Constructing therapeutic support and negotiating competing agendas: A discourse analysis of vocational advice provided to individuals who are absent from work due to ill-health.

Work participation is known to benefit people's overall health and wellbeing, but accessing vocational support during periods of sickness absence to facilitate return-to-work can be challenging for many people. In this study, we explored how vocational advice was delivered by trained vocational support workers (VSWs) to people who had been signed-off from work by their General Practitioner (GP), as part of a feasibility study testing a vocational advice intervention. We investigated the discursive and interactional strategies employed by VSWs and people absent from work, to pursue their joint and respective goals.

Morbidities among older workers and work exit: the HEAF cohort.

Background: Governments need people to work to older ages, but the prevalence of chronic disease and comorbidity increases with age and impacts work ability.

Aims: To investigate the effects of objective health diagnoses on exit from paid work amongst older workers.

Methods: Health and Employment After Fifty (HEAF) is a population cohort of adults aged 50-64 years recruited from English GP practices which contribute to the Clinical Practice Research Datalink (CPRD).

Physical Activity and Diet in a Global Pandemic: An Investigation of the Impact of COVID-19 on Factors Relevant for Musculoskeletal Health at Two Different Stages of the Lifecourse.

Background: Physical activity, nutrition and other lifestyle factors play important roles in maintaining musculoskeletal health. The coronavirus disease (COVID-19) originated in late 2019, spread globally to be declared a pandemic by the World Health Organisation in March 2020, and led to widespread behaviour change. The aim of this study was to use two existing cohorts, the Hertfordshire Cohort Study (HCS) and Health and Employment After Fifty Study (HEAF), to understand how wave one of the COVID-19 pandemic impacted lifestyle factors associated with musculoskeletal health in the UK.

Risk of revision arthroplasty surgery after exposure to physically demanding occupational or leisure activities: A systematic review.

Introduction: Lower limb arthroplasty is successful at relieving symptoms associated with joint failure. However, physically-demanding activities can cause primary osteoarthritis and accordingly such exposure post-operatively might increase the risk of prosthetic failure. Therefore, we systematically reviewed the literature to investigate whether there was any evidence of increased risk of revision arthroplasty after exposure to intensive, physically-demanding activities at work or during leisure-time.

Recent UK retirees' views about the work-related factors which influenced their decision to retire: a qualitative study within the Health and Employment After Fifty (HEAF) cohort.

Background: Lower birth rates and increasing longevity have resulted in ageing populations in European countries. These demographic changes place challenges on pension provision as numbers of those who are economically inactive and retired increase relative to those in paid work. Therefore, governments need workers to postpone retirement and work to older ages.

Shift work amongst older UK workers and job exit.

Background: Night/shift work may be increasing but there are few data about the prevalence amongst older workers. With governments encouraging people to work to older ages, it is important to know how feasible night/shift work is for them and whether there are any adverse health consequences.

Aims: Amongst current older workers (aged 50-64 years), to explore the prevalence of night/shift working and evaluate its health impacts and sustainability over 4 years of follow-up.

Older working adults in the HEAF study are more likely to report loneliness after two years of follow-up if they have negative perceptions of their work quality.

Background: Loneliness is an important public health issue associated with mortality and morbidity. Often researched amongst older people, less is known about risk factors for loneliness among adults aged 50-64 years who are in work. We investigated (a) if exit from the workforce increases the odds of loneliness; (b) whether adverse psychosocial work factors are associated with increased odds of loneliness over 2 years of follow-up; and (c) whether the association is stronger among subjects still working compared with those who have exited the workforce.

Individualised placement and support programme for people unemployed because of chronic pain: a feasibility study and the InSTEP pilot RCT.

Background: Chronic pain is a common cause of health-related incapacity for work among people in the UK. Individualised placement and support is a systematic approach to rehabilitation, with emphasis on early supported work placement. It is effective in helping people with severe mental illness to gain employment, but has not been tested for chronic pain.

Work participation and risk factors for health-related job loss among older workers in the Health and Employment after Fifty (HEAF) study: Evidence from a 2-year follow-up period.

Introduction: Rapidly increasing population old age dependency ratios create a growing economic imperative for people to work to older ages. However, rates of older worker employment are only increasing slowly. Amongst a cohort of contemporary older workers, we investigated risk factors for health-related job loss (HRJL) over 2 years of follow-up.

How does job dissatisfaction interact with self-rated health in determining the risk of health-related job loss? Prospective findings from the Health and Employment After Fifty (HEAF) study.

Objectives: Health and job satisfaction are key independent determinants of ability to work to older ages. We investigated the interaction of these two important factors on health-related job loss (HRJL) over 2 years of follow-up comparing male and female older workers.

Methods: A population sample of adults aged 50-64 years, recruited from 24 English general practices in the Health and Employment After Fifty (HEAF) study, completed questionnaires at baseline with follow-ups at 12 and 24 months.

Individualised placement support as an employment intervention for individuals with chronic pain: a qualitative exploration of stakeholder views.

Background: Individualised Placement and Support (IPS) is a tailored, client-centred employment intervention for people with chronic health conditions. It involves the integration of vocational advisers within health teams to optimise return-to-work strategies. The intervention aims to get clients into employment by complementing traditional job searching skills with placements, and one-to-one mentoring alongside a work-focused health intervention.

Relationships between informal caregiving, health and work in the Health and Employment After Fifty study, England.

Background: To investigate the prevalence of caregiving and its relationship with work, health and socio-economic circumstances in the Health and Employment After Fifty (HEAF) study.

Methods: The HEAF study comprises 8134 men and women aged 50-64 years recruited from 24 general practices. Socio-demographic, lifestyle and health characteristics and hours per week giving personal care were elicited by postal questionnaire.

Exploring the views of stakeholders about the feasibility of carrying out a randomised controlled trial of Individual Placement and Support for people unemployed with chronic pain based in primary care (the InSTEP study).

Background: Individual Placement and Support (IPS) is a model of vocational rehabilitation originally developed to help people with severe mental illness obtain and maintain employment. Work disability is common amongst people with chronic pain conditions, yet few effective interventions exist. As part of mixed-methods feasibility research and as a forerunner to a pilot trial (In STEP), we investigated the barriers and facilitators to carrying out a future randomised controlled trial of IPS set in primary care amongst people unemployed with chronic pain.

Body Mass Index (BMI) and Work Ability in Older Workers: Results from the Health and Employment after Fifty (HEAF) Prospective Cohort Study.

This study explores associations between BMI and prolonged sickness absence; cutting down at work; and health-related job loss (HRJL) over two years of follow-up among workers aged ≥50 years. A cohort of 2299 men and 2425 women (aged 50-64 years) self-reported height and weight at baseline and provided information about work ability at 12 and 24 months for the Health and Employment after Fifty (HEAF) Study. Associations between BMI and work ability were assessed by logistic regression and HRJL by multiple-record Cox's proportional hazards models, with adjustment for other risk factors.

Job stress and post-retirement health in the Hertfordshire Cohort Study.

Background: Job demand-control (DC) and effort-reward imbalance (ERI) are two commonly used measures of work stress which are independently associated with health.

Aims: To test the hypothesis that DC and ERI have different and cumulative effects on health.

Methods: DC and ERI were assessed in the Hertfordshire Cohort Study.

Frailty, prefrailty and employment outcomes in Health and Employment After Fifty (HEAF) Study.

Objectives: Demographic changes are requiring people to work longer. No previous studies, however, have focused on whether the 'frailty' phenotype (which predicts adverse events in the elderly) is associated with employment difficulties. To provide information, we assessed associations in the Health and Employment After Fifty Study, a population-based cohort of 50-65-year olds.

Sleep disturbance and the older worker: findings from the Health and Employment after Fifty study.

Objectives The aim of this study was to characterize the descriptive epidemiology of insomnia in midlife and explore the relative importance of different occupational risk factors for insomnia among older workers. Methods A questionnaire was mailed to all adults aged 50-64 years registered with 24 English general practices. Insomnia was defined as having at least one of four problems with sleep severely in the past three months.

Job dissatisfaction and the older worker: baseline findings from the Health and Employment After Fifty study.

Objectives: Demographic changes are requiring people to work longer. Labour force participation might be promoted by tackling sources of job dissatisfaction. We aimed to describe the epidemiology of job dissatisfaction in older British workers, to explore which perceptions of work contribute most importantly, and to assess possible impacts on health.

Shoulder disorders and occupation.

Shoulder pain is very common, and it causes substantial morbidity. Standardised classification systems based upon presumed patho-anatomical origins have proved poorly reproducible and hampered epidemiological research. Despite this, there is evidence that exposure to combinations of physical workplace strains such as overhead working, heavy lifting and forceful work as well as working in an awkward posture increases the risk of shoulder disorders.

Health and Employment after Fifty (HEAF): a new prospective cohort study.

Background: Demographic trends in developed countries have prompted governmental policies aimed at extending working lives. However, working beyond the traditional retirement age may not be feasible for those with major health problems of ageing, and depending on occupational and personal circumstances, might be either good or bad for health. To address these uncertainties, we have initiated a new longitudinal study.

Sensory impairments, problems of balance and accidental injury at work: a case-control study.

Objectives: Sensory impairments are becoming increasingly common in the workforces of Western countries. To assess their role in occupational injury, and that of disorders of balance, we undertook a case-control study.

Methods: Using the Clinical Practice Research Datalink, which documents all medical consultations, referrals and diagnoses in primary care for 6% of the British population, we identified 1348 working-aged patients who had consulted medical services over a 22-year period for workplace injury (cases) and 6652 age-matched, sex-matched and practice-matched controls.

Epilepsy, diabetes mellitus and accidental injury at work.

Aims: To assess the contribution of epilepsy and diabetes to occupational injury.

Methods: The Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations and treatments. Using this, we conducted a population-based case-control study, identifying patients aged 16-64 years, who had consulted over two decades for workplace injury, plus matched controls.

The role of mental health problems and common psychotropic drug treatments in accidental injury at work: a case-control study.

Objectives: Mental illness and psychotropic drugs have been linked with workplace injury, but few studies have measured exposures and outcomes independently or established their relative timings. To address this shortcoming, we conducted a case-control study nested within a database prospectively recording injury consultations, diagnoses and drug prescriptions.

Methods: The Clinical Practice Research Datalink logs primary care data for 6% of the British population, coding all consultations (by the Read system) and drug prescriptions.