Int Arch Occup Environ Health (2011) 84:705–712 DOI 10.1007/s00420-010-0588-1 O R I G I N A L A R T I C L E The importance of job control for workers with decreased work ability to remain productive at work Tilja I. van den Berg · Suzan J. Robroek · Jan F. Plat · Marc A. Koopmanschap · Alex Burdorf Received: 19 July 2010 / Accepted: 1 October 2010 / Published online: 16 October 2010 © The Author(s) 2010. This article is published with open access at Springerlink.com Abstract Purpose Workers with decreased work ability are at greater risk of reduced productivity at work. We hypothe- sized that work-related characteristics play an important role in supporting workers to remain productive despite decreased work ability. Methods The study population consisted of 10,542 work- ers in 49 diVerent companies in the Netherlands in 2005– 2009. Productivity loss at work was deWned on a 10-point scale by asking how much work was actually performed during regular hours on the last regular workday when compared with normal. Independent variables in the logis- tic regression analysis were individual characteristics, work-related factors, and the work ability index. Additive interactions between work-related factors and decreased work ability were evaluated by the relative excess risk due to interaction (RERI). Results The odds ratios and 95% conWdence intervals (CI) for the likelihood of productivity loss at work were 2.03 (1.85–2.22), 3.50 (3.10–3.95), and 5.54 (4.37–7.03) for a good, moderate, and poor work ability, compared with an excellent work ability (reference group). Productivity loss at work was associated with lack of job control, poor skill discretion, and high work demands. There was a T. I. van den Berg · S. J. Robroek · A. Burdorf (&) Department of Public Health, Erasmus MC University Medical Center, P. O. Box 2040, 3000 CA Rotterdam, The Netherlands e-mail: a.burdorf@erasmusmc.nl J. F. Plat PreventNed, Enschede, The Netherlands M. A. Koopmanschap Department of Health Policy and Management, Erasmus MC, Rotterdam, The Netherlands signiWcant interaction between decreased work ability and lack of job control (RERI = 0.63 95% CI 0.11–1.16) with productivity loss at work. Conclusion The negative eVects on work performance of decreased work ability may be partly counterbalanced by increased job control. This suggests that interventions among workers with (chronic) disease that cause a decreased work ability should include enlargement of pos- sibilities to plan and pace their own activities at work. Keywords Presentism · Productivity loss at work · Work ability · Job control Introduction Various publications have addressed the negative conse- quences of impaired health, illness, and disease for produc- tivity loss at work. In a systematic review, Schultz et al. showed that diVerent health conditions, such as impaired mental health, allergies, and arthritis, are associated with productivity loss at work (Schultz and Edington 2007). Likewise, individual studies have shown that the preva- lence of productivity loss at work had a broad range vary- ing between 7 and 60% among workers with impaired health (Goetzel et al. 2004; Lötters et al. 2005; Meerding et al. 2005; Geuskens et al. 2008; Martimo et al. 2009). The average productivity loss at work ranged between some 12 and 34%, which accounts for 1.0 to 2.7 h per day for an 8 h workday (Goetzel et al. 2004; Lötters et al. 2005; Meerding et al. 2005; Martimo et al. 2009). A recent study also showed that a decreased ability to cope with work due to the health problems and consequent functional limitations was associated with higher productiv- ity loss at work (Alavinia et al. 2009). Besides health-related 123