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BACKGROUND: Many work-related items are not included in the current classification of environmental factors from the International Classification of Functioning, Disability and Health (ICF). Furthermore, personal factors are not classified and the ICF only provides a very limited list of examples. These facts make the ICF less useful for occupational health care and for research in the field of occupation and health. OBJECTIVE: The objective of this discussion paper is to introduce an elaboration of contextual factors, focussing on factors that influence work participation. METHODS: During the last 12 years, we developed two concept lists from the bottom up. These lists are based on our experiences in teaching and research, suggestions from students and other researchers, and factors found in the literature. In the fall of 2015 a scoping literature review was done to check for missing factors in these two concept lists. RESULTS: An elaboration of contextual factors, consisting of a list of work-related environmental factors and a list of personal factors. CONCLUSIONS: Important contextual factors that influence work participation are identified. Researchers, teachers, students, occupational and insurance physicians, allied health care professionals, employers, employees, and policy makers are invited to use the elaboration and to make suggestions for improvement. The elaboration and the suggestions received can be used in the ICF revision process. The development of an ICF ontology must be given priority, to give room to this elaboration, which will increase the applicability of the ICF and enable mapping with other terminologies and classifications. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the cost-effectiveness of a multifaceted implementation strategy for the prevention of hand eczema in comparison with a control group among healthcare workers. A total of 48 departments (n = 1,649) were randomly allocated to the implementation strategy or the control group. Data on hand eczema and costs were collected at baseline and every 3 months. Cost-effectiveness analyses were performed using linear multilevel analyses. The probability of the implementation strategy being cost-effective gradually increased with an increasing willingness-to-pay, to 0.84 at a ceiling ratio of €590,000 per person with hand eczema prevented (societal perspective). The implementation strategy appeared to be not cost-effective in comparison with the control group (societal perspective), nor was it cost-beneficial to the employer. However, this study had some methodological problems which should be taken into account when interpreting the results. [ABSTRACT FROM AUTHOR]

Background: Role models often play a role when implementing guidelines in healthcare. However, little is known about how role models perform their respective roles, or about which factors may hamper or enhance their functioning. The aim of the present study was therefore to investigate how role models perform there role as a part of a multifaceted implementation strategy on the prevention of hand eczema, and to identify barriers and facilitators for the performing of their role. Methods: The role models were selected to become a role model and received a role model training. All role models worked at a hospital. In total, 19 role models, were interviewed. A topic list was used focussing on how the role models performed their role and what they experienced to be facilitators and barriers for their role. After coding the interviews, the codes were divided into themes. Results: This study shows that the main tasks perceived by the role models were to raise awareness, to transfer information, to interact with colleagues about hand eczema, to provide material, and to perform coordinating tasks. Barriers and facilitators were whether the role suited the participant, affinity with the topic, and risk perception. Conclusions: Most role models performed only the tasks they learned during their training. They mentioned a wide range of barriers and facilitators for the performing of their role. To enhance the functioning of the role models, a suggestion would be to select role models by taking into account prior coaching experience. Trial registration: Trial registration number: NTR2812. [ABSTRACT FROM AUTHOR]

Objectives: The aim of this study was to investigate the Work Ability Index (WAI) as a tool to screen for risk of different durations of long-term sickness absence (LTSA) among manual and office workers. Methods: The prospective study comprised a cohort of 3049 (1710 manual and 1339 office) workers participating in occupational health surveys between 2010-2012. The survey date was set as baseline and incident LTSA episodes of different duration (>14, >28, >42, >60, and >90 days) were retrieved from an occupational health register in the year following the survey. Baseline WAI scores were associated with LTSA episodes occurring (no/yes) during one-year follow-up by logistic regression analysis in a random sample (N=1000) of the cohort. Predictions of LTSA risk were then validated among the workers not included in the random sample. Results: The odds of LTSA episodes at follow-up decreased with increasing baseline WAI scores (ie, better work ability). The WAI accurately predicted the risk of future LTSA episodes >28, >42, >60 days, but over-predicted the risk of LTSA episodes >14 and >90 days. The WAI discriminated between workers at high and low risk of LTSA episodes of all durations. Office workers had higher WAI scores than manual workers. Consequently, falsenegative rates were higher among office workers and false-positive rates were higher among manual workers at each WAI cut-off point. Conclusion: The WAI could be used to screen both manual and office workers for risk of LTSA episodes lasting >28, >42, >60 days. WAI cut-off points depend on the objectives of screening and may differ for manual and office workers. [ABSTRACT FROM AUTHOR]

Process data give important insights into how an intervention is implemented. The aim of the present study is to conduct a process evaluation, alongside a randomised controlled trail, on the implementation of recommendations for the prevention of hand eczema. The intervention was carried out in healthcare workers' departments and consisted of working groups and role models. The role models were selected based on their representativeness, their influence on colleagues, and their motivation. The focus of the working group was to implement recommendations for hand eczema at the department by choosing solutions to overcome barriers for implementation. Out of the 104 solutions, 87 were realised. Solutions regarding moisturisers and use of cotton under gloves, were used by 90.9% and 30.8% of the employees, respectively. Of all participants, 58.2% actively engaged with the role models. This process evaluation showed that the intervention was executed according to protocol and that the solutions were implemented well. However, the role model component in the intervention should be improved. [ABSTRACT FROM AUTHOR]

Background: As academic workload seems to be increasing, many studies examined factors that contribute to the mental workload of academics. Age-related differences in work motives and intellectual ability may lead to differences in experienced workload and in the way employees experience work features. This study aims to obtain a better understanding of age differences in sources of mental workload. 33 academics from one faculty discussed causes of workload during focus group interviews, stratified by age. Findings: Among our participants, the influence of ageing seems most evident in employees' actions and reactions, while the causes of workload mentioned seemed largely similar. These individual reactions to workload may also be driven by differences in tenure. Most positively assessed work characteristics were: interaction with colleagues and students and autonomy. Aspects most often indicated as increasing the workload, were organisational aspects as obstacles for 'getting the best out of people' and the feeling that overtime seems unavoidable. Many employees indicated to feel stretched between the 'greediness' of the organisation and their own high working standards, and many fear to be assigned even less time for research if they do not meet the rigorous output criteria. Moreover, despite great efforts on their part, promotion opportunities seem limited. A more pronounced role for the supervisor seems appreciated by employees of all ages, although the specific interpretation varied between individuals and career stages. Conclusions: To preserve good working conditions and quality of work, it seems important to scrutinize the output requirements and tenure-based needs for employee supervision. [ABSTRACT FROM AUTHOR]

Background: Employees with a chronic disease often encounter problems at work because of their chronic disease. The current paper describes the development of a self-management programme based on the Chronic Disease Self-Management programme (CDSMP) of Stanford University to help employees with a chronic somatic disease cope with these problems at work. The objective of this article is to present the systematic development and content of this programme.Methods: The method of intervention mapping (Bartholomew 2006) was used to tailor the original CDSMP for employees with a chronic somatic disease. This paper describes the process of adjusting the CDSMP for this target group. A needs assessment has been carried out by a literature review and qualitative focus groups with employees with a chronic disease and involved health professionals. On the basis of the needs assessment, the relevant determinants of self-management behaviour at work have been identified for the target population and the objectives of the training have been formulated. Furthermore, techniques have been chosen to influence self-management and the determinants of behaviour and a programme plan has been developed.Results: The intervention was designed to address general personal factors such as lifestyle, disease-related factors (for example coping with the disease) and work-related personal factors (such as self-efficacy at work). The course consists of six sessions of each two and a half hour and intents to increase the self management and empowerment of employees with a chronic somatic disease.Conclusion: Intervention mapping has been found to be a useful tool for tailoring in a systematic way the original CDSMP for employees with a chronic somatic disease. It might be valuable to use IM for the development or adjusting of interventions in occupational health care. [ABSTRACT FROM AUTHOR]

The article presents a systemic review on common prognostic factors for work disability among employees suffering from chronic diseases. It states that disease-related factors vary depending on the chronic disease suffered by an employee including rheumatoid arthritis, diabetes mellitus, and ischemic heart disease (ISD). Common prognostic factors identified include perceived health complaints, heavy manual work, and female gender. It concludes that these factors can help detect high risk groups.

Discusses a study that evaluated the association between certain characteristics of farms in the United States or the way they are run and a decline in lung function. Population and methods of the study; Personal characteristics and lung function; Associations between lung function and farm characteristics.

Objectives: To determine the prevalence of musculoskeletal complaints of the back, arms or neck, and legs among nurses, and to investigate the relation between these complaints and various work related and personal variables.Methods: A questionnaire survey was carried out in four nursing homes in The Netherlands.Results: The response was 95% and resulted in 846 completed questionnaires. It was found that a large proportion of the subjects regularly had back complaints (36%) but also had arm or neck (30%) and leg complaints (16%). Almost all respondents (89%) considered nursing work as physically strenuous. Most of them complained of working under time pressure (69%), increased work pressure (70%), and having no opportunity to take a break from the work (70%). The physical variables which seem to trouble the subjects most were lifting (65%), working in awkward postures (47%), and stooping (34%). Moreover, 53% of the subjects responded that the ergonomic lay out of the ward was disagreeable. Most of the work related variables under study seemed to be associated with musculoskeletal complaints. For all types of complaints the strongest associations were found with having to lift heavy loads. Apart from physical stress various aspects of work pressure showed strong associations with the occurrence of musculoskeletal complaints. The variables on the ergonomy of the ward showed less clear associations with musculoskeletal complaints than were found for physical stress and work pressure.Conclusions: From these results it may be concluded that future research of health risks of nursing work should have a wider focus than the relation between physical workload and low back pain. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Approaches for predicting long-term sickness absence" by L. G. van Amelsvoort and colleagues in the 2015 issue.

Introduction: The aim of this study was to investigate whether teenagers and adolescents (10-22 years) with asthma or asymptomatic bronchial hyperresponsiveness, were more likely to experience vocational or professional career limitations in the future, as compared to non-asthmatic contemporaries., Methods: Data were used from a 14-year follow-up study in general practice, investigating the relationship between respiratory health in childhood and adolescence. At follow-up, the respiratory health status and information about career limitations were obtained., Results: There were no statistical significant differences between asthmatics (n=52) and non-asthmatics (n=154) in the proportion currently employed subjects, or contract type. Most examined career limitations were infrequently reported in both groups, but seemed to occur slightly more frequent among asthmatics. Asthmatics seemed to have an increased risk for limitations in daily activities both attributable to their respiratory health (OR=2.6, 95% CI [1.0; 7.0]) and all-cause (OR=1.8, 95% CI [0.9; 3.3]), and for absence from work all-cause (OR=1.7, 95% CI [0.9; 3.3]). However, the differences were in most cases in the magnitude of only a few days per year. Neither lung function nor bronchial hyperresponsiveness did predict absence from work, or limitations in daily activities., Conclusion: Asthmatic young adults seem to experience somewhat more limitations in their vocational and professional careers. Nonetheless, the majority of the young asthmatics seem to be only slightly limited in their careers. In non-asthmatic young adults the presence of asymptomatic bronchial hyperresponsiveness does not seem to lead to career limitations.

We sought to investigate associations between knowledge about the disease and sick leave, health complaints, functional limitations, adaptation and perceived control. Patients with asthma (n = 101) and COPD (n = 64) underwent lung function tests and completed questionnaires. In addition, all were asked the question: 'what is the diagnosis of your disease?', with the response categories: 'asthma' and 'COPD (chronic bronchitis or emphysema)'. Thirty-five percent of the asthma patients and 30% of the COPD patients did not know their correct diagnosis. Sick leave was not associated with knowledge about the disease in asthma and COPD. In asthma, much knowledge about management of the disease was associated with better adaptation (P = 0.01) and less perceived control over health by external factors (P = 0.02). Knowing the correct diagnosis was associated with less control over health by powerful others (P = 0.02). For COPD, more knowledge about management of the disease was associated with better adaptation (P = 0.02) and less control over health by internal factors (P = 0.01). Knowing the correct diagnosis was associated with less control over dyspnea at work (P = 0.01).

The aim of this exploratory study was to investigate associations between sick leave in workers with asthma or COPD and disease-related variables, psychosocial variables, and work characteristics. Hundred and eighty-nine patients with physician-diagnosed asthma (N=118) or COPD (n=71) who had paid work in the past 12 months completed questionnaires on sick leave, health complaints, functional limitations, work characteristics and psychosocial issues, and underwent a pulmonary function test (FEV1 and FVC before and after bronchodilation). Logistic regression analyses were performed to investigate variables independently associated with high sick leave (i.e. more than twice a year and/or longer than 1 month per episode). Asthma patients, not having an emotionally difficult job, with low job satisfaction, who had changed employers, utilized job control, and who encountered pulmonary aggravating factors at work were found to have a higher incidence of sick leave. COPD patients, who had informed the employer or colleagues about the disease, who did not have difficult tasks at work, who did not hide dyspnea and limitations, and who reported high fatigue were showing higher sick leave. FEV1 and FVC were not associated with sick leave in either group. It was concluded that psychosocial variables, work characteristics, functional limitations, and complaints play a more important role in sick leave in workers with asthma and COPD than FEV1.