi, K. and Klockars, M., (1997). Changes in the Work Ability of Active Employees over an 11-year Period. Scandinavian Journal of Work Environment and Health, 23: pp. 49–57 Ilmarinen, J. and Rantanen, J., (1999). Promotion of WorkAbility DuringAging. American Journal of Industrial Medicine, Supplement 1: pp. 21–23 Miles, M. B. and Huberman, M., (1994). Qualitative Data Analysis. (Thousand Oaks: Sages Publications). Mykletun, R.J., Furunes, T., and Solem, P.E., (2006). Extending Senior Workforce Careers: Public Sector Managers’ Beliefs about Adequate Measures. (Subm). Neuman, W. L., (2003). Social Research Methods: Qualitative and Quantitative Approaches. (Boston: Allyn and Bacon). Skoglund, B and Skoglund, C., (2005). Åldersmedvetet ledarskap. Att inte skjuta problemen framfør seg. (Age Management. Face the Problems Now.) (Boden, Sverige: Age Management i Sverige AB (AMSAB)). Sims, H. P. Jr. and Lorenzi, P., (1992). The New Leadership Paradigm. Social Learning and Cognition in Organizations. (Newburry Park, CA: Sage). Yukl, G., (2006). Leadership in Organization. (Upper Saddle River: Pearson Prentice Hall).

175

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Managers’ decision making latitudes in relation to managing ageing workers Trude Furunes & Reidar J. Mykletun Norwegian School of Hotel Management, University of Stavanger, Stavanger, Norway

ABSTRACT: In order to put age management into practice, it is important that managers at all levels are involved. Drawing on three different samples, this study illustrates how manager decision making latitude in regard to age management practise can be defined and measured across samples. The core dimensions identified were access to human and budget resources, possibilities to organise work to meet the demands of ageing workers, and possibilities to unite age management with increasing demands on effectiveness. The decision latitude measure was found to differ with managers’ beliefs about and attitudes towards ageing and older workers, and may also differ in size across organisations. Managers’ age and work ability did not affect their perception of decision latitude.

1 INTRODUCTION Although there has been an increasing focus on age management and work ability in the Nordic countries, results in terms of extended work careers and better possibilities for older workers at the labour market have been slow in coming. For that reason, it is suggested that managers may have difficulties in handling their age management duties. One of the intentions of introducing the age management concept as stated by Ilmarinen (Ilmarinen, 2004), was to empower both white and blue collar workers to reach both personal and corporate goals regardless of their age. This should be done through considering age-related factors in daily management in relation to management styles, task design, work environment, and organization of work. Hence implementing age management may, by and large, be an encompassing managerial task. To better understand managerial challenges with age management, this paper describes and explains which issues managers perceive as limitations to their decision making latitude on age management. Decision making latitude implies the amount of freedom managers have to perform and to change existing practices or modify current structures .(Furunes, Mykletun and Solem, 2007) in order to implement age management within their unit. Similar to this, Meijman and Mulder (1998, pp. 22) describe decision latitude as “the possibility of control which the situation allows”, and their reasoning is seemingly appropriate for age management. For a manager to utilise his or her decision latitude, he or she has to perceive it. The core components identified as defining a manager’s job as well as strongly influencing managerial behaviour are demands, constraints, and choices (i.e. Stewart 1982, in Yukl, 2006). Yukl adds on the three situational determinants pattern of relationships, work pattern, and degree of exposure to decision making and associated consequences. Based on these components and from information contained in relevant management literature, seven different aspects that potentially influence managers’ decision making latitude on age management emerged and were included in the survey. According to Bowditch and Buono (2001) it is important for managers to have the power to influence work procedures including practical possibilities to organise work for older workers (i.e. choice). Further potential prerequisites for contributing to organisational performance through 177

optimal handling of older workers could be availability of adequate budget resources, as well as the availability of human resources (i.e. constraints) (Bowditch and Buono, 2001). Implementing age management might be conceived of as breaking the informal conceptions of organisational justice (Colquitt, Conlon, and Wesson et al., 2001). Along the same lines, Yukl stated that managers often have less freedom of action, here defined as decision latitude, as one goes down through the authority hierarchy. This also implies that lower-level managers have less time, and to a lesser degree are able to allocate resources, as well as make their own decisions. Hence, the fourth potential aspect could be managers’ possibilities to fit age management duties into a work schedule with increasing demands for efficiency within the organisation (i.e. demands). Three additional aspects that according to Yukl could influence managers’ decision latitude are patterns of relationships and communication, here defined as managers’ communication with older workers; support from co-workers for age management issues, as well as employees’ attitudes towards age management. Implementing age management might be conceived of as breaking the informal conceptions of organisational justice (Colquitt et al., 2001). In this study a scale for managers’ perceived decision making latitude on age management was tested and established. In this process it was interesting to explore if managers’ perceptions were equal across samples, or if perceptions would vary from sample to sample. The second aim of this study was to see how managers’ decision latitude differs with manager’s age, work ability, their own beliefs about the role of the employer in relation to preventing early exits and work design for the mature workers, his/her knowledge about relevant work re-design for elderly, and his/her own attitudes to the timing of their own retirement.

2 METHOD The study utilizes three samples of managers, respectively in public sector organizations (n = 672), a public hospital (n = 114) and an energy company (n = 352). Data were collected by use of survey questionnaires, and the response rates were respectively 42.3, 60.3 and 49.1 percent. All participants answered a set of seven items concerning their possibilities to manage their age management program. The seven items were developed from management literature as discussed in the introduction and covered the following issues: (1) possibilities to organise work; (2) available budget resources; (3) available human resources; (4) managers’ possibilities to fit age management duties into a work schedule with increasing demands for efficiency within the organisation, (5) communication with elderly workers, (6) support from co-workers, and (7) employees’ attitudes towards age management. In a factor analysis (Principal Component Factor Analysis, Varimax rotation), four items (listed 1-4 above) loaded on the first factor for all three samples. Internal consistency tested by Cronbach’s Alpha was .69, .78 and .76, correspondingly. For each sample, a sum score variable for ‘decision latitude’ was created, based on these four items. These sum score variables were used as dependent variables in three separate multiple regression analyses. In the regression analyses, the predictors were manager’s beliefs about and attitudes towards older workers and age management, managers’ work ability and manager’s age.

3 RESULTS This study developed a measure for evaluating managers’ decision making latitude on age management duties. Across these three samples, the data showed that four variables load on factor 1 in a Principal Component Factor Analysis, with varimax rotation. The first factor explained 30–34 percent of the variance across these three samples. There were at least two different ways of applying and interpreting these factors. First it was interesting to see how managers’ perception of decision making latitude varied across different samples. Although the same four variables loaded on factor 1 in all three samples, this does not imply that the internal distribution of responses was equal across the samples, as can be seen in the 178

Table 1.

Factor loadings for component 1 for all three samples.

Possibilities to organise work Availability of human resources Availability of budget resources Possibilities to unite age management with increasing demands on efficiency

Table 2.

Energy company

.674 .786 .772 .611

.732 .767 .821 .744

.727 .723 .766 .732

Strongly disagree

Disagree

Agree

Strongly agree

6.7 30.1 34.8 36.4

45.6 49.6 50.8 43.3

38.2 18.3 12.7 18.2

9.5 2.0 1.7 2.1

Frequency levels for public hospital managers (n = 114).

Possibilities to organise work Availability of human resources Availability of budget resources Possibilities to unite age management with increasing demands on efficiency

Table 4.

Public hospital

Frequency levels for public sector managers (n = 672).

Possibilities to organise work Availability of human resources Availability of budget resources Possibilities to unite age management with increasing demands on efficiency

Table 3.

Public sector

Strongly disagree

Disagree

Agree

Strongly agree

10.5 41.4 37.8 39.4

52.8 39.6 46.6 43.1

31.6 15.8 14.2 14.7

4.4 2.6 0.9 2.8

Strongly disagree

Disagree

Agree

Strongly agree

7.8 16.9 17.8 27.0

32.8 39.6 37.6 37.4

45.7 35.8 34.9 27.5

13.1 7.4 9.4 8.1

Frequency levels for energy company managers (n = 352).

Possibilities to organise work Availability of human resources Availability of budget resources Possibilities to unite age management with increasing demands on efficiency

factor loadings and frequency distributions (Tables 1–4). In itself this was an interesting finding, as it illustrated that managers’ decision latitude on age management is perceived differently in different organisations. As displayed in Table 2, public sector managers report that they to some degree have possibilities to organise work for older workers (ca. 48% agree). However, lack of human and budget resources are perceived to constrain managers’ decision latitude. About 20 percent perceive to be in control of demands; the remaining 80 percent disagree in having possibilities to unite age management intentions with increasing demands. 179

Table 5.

Regression analysis for ‘decision latitude’-variable, beta correlation coefficients and significance levels.

Predictors To what extent can the employer prevent early exits I have a good dialogue with elderly workers and know their needs I think it is important to design work to fit older workers I think there is too much focus on age management issues I miss information about how to redesign work for elderly workers Age Work ability To what extent would you prefer early retirement

Public sector

Public hospital

Energy company

.203∗∗∗

.046

.257∗∗∗

.128∗∗

.015

.006

.000

.033

.116∗

.098∗

.322∗∗∗

.161∗∗

−.179∗∗∗

−.187∗

−.261∗∗∗

−.014 −.024 −.093∗

−.043 .111 .066

.020 N/A N/A

* p < .05, ** p < .01, ***p < .001

Among public hospital managers about 36 percent agree that they to some degree have possibilities to organise work for older workers (Table 3). Also here, lack of human and budget resources is perceived to constrain managers’ decision latitude. In this sample only 17 percent perceive to be in control of demands; the remaining 83 percent disagree in having possibilities to unite age management intentions with increasing demands. Although the same variables loaded on the decision making latitude factor for all samples, the frequency pattern was somewhat different for energy company managers than observed in the previous two groups (Table 4). Almost 59 percent report that they have possibilities to organise work for older workers. Respectively, 43 and 45 percent agree that they have adequate budget and human resources, whereas the remaining perceives resources to constrain age management efforts. About 35 percent perceive to be in control of demands; the remaining 65 percent disagree in having possibilities to unite age management tasks with increasing demands. As the second aim of this study was to see how managers’ decision making latitude differed with manager’s age, work ability, and their beliefs and attitudes, multiple regression analyses were applied (Table 5). According to these analyses, managers’ age and work ability did not affect their perception of decision making latitude, as low Beta values and no significant values were observed for these predictors. In the public sector and energy company samples managers’ beliefs in employer’s influence on early exits were significant predictors. Managers who believe that the employer can prevent early exits (i.e. believe in age management intentions) reported to have more decision making latitude. Similar results were found for managers who think there is too much focus on age management, this effect was significant across all samples, but strongest for public hospital managers. Another predictor that was significant illustrated that managers who miss information on how they can redesign work for older workers perceive to have less decision making latitude. In the public sector sample two additional predictors were significant, indicating that managers having a good dialogue with older workers perceive to have more decision making latitude, and managers who would prefer early retirement themselves perceive to have less decision making latitude. In the energy company a significant effect was found for managers who think redesigning for older workers is important, as these managers also perceived to have more decision making latitude. In sum, the analyses showed that managers’ own work ability and age did not predict managers’ perceived decision latitude, however managers’ attitudes towards age management duties to a varying degree did. 180

4 DISCUSSION Managers’ decision making latitude may be of salience to develop work organisations towards more age inclusive practices. The findings of this study support the statements of Stewart (1982, in Yukl, 2006) on leadership being influenced by demands, constraints, and choices. Managers feel that they have limited freedom to act when it comes to adequate adaptation of the workplace to mature workers’ needs. At least seven measurable dimensions restrict managers’decision making latitude on age management, and four of these were consistently integrated across three studies, supporting the proposition of an age management decision making latitude construct. Furthermore, accepting an organisational need and obligation to develop age-inclusive workplaces, owners and boards of work organisations should be concerned about granting managers more choices to organise work and access human and budget resources, and less conflicting demands and fewer constraints in combining unit effectiveness with considerations on individual human capacities (Furunes et al., 2007). Managers’ perception of decision making latitude may vary from one industry to another as a consequence of organisation specific differences in traditions, cultures, type of work, and budgets. Generally the study showed that the energy company selling their products and services on the private market reported larger decision making latitudes on age management, while the public sector and the hospital being publicly owned “budget organisations” have narrower frames for managers in these issues. However, these findings are based on one study with limited sampling and need to be substantiated by future research. Managers’ perception of decision making latitude appears to vary according to their knowledge, attitudes, beliefs and the situational determinants like relationships to elderly workers. This may imply that organisations have to put more effort into raising awareness and educating their managers on ageing and the age management concept as well as influencing their attitudes. Requiring managers to report to their supervisors on age management results would most likely be useful for an adequate use of increased decision making latitude, as managers tend to do what pays off or gives access to rewards. Finally, contextual factors may influence managers’ attitudes and beliefs. Managers’ attitudes towards employing elderly workers have changed from 49 percent being positive in 2004 to 63 percent being in favour of elderly workers in 2006. Lack of labour has been proposed as the main explanatory factor behind this radical change (Dalen, 2007), forcing managers to also employ elderly workers. ACKNOWLEDGEMENT The authors are indebted to Professor Linda Stromei for skilful help with the manuscript. REFERENCES Bowditch, J. L., and Buono, A. F., (2001). A primer on organizational behaviour 5th Edition. (New York: John Wiley & Son, Inc). Colquitt, J. A., Conlon, D. E., Wesson, M. J., Porter, C. O. L. H., and Ng, K.Y., (2001). Justice at the millenium: A meta-analytic review of 25 years of organizational justice research. Journal of Applied Psychology. 86 (3): pp. 425–445 Dalen, E., (2007). Norsk seniorpolitisk barometer: Ledere i arbeidslivet. (Oslo: Synovate/MMI. Report). Furunes, T., Mykletun, R. J., and Solem, P. E., (2007). Age management in the public sector: Managers’ decision making latitude. Submitted for publication. Ilmarinen, J., (2004). Finnish National Program on Ageing Workers (FINPAW) 1998–2002. Paper presented at the Third International Course on Age Management in the Information Society. Meijman, T. F., and Mulder, G., (1998). Psychological Aspects of Worklaod. In Work Psychology. 2nd ed. edited by Drenth, P. J. D., Thierry, H., and Wolff, C. J. D. (East Sussex: Psychology Press). Yukl, G., (2006). Leadership in organizations 6th Edition. (Upper Saddle River: Pearson Prentice Hall).

181

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

The DRUVAN-project: A major increase in Occupational Health Service based on the Metal Age method in a Finnish municipality improved the work ability and gave significant financial return Ove Näsman Dalmed OyAb, Dalsbruk, Finland

Guy Ahonen Department of Management and Organisation, Hanken Business School, Helsinki, Finland

ABSTRACT: Following increases in sick-leaves and early retirements among employees in the small municipality of Dragsfjärd in Finland, it was decided to initiate a health promotion and prevention program. The annual investment in occupational health and safety (OHS) increased from 20 to over 400 Euro/employee. Method: The multidimensional OHS model is a process which continues throughout the whole working life from recruitment to retirement, including health checkups, rehabilitation courses, medical treatment, ergonomics, work place analysis, physical activities and intoxicant programs. The expert advice given by the OHS personnel to the management is an important part of the Druvan project. The development of the work content and work community is based on a systematic use of the Metal Age method for participative planning for increased wellbeing, work ability and total productivity. Results: At the end of the project, there was a significant decrease in sick-leave and fewer early retirements. The Kiva personnel questionnaire showed that, compared with other employees, the employees in the municipality of Dragsfjärd were more satisfied with their situation at work. The work ability index (WAI) developed favourably. In a cohort (N = 67) there was during four years only a 0.13 point decline in the WAI score as opposed to an expected decline of 2. The monetary investment in the project gave a 46% return on investment (ROI). Discussion: The results are very encouraging. The participative approach using the Metal Age method played a crucial role in this. A 20-fold increase in investment in multidimensional OHS is only possible if the organization has a low expenditure in OHS before the increase. Conclusion: The results indicate that a work place health promotion program based on participation and collaboration can significantly increase the wellbeing and work ability among the employees. A major increase in the OHS expenditure can be very profitable.

1 INTRODUCTION Due to an increase in sick leaves and early retirements 1998–2001 among the 190 employees, the council of the small municipality of Dragsfjärd in Finland, decided unanimously on starting a threeyear project (2002–2005), named the DRUVAN project. The annual investment in Occupational Health Service (OHS) increased from 20 to over 400 Euro/employee. The multidimensional OHS model was modified from the local steel industry. 2 METHOD The Druvan model (Druvan = Grape in Swedish) is a multidimensional OHS process (Figure 1), which continues throughout the whole working life from recruitment to retirement including health 183

Municipality of Dragsfjärd 2002–2005 Promotion of Well-Being, Work Ability and Total Productivity

Retirement

Basic tasks of Occupational Health Service

Activities based on age or years of service

• Medical treatment 57–58 years Sundia (10 empl./year)

• Ergonomics • Physical exercise -pause gymnastics, ball games, Nordic walking etc.

↑ Health check-up every 3rd year 50years ↓ Health check-up every 5th year

• Intoxicant programs - Shall we talk? - No-smoking activities - Drugs • Work place investigations

 15–30 years Redirecting resources (Wire-Impuls)

• Statutory health controls

Expert advice for the line organisation • Development of the work community - Metal-Age, 3 groups/year - Special topics - Solution based development - Personnel questionnaire x2/year

 3–15 years

Wireys-course (3 empl./year)

• Development of work contents • Development of vocational skills • Continuous development of leadership • Birthday discussions

Employment health check-up

Employment Figure 1. The Druvan Program.

checkups, rehabilitation courses, medical treatment, ergonomics, work place analysis, physical activities and intoxicant programs. The expert advice given by the OHS personnel to the management is an important part of the Druvan project. The development of the work content and work community is based on a systematic use of the Metal Age method for participatory planning for increased well-being, work ability and total productivity. The Kiva-questionnaire (Kiva = Nice or Fun in Finnish) was used during the project to assess the working climate. The Birthday discussion is a mini development discussion. The supervisor gives a small present to the employee at his/her birthday and they have a cup of coffee together while discussing the employee’s well-being at work. 2.1 Metal age The Metal Age (MA) method for participatory workplace health promotion was developed by Näsman and Ilmarinen (1999). The model is a solution based method which identifies problems at work and turns the problems into opportunities and finally generates positive manageable solutions to them. 184

In the MA process the personnel of the company or organization is divided into groups of 5–20 people, often by departments or people normally working together. Each group has development sessions that take about eight hours in total, followed by a shorter follow-up session usually 3–6 months later. The MA process consists of the following phases: Orientation Identification of development (problem) areas Prioritizing Consensus decision-making about concrete, manageable actions Follow-up In the orientation phase, the workplace is seen as a matrix of problems/opportunities, solutions and results on an individual, work unit and enterprise level. In the identification of development areas, the session participants are encouraged to list all relevant development areas they can think of in order to increase their well-being at work. The prioritizing of initiatives is made using a priority matrix. All participants are asked to rate the importance, prevalence and possibility to influence initiatives on a scale of 1 to 10. A total score is achieved by multiplying the ratings. The development area with the highest score is then taken for a more detailed analysis in order to agree on concrete actions, on the person in charge of them, and on dead lines for their implementation. During the first follow-up session, the achievements concerning the concrete actions of the first development area are discussed one by one. Thereafter, the session participants continue by planning concrete actions for the second development area. During the Druvan-project there were nine Metal Age groups. The first Metal Age planning group consisted of employees at the Central administration working in the same building. This was considered a good way of introducing Metal Age in the municipality as many managers worked in this building. It is always important that the manager knows about methods used in his/her organization or problems may appear when implementing the concrete actions agreed on in the Metal Age planning group. The Nursing home’s second development area “Information, meetings, communication” is presented in Table 1. 2.2 Kiva-questionnaire The Kiva-questionnaire is a short, user-friendly questionnaire with seven standard questions, (Table 2), to evaluate the work climate. The work climate was measured twice a year using the standard formula during the Druvan project. The VOOP program enables an interactive presentation of the Kiva-questionnaire results. When presenting the Kiva-questionnaire results online, it is possible to cross-tabulate all Kiva-questions according to the needs and wishes of the respondents. The Metal Age planning sessions were often started with a presentation of the Kiva-questionnaire. This procedure created engagement to develop, for example, comradeship when the respondents could see how, in their own work community, bad comradeship (Question 4) influenced the answer in Question 1 (Enjoyed coming to work). The same changes appear in Question 1 when the respondents have low score in Question 5 (Leadership). A high score in Question 7 (Influence) usually gives high scores in Question 1.

3 RESULTS All measured indicators showed favorable figures and the general opinion among the employees in the municipality was that the Druvan project was a big success. A questionnaire at the end of the project showed that aging employees in particular had benefited from Druvan. 185

Table 1.

Metal Age, Concrete actions for the Nursing home. Development area 2 “Information, meetings, communication”.

Development area 2: Information, meetings, communication Concrete Actions

Responsible person

Schedule

Modul meetings x 3/year, 1–3 pm – spring, autumn, around New Year – participation “compulsory”

Bettina Petra Lena

W23/2005

Department hour – every week, different day, 2–3 pm – short documentation in a booklet – documentation from the unofficial morning coffee gathering in the same booklet but from the other direction

Dea

W21/2005

Personnel meeting 1.30–2.30 pm – January, March, May, September, November – all the personnel in the nursing home – participation “compulsory”

Eva

Sept. 2005

Development of the reporting technique – during module meetings and department hours

Dea

W21/2005

Hannahemmet, Nursing home 19/5/2005

Table 2. The Kiva-questionnaire. Have you enjoyed coming to work in the last weeks? 1 2 3 4 5 Not at all

6

7

8

9 10 Yes, very much

I regard my job as 1 2 3 Not meaningful at all

4

5

6

7

8

9 10 Very meaningful

I feel in control of my work 1 2 3 Not at all

4

5

6

7

8

9 10 Very much so

I get on with my fellow-workers 1 2 3 4 Not at all

5

6

7

8

9 10 Very well

My immediate superior performs as superior 1 2 3 4 5 Very poorly

6

7

8

9 10 Very well

How certain are you that you will keep your job with this employer? 1 2 3 4 5 6 7 Not certain at all

8

9 10 Very certain

How much can you influence factors concerning your job? 1 2 3 4 5 6 Not at all

8

9 10 Very much

7

3.1 Work Ability Index (WAI) The WAI (Ilmarinen et al., 1997, Ilmarinen and Tuomi, 2004) was completed by 67 persons before (2001) and after (2005) the Druvan project. The expected decline in WAI during four years among 186

8.1 8 7.9 7.8 7.7 7.6 7.5 2002

2003

2004

2005

2006

Ref.4000

Figure 2. The development of the average score of the seven Kiva-questions. The reference score is from 4,000 respondents from different work places.

municipality workers with mean age over 40 years is of about 2.4. The decline during the Druvan project was of only 0.13 in the above cohort. The WAI-cohort study will be completed in 2008. Correlations between different Druvan activities and the WAI-development are being studied. These activities are physical activities, workload, sick leaves, development discussions, gymnastics pauses, ergonomics, weight control, tobacco, visits to the OHS unit, rehabilitation courses, health check-ups etc.

3.2 Kiva-questionnaire The work climate measured by the average of the seven Kiva-questions was already initially at a good level compared with a reference material that compiled results from 4,000 respondents from different work places (Figure 2). The total average scores showed a slight u-formed curve for the measured years. The first measurement was done half a year after the start of the Druvan project, so no baseline measurement exists. The high first measurement may be due to a Hawthorne effect (Roethlisberger and Dickson, 1939).

3.3 Sickness absence There was a dramatic decrease in sickness absence. Dragsfjärd had a much higher sick leave rate than the average Finnish municipality before the Druvan project. After the project, the situation was the opposite (Figure 3). The comparison between Dragsfjärd and all Finnish municipalities shows that, in reality, the development is even better than that seen in Figure 2. The numbers from Dragsfjärd are real numbers whereas numbers from other Finnish municipalities are taken from annual interviews. Weekends and days off are also excluded from the results for the numbers for all Finnish municipalities. If this were also calculated using Dragsfjärd’s sickness absence, the numbers would decrease by more than 20%.

3.4 Retirements The retirements are few because there were only 190 employees. However, the trend since the start of the Druvan project has moved from disability pensions to old age pensions (Table 3). 187

18,0 16,0 14,0 12,0 10,0

Dragsfjärd Finland

8,0 6,0 4,0 2,0 0,0 2001

Figure 3.

Table 3.

2002

2003

2004

2005

2006

Sick leave days/employee in Dragsfjärd and in all Finnish municipalities.

Old age and disability pensions in Dragsfjärd 2001–2006.

Old age pension Disability pension Partial disabilty pension

2001

2002

2003

2004

2005

2006

2 2 0

1 1 1

1 2 2

4 1 0

3 1 0

0 1 1

3.5 Economic analysis A Cost-Benefit Analysis (Ahonen et al., 2002) was made using the Potential Model (Miljodata, 2002). The analysis shows that there was a 46% annual return on investment (ROI) as a result of the project. The labor cost of efficient working hours before the intervention was calculated with this model. This unit value and direct monetary savings were used for calculating the total economic benefit of the intervention, which was compared with the direct monetary investment to calculate the financial return on investment (ROI) of the project.

4 DISCUSSION The results were very encouraging. The multidimensional Druvan model made it possible for almost every employee to participate in something he or she benefited from personally which is crucial in creating engagement. This was the main reason for Druvan becoming “Our Project” among the municipality workers. The participatory approach using the Metal Age method and the Kiva-questionnaire were very important in this aspect. It is difficult to engage employees in a project focusing on decreased sickness absence and longer working life. It is much wiser to use the positive marketing approach of the project as being a project aimed at increasing wellbeing. None can oppose such a project and the outcome still remains decreased sick leaves and longer working life. The collaboration and participation of many external experts from different fields gave important advice to the local actors and lent authority to the project. The economic analysis could not have been made without external expertise. 188

A 20-fold increase in investment in multidimensional OHS is possible only if the organization has a low expenditure in OHS before the increase. The Druvan project ended in 2005 but the municipality has decided, due to the good results, to continue with multidimensional OHS in the same manner as during the Druvan project. The project activities have since become normal procedure. In conclusion, the results indicate that a work place health promotion program based on participation and collaboration can be very successful as measured with wellbeing, work ability and monetary units and may lead to a new, lasting way of maintaining and developing the wellbeing of the employees and the whole organization. REFERENCES Ahonen, G., Bjurström, L-M., and Hussi, T., (2002). Economic Effectiveness of Maintenance an Promotion of Work Ability in Peltomäki et al. (Eds.): Maintenance of Work Ability Research and Assessment: Summaries. Ministry of Social Affairs and Health, FIOH, Social Insurance Institution, Report No 7: pp. 33–44, Helsinki Ahonen, G., and Näsman, O. The Economic Consequences of Multidimensional Development of Human Capital by Using the Metal Age Method in a Finnish Municipality. Melbourne: Monash University, Melbourne 2007. Paper presented at The Eighth International Research Conference on Quality, Innovation and Knowledge Management, New Delhi, India 12–14 February 2007 Ilmarinen, J., and Tuomi, K., (2004). Past, present and future of work ability. People and Work Research reports, 65: pp. 1–25 Ilmarinen, J., Tuomi, K., and Klockars, M., (1997). Changes in the work ability of active employees over an 11-year period. Scandinavian Journal of Work Environmental Health, Vol. 23 suppl 1: pp. 49–57 Miljodata, (2002): The Productivity model. A computer based model to calculate the business economic effects of work environmental investments. www.miljodata.se Näsman, O., and Ahonen, G. The DRUVAN-project: Participatory development of wellbeing, work and productivity by using the Metal Age method in a Finnish municipality. 39th Nordic Ergonomics Society Congress. CD. October 2007. Lysekil, Sweden Näsman, O., and Ilmarinen, J. Metal-Age: A process for improving well-being and total productivity. Experimental Aging Research Vol 25, Number 4, USA Roethlisberger, F., William, J., and Dickson, W.J., (1999). Management and the Worker. In: The Early Sociology of Management and Organization, Ed. Thompson, K., Routledge (UK) 1939.

189

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

A study on effects of support systems for KAIZEN in casting production of non-ferrous alloy by aged foundry workers Yuki Mizuno & Nobuyuki Motegi Institute for Science of Labour, Kanagawa, Japan Musashino University, Tokyo, Japan

Miyuki Sugiura Juntendo University Graduate School, Chiba, Japan

Fumiko Matsuda Institute for Science of Labour, Kanagawa, Japan Musashino University, Tokyo, Japan

Toru Yoshikawa & Kazuhiro Sakai The Institute for Science of Labour, Kanagawa, Japan

Tetsuo Misawa Chiba Institute of Technology, Chiba, Japan

ABSTRACT: This study evaluated the effects of work environment improvements on aged workers by applying the KAIZEN method. It was based on a field study conducted at a foundry in Japan. Using the viewpoint of Ergonomics we investigated the work loads involved in the operation of smelting machines, which provide a key part of the casting production process. Based on our findings, we developed support systems to reduce the work loads. We found that workers complained of high fatigue of their eyes and feet. Because there were fumes created by the burning of heavy fuel oil, workers complained of pains in their eyes and throats. Following the principles of the KAIZEN method, support systems were developed that reduced heavy life work and created work environments in which it was easy to perform work. Because changes were made in the fuel, changing from heavy fuel oil to gas, the amount of exhaust gas decreased. In addition, the pain in workers’ eyes and throats was reduced. Moreover, a new gas furnace that managed the ignition and fire power adjustment collectively by using a control panel was introduced. Operations such as ignition and temperature control have needed expert skills so far, but these aims can now be achieved and all workers can easily carry out their work by using the control panel of the new gas furnace.

1 INTRODUCTION This study aimed at evaluating effects of work environment improvements for aged workers by applying the KAIZEN method. It was based on a field study in a foundry in Japan. It is known that the physiological stress is high in the work environment of the casting production line in a foundry because of the high temperatures and heavy lifting work. In particular, foundry workers easily develop chronic fatigue. Aged foundry workers over fifty-five years old constitute 80% of the total, and many aged workers choose early retirements. There is now a problem that young workers can’t smoothly acquire the skills of the aged workers. 191

Working processes include “preparation of materials”, “checking of fuel”, “igniting a furnace”, “controlling the temperature of a furnace”, “throwing materials into a furnace” and “taking out smelted materials to a sand form”. The work of controlling the temperature requires high skill and often relies on aged workers who have become skilled. Because the fireplace is on the 2nd floor, workers must carry heavy materials by hand from the 1st floor. Therefore, throwing materials into the fireplace is a job which places a heavy responsibility on aged workers. In this study, using the viewpoint of Ergonomics, we investigated the work loads in smelting work using machines which provide a key part of the casting production process. Then, we developed the support systems to reduce work loads.

2 METHOD 2.1 Work involved The working process includes “preparation of materials”, “checking of fuel”, “igniting a furnace”, “controlling the temperature of a furnace”, “throwing materials into a furnace” and “taking out smelted materials to a sand form”. 2.2 Investigation items 1) Time Study The subject was a worker (1 aged worker). We observed the working process of casting products on a working day. Work operation and work place were recorded each second. 2) Investigation by questionnaires Subjects were four workers (1 young, 3 aged workers). They were also asked to fill in a survey sheet of Subjective Fatigue Symptoms and one of Tired Body Parts four times in a working day. The statistical testing examined the significance level by using t-test.

3 RESULTS AND DISCUSSION 3.1 Results of existing condition investigation 1) Time Study The works of controlling the temperature and the ignition required high skills, so aged workers who had become skilled performed this work. In addition, the workers had to take a halfcrouching position during their work many times, so there were high work loads (Fig. 3). Because the furnace was on the 2nd floor, aged workers carried weighty materials by hand from the 1st floor. They performed a lot of movements. 2) Investigation by questionnaires Workers complained of blurred vision, flickering and strain on their eyes caused by fumes resulting from the burning of crude petroleum. They also complained of lassitude, such as backache and fatigue of their feet, because of the wide range of movements required (Fig. 1). 3.2 Design and development of support system 1) Indicators of System Design As part of the KAIZEN method, support systems were developed that reduced heavy life work and created work environments in which it was easy to perform work. The conditions for system design are shown below. #1. Making the work environment easier: Because there were fumes created by the burning of heavy fuel oil, workers complained of pains in their eyes and throats. 192

100% 75% 50% 25% 0% 8:00 12:00 12:50 17:00

8:00 12:00 12:50 17:00

Aged subject A

Drowsiness

Aged subject B

Unbalance

Indisposition

8:00 12:00 12:50 17:00

Aged subject C

Lassitude of body

Figure 1.

Subjective fatigue symptoms; existing works.

Figure 2.

Controlling the temperature (left: existing work, right: new systems).

8:00 12:00 12:50 17:00

Young subject D

Blurred vision

#2. Reduction of the worker’s physiological load: Workers assumed a half- crouching position when controlling the temperature and the work posture involved bending the head forward. #3. Batch processing in igniting the furnace and fire power adjustment: There were a lot of movements because in the ignition and fire power adjustment air was controlled in the 1st floor, and fuel on the 2nd floor. 2) Development of Support Systems Trial systems were developed with workers, managers and researchers. On the basis of the above described requirements, new support systems were developed as follows. #1. Change to gas fuel: The amount of exhaust gas was decreased in burning because the fuel was changed from t heavy fuel oil to gas. #2. New control panel (Fig. 2): A new gas furnace managed the ignition and fire power adjustment collectively by means of a control panel. The working position was changed from a half-crouching to standing position. The color of the display was changed so as to avoid improper operation, and an operating manual was placed on the panel. #3. Use of new bucket: It became possible to carry materials weighing up to 500 kg at once with a new bucket, and carrying by hand was decreased.

3.3 Reduction of work loads by support systems By using new systems, work which had required high physiological loads and difficult movements decreased and the complaints of subjective symptoms decreased sharply (Fig. 3, 4). Especially, the pains in worker’s eyes and throats were reduced (p < 0.01) and they were able to work in a healthy and safe environment. 193

Working hours Number of working times 0

10

20

30

0 500 1000 1500 2000 2500 40

Carrying and placing materials

Carrying and placing materials

Ignition a furnace

Ignition a furnace

Controlling temperature

Controlling temperature

Remove used stairs

Figure 3.

3000 sec

Existing works

New systems

Number of working times and working hours.

100% 75% 50% 25% 0% 8:00 12:00 12:50 17:00 Aged subject A

Drowsiness

Figure 4.

8:00 12:00 12:50 17:00

8:00 12:00 12:50 17:00

Aged subject B

Unbalance

Aged subject C

Indisposition

Lassitude of body

8:00 12:00 12:50 17:00 Young subject D

Blurred vision

Subjective fatigue symptoms; new system.

4 CONCLUSION In this study from the viewpoint of Ergonomics we investigated the work loads involved in smelting work using machines which perform a key part in the casting production process. Based on our findings we developed a support system to reduce work loads. As part of the KAIZEN method, support systems were developed that reduced heavy life work and created work environments in which it was easy to perform work. Because the fuel was changed from heavy fuel oil to gas, the amount of exhaust gas decreased. In addition, the pains in worker’s eyes and throats were reduced. Moreover, a new gas furnace that managed the ignition and fire power adjustment collectively by means of a control panel was introduced. Works such as ignition and temperature control which formerly needed expert skills can now be easily performed by all workers by using the control panel of the new gas furnace. Additionally, they can look forward to an expansion of job categories among workers in the middle and advanced age groups. REFERENCES Mizuno Y, Matsuda F, Yamada Y, & Misawa T. (2004), The Case Study of the Participative KAIZEN by Employees and Researchers. The Japanese Journal of Ergonomics, Vol. 40, Supplement, pp. 210–211. Mizuno Y, Toriizuka T, Misawa T, & Horie Y. (2006), Case Study on the Development of High Usability Equipment and the Work Improvement, Proceedings of the XVIth Triennial Congress of the International Ergonomics Association, CD-ROM. Motegi N, Mizuno Y, Sugiura M, & Misawa T. (2007), Investigative Study of Workload in the Non-Ferrous Metal Casting Manufacture. The Japanese Journal of Ergonomics, Vol. 43, Supplement, pp. 148–149.

194

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Discovering the treasure: The use of the Work Ability Concept and the WAI in a bus company within a workplace health promotion process Jürgen Tempel & Jutta Schramm Occupational Health Practice, Verkehrsbetriebe Hamburg Holstein AG – Pinneberger Verkehrsgesellschaft mbH Corporation (VHH PVG Corporation), Hamburg, Germany

ABSTRACT: Bus drivers generally like their work and try to avoid premature disability. With increasing age they are involved in a decreasing number of traffic accidents, whether they are responsible or not. There is a win-win situation for both the staff and the company in promoting and maintaining work ability. Since 2002, the company doctors of the VHH PVG Corporation (a regional public transportation company in Northern Germany) have established the use of the Work Ability Concept (WAC) and the Work Ability Index (WAI) within the existing work place health promotion process. According to the WAI-results, a “treasure” was discovered. There exists a successful balance of “good work quality and productivity” and “good quality of life and wellbeing”. But a more detailed and complex view of the results based on the WAC components and all data and experiences available reveals a certain instability for the future: The ageing staff will not be able to cope with growing work demands. To maintain the existing state of work ability and to ensure the future success of the enterprise there are three major tasks ahead: Continuation of the appreciative exchange of experience and integration of the new style of leadership into the company climate. Analysing the services and successfully implementing a structure of driving time and breaks that is supportive for the drivers. And reducing the overwork to decrease the risk of premature invalidity with increasing age. Both the WAC and the use of the WAI have proven to be helpful to rise to future challenges.

1 SALUTOGENIC ASPECTS OF WORK Bus drivers generally like their work and are particularly afraid of premature disability. A lot of them are “communicators” and they enjoy the contact with passengers, especially when they get older and have gained supportive professional experience. Many are proud of their good driving style: they easily manoeuvre a big bus in narrow streets, arrive without delay, and are not involved in accidents or minor damages. Others appreciate their autonomy and decision latitude (Karasek and Theorell, 1990): “when I’m on the bus, I’m the boss!” (Geißler-Gruber and Geißler, 2000). Recent research within the VHH PVG Corporation (a regional public transportation company in Northern Germany) and others has focussed on learning from workers who manage to maintain a good state of health and work ability or from those who have successfully recovered from diseases or other restrictions of their work potential (Geißler-Gruber and Geißler, 2000). With increasing age, bus drivers have a decreasing number of traffic accidents, whether they are responsible for them or not (Ell, 1995). This may help explain why 74% of the participants in our study wanted to continue working until retirement age, while only 14% were uncertain and 12% unwilling (N = 132). A win-win situation can be created for both the staff and the company if a mutual interest exists in work place health promotion and a low rate of premature disability. Nevertheless, from 1987 to 2005, 127 employees of the “Verkehrsbetriebe Hamburg-Holstein AG” had to leave work because 195

of invalidity. Their average age was 56 years. The company therefore required an analysis of the actual potential of its staff, so as to define the optimal balance between – growing – demands of the job and the quality of life and well-being of its employees. 1.1 Workplace health promotion and work ability concept In 2001 the VHH PVG corporation started a process based on the above-mentioned studies of Geißler-Gruber and Geißler. The crucial change in paradigm was to avoid a discussion about absenteeism in the company, but rather to learn systematically from those who successfully stayed at work. The defined aims of the process are as follows: • • • • • • • •

Raising responsibility for health among staff and management. Increasing health potential at the workplace so as to decrease the cost of illness. Considering employee health as an advantage in competition with other companies. Achieving a perception of support for their health by the company among at least 80% of the employees. Achieving measurable effects and evaluating results of installed measures. Organising the demands of the job so as to improve the individual’s situation while accounting for the company’s competitive needs. Requiring employees to participate in the process. Reducing the number of sick days to a certain amount.

Within this context, the company doctors began in 2002 to use the scientifically and practically proven model of the Work Ability Concept (Ilmarinen, 1999) to organise and evaluate the change process, to gain valid data using the Work Ability Index (WAI) for cross-sectional as well as longitudinal assessment (Hasselhorn and Freude, 2007), and to develop the so-called “WAI dialogue”. The seven items of the WAI are helpful in creating an employee-centred discussion about what a person is going to do, what the company could do and how the company doctor can support this process (Tempel, 2004). The basic concept is illustrated by the following scheme: 1.1.1 Conditions The corporation had started its workplace health promotion program after a period of restructuring, dismissals, premature retirements and reduction of staff – a development which eventually led to the company’s economic stabilisation. There was also a growing gap between the intentions of senior management and the somewhat risk-centred interest of the previous company doctors. So we found the doors wide open for our program when we started. Management as well as the workers’ committee accepted the use of the WAI and eventually began to show interested in the Work Ability Concept as an explanatory model and practical tool. Since 2002 we have gathered data from 663 WAI-questionnaires, more than half of which stem from a WAI-dialogue.1 Every five years bus drivers are required to pass a medical assessment, which presented a natural fix point for our work. Other employees come to see us because of personal problems or other occupational assessments. Participation in the program is strictly voluntary, and until 2006 we did not link the data to the person assessed. We were just trying to develop a sufficiently valid cross-sectional WAI – epidemiology as the first step, and this decision proved to be very helpful: Bus drivers are forced by law to consult us and to pass the examination. Therefore it took two to three years until they started to trust in our balancing of the obligatory check-up and the support we were offering within the health promotion process. Another important point was to win over the company’s leadership (supervisors, station managers) for the use of the questionnaire, because this would essentially benchmark them against others, which requires their consent. Both

1 Occupational Health Service of the VHH PVG Corporation – Dr. med. Jutta Schramm, Dr. med. Jürgen Tempel (VHH), Dr. med. Peter Schmidt-Wiederkehr (PVG)

196

parts needed and took the time to observe how we carried out the interviews, how we handled the data we generated, and how we organized feed back within the enterprise. Today we follow a rather strict separation: first we administer the driving license examination, fill in the papers, and hand them over to the person being assessed. Then we ask them to participate in the health promotion-interview. Since 2006, with the consent of the employee, we have been able to add WAI-index, category, and results of the different items to personal health records. We ask the interviewees to create a password, which helps us with the follow ups (generating longitudinal data). Since 2002, less then ten persons have declined to join the interviews and there where no complaints about the use of the questionnaire. We need 20 to 30 additional minutes to do this work in a friendly and open minded manner. The company agrees to these proceedings and pays us for the extra time we require. 1.1.2 Work demands and facts Riding the bus is one of the safest means of transportation one can choose (Vorndran, 2006, pp. 17). In the VHH PVG Corporation you will find 1750 employees, about 1300 of whom are bus drivers and 12% are women. They perform irregular day-time work amounting to more than 40 hours a week, depending on public demand and possibilities of organising shift schedules that are based on scientific standards are reduced. 90.7 million passengers are transported annually in 600 busses. Work demands involve mostly local and commuter traffic with 159 bus routes, but also long distance driving and shuttle and substitute service on special occasions. There is a growing need for drivers, which effectively leads to overtime work among existing drivers and difficulties in compensating these hours by granting spare time as is customary. The employees’ average age is 46 years, 42 years among women and 46.6 among men. Split by occupations, bus drivers are on average 46 years old, office staff 42 years, repair workers 45 years, cleaning personnel 47 years, and we find about 150 temporary workers with an average age of 53 years. Most of these are retired bus drivers who wish to continue working, either to support their company or for financial reasons. These figures also show that there is no tendency towards “age discrimination” within the company. On the contrary, maintaining their ageing workforce is a decisive part of the VHH PVG Corporation’s strategy to cope with the lack of employees and to ensure regular service hours. Within the next 15 years 37% of the drivers will reach their regular pension age and about 30 drivers per year will retire. So every driver who must leave work prematurely because of invalidity is one too many, a fact that is well known among the company’s leadership. The local public administration exerts increasing economic pressure: They demand to receive the same service at lower cost or less service at lower cost, transferring the resulting problems to VHH PVG passengers, drivers and the company as a whole. Since July 2007, a bus driver starts working for 1.830 a gross monthly income, advancing towards the limit of 2.030 a over the course of 13 years. From the very beginning, overtime is required, which may be only a minor problem for younger drivers, but can lead into a vicious circle for the aging driver: recovery of health instead of additional pay, and modest but satisfactory living standards are both important components of what we call “quality of life” and “well-being”. Finally, there is a shortage of bus drivers in neighbouring European countries such as Denmark. It is reported that there are better working conditions and higher wages to be had there, and the first VHH PVG drivers have already set off to raise their fortunes. At the same time, former employers try to lure back into their industries drivers who were once mechanics, construction or automotive workers. 1.1.3 Tools Following the stress-strain concept (Wakula, 2007), the work ability index (WAI) (Tuomi, and Ilmarinen et al., 1998) generates data on strain, defined as the individual or collective reaction or coping strategy devised in the face of a certain work demand (stress). This concept has been developed by Rohmert, Rutenfranz, Ulich and others since the 1960s. The surrounding debate 197

Work and Work Conditions (ergonomics, occupational hygiene, occupational safety) • Organization of work • Work spaces and tools • Work postures and movements • Physical load

Employee (resources, health) • Functional capacity • Physical activities and other lifestyle factors • Self-inititative

Work Ability Maintenance

Work Community (management, interaction) • Work organization • Age management • Work arrangements • Schedules

Professional Skills (competence) • Learning • Versatile skills • New technology

Good work ability and health

Good work quality and productivity

Good quality of life and well-being Active and meaningful retirement ‘‘third age’’

Figure 1. Basic model for work ability and its influence in enterprises and work organisation (Ilmarinen, 2006).

continued between Rutenfranz and Ilmarinen and finally had an important influence on the origins of the work ability concept and the related questionnaire. The WAI’s index points or categories measure and describe the balance between these demands and the coping potential of the individual, but higher or lower point scores cannot explain what is going well or wrong. To do this we must gather further information about “work and work conditions”, “professional skills” and the “work community” (Figure 1, chapter 1.2), so as to learn more about the stress, or rather the resources the enterprise creates by means of work-organisation. The WAI has been combined with a number of questions used in the PIZA- project (Frevel, and Geißler-Gruber et al., 2006) and the ABI-NRW-project (Tempel, and Giesert et al., 2005), together with basic facts about the work of the drivers. Apart from this WAI-assessment in 2002, 2005 and 2007, the entire VHH PVG staff was asked what they think about the ongoing work place health promotion process. This data provided an additional view of the company climate, the opportunities for participation open to employees, and their relationship with the company’s management. The results will be presented in the following chapters. In 2006, after four years of experience with the VHH, we occupational physicians asked the staff about their satisfaction with the medical assessment. 198

Mean WAI-index (points)

50

Excellent Good

40

Moderate

30

20

10

Poor R-Quadrat linear
0.015 20

30

40 50 Age (years)

60

70

Figure 2. Work ability and age, VHH PVG Corporation. 2002 to 2007, cross-sectional data, scatter plot.

2 RESULTS: HOW TO DISCOVER A TREASURE After five years we have gained data that represent the staff well according to age (VHH PVG average age 46 years / WAI-sample 46 years), but rather than to gender (percentage of women in VHH PVG 15% / WAI-sample 10%), because more women work in the office and often do not have a bus driving license, hence do not come to us for their annual check-up. The mean WAI among participants of our study was 43 points, and there was significant negative correlation with age (Pearson −.121∗∗ ), though much smaller than we had expected. A scatterplot (Figure 2) gives a first impression of the relationship between age and WAI-points. In all age groups we find a predominance of excellent (total 55%) and good (total 35%) balance of work demands with individual or collective potential of the workers. There is little variation in relation to age and a negligible linear regression: Age does not have the expected negative influence on the work ability of the staff. 7.5% of the surveyed employees have a moderate work ability and 2% have a poor one. The latter categories are more or less evenly distributed across all age groups. Among the occupations, the lowest mean WAI-index is found in the cleaning department where we find three work shifts, higher physical demands and a higher average age of workers. These findings seem quite similar to those of other studies across Germany. The German WAInetwork describes a WAI-index for bus and tram drivers between 43 and 40 points, with an increase at the age of 40 plus to 50 plus years (Hasselhorn and Freude, 2007, 18). However, they are remarkably different from what we know from Finland when looking at the WAI –index points. In terms of the WAI – classification, the most important difference is found among the repair units.2 The VHH PVG sample is completely inconsistent with the findings of Karazman (1999). He found 11.7% of his sample population with a poor and 36.2% with moderate work ability, with a plainly reduced work potential among 55% in the age group of 50 to 59 year-olds (Ilmarinen, 1999). As the work demands of the different driver samples can be considered consistent, more details are required to define and understand the “treasure” we found in our study. The relatively low share of 10% of staff members whose future work ability is uncertain according to WAI points and

2 Sini

Palo, 2000, permission of Ilmarinen and Tuominen. We would like to thank Eva Tuominen, FIOH Helsinki, for the discussions we head in 2006.

199

categories means that about 160 members of staff are threatened by premature disability and may not reach retirement age (Ilmarinen, 1999).

3 DISCUSSION: WHAT CAN WE FIND WITHIN THE TREASURE CHEST? Basically, our positive findings can be considered a result of VHH PVG’s work place health promotion process and occupational safety standards. A more detailed view shows four components that should be analyzed: Staff developments, the new leadership style, occupational health management, and the limits of cross-sectional WAI data within the process of promotion and maintenance of work ability. 3.1 Reduction of staff From 1995 to 1997 the number of VHH bus drivers was reduced by 200, as mentioned above. Within this context it is interesting to note that many of the dismissed staff (may have) had a history of chronic diseases, decreasing work ability, and increasing incidents of sick leave or absenteeism. But staff-reduction measures, taken by the leadership within a specific historical and economic situation, do not explain why 8 to 10 years later such high potential was found among the staff of the VHH. Though at times maybe necessary, such measures are neither suitable to solve the problems of an aging workforce, nor can they promote or maintain work ability. Hence, staff-reduction cannot explain our positive findings. 3.2 The appreciative exchange of experience – a new leadership style Once restructuring was completed – the number of bus drivers has been constant since 1997 – the leadership initiated a new style of communication and support for the employees, which led to the creation and implementation of what is called an “appreciative exchange of experience” (Geißler, Bökenheide et al., 2003). Every single employee or worker is seen and appreciated as an experienced carrier of ideas and knowledge. Within this context managers can influence the work ability by “reflecting on and changing their opinions of the workforce, adopting a credible participative-cooperative leadership style, and considering, maintaining and even increasing the existing resources at work that healthy and recovered staff members regard as indispensable” (Geissler-Gruber, Geissler et al., 2004, 215;, Geißler, Bökenheide et al., 2003). The implementation of this appreciative exchange of experience throughout the corporation is not yet completed, but first results show its contribution to the current high level of work ability, and demonstrate the advantage of the concept for both supervisors and staff (see chapter 3.2.4). 3.3 Work place health management since 2001 From the very beginning of the program there was a mixture of measures applied to raise individual health (see chapter 3.2.1) as well as to improve work demands in general (see chapter 3.2.2). In 2007, more than 50% of the staff rated the project as “very good” (7%) or “good”, 32% were “indifferent”, and 4.6% were not aware of the project. In 2007, 58% agreed with the statement that the company is supporting their health, while 29% were indifferent. As to the work demands, more than 60% of the participants are generally content, while 32% are indifferent. All ratings have been improving since 2002. In 2005 a further question was added: “How content are you with extra driving shifts during your free period?” 30% of the respondents are rather content, 30% are indifferent, and another third are not content. This rating is decreasing, showing growing dissatisfaction with overtime work. Asking about contentment with the duration and timing of breaks within the service provides similar results, also with a decrease in rating during the past two years. Two time-study groups have 200

been set up to gain deeper understanding of the details involved, but had to be cancelled due to the threat (and fear) of additional costs. All in all, we find growing acceptance among VHH PVG employees of the health promotion work that is being done, though recent opinion polls contain early hints at excessively tight work schedules (see chapter 3.2.2). Even though there was no WAI-epidemiology before the health promotion process started, we can say that its activities contributed to the positive results. 3.4 Limits of cross-sectional WAI-data Up until now we have gathered cross sectional data based on a mean age of 46 years. Finnish longitudinal research shows that the most significant decline in work ability appears at 45 to 60 years of age (Ilmarinen, 1999), where the decline follows an exponential pattern rather than a linear one. In the VHH PVG sample there seems to be no decline of work ability with growing age, but in fact we can observe an enormous change in work demands: longer services, overtime work, increasing traffic problems, social difficulties with passengers, and economic measures to cut costs by up to 20%. Work within the bus company entails many salutogenically complex tasks and requires learning new things (“you never know what will come next, that’s why I like my job”). But it also involves tight schedules changing for the worse, decreasing possibilities to manage one’s work and free time, and few chances to take a break according to individual needs. Aging employees or workers are especially sensitive to these changes, and only when they “are able to make their own choices and adjust to their work according to their own resources, aptitudes and routines, they will cope well in their work” (Ilmarinen, 2006). Actually, bus drivers are gradually loosing the possibility of choice. The company has sufficient time to plan for further steps, but the direction of the process is still somewhat open. The results we found can help us look back at the past years and explain our WAI-findings. But they have small predictive value for the future. The next steps to promote and maintain the prevailing work ability must be defined by the steering committee.

4 THE USE OF THE WORK ABILITY CONCEPT “The most important asset of employees in work life is their work ability. Because enterprise profits are made possible by the work ability of its personnel, the enterprise has a certain role in supporting and promoting the work ability of its employees. Concepts of work ability have changed and developed during the last decade in a more holistic and versatile direction” (Ilmarinen, 2006). Accordingly, it is the task of the steering committee to integrate all existing knowledge, data and scientific understanding that is available and necessary to support the company in taking its next steps in the right direction. In other words: State-of-the-art technology and most comfortable buses cannot replace the driver. His or her work ability is based on four components that should be kept in mind and view. 4.1 Employee Over 80% of the staff rate their current work ability between 8 and 10 points with “lifetime best” at 10 points (WAI-item Nr. 1). The overwhelming majority can use their potential to cope with the daily work demands, physically and mentally (WAI-item Nr.2). About 75% have no or only one current disease, and 38% have mostly one illness or health problem (“own opinion”) with which they cope successfully (WAI-item Nr.3). 85% have no estimated impairment due to diseases, and 10% experience some symptoms, but are able to do their work (WAI-item Nr.4). 47% have taken no sick-leave during the previous 12 months, and 26% have had nine or fewer days off for health reasons (WAI-item Nr.5). We found this self-reported data to be consistent with data we collected from VHH personnel in 2006. The 2006 data was gathered anonymously and categorized in the 201

same way as in the current study. In 2006, 95% of the respondents were relatively certain that, from the standpoint of their health, they would still be able to do their current job two years from then (WAI-item Nr.6). About 5% had rather reduced mental resources, with only 2 points or less as compared to the average score of 4 or 3 points (WAI-item Nr.7). Apart from the medical tests described above, the bus drivers must pass a neuropsychological test to acquire the driving licence and repeat it every 5 years once they reach the age of 50. The parameters tested for here (resilience, orientation, concentration, awareness, and speed of reaction) do not really inhibit one’s driving skills (and license). These are limited by diseases such as musculoskeletal deficiency and disorders, psychosomatic illnesses and sufferings, overweight, diabetes and hypertension (“metabolic syndrome”), coronary heart disease, infarction of the heart, and stroke. Incidence and prevalence of these diseases are not higher among VHH PVG bus drivers than in the German population as a whole. The crucial question is how to get the employees to play their own part within the work place health promotion program. In the WAI-dialogue, we used the items of the index to structure the assessment and to develop employee-centred communication. The aims of the dialogue are not only to give information about health risks, but to raise individual initiative, self-responsibility and enjoyment in getting involved in the health promotion process. In 2006 we assessed the quality of communication between bus drivers and the physicians during the health check-up meetings by asking: “When you have an appointment with the company doctor, do you have the feeling that you can talk about your problems?” “Do you have the feeling that the company doctors are listening to what you say?” “Are the decisions and explanations of the company doctors comprehensible to you?” 75% of the answer were positive (“very well” and “well”), 15% had not had an appointment within the relevant time frame, and 10% rated their experiences as negative (“indifferent”, “little” and “bad”). The following figure compiles our experiences and ideas concerning the WAI-dialogue. Table based on discussion with Ilmarinen, 2006; Geißler-Gruber, Geißler and Bökenheide, 2007. In the steering committee, we are altogether deeply convinced that fear is an inacceptable healthinfluence which should be substituted by providing options, free choice and participation, individual and collective support, sustainable contracts, and a defined right for both the company and the employee to end the health promotion activities without discrimination. The corporation has prepared different offers to accommodate its employees: Some bus stations now have fitness rooms, others offer physiotherapy and massages (company pays the therapist, employee participates in spare-time), and there are walking-groups and soccer teams. Poor physical fitness can be considered the highest risk factor for impaired health, followed by smoking, hypertension, cholesterol and obesity (Blair et al., 1996, stated in Ilmarinen, 1999). Therefore we launched the two year-program “active with all one’s heart” in 2006 in order to encourage employees to exercise. In whichever way they like: (belly) dancing, inline skating, swimming, or walking are all fine, as long as the activity is carried out twice to three times a week in their spare-time. The company contributes up to 500 a per year towards expenses like gym memberships, swimming pool entry, or a bicycle. The participant signs a contract and has a little notebook to register all his activities. There are regular meetings for information and to share experiences, comments and questions. To spread the idea, all bus stations have been visited and possibilities and wishes were recorded. 76 people have joined the program so far. Their average age is 49 years, and about two thirds are “real beginners” in sports after a lengthy period of inactivity. Sometimes it is necessary to restore health and work ability in a very profound and individual manner. In 2007 a partnership contract was signed with a rehabilitation centre specialised on the specific professions of the company and with the pension insurance which bears the costs of disability retirement. With the employee’s consent, the company doctor can now prescribe a stationary treatment at the centre, shorten the employee’s waiting time, ensure the quality of treatment, and support the employee during treatment. All these projects are carried by the idea of maintaining a win-win-situation for the employee and the company. 202

Table 1.

FBC VPG

WAI

Table 2.

Finnish Bus Company (FBC)/VHH PVG Corporation (VPG): Mean WAI/SD/number/age if available/by occupational groups and WAI classification. Office

Supervisors

Repair

Cleaning

Drivers

41.7/4.2/6 43.2/5.3/82/42.4 ys office and supervisors classification

37.2/6.7/9

35.5/7.3/13 43.5/5.1/ 34/44.7 ys

./. 33.2/8.0 7/47 ys

39.2/7 7.9/77 43/5.6/529 46.5 ys

good/same

moderate/good

good/same

Good reasons for company doctors and employees to start a WAI-dialogue.

Mutual benefits using the WAI – items for a dialogue: For the company doctor (CD) 1. CD gets an employee centred view. 2. What does it mean for this person?! 3. Getting to know the minor social back- ground (family and friends) 4. Getting a more holistic view of the potential of the person. 5. Better and deeper understanding: How can I support the person best? 6. More joy at work.

For the employee 1. Own standing gets more clear. 2. What can I do for my work ability? 3. I am not alone. Where do I get personal support? 4. Evaluation of the actual situation (personal strength and deficits). 5. Ranking and acting: What can I do, what could the company do? 6. Comfort: CD listens, understands and explains well.

4.2 Work and Work conditions Since 2001 the VHH company was awarded prizes twice by the Hamburg occupational health and safety authorities for its health and safety standards. In the repair and cleaning departments, high ergonomic standards support the aging workers in staying at work successfully, and all age groups are enabled to prevent musculoskeletal diseases. The physical work load has been reduced by the use of carriers (a young woman can easily change a bus tire or brake lining), and mechanics and workers have appropriate possibilities to manage their work breaks, organise the order of tasks, and a satisfactory choice of methods, work pace and amount of work (Ilmarinen, 2006). The number of occupational accidents is below the German average. Workers in the office as well as in the repair and cleaning department enjoy satisfactory working hours (opinion poll 2007), but the technical department (repair and cleaning) has the highest number of workers with moderate or poor work ability. To date, the number of participants in the study is low and hence the results can not be considered representative (Table 1, chapter 2.2, 41 out of 170). Therefore there will be a specific assessment of this issue in 2008. It was mentioned already (section 2.2.3) that tight schedules, workweeks of more than 40 hours, irregular day-time work and two-shift or night shift work have become a problem for the bus drivers during the last years. 10% of the bus drivers regard their work demands as primarily physical, 51% as mental and 44.5% as both mental and physical. With increasing age there is a definite (Pearson .211∗∗ , mean age ANOVA ,000) change in this view towards a mixed work demand. Long services3 , overtime and tight schedules are experienced as more physically and mentally demanding. 3 Service

means a mixture of driving time with minor and major breaks. Every service has a certain structure that is created by occupational or traffic law and the organizer, whose possibilities are limited by public demands and costs.

203

46

WAI-index of VHH PVG bus drivers compared with night shift workers with different work loads

Mean WAI-index (points)

44 42 40

Night shift workers (N
368)

38

Night shift workers without firefighters (N
271) VHH PVG CG bus drivers (N
522)

36 34 32 30 Total

Figure 3.

Up to 39 40 to 44 45 to 49 50 to 54 years years years years Age groups

55 plus years

Comparison of WAI scores of VHH PVG bus drivers (2002–2007) with night shift workers (1996–1997) with different work loads (Tempel 2002), data by permission of GP Forschungsgruppe, Munich, 2002.

34% of the drivers want spare time as compensation for overtime work, 32% want money and 31% want a mix of these two according to their needs. It is reported that drivers have begun to accept extra services only when they are guaranteed additional time off. Figure 3 (above) may give an impression of this. Comparing the work ability of bus drivers with “real” night shift workers with different workloads such as fire fighters, the chemical or paper industry points to important and helpful differences. Salutogenic factors have been described and the mean age of the sample is between 38 and 46 years. The samples of night shift workers were not representative and the participation rate was low. All this put together shows that more important differences remain: The physical workload for bus drivers is low, the risk is rather one of monotonous underchallenge, but autonomy at work is rather high compared to other shift workers (Karasek and Theorell, 1990), and finally there is a successful workplace health promotion process which contributes to the actual findings. To date (N = 101), we have found a positive correlation between work ability and contentment with choice alternatives and decision latitude, but there is weak significance and more data is needed to support this. In 2007 we started discussing that even the change of leadership style will not be able to compensate the problems the drivers have (and will have in the future) with increasing age. Bus driving is considered moderate to heavy work (physical, mental and social) by the leadership as well as the drivers, and with increasing age there is a growing need for recuperation: “It is essential for the efficiency of recovery that it can start immediately after a peak load or a heavy burden” (Ilmarinen, 1999, 1997). But in practice there is a tendency to keep up the service until it ends, to go on until the next day off, to extend the working week to the next bank holiday or scheduled vacation. All these coping strategies are helpful and necessary to navigate the actual changes in work demand with which the company is confronted. But they are not a sustainable strategy to cope with the demographic changes. On the contrary, growing fatigue is a severe accident and health risk for both the company and the drivers. So finally a project to study this issue was started in two steps: A pilot study (Amelsberg, and Tempel et al., 2007) was to define scientific standards for creating a service concept that a bus driver can follow until pension age. That means that the services have to be organized within a shift schedule that satisfies modern occupational knowledge (Härmä and Ilmarinen, 1999; Knauth and 204

Hornberger, 1997). Finally, an “alarm system” was created (red: service not acceptable according to occupational science; yellow: problematic result, has to be developed; green: you can go on up to pension age as far as we know, preserve!) and the prevailing services were analysed. After this successful pilot study, the further timetable will be analysed in 2008 as the actual work demand set by the company and the results are discussed with drivers at the different stations. We must learn how they perceive the different services and routes, e.g. with respect to traffic, passengers, or working time. The drivers may hold completely different views about the quality and content of a break. Minor breaks of one to five minutes are highly valuable according to work physiology, but in traffic – there is a common consent on this – they easily “get lost”. And the efficiency of pauses is not the same with regard to physical or mental work demands. The drivers need much more time to cope with mental problems than with physical ones. We will compare the views and ideas of the drivers concerning the 2008 timetable with driving reality: The company uses CAD/AVL (Computer Aided Dispatch/Automatic Vehicle Location) to survey, organise and maintain public transport. The same system can be adapted to check actual driving time by gathering mean scores. The board and works committees have agreed to end the endless discussion about what it is actually possible to drive. So the work demands set by the company will be compared with actual driving time and conditions, and finally be categorized. 4.3 Professional Skills Learning and vocational training have a long tradition in the corporation. There is an own driving school and the participants have to drive various buses with different types of technology. Every bus driver has to spend five hours per year on special subjects such as how to cope with difficult passengers, driving techniques, first aid on the bus, or how to deal with accidents. From 2008 on these procedures are enforced by European regulations. Corresponding rules exist for the whole staff. Among the leadership, learning and vocational training is considered to be a decisive part of maintaining the potential of the employees and workers as well as a contribution to “good quality of life and well-being”. 4.4 Work Community Since 2006 we have been assessing the correlation between work ability and the quality of communication with the supervisor, as well as the possibility of discussing and solving problems with the supervisor and with colleagues. Leadership has the strongest positive or negative influence on a sustainable balance between work demands and individual potential of an employee or worker (Ilmarinen, 1999). Within the context of the work ability concept, our findings seem comparable with the Finnish results that are based on more robust statistical methods (Ilmarinen, 2006). There are different scores for the bus drivers: The quality of communication has no significant correlation with work ability, and the correlation with the possibility to discuss and solve problems is less significant (Pearson −.363∗∗ , ANOVA .003, R2 .132). This can be taken as an early indicator that the climate for the drivers might be changing for worse.

5 COMPANY CLIMATE AND PUBLIC POLICY Since 2002 we have been trying to gather more details about the existing climate within the whole VHH PVG Corporation. Important components of the climate are “the general impression the company makes on the staff, the colleagues, the leadership, information and participation, the works committee and company’s payment, fringe benefits and appreciation” (Rosenstil and Bögel, 1992). To assess the climate, we use four questions about satisfaction with pay, the climate, social welfare 205

50

Mean WAI-index and communication with supervisor or possibility to discuss and solve problems (N
131) Quality of communication with supervisor (a)

Mean WAI-index

45

Discuss and solve problems with collegues and supervisor (b)

40 35 30

Po or

In di ffe re nt M od er at e

G oo d

go od Ve ry

To ta l

25

Categories

Figure 4. WAI of employees and leadership: Quality of communication and possibility to discuss and solve problems are highly significantly correlated. (a: Pearson −,278∗∗ . ANOVA .010; b: Pearson −.418∗∗ , ANOVA .000, R2 .175).

70

General satisfaction - VHH PVG Company Group

60

Percentage

50 Very satisfied Rather satisfied Rather dissatisfied Very dissatisfied

40 30 (n=63) 20 10 0 Payment

Figure 5.

Company climate Social welfare benefits Categories

General leadership style

General satisfaction of the staff with pay, company climate, social welfare benefits and general leadership style.

benefits, and the general leadership style. Figure 5 shows first results that should be followed up during the next years – nevertheless they are valuable already as early indicators. About 65% of the employees are “rather satisfied” with their pay and 35% are not. Especially younger drivers and newcomers receive lower wages. 79% are “very and rather satisfied” with the company climate, 83% with the social welfare benefits and 79% with the general leadership style. The perception of company climate is weakly correlated with work ability (Pearson −.284∗∗ , ANOVA .0014, R2 .081). 206

Bus companies experience high public pressure and are often exposed to discussions about costs, and many drivers report that they no longer feel appreciated by the public and the passengers. Since 2006, we have been using the question “I experience the public situation as supportive for my work ability” (very much so, rather much, indifferent, rather not, not at all). 42% answer “not at all” (7%) or “rather not”. If we look at perceived public support for work ability, there is a U-shaped distribution which might be interesting: Those bus drivers who are “indifferent” have the lowest mean WAI-index (41.4 points), and both the group which feels supported and the one which does not display much higher mean scores. In our WAI-dialogues we find two coping strategies for this issue: “At work I don’t care about politics and don’t want to think about it” or “I mind my own business”, and “hard times need strong efforts to get along”. 6 CONCLUSIONS AND OUTLOOK The Work Ability Concept has proved helpful for structuring the work place health promotion process of a company. Based on a scientific and practical understanding, the steering committee can analyse the past and present situations and thus support the company (management and works committee) in structuring the future. The use of the WAI together with the concept creates a deeper understanding of the current state of balance between the “Work Quality and Productivity” the enterprise needs and the “Quality of Life and Well-Being” of the staff. The different measures taken to promote and maintain work ability can be evaluated according to their influence on the WAI-index or the different WAI-items. As for the VHH PVG Corporation, the actual balance seems to be somewhat instable. The positive results of the work place health promotion process that was started after a period of change and reduction of staff can explain the present situation. To ensure this for the future, three major tasks must be taken on: Continuing the appreciative exchange of experience and integrating the new leadership style into the company climate. Analysing the services and successfully implementing a structure of driving time and breaks that is supportive for the drivers. Reducing the overtime work in order to reduce the risk of premature invalidity with growing age. ACKNOWLEDGEMENT The presentation in Hanoi and the article were funded by VHH PVG Corporation. Jens Peter Becker, Miriam Krieger, Jan Krohn and Heike Tempel gave me valuable support to write the article in English. REFERENCES Amelsberg, S., and Tempel, J. et al., (2007). Alters- und alternsgerechte Schichtplan- und Dienstgestaltung unter schwierigen wirtschaftlichen Bedingungen zur mittel- und langfristigen Zukunftssicherung der VHH PVG Unternehmensgruppe – Abschlussbericht. Hamburg und Bremen, VHH PVG UG und Universität Bremen – ZeS. Ell, W., (1995). Arbeitszeitverkürzung zur Belastungsreduzierung älterer Arbeitnehmer im öffentlichen Personennahverkehr – 10 Jahre Erfahrung aus den Interventionsmaßnahmen in den Verkehrsbetrieben in Nürnberg. Alt, erfahren und gesund. Betriebliche Gesundheits-förderung für älterwerdende Arbeitnehmer. H. G. l. Rudolf Karazman, Irene Kloimüller, Norbert Winker. Gamburg, Verlag für Gesundheitsförderung G. Conrad. 1: pp. 160–170. Frevel, A., and Geißler-Gruber, B. et al., (2006). Dialoge verändern, Partizipative Arbeitsgestaltung – Voraussetzungen, Methoden und Erfahrungen für eine zukunftsfähige Arbeitsforschung. Köln, Kölner Wissenschaftsverlag.

207

Geißler-Gruber, B., and Geißler, H., (2000). Von den Gesund (et) en lernen. Der Nahverkehr – Personen- und Güterverkehr in Stadt und Region 10: pp. 1–6. Geissler-Gruber, B., and Geissler, H. et al., (2004). Appreciative exchange of experiences: an “empowerment” tool for and by managers. Applied Participation & Empowerment at Work. C. R. Johansson, A. Frevel, B. Geißler-Gruber and G. Strina. Lund, Studentlitteratur: pp. 211–222. Geißler, H., and Bökenheide, T. et al., (2003). Der Anerkennende Erfahrungsaustausch – Das neue Instrument für die Führung. Frankfurt / New York, Campus. Härmä, M. and Ilmarinen, J., (1999). Towards the 24-hour society – new approaches for aging shift workers? Scand J Work Environ Health 25(6, special issue): pp. 610–615. Hasselhorn, H. M., and Freude, G., (2007). Der Work Ability Index – ein Leitfaden. Bremerhaven, Wirtschaftsverlag NW. Ilmarinen, J., (1999). Ageing Workers in the European Union – Status and promotion of work ability, employability and employment. Helsinki, Finnish Institute of Occupational Health, Ministry of Social Affairs and Health, Ministry of Labour. Ilmarinen, J., (2006). Towards a longer worklife! Ageing and the quality of worklife in the European Union. Jyväskylä, Gummerus Kirjapaino Oy. Karasek, R. and Theorell, T., Eds. (1990). Healthy Work. Stress, Productivity, and the Reproduction of Working Life. USA, BasicBooks. Knauth, P., and Hornberger, S., (1997). Schichtarbeit und Nachtarbeit. München. Rosenstil, L. v. and Bögel, R., (1992). Betriebsklima geht jeden an! München, Bayerisches Staatsministerium für Arbeit und Sozialordnung, Familie, Frauen und Gesundheit. Tempel, J., (2002). Der Einfluß der Nachtarbeit auf den Gesundheitszustand. Ernährungszustand von Nachtschichtarbeitern. D. Korczak, S. Klotzhuber, J. Tempel, C. Eggerdinger and G. Schallenmüller. Bremerhaven, Wirtschaftsverlag NW. S 68. Tempel, J., (2004). The Work Ability Index (WAI) is an useful instrument to structure the client/patient-doctorrelationship in occupational medicine. Proceedings of the 1st International Symposium on Work Ability – Past, Present and Future of Work Ability. J. Ilmarinen and S. Lehtinen. Helsinki, FIOH. 65. Tempel, J., and Giesert, M. et al., (2005). Arbeitsfähigkeit 2010: Von 16 bis 65 in einem Unternehmen! Abschlussbericht zum ABI-NRW-Projekt. Düsseldorf, IQ-Consult gGmbH. Tuomi, K., and Ilmarinen, J. et al., (1998). Work Ability Index. Helsinki, K-Print Oy Vantaa, Finland. Vorndran, I., (2006). Unfallgeschehen im Straßenverkehr 2005. R. V. Statistisches Bundesamt, Referat V C “Verkehr”, Pressestelle, Wiesbaden. Wakula, J., (2007). Belastungs-Beanspruchungskonzept. Lexikon Arbeitsgestaltung. K. Landau. Stuttgart, Gentner Verlag – ergonomia Verlag: pp. 305–306.

208

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Prolonging working life in intellectual work Ülo Kristjuhan Department of Working Environment and Safety, Tallinn University of Technology, Tallinn, Estonia

ABSTRACT: A later retirement age is typical of intellectual workers, e.g. in the case of university teachers and researchers. The ability to do part of the work at home, including telework, is probably part of the reason. During 2005–2006 questionnaires were designed and a research of telework was carried out in Tallinn University of Technology. Among 260 academic respondents, telework usage did not vary significantly between the age of 40 and 70. Employees younger than 30 years were using it less than the older. Computer and Internet experience might be a better predictor than age. Data shows that doing some work at home, 10–20 hours per week, is healthier and is associated with less stress and hypertension. There is also a tendency to report less visual fatigue. The option to work one to three days per week at home is the best.

1 INTRODUCTION At present many developed countries including Estonia are entering a workforce situation never experienced before. There is a shortage of young workers as birth rates are low. The average age of manual and professional workers is rapidly increasing. Compared to previous times, older people are working or seeking employment more often (see: EU job situation improves . . . , 2006). There are several causes: • Good pensions are becoming more difficult to receive. Pension replacement rate is decreasing. • In previous times the life expectancy increased mainly because of the decreasing mortality of young people. At present the situation is different. Life expectancy is increasing as a result of years of good health. The ageing workforce will pose new challenges to enterprise and organisational management. These challenges are different in the cases of blue-collar and white-collar workers. This article considers intellectual workers. Older white-collar workers are physically weaker compared to younger ones and many of their physiological and psychological characteristics are worse. However these workers mostly compensate the deterioration of their functional capacities with knowledge and competence. Older workers have more accumulated (crystallized) knowledge. Therefore scientific research has shown that their productivity is practically the same as the productivity of younger persons, and sometimes higher. There is a need to transfer both knowledge and experience to younger generations in society and to create appropriate conditions for this process. There are also older intellectual workers who finished their studies many years ago and need training courses. However this training costs less than preparing new young specialists. Older intellectuals want to continue teaching and research in the university. They want to have more privacy and autonomy within their organizations. They sometimes need extra time for recreation. They don’t want to have a long way from home to the workplace. 209

2 TELEWORKING AS A SOLUTION Teleworking (working from home, satellite office or a telework centre near home), full-time or part-time, is one possible solution, especially in the case of university teachers and researchers. Teleworking contributes to using modern information technology, and improves the use of accumulated knowledge and experience. Older intellectual workers who are partly working from home have an extra 1–2 hours per day of free time (decreasing travel times), affording time to be with their families. These workers can thereby avoid the impact of negative social changes on their personal well-being in later life and therefore better maintain health. Working from home has many different positive effects for society. While cars, buses, trams and trains need to be used, it is safer and healthier for people to change their thinking, changing the transport idea by the idea of telecommuting. Telecommuting provides many benefits: avoiding road accidents, protecting the environment, and conserving energy. Sometimes working from home is criticized because of the possibility of overworking. Factually, this possibility always exists. Even without telework most intellectuals do not limit their working by eight hours per day. Sometimes these workers are not thinking about their work during traditional working hours but during traditional leisure hours. There are a lot of studies about telework. However, in the case of older intellectual workers telework is often a new phenomenon. It is studied superficially, especially when it regards health issues. We have recently carried out research in telework at Tallinn University of Technology. 3 THE SITUATION IN ESTONIA Here are some factors that push older people to work and use computers in Estonia: • The unemployment rate is low (less than 5%). The employment rate for olderworkers has rapidly increased during the last few years. • Wages and salaries are relatively low as in most former Soviet Union countries but they are also rapidly increasing. In the second quarter of 2007, the average monthly gross wages and salaries were 11,549 kroons (738.1 EURO). The average monthly old-age pension was 3,515 kroons (224.6 EURO), about 30% of average wages and salaries (see: Main Social and Economic. . . , 2007). • Estonia is very intensively introducing and using modern information technology everywhere. Personal identity cards are used instead of tickets in public transport. The Internet is widespread as in the most developed Western countries and teleworking has become a standard element in the Estonian workforce. Computers with data projectors appeared in the laboratories and cabinets of Tallinn University of Technology in the 1980s and in auditoriums in the 1990s. There are many computer training and education courses and seminars (virtual learning environments WebCT, Moodle, etc) for teachers at Tallinn University of Technology and virtual learning environments are widely used in practice at present. The average age of academics at Tallinn University of Technology is similar to most western universities, but the University has a long tradition of using an older workforce and offering opportunities to work from home. The University encourages age diversity. Even during the Soviet period academics were permitted to work part-time at home according to negotiations between employers and employees. At present there is no mandatory retirement in the University. Currently the oldest researcher is 85 and the oldest associate professor is 79 (born 1922 and 1928, respectively). Most academics retire in their late 60s and 70s. Studies in Tallinn have shown that productivity is highest among teachers and researchers 56–65 years old (Kristjuhan and Taidre, 2005). There is no decrease in work efficiency among older academics in their 50s and 60s as they are not waiting for retirement. 210

4 RESEARCH ON TELEWORK AT TALLINN UNIVERSITY OF TECHNOLOGY 4.1 Method We carried out a survey of telework at Tallinn University of Technology during 2005–2006 (Arvola, 2007). A questionnaire was developed that consisted of 18 questions and was available on paper. There were open questions as well as multiple choice questions. Academics were asked to answer the questions about different characteristics of work, health indices and complaints in different parts of the body, and conditions at home. 260 university teachers and researchers completed the questionnaire. There were questions about the number of hours of telework and attitude toward it, about different factors that compared the working environment at home to the University office, including contact with chemicals, and about the negative aspects of telework. The questions were about teachers’ mastery working with a computer and communication tools, about the size of their family, their income and age, about the number and pages of publications and hours spent on scientific work (working with literature, planning and carrying out the research). Data about time spent travelling between the University and home and about income were also included. Questionnaires were sent to academics by e-mail or by post. Participation in the research was voluntary. All data collected were subjected to statistical analysis. 4.2 Results and discussion There were significant differences in responses regarding the use of telework. Telework usage was 44.3% when it was used 1–10 hours per week and 30.2% when used 11–20 hours per week. 8.0% of academics did not use telework at all. Only 13.2% of respondents used telework more than 30 hours per week. Consequently the common fear of overworking as a result of the unlimited possibility of working at home was not confirmed. Telework usage did not vary much by gender. The research showed that personnel younger than 30 years used teleworking less. Telework usage did not vary significantly between the ages of 40 and 70, and did not depend on time of travel between home and the workplace. Computer and Internet experience, not age, probably predicts telework usage. The research showed that the academics’ stress level was significantly lower when working outside of the employer’s workplace (mostly at home) instead of working at the office. A low stress level is very important to older intellectual workers. There was also less hypertension among teleworkers compared to non-teleworkers. Subjects were better able to focus on work at home. There was more privacy. Visual fatigue was an overall problem, but it was more widespread in non-teleworkers. There were minimum complaints of visual fatigue in the case of those using telework 21–30 hours per week. Most data regarding health and productivity characterized part-time teleworking 10–20 hours per week as the best variant. It appears that maintaining health is easier in the conditions of home. General recommendations about older workers workplaces described in detail by researchers (Ilmarinen, 2005) are easier to put into practise at home than in the office. The ability to plan and regulate work is better at home. Telework offers to the worker the opportunity to design an office environment at home that best fits his/her needs. This takes into account the timely recognition of body signals in order to prevent health disorders, flexible, individual, and ergonomic working hours, individual rest breaks and periods for movement, relaxation and eye exercises, dynamic sitting behaviour (regularly changing body positions), and individual workstation organization, including lighting. The ability to postpone the aging processes by means of a beneficial environment is a common understanding among biogerontogists at present. Aging is the gradual change in the structure and function of organisms that occurs for intrinsic processes and extrinsic influences and increases the probability of death. There is modest age postponement in developed countries, the ages of the concrete probabilities of death increasing every year. It is likely that aging will be postponed to some extent for those working in the beneficial conditions of freedom and home (see Kristjuhan, 211

2007, 2006). Also, using computers and the Internet improves information about health issues of the computer user and opens new horizons for creating optimum working environments and computer-assisted instruction (Kristjuhan, 2004). The knowledge and experience of intellectual workers should be better used. Using experienced teachers in scientific work and as supervisors of doctoral students has some advantages for the institution, and also provides more years of good health in academics. Complex solutions are the best. One of them is the ‘flexicurity’ approach. The concept of ‘flexicurity’ attempts to find a balance between flexibility for employers (and employees) and security for employees. Flexicurity combines active labour market policies, flexible contractual arrangements, lifelong learning and modern social protection systems. It can help to confront the challenges of globalisation and demographic aging. In the future life probably will not be divided into three blocks – hard studying, earning and enforced leisure – but will show a mixture of education, work and leisure over the course of life.

5 CONCLUSIONS AND RECOMMENDATIONS Our studies show that: • Older intellectual workers should have the possibility to work without any mandatory retirement age. • Telework should be an option for older academics. • Working partly at home, around 10–20 hours per week, can maintain better health in intellectual workers. • Using older academics in research, instruction and as experts is especially important for using accumulated knowledge and experience.

ACKNOWLEDGEMENT I am grateful to PhD student René Arvola and former bachelor student Mari Arnover for carrying out the survey at Tallinn University of Technology. REFERENCES Arvola, R., (2007). New data of working from home (Research in case of intellectual work). Telework as Solution for Senior Workforce. Ü. Kristjuhan & R. Arvola, eds., (Tallinn University of Technology Press), pp. 13–27, ISBN 978-9985-59-701-9. EU job situation improves, but new reform push needed to hit 2010 target. Europa. Rapid Press Releases. Brussels, 6th November 2006. Ilmarinen, J., (2005). Towards a Longer Worklife. Ageing and the Quality of Worklife in the European Union, (Helsinki, Finnish Institute of Occupational Health). ISBN 951-802-685-8. Kristjuhan, Ü., (2007). Vista of youth maintenance and body sensations. Ü. Kristjuhan & R. Arvola, eds., Telework as Solution for Senior Workforce, (Tallinn, Tallinn University of Technology Press), pp. 5–12 Kristjuhan, Ü., (2006). Soft strategies for postponing aging and prolonging human life. Rejuvenation Res. 9: pp. 329–332. Kristjuhan, Ü., (2004). Computer as a tool in postponing aging. First Central European International Multimedia and Virtual Reality Conference. Veszprém, Hungary, 6–8 May 2004, Veszprém University Press, pp. 95–100, ISBN 978-9985-59-701-9. Kristjuhan, Ü., and Taidre, E., (2005). Workability and health of older academics. Assessment and Promotion of Work Ability, Health and Well-being of Ageing Workers. Elsevier, pp. 101–105. Main Social and Economic Indicators of Estonia (e-publication). Monthly bulletin, Statistics Estonia. July, 2007.

212

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Ergonomic and safe design of railway vehicles for elderly and handicapped people Manfred Rentzsch & Denis Seliger Research Department, IAS Institute for Occupational and Social Hygiene Foundation, Berlin, Germany

ABSTRACT: According to COST 335 disabled people represent around 13% of the population of Europe. This is approximately 63 million people. The share of the elderly in the total population of Europe is expected to rise from 21% now to around 31% by 2020, and to around 34% by 2050. The starting point of the investigation was to analyse the current access situation for disabled and elderly persons in passenger trains, considering the relevant regulations, standards, operation instructions as well as the large volume of research work that has already been carried out at the international and national levels. A user-focused analysis based on an interview manual and questionnaires was carried out. The results of the user-focused analysis were used as inputs for the design guidelines. Altogether 67 subjects (33 females and 34 males) with different handicaps took part at the tests. The mean age of the subjects was 53 years. The distribution of age of the test persons is presented in Table 2. The test duration was about three hours. Approximately 63% of the test persons evaluated the accessible design as good or very good. Regarding the influence of age it can be summarized that there is not a big difference between the two age groups. That means handicapped persons as well as elderly persons have assessed the quality of the product design as positive. There is still the need for further improvements to enter the train, to get the necessary information within the train and to operate the emergency and service facilities without any problems and thus to achieve a barrier free design for all. This concerns e.g. to increase the character size and the contrast between the characters and the background on the touch screen, and to increase the contrast within the entrance and compartment area and the toilet as well as environment related elements like handholds, handrails, buttons for soap, water and drier.

1 INTRODUCTION This paper is an output of an European collaborative project financed by the European Commission with experts of railway operators (DB, SNCF and Trenitalia), manufacturers/suppliers (Bombardier, Siemens, Alstom), associations of persons with disabilities and scientific institutions (FAV Berlin, IAS Berlin, VUT Vienna, UPC Barcelona) from six European countries taking part. The project is coordinated by UNIFE Brussels. The objective of the project is to optimise the access, the entrance vestibule, information systems inside and outside the train, emergency facilities, toilet with all conveniences and the additional test arrangements regarding push buttons, steps and emergency equipment as an important segment of a barrier free travel chain. For this reason physically, visually and hearing impaired people, persons of small stature, elderly people and parents with small children were included from the very beginning (Seliger and Rentzsch 2006). According to COST 335 (1999) disabled people represent around 13% of the population of Europe. This is approximately 63 million people. The share of the elderly in the total population of Europe is expected to rise from 21% now to around 31% by 2020, and to around 34% by 2050. The median age in Europe is growing up from 37.7 in the year 2000 to 49.5 by 2050 (Höhn, 2002). 213

VUT, IAS foundation, UPC, FAV

Transfer of knowledge

User focused analyses

Design

Functional

Guidelines

Mock-up

Test criteria

Test programme

Derivation

of standards

Innovative phases of the project partners

Figure 1.

Basic structure of the methodology.

In Germany 6.6 million people are handicapped (3.5 million males and 3.1 million females). 75% are older than 55 years and 52% older than 65 years (Statist. Bundesamt, 2004). Handicapped people favour public transport over private cars. Therefore the vehicles of the local public and long distance traffic have to be designed in such a way that they can be used from all the interested persons in the sense of a barrier free travel chain including elderly and handicapped people.

2 METHODOLOGY 2.1 Basic structure Figure 1 illustrates the basic structure of the methodology used in the project. The starting point of the investigation was to analyse the current access situation for disabled and elderly persons in passenger trains, considering the relevant regulations, standards, operation instructions as well as the large volume of research work that has already been carried out at the international and national levels. A user-focused analysis based on an interview manual and questionnaires was carried out. The main structure of this manual is listed below: • • • •

Classification of people with reduced mobility and their aids. Ergonomic design of the access area. Information. Emergency facilities.

The main components and items of the interview manual are summarized in Table 1.

2.2 Test equipment The results of the user-focused analysis were used as inputs for the design guidelines. A computer version of a mock-up (see Figure 2) and finally a functional mock-up in the scale 1:1 were then produced. Further, two additional elements were included in the tests. The first was a test panel consisting of different kinds of push buttons to open and to close the doors and the other was a special test stand consisting of steps with different depths and heights. 214

Table 1.

Main components and items of the interview manual.

Components

Items

Ergonomic design of the access area

– General aspects – Access doors and its controls – Horizontal and vertical gap

Information

– Acoustic signals – Visual signals – Emergency brake – Alarm signal – Toilet – Changing table

Emergency facilities Service facilities

2600 2500

900

2400

2150

1880

– Boarding aid devices – Access room – Lighting, colour – Materials – Tactile signals

700

1900

1900

728

2913

955 900

4650

Figure 2.

8008

CAB (floorheight 1360)

REG/HST (floorheight 800)

Eupax Mock-up layout.

2.3 Subjects Altogether 67 subjects (33 females and 34 males) with different handicaps took part at the tests. The mean age of the subjects was 53 years. The distribution of age of the test persons is presented in Table 2. The test duration was about three hours.

3 RESULTS The general assessment of the handicapped accessible design depending on age is presented in Figure 3. Approximately 63% of the test persons evaluated the accessible design as good or very 215

Table 2.

Number of subjects and distribution of age.

Number of subjects

Distribution of age

30 15 12 5 4 1

20–49 50–59 60–69 70–79 80–89 >89

Mock-up general

100 90 80 70 60 50 40 30 20 10 0

Bad Fair Good Very good

All (n
63)

 50 (n
28)

 50 (n
35)

Handicapped accessible design p
0.05

Figure 3.

Product design for handicapped and elderly people.

good. Regarding the influence of age it can be summarized that there is not a big difference between the two age groups. That means handicapped persons as well as elderly persons have assessed the quality of the product design as positive. Finally the subjects were asked to distribute 100 points to the four different aspects and thus setting priorities for the barrier free design. The aspects were: Access to the train/entrance area, compartment area, use of control elements (e.g. push buttons) and perception of information (outside and inside the train). The results of prioritization of different aspects depending on age are shown in Figure 4. That means for all test subjects the barrier free access to the train is the most important in handicapped accessibility design. The other three parts are more or less equally ranked at about 20% each. For people older than 50 years the perception of information has the second priority due to visual and hearing problems as these kinds of impairments strongly increase with rising age.

4 CONCLUSIONS There is still the need for further improvements to enter the train, to get the necessary information within the train and to operate the emergency and service facilities without any problems and thus to achieve a barrier free design for all. This concerns e.g. • To increase the character size and the contrast between the characters and the background on the touch screen. • To increase the contrast within the entrance and compartment area and the toilet as well as environment related elements like handholds, handrails, buttons for soap, water and drier. 216

45 40 35 Access to the train/ entrance area

30 25

Compartment area

20

Use of control elements (e.g. push buttons)

15

Perception of information (at and in the train)

10 5 0 All (n
63)

Figure 4.

 50 (n
30)

 50 (n
34)

Prioritization of handicapped accessible design and age.

REFERENCES COST 335, (1999). European Commission, Directorate General Transport; Passengers’Accessibility of Heavy Rail Systems, Final Report of the Action; Office for Official Publications of the European Communities; Luxembourg Höhn, Ch., Alterung der Bevölkerung, (2002). http://www.berlin-institut.org/pages/ buehne/buehne_beventw_ hoehn_alterung.html Seliger, D., and Rentzsch, M., (2006). Barrier free design of the access area and the information system of railway vehicles, 14th International Symposium EURNEX – Zel “Towards the competitive rail systems in Europe”, Proceedings edited by Jiri Zahradnik, Pter Nagy and Michal Mikulas Zilina, Slovenska Republika ISBN 80-8070-552-6 Statistisches Bundesamt, (2004). Wiesbaden, http://www.destatis.de

217

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Female workers’ superior peculiarity and consideration for aging for the activation of “super-advanced age and fewer children” society Koki Mikami Department of Humanity and Social Science, Hokkaido Institute of Technology, Sapporo, Japan

Kenichi Iida Department of Production System, Hokkaido Industrial Research Institute, Sapporo, Japan

Masaharu Kumashiro Department of Ergonomics, IIES, University of Occupational and Environmental Health, Kitakyushu, Japan

ABSTRACT: Taking Japan’s “super-advanced age and fewer children” society into consideration, one measure to promote the economy of Japan is efficient use of women. In order to contribute to the activation of women’s work, this paper describes 1) women’s superior peculiarity compared with men’s, 2) the influence of aging and 3) consideration points for women’s work, using the results of experimental research and a case study conducted to solve these KAIZEN problems. Keywords: KAIZEN

aging, female workers’ superior peculiarity, super-advanced age and fewer children,

1 INTRODUCTION Japan cannot avoid a “super-advanced age and fewer children” society. In 2013, it is estimated that one out of four people will be over 65 years old. And in 2035, one out of three people will be over 65 years old. The Employment Stability Law for the Aged was amended and put into effect on April 1, 2006, and this obliges employers to continue employing their employees until the age of 65, the final starting age of pensions. And then, since April 2007, the government has promoted the expansion of continued employment until the age of 70 for employees wishing to continue working. Taking Japan’s “super-advanced age and fewer children” society into consideration, one measure to strengthen the economy of Japan is efficient use of women. In order to contribute to the activation of women’s work, the authors made a study of women’s superior peculiarity, the influence of aging and consideration points for women’s work, using the results of two kinds of experimental research and a case study.

2 METHODS 2.1 Women’s superior peculiarity compared with men’s (experimental study) Women’s work adaptability in four tasks of visual information processing work was examined compared with men’s from the viewpoints of workload and efficiency in order to appreciate women’s work ability and make the best use of it in the workplace. 219

2.1.1 Experimental conditions 1) Task Classification Task A: An eye-hand coordination task with a microscope Task B: A wave inspection task requiring both hand movement and visual judgment with a VDT Task C: A task of pattern recognition requiring eyesight, thought, and judgment with a VDT Task D: A task of choice of the correct one from the three options requiring knowledge and thought with a VDT 2) Subject: 10 females, average age 20.0 ± 1.0, 10 males, average age 0.9 ± 0.5 3) Work control: Each subject’s own pace 4) Work posture: Each subject adjusted the height of his or her chair. 5) Composition of the work periods, breaks, and measuring points of each task.

M1

1st work Period 70 min. M2

M3

Break 5 min.

2nd Work Period 90 min. M4

M5

3rd Work Period 120 min. M6

Lunch break 45 min.

4th Work Period M7 105 min.

M8

Break 5 min.

6) Measuring items: (1) VRT (Visual Reaction Test), (2) CFF (Critical flicker Fusion frequency), (3) Near-point Accommodation. (4) Subjective Feelings of Fatigue, (5) Sites of Physical Fatigue Symptoms These items were measured eight times, before and after each work period. (6) Subsidiary Behavior, (7) Heart rate, (8) Performance, (9) Error Rate. These items were measured during work. 2.2 The influence of aging (experimental study) The characters of the work efficiency and workload of middle-aged or elderly females who had no job for a year or more were examined and compared with the results for younger females in task A and task B. Experimental Conditions (1) Task Classification: Task A, Task B (2) Subject: 10 middle-aged or elderly females, average age 48.0 ± 3.4 10 younger females, average age 20.0 ± 1.0 (3) The other conditions were the same as the above 2.2. 2.3 Consideration points for women’s work (case study) Target company: The main products were various kinds of noodles (Factory 1) and box lunches (Factory 2). The research was performed based on the Ergoma Approach (M., Kumashiro, 1987, K., Mikami, et al., 1997, and K., Mikami, 2002)

3 RESULTS 3.1 Female workers’ superior peculiarity (experimental study) 3.1.1 Females’ work adaptability to four visual information-processing tasks Females’ fluctuations in the psycho-physiological functions did not show significant lowering compared with those of males. Although in some tasks their complaint rates of subjective feelings of fatigue about the local muscles were higher than those of males, there were no significant 220

Table 1.

Relative evaluation on the basis of males.

Fluctuation in function VRT CFF N.P Heart Rate Subsidiary Behavior Subjective Feeling of Fatigue Sites of Physical Fatigue Symptom Ocular Discomfort Performance Error Rate Finished Parts

Task A

Task B

Task C

Task D

N S I N S N N

N S N S S N I

N S N N S N I

N N N N S N N

N S N S

N N S S

N N S S

N N S S

No Superiority 3 1 4

difference 4 1 3 3 4 2

1 3 4

Inferiority

1

2

4 3 1

N: no difference between genders; S: females are superior to males; I: females are interior to males

differences observed in subjective feelings of fatigue and ocular discomfort, and females had less behavior of escape from work. In respect to work efficiency, there was no significant difference in performance between females and males, but the numbers of females’ inferior areas was generally smaller. As a result, in all the tasks the numbers of finished areas females made a day was larger than those of males, which clarified females’ higher adaptability to this kind of work. 3.1.2 Females’ predominant characters in the visual information-processing work Females’ lowering of the cerebral cortical activity level was less and their durability of the cerebral cortical activity level was higher, compared with those of males. In all the tasks, the females’ occurrence rates of subsidiary behavior were lower, and their behavior of escape from work was less. In thought work, such as the task requiring thought and judgment and the task requiring knowledge and thought, females showed lower work efficiency at early stages of work, but the combined effect of their marked learning effect in the working process, higher durability of the cerebral cortical activity level, and less behavior of escape from work led to an increase in performance] and decrease in inferior areas, which made economical, effective production possible. 3.2 Effects of aging (experimental study) In Task A and Task B, many of the psycho-physiological functions of the middle-aged or elderly females showed lower values than those of the younger females, but no significant decrease was observed over the course of time. Subsidiary behavior and complaints of feeling of fatigue increased in the middle-aged or elderly females, which showed their difficulty in maintaining concentration on the work. The above results show women have excellent ability compared with men, but that they cannot avoid the effects of aging. Therefore, it is important to conduct KAIZEN to best utilize the ability of female workers. 3.3 Consideration points for women’s work (case study) A study on KAIZEN for female workers at a food processing factory for the activation of “superadvanced age and fewer children” society 3.3.1 Aspect of the target company The main products were various kinds of noodles (Factory 1) and box lunches (Factory 2). 221

Figure 1. The main products of this company.

Figure 2. An electronic work manual with animated cartoons.

Many of their products were daily foods, and a timely and flexible production system was required. Part-time workers with long experience played the most important role in this company. However, 60.5% of the 1st factory workers answered in the questionnairing conducted there, “I don’t want to be a full-time worker.” The main reasons were “That will reduce my free time” (42.3%) and “I cannot work full time for family reasons such as housework and childcare” (36.0%). At the 2nd factory 86.8% answered in the negative. For the continued employment of female part-time workers who had the key to the existence of the food company, we made a study of the creation of a healthy workplace, which would be easy to work in and accommodate the needs of the changes in the female lifecycle including housework. 3.3.2 Practice of work management 1 We introduced a new part-time employment system: The personnel department in the head office controls part-time employment directly and decides whom to employ after giving applicants a sufficient understanding of the company’s policies and work substance. Workers wishing to continue working can work until the age of 65. To utilize part-time workers efficiently, quick introduction of clear and effective education/training was indispensable. So, we made an electronic work manual with animated cartoons and a work standards book which would give a sufficient understanding of the substance of their work at the time of employment or orientation. 3.3.3 Practice of work management 2 Internal enlightenment lectures were held for a strong company composition that is the base of continued employment. The following five kinds of lectures were offered. 1) Necessity of higher productivity 2) Women’s superior peculiarity 222

3) IE basics 4) Production management and JIT production method 5) Standard work composition drills

3.3.4 Practice of work management 3 We conducted 11 kinds of support apparatus KAIZEN. 1. KAIZEN for keeping and cleaning cutters

Before

Figure 3.

After

Making of a work table for keeping and cleaning cutters.

2. KAIZEN for vacuum refrigeration

Before

Figure 4.

After

Introduction of an automatic stop device, a buzzer, and pilot lamps for vacuum refrigeration to avoid careless mistakes.

3. KAIZEN for putting noodle dough in the refrigeration machine

Before

Figure 5.

After

Making of an aluminum push car for vacuum refrigeration and guiding lines on the floor.

223

4. Workload reduction of standing inspection work

Before

Figure 6.

After

Introduction of a rubber mat to reduce the workload.

5. KAIZEN of the cutting machine for egg noodles

Before

Figure 7.

After

Lowering of the cutter position and making of a new wider, two-roller cutter.

6. KAIZEN for checking the residual quantity in the feeder

Before

Figure 8.

After

Installing a mirror for checking from the 2nd floor.

224

7. KAIZEN for checking the tanks

Before

Figure 9.

After

Making of an acrylic-resin tank with an automatic valve.

8. Safety measure for the noodle roller safety bar

Before

Figure 10.

After

Improvement of the bar so that it could move in two directions (one direction before this).

9. KAIZEN in producing deluxe egg noodles

Before

Figure 11.

After

Simplification of the machine structure for cleaning and prevention of contamination by foreign matter.

10. Environmental KAIZEN for standing inspection work

Before

After

Figure 12. A shift of ceiling lamps and setting of a dimming cover on the nearby lamp.

225

11. KAIZEN for feeder cleaning

Before

Figure 13.

After

Making of a feeder work stool.

4 CONCLUSION Although women have excellent ability compared with men, they cannot avoid the effects of aging. It is important to conduct KAIZEN to best utilize the abilities of female workers. We are certain that we have been able to make the company an appealing one from the viewpoint of part-time workers’ continued employment, and form a basis for a continuous KAIZEN structure. REFERENCES Kumashiro, M., (1987). Work load , – Postures and Job Redesign – An Ergonomic and Industrial Management (Ergoma) Approach, NEW METHODS IN APPLIED ERGONOMICS, Taylor & Francis. London, pp. 247–252. Mikami, K., (2003). Aging and Work. Taylor & Francis. London, pp. 233–244 Mikami, K., Kumashiro, M., (1997). A scientific Approach to Work Improvement (I) – From the viewpoint of Ergoma Approach and Virtual Simulation-, The 14th International Conference on Production research, Osaka, Japan, pp. 1152–1155

226

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Usability research on the older person’s ability for Web browsing Daiji Kobayashi Department of Human Relations, Nihonbashi Gakkan University, Kashiwa city, Japan

Sakae Yamamoto Department of Management Science, Tokyo University of Science, Tokyo, Japan

1 INTRODUCTION 1.1 Usability and accessibility issues concerning Web browsing for the elderly in Japan The percentage of the Japanese population aged over 65 years is now over 21 percent, which is the highest ever. Although nearly 20 percent of the Japanese people in the over 65 age bracket have Internet access, most of the elderly lack sufficient information about the facilities available to them in order to make their life as comfortable as possible. Much of the information, from both public and private sources, about facilities such as healthcare, social insurance and other services, is available on the Internet. Among people aged over 65 years, the most popular method of obtaining information through the Internet is via web pages; therefore, making their Web browsing experience more comfortable could consequently enhance their skills and expand the number of job categories they are eligible for. However, Japanese elderly have less experience in using the typewriter. This is also the reason why they have an aversion to using the personal computer (PC). In this regard, the universally relevant issue of accessibility should be discussed. 1.2 Japanese response to usability and accessibility issues Usability is defined in ISO 9241-11:1998 as follows: a product can be used by specified users to achieve specified goals with effectiveness, efficiency and satisfaction in a specified context of use. This means that the products having usability are used to the specified users’ satisfaction in a specified context. Thus, the concept of usability specifies the user, the user’s goals and the context of use. On the other hand, these restrictions on the targets are not present in the concept of accessibility. Bergman and Johnson (1995) described accessibility as follows: ‘Providing accessibility means removing barriers that prevent people with disabilities from participating in substantial life activities, including the use of services, products, and information’. Therefore, specifying or identifying the barriers is difficult for persons without disabilities. Moreover, the degree to which a barrier is perceived is subjective and depends on the user’s characteristics. Hence, evaluating whether a product or service is accessible is difficult. However, some relevant standards on usability and accessibility have been issued by the International Standards Organization (ISO)1 , and the United States has enforced the regulations for making products for use by the elderly. Since the Amendment to Section 508 of the Rehabilitation Act came into effect in 1998 in the United States, Japanese electronics companies and computer makers have been paying attention to the concept of accessibility. In 2001, the METI2 published the original of ‘ISO/IEC Guide 71’which contains the guidelines for addressing the needs of the elderly and persons with disabilities. Since then, the guidelines have been providing directions to Japanese 1 For

example, ISO 9241-11 and ISO FDIS 9241-20 are well known. Ministry of Economy, Trade and Industry

2 METI:

227

manufacturers for making products for the elderly and persons with disabilities. Moreover, the Japanese government has actively promoted standardising through ISO, and a few committees and associations have been formed for the purpose of laying down standards, guidelines, and recommendations for providing accessible devices and services. Thus, the Japanese government has been actively involved in addressing the issue of accessibility. 1.3 Does the concept consider Web browsing accessibility issues for the Japanese elderly? Although guidelines, standards, regulations and recommendations exist, these have just abstractly informed us about how to realise accessibility. On the other hand, some researchers have attempted to address the accessibility issues experimentally. For example, Fisk et al. (2004) proposed design guidelines for older adults based on human factors approaches. However, these guidelines did not fit the Japanese elderly, who do not live in the English-speaking world as described in our previous work. Our previous research on Japanese older persons showed that they preferred fewer pages and menu branches, with information condensed using a smaller font size, rather than more pages with a larger font size. This was because they felt uncomfortable with multiple selections and preferred having all the information displayed in one place, rather than having to select individual topics Kobayashi and Yamamoto (2003). This observation indicates that the concept and technique of providing accessibility could depend on the various characteristics of Japanese users. According to the ‘General principles concerning measures for the aged society’ issued by the Japanese government (2004), the individual situation of Japanese elderly people and their living circumstances can vary widely according to gender, state of health, financial situation, family structure, and housing. Thus, it is incorrect to treat them all as similar. Therefore, the conventional knowledge about providing accessibility should be reconsidered from an older person’s perspective. 1.4 Aim of this study In this paper, through some case studies, we discuss the reason why only vague ideas for realising accessibility are indicated in the existing standards and recommendations, and propose some ideas for providing accessibility to the Japanese elderly. The concept of accessibility is applicable to people with disabilities; however, the people with disabilities have such a wide range of characteristics that considering all the issues for all of them would be difficult. Therefore, we narrowed the scope of our study to Japanese older persons. We investigated their characteristics in the context of Web browsing using a Web browser on a notebook PC and focussed on the issue of providing accessibility to the users. Thus, we considered the issue of Web browsing accessibility based on investigation among a range of users. Thus, the present study is basic research focusing on the issues involved in expanding older persons’ ability for participating in the Japanese Internet environment. 2 CASE STUDY OF HANDLING A COMPUTER MOUSE The computer mouse can be assumed to be the device that is commonly used for obtaining information from Web sites, although some types of notebook computers have other pointing devices. In Japan, a computer mouse with two buttons is most common pointing device used by the elderly, and most textbooks on using Web browsers and application software assume the use of a computer mouse. Therefore, we first observed a few older persons handling a computer mouse in order to identify the barriers they faced. 2.1 Participants The participants were 16 older persons, 11 males and 5 females, with ages ranging from 63 to 83 years (mean = 72.9, S.D. = 6.2), and all of them were right-handed. All of the participants were volunteers. Four male participants had prior experience browsing the Web using a computer. None of the participants had any physical or psychomotor disabilities. All participants were residents of the Shinjuku ward in Tokyo and visited a public community center in their neighbourhood. 228

Figure 1.

Home page of the official Web site of the Shinjuku ward.

2.2 Apparatus and materials All participants visited a public Web site (official Web site of the Shinjuku ward) using a notebook computer (IBM ThinkPad R40) with a mouse (Microsoft IntelliMouse® ) having two buttons and a wheel. The notebook computer was running the Microsoft® Windows® XP Professional operating system, Japanese edition, and had a 1024 × 768 pixel (15 inches) display. The Web browser used was Microsoft Internet Explorer Version 6. The public Web site provides a great amount of useful information for residents of the ward (see Figure 1). The Web site provides information regarding public and private services, the national pension, health care, etc. It consists of hierarchical pages with more than four layers requiring multiple selections. However, this study used a part of the Web site that was copied and was stored on the hard disks of the users’ notebook computers because the public community center did not provide Internet access facility to users. Further, a custom software was installed on the participants’ notebook computers that recorded mouse events on the hard disk of the notebook computer. Therefore, the locus of the mouse pointer and click events were obtained from the recorded files. 2.3 Procedure We instructed every participant on how to hold, move, and click the mouse, and allowed them to practice mouse operation. After receiving the instruction, each participant browsed the Web site without restraint, in succession. They stated their impressions of browsing each Web page of the Web site. The participants felt slightly nervous when a video camera pointed at them to record their actions. Their reports were recorded using a tape recorder, and their performance was recorded as mouse events using the custom software. After their Web browsing, their opinions about the experience were obtained. 2.4 Results of the observation The mouse events recorded in the data files indicated that the many erroneous clicking around each target in different font sizes occurred. Further, we observed the following characteristics of their Web browsing performance: • Several gaps were observed on the screen between the mouse pointer and the location of correct hypertext link that needed to be clicked (see Figure 2). 229

Figure 2.

Gaps observed on the home page of the Web site in the mouse events of all 16 participants. (The length of the gaps has been magnified 10 times in the figure).

• Unintentional manipulation such as clicking the middle or right buttons on the mouse caused the browser to scroll the Web page automatically or to display pop up context menu, which caused thorough confusion among the participants. • There were numerous small target areas on the Web pages, making it difficult for some participants to accurately point at them using the mouse. • There were some Japanese sentences in 8 point font, which was difficult for many participants to search and read. 2.5 What are the barriers they face? From the results of the above-mentioned observation, the difficulties faced during Web browsing by the elderly participants can be classified into the following three points: • Moving the mouse pointer to the desired hypertext link. • Keeping and holding the mouse in order to push and release the button. • Using small hypertext links on Web pages. Taking the above results into account, we had to identify the measures to be taken in order to improve the accessibility of Web browsing for the elderly. The results suggest that it is difficult for them to adjust their movements for correct mouse operation. In other words, they would continue to face mouse operation as a barrier. To remove this barrier, therefore, the layout of Web pages should be rearranged according to accessibility guidelines such as ISO/FDIS 9241-151 and W3C. Small hypertext links increase the difficulty of handling a computer mouse, and enlarging the font size of the Web page affects the layout and size of the Web page. Thus, improving the layout of Web pages alone is not sufficient to remove the barrier. Therefore, we should identify alternative methods for improving their Web browsing experience. 2.6 How can the barrier be removed? In order to improve the Web browsing experience for the elderly, we tried to develop an accessibility tool. This accessibility tool aimed to remove the barriers faced by the participants in the observation. Thus, we concluded that the following three functions must be incorporated into the Web pages in order to modify the Web browsing environment to the needs of the elderly: • Moving the mouse pointer to the desired hypertext link on the screen. • Enlarging the click area. • Accepting commands only from the left mouse button (see Figure 3). 230

Figure 3. Three functions for expecting providing accessibility.

Figure 4.

Experimental Web pages: Each page shows nine Japanese hypertext links using 8 point font size (left), 12 point font size (centre) and 16 point font size (right).

The above three functions are provided by two modules of the accessibility tool. The first module processes the mouse events using a system standard Application Program Interface (API), and the second module, which processes Hypertext Markup Language (HTML), embeds JavaScript and Cascade Style Sheet (CSS) in the HTML file through an HTTP proxy3 . 2.7 Verification of the accessibility tool’s effectiveness The effectiveness of the tool should be tested under use by the elderly; therefore, we conducted experiments and compared their performances with and without using the tool. The results suggested that the difficulty of handling a computer mouse could be related to the font size of the hypertext link. Therefore, we investigated the number of erroneous clicks and time taken for completing three different tasks (see Figure 4). The participants of the test were 21 older persons with ages ranging from 60 to 74 years (mean = 65.1, S.D. = 4.4). Eleven participants had prior experience operating a PC. None of the participants had any physical or psychomotor disabilities, and all of them were right handed. They were instructed on how to use the mouse and about the requirement of the task. They were allowed to practice mouse operation, on which no time limit was set, and assistance was provided on demand. The task was locating and clicking the hypertext links on the first Web page with 8 point font size, 3 Takahashi, Y., Kobayashi, D. and Yamamoto, S., 2005, Development of Accessibility Tool for Elderly People.

In Proceedings of HCI International 2005, Las Vegas.

231

5

Normal With the tool

***

Erroneous clicks

4

***: p  .01 **: p  .05 **

3

** 2 1 0

Figure 5.

8

12 Font size (point)

16

Comparison of the number of erroneous clicks.

100

Normal

***

With the tool ***

Time taken (sec)

80

***: p  .01 ***

60 40 20 0

Figure 6.

8

12 Font size (point)

16

Comparison of time taken for a task.

as shown in the image on the left of Figure 4. When all the hypertext links were clicked, the next page, with 12 point font size, was displayed (see the image in the centre of the figure). Similarly, the last page with 16 point font size was displayed after the participant had clicked all hypertext links on the previous page (see the image on the right of the figure). Every participant was presented with three trials without using the functions of the accessibility tool, and three more trials were completed after the functions were enabled. The apparatus used by the participants was the same as that used in the observational study described earlier. Based on the mouse events recorded in the data files, we counted the number of erroneous click events around each click area in every font size. The time elapsed between the first and last clicks on a page. The number of erroneous clicks and the time taken for the task are shown in Figures 5 and 6. Figure 5 presents the comparison between the average numbers of erroneous clicks. This result statistically indicates that the tool significantly reduced erroneous clicks (p < .05 or p < .01). The participants responded ‘Mouse operation became easy’, ‘The link objects were enlarged, so I could 232

see the links clearly’, ‘I could locate the link easily’. Therefore, we conclude that some of the barriers leading to erroneous clicks were reduced by the following: • The function for enlarging click area, which made it easy for the participants to select the link object. • The function for moving the mouse pointer, which helped the participants to move the mouse pointer to the desired hypertext link. • The function for moving the mouse pointer, which reduced erroneous clicks by decreasing the gap between the mouse pointer and the click area. Figure 6 shows that the average time taken was significantly reduced (p < .01) when the tool was used. Moreover, no assistance was required when all the functions of the tool were enabled.

2.8 Discussion Opinions about the tool and the trials were obtained from all participants after the trials. Seventeen participants felt that the operation became easier than normal, using the tool. However, four participants responded that they did not experience any changes in the operation. Two of these participants cited the reason ‘I did not have difficulty in the operation even without the tool’, and the other two participants said that ‘I did not understand the functions of the tool well because I am not interested in operating the PC’. In spite of the preferable performance using the tool, these opinions suggest two things. Firstly, it was difficult to improve accessibility for every participant, and secondly, it would be difficult to satisfy them regardless of whether accessibility is improved or not. The concept of accessibility is different from that of usability, in that the user’s satisfaction is not considered. However, the barriers faced by the elderly could be subjective distress and the feelings in their subconscious. Therefore, the satisfaction of users may represent the accessibility for them, so every user’s opinion is important. In this regard, we conducted further research, which is described later in the paper.

3 VERIFIYING THE EFFECTIVENESS OF THE ACCESSIBILITY TOOL’S FUNCTIONS Through another observational study, we attempted to identify the reason why the accessibility tool we developed could not satisfy every elderly user. Although the concept of a user should not be restricted by the accessibility concept, we should consider the factors affected by experience because it could affect the perception of a barrier for some elderly users. Further, since the accessibility tool contains three functions, we checked the effectiveness of each function. From these viewpoints, we conducted further investigation to ascertain the effectiveness of the accessibility tool.

3.1 Method Participants were 17 older persons with ages ranging from 65 to 83 years (mean = 73.3, S.D. = 6.3). Five participants had experience operating PCs for more than one year. None of the participants had any physical or psychomotor disabilities, and all of them were all right handed. The task was to find out the telephone number of four municipally-owned facilities on the public Web site (see Figure 1). Every participant first attempted to complete the task without the functions of the tool; later, another trial was completed with the functions enabled. In each trial, we randomly selected a facility and asked each participant to find its telephone number. After the trials, the participants’ opinions about the trials were obtained. The apparatus used in this study was the same as that used in the above-mentioned investigations. Thus, the participants’ performance was recorded as mouse events, using the custom software. 233

3.2 Results Based on the experimental data, the effectiveness of the three functions is discussed as follows. Firstly, based on the mouse events, we investigated the effectiveness of the function ‘moving the mouse pointer to the desired position’. Erroneous clicks were observed in six inexperienced participants’ performance when they did not use the tool, although many gaps were observed in the performance of every participant. When the tool was used, none of the participants realised that the gaps were corrected by the tool’s function; however, erroneous clicks were greatly reduced when the function was used. Therefore, it is fair to say that the effectiveness of the function was clarified. Secondly, the effectiveness of the function ‘enlarging click area’ was investigated based on the participants’ opinions. The results revealed that five participants, including an experienced older person, indicated that the click area was eye-friendly; however, the other five participants, including three experienced older persons, complained about the function because the enlarged click area overlapped other contents of the Web page. Therefore, this function was not useful for the elderly in some cases. Lastly, the function ‘accepting commands only from the left mouse button’ was evaluated. Although the participants could complete the task using the left button and a center wheel for scrolling, the 12 inexperienced participants pressed the middle and left buttons with an average frequency of about ten, without using the tool. On the other hand, the experienced participants’ frequency was about two. These results suggest that the function was effective just for the older persons inexperienced in handling a computer mouse. Further, we observed that some participants unintentionally browsed the same page repeatedly. The inexperienced participants said that they were not able to perceive the change in the colour of hypertext link that they clicked. These perception errors confused the inexperienced participants; therefore, during trials, most of these participants asked queries such as ‘What should I do?’ The performance of these participants’ indicates that the perception error causing confusion may be a barrier to Web browsing for the elderly. 3.3 Discussion The results revealed that the functions, except for ‘moving the mouse pointer to the desired position’, have limited effect in providing accessibility. This suggests that the context in which the tool is used affects the level of accessibility provided, in accordance with the participants’ characteristics such as experience and skill. Therefore it is difficult to standardise the recommendations for accessibility. Moreover, the factors causing the participants overlook the clicked hypertext links may raise a barrier for them; therefore, these factors should be addressed in order to provide accessibility for the elderly. There may be some methods for addressing these factors; however, it is important that the methods do not induce nervous strain on the older persons, as training does, given Japanese older persons’ aversion to the PC. Based on this point, another function prevents the older persons from overlooking the change in the colour of the hypertext link was proposed. 3.4 Effectiveness of reversing clicked hypertext links The function we tried was to highlight the clicked hypertext in order to prevent the participants’ perception error. The clicked hypertexts links were indicated by reversed characters using the Stylesheet Language for Web pages. This function was believed to be extremely effective and easy to use. Therefore, the effectiveness of this function was tested through the following experiment. Participants were eight older persons with ages ranging from 65 to 82 (mean = 70.5, S.D. = 6.9), and all of them were right-handed. Two of them had experience operating personal computers for more than one year. The apparatus, the task, and the procedure were the same as those used in the experiments described earlier. The results revealed that every participant subjectively agreed with our idea; therefore, we conclude that the function is effective in providing subjective accessibility, based on the context of use. 234

4 CONCLUSION In order to expand the older person’s work ability, some characteristics of elderly participants have been studied through some experiments and trials. The results revealed the characteristics of Japanese elderly that raised some barriers for them with regard to Web browsing. These barriers fall under two categories. The first category concerns their ability for Web browsing, which is covered under the conventional concept of accessibility. On the other hand, the second category concerns their manner and motivation for browsing the Web. Further, it was found that the barriers in the second category could not be removed by approaching the issue by the conventional accessibility concept alone. The experimental results also revealed that the level of accessibility felt differed from one participant to the other because their respective contexts of use were also different. This finding suggests that it is difficult to evaluate the accessibility level with respect to their physical or psychomotor abilities. Therefore, a measure of users’ satisfaction should be incorporated into the concept of accessibility as well as the usability concept. The definitive method for providing accessibility has not yet been proposed in the several existing accessibility guidelines and standards. In this regard, we should develop more methods for expanding the older person’s ability to utilize information technology, according to their respective contexts of Web use. REFERENCES Bergman, E. and Johnson, E., (1995). Towards Accessible Human-Computer Interaction. In: Advances in Human-Computer Interaction, Vol. 5, 1st, edited by Nielsen, J. (New Jersey: Ablex Publishing Corporation), pp. 87–113. Fisk, A. D., Rogers, W. A., Czaja, S. J., Charness, N. and Sharit, J., (2004). Designing for Older Adults, (London: CRC Press).

235

Chapter 5 Age Affected Functions

Promotion of Work Ability towards Productive Aging – Kumashiro (ed) © 2009 Taylor & Francis Group, London, ISBN 978-0-415-48590-6

Impact of psychosocial work environment factors measured by the COPSOQ on the need for recovery after work in aging workers. Preliminary results Philippe Kiss & Marc De Meester Securex Occupational Health Service, Ghent, Belgium Department of Public Health, Ghent University, Ghent, Belgium

1 INTRODUCTION In recent research it has been demonstrated that long-term adverse health effects are preceded by short-term effects (Sluiter et al., 1999). These short-term effects are signs of fatigue which are mostly experienced during or immediately after a day’s work. This is thought not to be a problem if enough recovery time is offered between two periods of work. If there is not enough time to recover from this fatigue in between two periods of work, the cumulated effects of this fatigue will lead to long-term adverse health effects (Sluiter et al., 1999). This is concordant with the cognitive activation theory of stress (CATS), where a sustained response may lead to illness and disease (Ursin and Eriksen, 2004). In the CATS stress response is defined as an alarm in a homeostatic system, producing neurophysiological activation. The activation can be reduced by coping mechanisms, triggered by the same alarm. If the coping mechanisms are inadequate to reduce the activation level, a certain aroused activation level remains. If sustained this may lead to adverse health effects (Ursin and Eriksen, 2004). The short term effects, manifested in feelings of temporary overload after work or subjective need for recovery, are recognizable in the immediate off-work situation and might be a useful indication of the personal psycho-physiological homeostatic balance at that moment (Sluiter et al., 2001). The subjective need for recovery can be measured by “The need for recovery scale”. This scale, used to measure early indications of fatigue at work, proved to be a powerful predictor of experienced health problems (Sluiter et al., 1999; Sluiter et al., 2003; van Veldhoven and Broersen, 2003). This was also confirmed in a study performed in 541 employees working in the public sector where the relationship between work stress and need for recovery was explored. The results showed that the presence of psychosomatic health complaints was significantly associated with the need for recovery (De Meester and Kiss, 2002). In earlier research, also the relationship between short-term effects and high psychosocial work load was demonstrated (Sluiter et al., 1999). More recently, it was shown that subjects who reported more job demands also reported more need for recovery from work (Sluiter et al., 2001). In a recent study (Kiss et al., 2007), it was pointed out that ageing workers had a higher need for recovery, even after taking into account several occupational, personal and social and family life factors. However, a detailed exploration on the influence of psychosocial work environment factors on the need for recovery was not performed up to now. The Copenhagen Psychosocial Questionnaire (COPSOQ) is a new tool for the assessment of psychosocial factors at work. The purpose of the COPSOQ concept is to improve and facilitate research as well as practical interventions at the workplaces. The COPSOQ concept turned out to be a valid and reliable tool for workplace surveys, analytic research, interventions and international comparisons. The questionnaire includes most of the relevant dimensions according to a number of important theories on psychosocial factors at work (Kristensen et al., 2005). 239

The aims of this study were to explore the impact of psychosocial work environment factors on the need for recovery using the COPSOQ and subsequently to explore differences between older and younger workers. However, since data collection is still in progress, these results can only be considered as preliminary.

2 METHODS This study has been approved by the Ethics Committee Progecov (Commissie voor Medische Ethiek OG 211, Ghent, Belgium). 2.1 Subjects 998 subjects employed in the public sector were asked to participate in a cross-sectional questionnaire study. All subjects received a standardized self-completed questionnaire at their home addresses by mail. One month later a second data collection was carried out amongst the nonresponders. Eventually 781 subjects returned the questionnaire (78.3% response rate). 15 subjects with missing values on the outcome variable and six subjects with unknown age were excluded from the analyses. This reduced the number of participants to 760 subjects (76.2% participation rate). Mean age was 41.6 years (SD 9.8), ranging from 19 to 63 years. For comparison of older and younger workers the subjects were divided into two age groups: older workers (45 years or older) and younger workers (younger than 45 years), according to the definition of the World Health Organisation (WHO 1993). 317 subjects (41.7%) were 45 years or older and 443 subjects (58.3%) were younger than 45 years. 2.2 Need for recovery The dependent outcome variable was the experienced need for recovery, which was assessed by “The Need for Recovery Scale” questionnaire. The need for recovery scale was computed by summing up the scores of the 11 constituent dichotomous (yes/no) items, resulting in a score ranging from 0 to 11, which was transformed to a 0 to 100 scale. Reliability of the scale in this study reached 0.89 (Cronbach’s α), which was comparable to the reliability found in earlier studies (Sluiter et al., 1999; van Veldhoven and Broersen, 2003; Jansen et al., 2003). A need for recovery score higher than 50 was defined as a high need for recovery, while a score of 50 and lower was defined as a low need for recovery. 2.3 Psychosocial work strain For the assessment of psychosocial work environment factors 17 dimensions of the COPSOQ were used, each transformed to a 0-100 scale: quantitative demands (seven items, Cronbach’s α 0.85), emotional demands (three items, Cronbach’s α 0.83), demands for hiding emotions (two items, Cronbach’s α 0.60), cognitive demands (eight items, Cronbach’s α 0.89), influence at work (10 items, Cronbach’s α 0.79), possibilities for development (seven items, Cronbach’s α 0.84), degrees of freedom (four items, Cronbach’s α 0.66), meaning of work (three items, Cronbach’s α 0.80), commitment to the workplace (four items, Cronbach’s α 0.62), social support (four items, Cronbach’s α 0.77), social relations (three items, Cronbach’s α 0.56), role clarity (four items, Cronbach’s α 0.67), role conflicts (four items, Cronbach’s α 0.82), predictability (two items, Cronbach’s α 0.72), feedback (two items, Cronbach’s α 0.61), sense of community (three items, Cronbach’s α 0.84) and quality of leadership (eight items, Cronbach’s α 0.94). The reliability figures were comparable with those found in the original study, where the detailed composition of the different scales was described (Kristensen et al., 2005). The dimension ‘role conflicts’ was coded reversed: high scoring for this item was concordant with a low degree of role conflicts. 240

2.4 Physical work strain and other occupational factors Physical work strain was assessed using a three item physical work load scale, comprising sustained physical efforts, lifting heavy weights and working in awkward positions (Cronbach’s α 0.83). Scoring for each separate item was analogous to scoring for the job demands items. The physical work load scale was computed by summing up the scores of the three constituent items, resulting in a score ranging from 0 to 9. The highest score was concordant with the highest physical strain. Other relevant occupational factors that could be of influence on the need for recovery were included in the questionnaire: part-time (3,83 (1–5) O.R.

Emotional exhaustion

1.34 1.19

0.96 1.09

2.06 1.71 1.32 1.09

1.06 0.86 1.16 0.99

0.72 0.69 0.56

1.78 1.53 1.60 0.88 0.66 1.34 1.52 0.76

1.06 0.94

0.69 0.90

1.08 0.96 1.20 1.03

0.51 0.43 0.66 0.52

0.56 0.53 0.39

1.17 1.00 1.00 0.57 0.38 0.86 0.88 0.58

1.70 1.51

1.33 1.32

3.91 3.05 1.46 1.16

2.23 1.74 2.05 1.88

0.91 0.89 0.80

2.72 2.34 2.55 1.35 1.14 2.07 2.65 0.98

>3 (range 1–5) O.R. 95% CI

Thought to give up health care job

2.88 1.44

0.98 1.17

0.94 1.13 1.44 1.24

1.79 0.77 1.20 1.06

1.17 1.23 1.29

3.91 3.26 2.65 3.48 2.33 9.29 5.35 1.87

2.26 1.11

0.73 0.99

0.54 0.75 1.33 1.18

1.07 0.43 0.85 0.75

0.91 0.95 0.92

2.05 1.71 1.35 1.84 1.16 4.95 2.69 1.35

3.67 1.88

1.32 1.39

1.59 1.70 1.58 1.30

3.00 1.35 1.70 1.48

1.50 1.60 1.82

7.46 6.21 5.21 6.58 4.65 17.43 10.62 2.57