Is the relation between physical work exposure and self-reported work ability dependent on age? 1st PEROSH Research Exchange in Warsaw Thursday 22. October 2015 Bo Veiersted Lars-Kristian Lunde Markus Koch Morten Wærsted Stein Knardahl Stami, Oslo, Norway bove@stami.no

Outline: Background Methods Preliminary results Discussion

Background

Background The elderly part of the population increases Many countries have increased the retirement age - or are planning to do so These trends will increase demands on the working life, either by reducing harmful work exposures for all (to improve general work-related health) - or to make work places better fit to include elderly workers with reduced health This concern may particularly be directed towards physically demanding work, as in the construction and health sector The aim of this presentation is to evaluate if physical work exposure related to perceived work ability changes by age

Methods

Material/ methods Subjects Methods: 293 construction workers (93% male) technical measurements of 64 subjects 301 health care workers (21% male) technical measurements of 63 subjects Methods: Questionnaire at baseline and every 6 months Technical measurements during work Ground reaction force by force insoles Muscle activity in neck and back by electromyography Activity and work postures by accelerometers Heart rate by «Actiheart»

Material/ methods Subjects Methods: 293 construction workers (93% male) technical measurements of 64 subjects 301 health care workers (21% male) technical measurements of 63 subjects Methods: Questionnaire at baseline and every 6 months Technical measurements during work Ground reaction force by force insoles Muscle activity in neck and back by electromyography Activity and work postures by accelerometers Heart rate by «Actiheart»

Questionnaire Mechanical work exposure (sum index, 0-13) Relative duration of work causing faster breathing Relative duration in awkward postures Both have grading; never or short time, proxy ¼, ½, ¾ and most of working day (5 cat.) (SN, 2013) Lifting 20 kg daily Grading; never, 1-4, 5-19 and ≥20 times (4 cat.) (SN, 2013) Perceived heavy work How physical demanding do you perceive your usual work (grading; 0, 0.5, … 10, >10; anchors, 13 cat.) (RPE10, Borg 1978)

Work ability and heart rate Perceived work ability at present compared to your all time best single question (graded; 0-10, 10 as best) (Nygård 2005) Heart rate (HR) measured by «Actiheart» Heart rate reserve (HRR) was calculated using minimum HR (during night), HR at work and age predicted maximal HR (Åstrand 2003, Tanaka 2001) %𝐻𝑅𝑅𝑤𝑜𝑟𝑘= (HRwork−HRmin) (HRmax−HRmin) x 100

Measurement setup Individual capacity: Cycle ergometer test (Åstrand, 2003) Isometric strength: Arm abduction Back extension Hand grip After finished work day most equipment is removed - except 5 actigraphs to be kept on continuously for the next 4-5 days Actiheart These pictures shows the application of all systems. Like one can see the chosen measurement systems are very suitable for every day use on the work place. The hole equipment can be worn under the clothes and has to initiated and synchonized once in the beginning of the working shift. The data of all systems is getting collected on data loggers. This allows us to analyze and compare the data of each system over 8 hours. Force insoles

Preliminary results

Correlation between work load, work ability and age – all participants Table 1 1 2 3 4 Age N=590 N=593 N=105 N=569 1. Mechanical work exposure (Index, 0-13) 0.56** 0.28** - 0.2** - 0.05 2. Perceived heavy work (0-12) 0.31** -0.25** - 0.01 3. Heart Rate Reserve during work (%) - 0.17 - 0.18 4. Work ability compared to best (0-10, 10 best) 0.01 Spearman’s rho; ** p<0.01

Mean work load and work ability - stratified by age group (SD, range) Table 2 16-24 25-34 35-44 45-54 55- N=33 N=132 N=154 N=164 N=103 Mechanical work exposure (Index, 0-13) 4.1 (2.7, 0-10) 2.8 (2.8, 0-11) 2.9 (2.8, 0-10) 3.1 2.6 (2.7, 0-9) N=156 N=104 Perceived heavy work (0-12) 5.5 (1.3, 3-10) 4.8 (2.4, 1-11) 5 (2.4, 1-12) 5.2 (2.3, 1-12) 4.7 (2.1, 1-9) N=9 N=20 N=31 N=27 N=18 Heart Rate Reserve during work (%) 38 (7, 25-45) 29 (8, 14-43) (7, 17-47) 28 (6, 14-41) (8, 14-44) N=32 N=128 N=146 N=158 N=102 Work ability compared to best (0-10, 10 best) 8.7 (1.3, 5-10) 8.4 (1.7, 0-10) 8.2 8.6 (1.5, 2-10) 8.5 (1.5, 3-10) 60- N=54 2.2 (2.5, 0-9) N=55 4.5 (2, 1-9) N=8 23 (7, 14-34) N=56 8.7 (1.2, 5-10)

Work load and work ability Correlation between Perceived Work Ability (0-10) and work load measures Table 3 16-24 25-34 35-44 45-54 55- Mechanical work exp. - 0.19 - 0.14 - 0.21** - 0.18* - 0.3** Perceived heavy work - 0.06 - 0.32** - 0.22** - 0.27** Heart Rate Reserve during work 0.08 - 0.44 - 0.13 - 0.29 - 0.02 Spearman’s rho; * p<0.05, ** p<0.01

Conclusions Reduced heavy work by age - indicated by both self-reports and a lower heart rate reserve during work A weak but significant negative correlation between self-reported mechanical work exposures / perceived heavy work - and work ability, (except for the youngest age group?) No consistent difference dependent on age

Discussion… Acknowledgement to external colleagues: Andreas Holtermann Mikael Forsman Svend Erik Mathiassen Discussion…