Work functioning of Dutch workers with a chronic disease in early, mid and late working life: cross-sectional findings from 38,470 participants in the Lifelines Cohort Study

Insight into the work functioning of workers with a chronic disease may help to improve their sustainable employability. This study examines the work functioning of workers with cardiovascular disease (CVD), diabetes mellitus type 2 (DM2), chronic obstructive pulmonary disease (COPD), rheumatoid arthritis and depression across early, mid, and late working life stages. This cross-sectional study used data from 38,470 participants of the Dutch Lifelines Cohort Study. Chronic diseases were classified based on clinical measures, self-reports, and medication use. Work functioning was measured with the Work Role Functioning Questionnaire, covering work scheduling and output demands, physical demands, mental and social demands, and flexibility demands. Multivariable linear and logistic regression analyses were used to examine associations between chronic diseases and work functioning (continuous) and low work functioning (dichotomous). Depression was associated with lower work functioning across all subscales and working life stages, with the lowest score in the mental and social demands subscale in early late working life (B:-8.7910.3; 95%CI:-102.64,-78.0026). Rheumatoid arthritis was most strongly associated with lower work functioning in the physical demands subscale, with the lowest score in early working life (B:-9.978.92; 95%CI:-190.02,-07.8968). Associations between CVD and, DM2 and rheumatoid arthritis and work functioning were mostly absent in early working life , partially but present in mid and late working life, and mostly present in late working life. Associations between COPD and work functioning were absent in mid working life but partially present in late working life. Research needs to determine how workers’ perceived difficulties in meeting work demands can be mitigated to improve their sustainable employability within the context of a specific working life stage for a particular disease.
Keywords: work functioning, chronic disease, life stage, sustainable employment, mental health, physical health