Using work, health and sick leave to predict work disability

In the Netherlands, a situation has developed in which there is one permanently disabled person for every seven to eight people active in the workforce. This is an economic emergency, for which countermeasures have been taken. The employer is made in large part financially responsible for employees' sickness absence and work disability and, at the same time, is obliged to use the professional support of a Health and Safety Service (HSS). It stands to reason that in this situation, making use of the HSS, the employer is motivated to prevent sickness absence and disablement of employees as effectively as possible. Preventing work disability critically depends on being able to predict disability through early identification of the future disabled. In order to develop a prediction procedure at the individual level, the present prospective study was conducted. Some 3,500 employees were followed for up to five years. Predictors of disability were sought among employees’opinions on their health, work, and working conditions as measured by the Questionnaire on Work and Health (QWH), and sick leave data. The QWH items are concerned with health, work and job circumstances. As expected, most (two thirds) cases of disability occur in male employees aged 50 and over. Disability in this group is strongly predicted by complaints about work strain, health, and illness behaviour, with the odds being in the 4 to 6 range. The odds can be raised to over 10 by including sick leave data. These predictions warrant individual preventive interventions. The results, taken together, speak for the predictive validity of the questionnaire and its usefulness to occupational health services in combating disability.