Disentangling longitudinal relations between physical activity, work-related fatigue, and task demands.

PURPOSE: This longitudinal study examined 'normal', 'reversed', and 'reciprocal' relationships between (1) physical activity and work-related fatigue; and (2) physical activity and task demands. Furthermore, the effects of across-time change in meaningful physical activity groups on levels of employees' work-related fatigue and task demands were studied. These groups were based on employees' compliance with the international physical activity norm. METHODS: Two waves with a one-year time lag of a national representative survey on the quality of work, health, and well-being among Dutch employees were used (N = 2275). Longitudinal effects were tested using Structural Equation Modelling. Meaningful physical activity groups were compared using group-by-time analysis of covariance. RESULTS: Support was found for reciprocal relations between physical activity and work-related fatigue. It was found that an increase in physical activity is associated with a decrease in work-related fatigue over time and that an increase in work-related fatigue is associated with a decrease in physical activity over time. No significant longitudinal relations were found between physical activity and task demands. Employees whose compliance with the physical activity norm changed over time showed fairly stable levels of work-related fatigue and task demands. CONCLUSIONS: The current findings provide evidence for the potential role of physical activity in the prevention and reduction in work-related fatigue. However, results also indicate that fatigued workers, who would benefit most from physical activity, are less physically active. Our results further indicate that relying on changes in compliance to the physical activity norm may not be the most suitable way to examine changes in work-related fatigue.

Who gets fired, who gets re-hired: the role of workers' contract, age, health, work ability, performance, work satisfaction and employee investments.

PURPOSE: Many workers have been dismissed in the past few years, either becoming unemployed or finding re-employment. The current study examined whether dismissal and its follow-up for the employee (re-employment versus unemployment) could be predicted from workers' employment contract and age, and their health status, work ability, work performance, work satisfaction and employee investments at baseline. METHODS: Our sample comprised a selection of participants from the Netherlands Working Conditions Survey 2010 who participated in a follow-up questionnaire in 2012 (N = 2,644). We used logistic regression analyses to test our hypotheses. RESULTS: Temporary employment, low health status, low work ability, poor work performance, low work satisfaction and no employee investments in terms of training predicted future dismissal. Furthermore, older workers and workers reporting decreased work performance due to impaired health at baseline had a lower chance of re-employment after being dismissed. Interestingly, after taking into account all predictors, former temporary workers without permanent employment prospects had much better chances of re-employment after their dismissal than former permanent workers. CONCLUSIONS: Temporary, less healthy, low work ability, poor performing, dissatisfied and "under-invested" workers are at risk for dismissal, whereas older and less healthy workers are (also) at risk for long-term unemployment after being dismissed.

Burden of Sickness Absence Due to Chronic Disease in the Dutch Workforce from 2007 to 2011.

INTRODUCTION: Chronic diseases are associated with productivity loss costs due to sickness absence. It is not always clear, however, which chronic diseases in particular are involved with how many sickness days and associated costs. OBJECTIVE: To determine the prevalence, additional days of sickness absence, and associated costs of chronic diseases among the Dutch working population from 2007 to 2011. METHODS: Prevalence of chronic diseases and additional days of sickness absence were derived from the Netherlands Working Conditions Survey (NWCS) from 2007 to 2011. The cost of each sickness absence day was based on linked personal income data. We used multiple regression analysis to derive the unconfounded additional days of sickness absence due to each chronic disease. RESULTS: Annually, approximately 37 % of the Dutch working population reported some type of chronic physical or psychological disease. No clinically relevant changes in prevalence of specific chronic diseases were observed in the studied period, nor in the number of additional sickness absence days or associated costs. The national financial burden due to sickness absence associated with chronic musculoskeletal disorders amounted to €1.3 billion annually. CONCLUSIONS: Chronic diseases result in substantial productivity loss due to sickness absence. Given the ageing population, the proposed increase in the state pension age and an increase in sedentary lifestyle and obesity, the prevalence of chronic diseases may be expected to rise. Coordinated efforts to maintain and improve the health of the working population are necessary to minimize socioeconomic consequences.

Relation between perceived health and sick leave in employees with a chronic illness.

INTRODUCTION: To improve work participation in individuals with a chronic illness, insight into the role of work-related factors in the association between health and sick leave is needed. The aim of this study was to gain insight into the contribution of work limitations, work characteristics, and work adjustments to the association between health and sick leave in employees with a chronic illness. METHODS: All employees with a chronic illness, between 15 and 65 years of age (n = 7,748) were selected from The Netherlands Working Conditions Survey. The survey included questions about perceived health, working conditions, and sick leave. Block-wise multivariate linear regression analyses were performed and, in different blocks, limitations at work, work characteristics, and work adjustments were added to the model of perceived health status. Changes in regression coefficient (B) (%) were calculated for the total group and for sub-groups per chronic illness. RESULTS: When work limitations were added to the model, the B between health and sick leave decreased by 18% (5.0 to 4.1). Adding work characteristics did not decrease the association between health and sick leave, but the B between work limitations and sick leave decreased by 14%, (5.3 to 4.5). When work adjustments were added to the model, the Bs between sick leave and work limitations and work characteristics changed from 4.5 to 3.4 for work limitations and from 2.1 to 1.9 for temporary contract and from -0.8 to -1.0 for supervisor support. CONCLUSIONS: The association between health and sick leave was explained by limitations at work, work characteristics, and work adjustments. Paying more attention to work limitations, characteristics and adjustments offers opportunities to reduce the negative consequences of chronic illness.

Productivity loss at work; health-related and work-related factors.

INTRODUCTION: Productivity loss is an increasing problem in an aging working population that is decreasing in numbers. The aim of this study is to identify work-related and health-related characteristics associated with productivity loss, due to either sickness absence or reduced performance at work. METHODS: In this cross-sectional study, data of the Netherlands Working Conditions Survey of 2007 were used, which includes a national representative sample of 22,759 employees aged 15 to 64 years. Demographic characteristics, health-related and work-related factors were assessed with a questionnaire. Logistic regression analyses were carried out to study the relationship of work-related and health-related factors with low performance at work and sickness absence in the past 12 months. RESULTS: Poor general health, the number of longstanding health conditions, and most types of longstanding health conditions were associated with productivity loss. Health-related factors were in general stronger associated with sickness absence than with low performance at work. Performance: poor health OR 1.54 CI 1.38-1.71, >1 health conditions OR 1.21 CI 1.09-1.35; sickness absence: poor health OR 2.62 CI 2.33-2.93, >1 health conditions OR 2.47 CI 2.21-2.75. Of the different types of longstanding health conditions, only psychological complaints and to a small extent musculoskeletal symptoms, were associated with low performance (respectively OR 1.54 CI 1.27-1.87; OR 1.09 CI 1.00-1.18). Low performance at work was less likely among employees with high physically demanding work (shift work OR 0.70 CI 0.63-0.76, using force OR 0.78 CI 0.72-0.84, and repetitive movements OR 0.74 CI 0.70-0.79). Psychosocial factors were stronger associated with low performance at work than with sickness absence (performance: job autonomy OR 1.28 CI 1.21-1.37, job demands OR 1.23 CI 1.16-1.31, emotionally demanding work OR 1.73 CI 1.62-1.85; sickness absence: job autonomy ns, job demands OR 1.09 CI 1.03-1.17, emotionally demanding work OR 1.09 CI 1.02-1.16). CONCLUSION: Except for psychological complaints, workers with a longstanding health condition generally perform well while being at work. Nevertheless, the likelihood of taking sick leave is increased. Among work-related factors, psychosocial work characteristics have the strongest relation with productivity loss, mostly with performance while at work.

Bidirectional relations between work-related stress, sleep quality and perseverative cognition.

OBJECTIVE: In this longitudinal two-wave study, bidirectional relations between work-related stress and sleep quality were examined. Moreover, it was investigated whether perseverative cognition is a potential underlying mechanism in this association, related to both work-related stress and sleep quality. METHODS: A randomly selected sample of Dutch employees received an online survey in 2012 and 2013. Of all invited employees, 877 participated in both waves. Structural equation modeling was performed to analyze the data. RESULTS: We found evidence for reversed relations between work-related stress and sleep quality. Specifically, when controlling for perseverative cognition, work-related stress was not directly related to subsequent sleep quality, but low sleep quality was associated with an increase in work-related stress over time. Moreover, negative bidirectional associations over time were found between perseverative cognition and sleep quality, and positive bidirectional associations were found between work-related stress and perseverative cognition. Lastly, a mediation analysis showed that perseverative cognition fully mediated the relationship between work-related stress and sleep quality. CONCLUSION: The study findings suggest that perseverative cognition could be an important underlying mechanism in the association between work-related stress and sleep quality. The bidirectionality of the studied relationships could be an indication of a vicious cycle, in which work-related stress, perseverative cognition, and sleep quality mutually influence each other over time.

Worktime control access, need and use in relation to work-home interference, fatigue, and job motivation.

OBJECTIVE: Worktime control (WTC) has been suggested as a tool to reduce employees' work-home interference and fatigue and improve job motivation. The purpose of this study was twofold: (i) to examine the prevalence of employees' need for, access to, and use of WTC, as well as the incongruence between need for and access to WTC (ie, mismatch); and (ii) to examine the associations of this mismatch and the use of WTC with employees' work-home interference (WHI), fatigue and job motivation. METHODS: Questionnaire data were collected among a large (N=2420) quasi-representative sample of Dutch employees. The prevalence of WTC need, access, use, and mismatch was assessed by means of descriptive statistics. Associations with employees' outcomes were assessed by analyses of covariance. RESULTS: The need for WTC was highly prevalent. For many employees, we observed a negative mismatch between access to and need for WTC (ie, access

Enterprise restructuring and the health of employees: a cohort study.

OBJECTIVE: To examine the influence of enterprise restructuring on general health and emotional exhaustion, and to investigate which factors explain the relation between restructuring and these outcomes. METHODS: Longitudinal data of the Netherlands Working Conditions Cohort Study were used. At baseline and after 12 months, 9076 employees filled out a questionnaire. Logistic regression analysis was applied. RESULTS: Prolonged exposure to restructuring increased the likelihood of poor general health, and its influence was partly explained by job insecurity. Emotional exhaustion was more likely among employees that experienced prolonged exposure to restructuring or restructuring during the past year. Job insecurity explained the influence of prolonged restructuring, together with job demands and supervisor's support. CONCLUSIONS: Prolonged exposure to restructuring adversely affects general health and emotional exhaustion in employees, and its influence seems to be explained by job insecurity.

Impact of employment contract changes on workers' quality of working life, job insecurity, health and work-related attitudes.

OBJECTIVES: Changes in employment contracts may impact the quality of working life, job insecurity, health and work-related attitudes. We examined the validity of two partly competing theoretical approaches. Based upon a segmentation approach, we expected no change in scores among stable trajectories, whereas upward trajectories were expected to be for the better and downward trajectories to be for the worse (Hypothesis 1). As turnover theories suggest that this hypothesis may only apply to workers who do not change employer, we also examined these contract trajectories stratified for a change of employer (Hypothesis 2). METHODS AND RESULTS: Drawing on the 2007 and 2008 waves of the Netherlands Working Conditions Cohort Study (N=9,688), repeated measures analysis of covariance showed little across-time change in the criterion variables, thus largely disconfirming our first hypothesis. These results could (at least partly) be explained by employer change; this was generally associated with improved scores among all contract trajectories (Hypothesis 2). However, workers receiving a less stable contract from the same employer were found to be at risk for health and well-being problems. CONCLUSIONS: Segmentation theory-based assumptions on contract trajectories primarily apply to stable and downward contract trajectories at the same employer, whereas assumptions from turnover theories better apply to contract trajectories combined with a change of employer. Future research should focus more closely on factors predicting "involuntary" downward trajectories into precarious temporary employment or unemployment.

Employment contracts and health selection: unhealthy employees out and healthy employees in?

OBJECTIVE: The healthy worker effect implies that healthy workers go "up" in employment status whereas less healthy workers go "down" into precarious temporary employment or unemployment. These hypotheses were tested during an economic recession, by predicting various upward and downward contract trajectories, based on workers' health status, work-related well-being, and work ability. METHODS: Two waves (2008 and 2009) of the Netherlands Working Conditions Cohort Study (N = 7112) were used and logistic regression analyses were performed to test the hypothesis of this study. RESULTS: Lower general health and higher emotional exhaustion at baseline predicted future unemployment among permanent employees. Various downward trajectories were also predicted by lower work-related well-being and lower work ability, whereas the opposite was true for one of the upward trajectories. CONCLUSIONS: Workers with lower health, lower work-related well-being, or lower work ability are at risk for ending up in precarious temporary employment or unemployment.