Work ability—a comprehensive concept for occupational health research and prevention

The use of the work ability index began in the early 1980s in Finland. The basic scientific question was how long workers and employees are able to work and to what extent being able to work depends on the work content and job demands. In those days, job-dependent retirement ages from 53 years (deep sea divers) to 63 years (administrative jobs) were common in Finnish municipal occupations. The early-retirement options were rather broad, and the costs of work disability tended to increase. The public discussion was dominated by a fear of an increasing trend towards work disability and a shortening of work careers due to a variety of reasons, not only medical in nature. A social need for a new, positive approach was obvious, as represented by work ability. Using the stress-strain concept, a multidisciplinary study group developed and validated the work ability index and started studies among municipal employees (N=6257) over 45 years of age and repeated them in 1985, 1991, and 1997 (1, 2). One of the main findings was that the mean work ability index declined significantly among 30% of the participants, remained rather unchanged among 60%, and improved among 10% over an 11-year period for both genders, as well as for physically, mentally, or mixed (physical and mental) demanding jobs. A logistic regression model indicated that factors related to management, ergonomics, and lifestyle explained both the decline and improvement in work ability during aging The consequences of the findings were significant and long lasting. First, the Finnish social partners agreed in 1989 about the maintenance and promotion of work ability in workplaces. Second, the promotion concept of work ability was created and validated in private, municipal, and government branches (5).Third, occupational health professionals, physicians, and nurses, were trained by the Finnish Institute of Occupational Health in the use of the work ability index. After 1993, translations of the questionnaire for the work ability index were used by Austrian and Dutch research groups, and, today, this questionnaire is available in 26 languages. The use of the index has become common in research worldwide. The Ageing and Work Committee of the International Commission on Occupational Health (ICOH) and the Aging Committee of the International Ergonomics Association (IEA) served as important platforms for further implementation of the work ability index internationally. The number of publications of scientific conferences and symposia dealing with the work ability index is considerable