Applied Ergonomics 45 (2014) 586e591

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Applied Ergonomics
journal homepage: www.elsevier.com/locate/apergo

A four-year follow-up study of physical working conditions and

perceived mental and physical strain among food industry workers
Subas Neupane a, *, Pekka Virtanen a, Tiina Luukkaala a, b, Anna Siukola a,
Clas-Håkan Nygård a
a
School of Health Sciences, University of Tampere, Tampere FI-33014, Finland
b
Science Center, Pirkanmaa Hospital District, Tampere, Finland

a r t i c l e i n f o a b s t r a c t

Article history: This study hypothesized that in a longitudinal setting deteriorating physical working conditions in-
Received 5 January 2012 creases the perceived physical and mental strain among food processing employees. The study was
Accepted 1 August 2013 conducted in 2003 and 2007. It examined 248 blue-collar workers, all of whom were in the same
occupation throughout the entire follow-up period. The data were obtained through a structural ques-
Keywords: tionnaire distributed to the employees at the workplace. Mental strain had increased (7%) significantly
Environmental factors
among younger employees during the follow-up. The changes in mental strain for the younger em-
Ergonomic factors
ployees were positively associated with the changes in physical strain. The changes in physical strain
Food factory
were also significantly associated with the changes in physical working conditions among both younger
and the older workers. The results of this study partly support the study hypothesis, namely that
deteriorating physical working condition increases physical strain and also increases mental strain,
especially among younger employees.
Ó 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.

1. Introduction work postures are associated with sick-leave (Laaksonen et al.,

Although the demands of work have changed from physical to
more mental demands in recent decades (Frese, 2000; Sutela,
2007), there are still branches where the physical demands are
heavy. Food manufacturing is an example of such branches where
the work still includes a lot of lifting and carrying, repetitive
movements and other heavy physical load. The work environment
of the food processing industry is also characterized by low and
high temperatures, draught, noise and poor lighting which are risk
factors for early cessation of working life, especially in that industry
(Salonen et al., 2003). Additionally, in many situations the envi-
ronmental factors and physical factors may act independently or
collectively as stressors (LaDou, 2007). As a result, repetitive strain
injuries are the most prevalent work-related diseases in the food
processing industry in Finland (Riihimäki et al., 2004).
Industrial workers are most exposed to job strain (Nicot, 2007).
The high job strain is mostly due to the physical work environment
in the industry. Several other studies have reported that physical
working conditions, especially heavy lifting and uncomfortable
* Corresponding author. Tel.: þ358 40 1909709; fax: þ358 3 35516057.
E-mail addresses: subas.neupane@uta.fi, subas.neupane@gmail.com
(S. Neupane).
2010; Lund et al., 2006; Allebeck and Mastekaasa, 2004). Conse-
quently, the risk for sick leaves and early retirement is typically
increased in such working conditions (Ilmarinen et al., 1997;
Nygård et al., 2005; Sell, 2009). Food industry workers have been
shown to have twice as much sick leave as the average among in-
dustry workers in Finland and the EU (Ilmarinen, 1999; Vahtera and
Kivimäki, 2004; Gimeno et al., 2004). The branch is also at the top
of the early retirement statistics (Salonen et al., 2003; Ilmarinen
et al., 1997).
Our study was based on a four-year follow-up of stress and
strain in four food processing factories. The stress-strain concept
(Rutenfrantz, 1981; Cox et al., 2000) assumes that the stress on a
worker depends on objective environmental factors acting upon
the person, whereas strain denotes the effects of stress which
will be individually different. The use of the stress-strain concept
is practical in the study of the effect of physical workload on the
cardiovascular system which is directly related to the individual’s
physical work capacity (Rutenfrantz, 1981). It also emphasizes
the role of individual characteristics such as age, gender, and
health status and work ability as modifiers of the relationship
between physical working condition and strain. Work ability is a
comprehensive concept for occupational health research and
prevention (Ilmarinen, 2009). The relationship between the
physical strain and heart rate depends on the type of muscular

0003-6870/$ e see front matter Ó 2013 Elsevier Ltd and The Ergonomics Society. All rights reserved.
http://dx.doi.org/10.1016/j.apergo.2013.08.010
 S. Neupane et al. / Applied Ergonomics 45 (2014) 586e591
Table 1
Attrition of the study cohort (N ¼ 603) from the baseline survey in 2003 to the follow-up survey in 2007 by age, gender and baseline working conditions.
Resigned in 2007
N ¼ 126 Percentage
Age
<45 years 89 72
45 years 37 28
Gender
Female 89 71
Male 37 29
Working conditions (mean, SD)
Physical (3e15) 9.53 (2.78)
Environmental (6e30) 17.52 (3.59)
work (Ilmarinen, 1984). Heart rate at a given physical strain is the
highest in industrial work that also includes much static work
(Ilmarinen, 1978). Moreover, the associations of work stressors
and individual stress symptoms with work ability are unclear:
there seems to be a strong effect in particular among the aging
(Tuomi et al., 1991), but there are also studies (Gamperiene et al.,
2008) that have not found a relation between physical strain and
work ability. Also, the physical working conditions among
younger and older workers are poorly understood, as some
previous research concluded that in the same occupation
younger workers are at greater risk of physical strain than older
workers (Pailhe, 2005). But the subjects of the aforementioned
study were not only the blue-collar but also the others who were
working in different job settings. Another study by Nygård et al.
(1997) reported higher strain among older municipal employees
in both blue- and white-collar jobs.
Although many studies have previously assessed the associa-
tion between work environment and strain, the association be-
tween changes in physical working conditions and parallel
changes in perceived strain has rarely been studied before. One of
the experimental study found that physical capacity is adversely
affected by mental stress (Mehta and Agnew, 2012) and that also
mental stress adversely affect biomechanical responses during
low back exertion (Marras et al., 2000). Our study is an original
contribution to studies of the links between physical working
conditions and perceived strain among food industries workers.
We hypothesized in this study among industrial blue-collar
workers that; a) deteriorating (negative changes) of the physical
working condition increases the perceived physical and mental
strain among younger and older workers and b) the perceived
mental and physical strain interact with each other among
younger and older workers.
2. Method
2.1. Study subjects
The study subjects were employees from four factories and
from one office department of a food industry company
employing more than 2000 people in Finland. Food processing is
a universal industry, employing substantial number of workforce,
e.g. in Finland, 34,000 workers (1e2% of the workforce)
(Neupane et al., 2013a). The questionnaires were distributed in
the workplaces, filled in during working hours, and the closed
response envelopes were collected and sent to the researchers. A
questionnaire survey was conducted among all employees of the
company in spring 2003 (N ¼ 1995, 1581 blue-collar and 414
white collar employees) with a response rate of 56% (N ¼ 1220).
Of the respondents, 71% (N ¼ 861, 603 blue-collar and 258 white-
collar employees) gave consent to being identified. The majority
587
Non-respondent in 2007 Respondent in 2007
N ¼ 229 Percentage N ¼ 248 Percentage
138 60 170 69
91 40 78 31
166 72 173 70
63 28 75 30
9.09 (2.78) 9.08 (2.83)
17.22 (4.05) 17.28 (4.02)
of the blue-collar employees were working in food processing
and maintenance departments, which entails muscular work
with a lot of lifting and carrying, while majority of white-collar
employees worked in the management department (Neupane
et al., 2013a, 2013b). The 603 blue-collar employees are the
cohort of interest in the present study. In a corresponding survey
in 2007, 126 of them were no longer in the service of the com-
pany; among those who had not resigned, the response rate was
52% (N ¼ 248). Their mean age at the beginning of the follow-up
was 39 years (SD ¼ 9.5) ranging from 20 to 60 years, and 70% of
them were women which is similar to European statistics where
food manufacturing blue-collar workers are mainly female
dominated (Eurofound, 2012). Statistics on sample attrition
revealed that non-respondents were somewhat younger than the
other groups, there was no gender difference, and the working
conditions at baseline tended to be worse among those who had
resigned between the surveys visits (Table 1). The study was
approved by the ethical committee of Pirkanmaa Hospital Dis-
trict, Tampere, Finland.
2.2. Measurement of strain
Perceived mental strain was assessed by a modified version of
the occupational stress questionnaire (Elo et al., 1992), using a
single question (“Stress means a situation in which a person feels
excited, apprehensive/concerned, nervous or distressed or she/he
cannot sleep because of the things on her/his mind. Do you feel this
kind of stress nowadays?”) (Elo et al., 1992), with the reply scale
from 0 (not at all) to10 (very much). Perceived physical strain was
elicited with the rating of perceived exertion (RPE) with the ques-
tion “How physically hard/exhausting do you feel your job is on a
normal work day?” on a scale from 6 (not at all) to 20 (very much)
(Borg, 1970) Box 1.
2.3. Measurement of physical working conditions
Factors in the physical working condition were asked by the
question “Do the following factors increase your strain at your
work? draught, noise, poor indoor climate, hotness, coldness and
blinding lighting” on a scale going from 1 (very little) to 5 (very
much) (Lehto and Sutela, 2009). In our study, the variable
describing environmental factors was summed into a single vari-
able ranging from 6 to 30. In a similar way, the variable describing
physical working conditions (restless work environment, repeti-
tive movements, bent or twisted working postures) was asked in a
scale 1 (very little) to 5 (very much) and the answers summed up
into a variable ranging from 3 to 15 (Virtanen et al., 2008). The
Cronbach’s alpha from the reliability test of the sum measures for
physical working condition was 0.80 and environmental factors
were 0.78.
588 S. Neupane et al. / Applied Ergonomics 45 (2014) 586e591

Box 1 deviations. Paired samples t-test was used to test the significance
Details of perceived exertion (RPE) scale of the changes of all outcome variable and determinant variables
at baseline and the follow-up year. Associations between changes
in physical working conditions and environmental factors with the
Perceived exertion is the single best indicator of the degree changes in mental and physical strain were first studied with
of physical strain (Borg, 1970). The perceived exertion (RPE)
Spearman’s correlation coefficients. Then multifactorial analysis
scale values range from 6 to 20 and can be used to denote
heart rates ranging from 60 to 200 beats/min. This scale is was conducted using linear regressions with enter method (pro-
easier to use because a certain value on the scale, e.g. 13, cedure for the multivariable regression analysis) by adjusting for
would match approximately a heart rate of 130 beats/min each independent variable by age, gender, changes in work ability
for 30e50-year-old subjects. and baseline factors (perceived work ability, physical working
conditions, and environmental factors, physical and mental strain)
Details of the scale:
in the model. All the analyses were divided into two age groups
6 e No exertion at all <45 years (young) and 45 years (old), (WHO, 1993) to analyze
7 e Extremely light the association separately among younger and older workers.
8e Statistical analyses were performed by SPSS for Windows version
9 e Very light 16.0.2. P-values under 0.05 were considered as statistical
10 e significant.
11 e Light
12 e
13 e Somewhat hard 3. Results
14 e Hard (heavy)
15 e Perceived environmental factors significantly (p < 0.01) dete-
16 e Very hard riorated among the younger workers but improved among the
17 e older workers (p < 0.01) (Table 2). As regards the outcome vari-
18 e
ables, mental strain had increased significantly (p ¼ 0.02) among
19 e Extremely hard
20 e Maximal exertion younger workers and the changes in physical strain were not sig-
nificant. Work ability decreased among the older (0.04), whereas
no changes were seen among the younger workers. Perceived
mental and physical strain and working conditions among younger
workers was higher than their older counterparts in both baseline
2.4. Measurement of work ability
and follow-up year.
Changes in physical strain correlated positively with the
The single-item question, in this study concerned one item from
changes in mental strain in both age groups; the correlation was
the work ability index (WAI) “current work ability compared with
statistically significant (p ¼ 0.02), and was particularly strong
the life time best” with a possible score of 0 (absolutely incapable to
among the older workers (Table 3). The correlation between
work) to 10 (work ability at its best) (Ilmarinen, 2009; de Croon
changes in physical strain and changes in mental strain and phys-
et al., 2005).
ical working conditions was significant among both younger and
older workers. The changes in physical strain correlated signifi-
2.5. Statistical analysis cantly with the changes in environmental factors among young
workers.
Changes of the physical working conditions as well as change Table 4 shows the unstandardized b e coefficients with 95%
in the mental and physical strain during follow-up were calculated confidence intervals, R2 and p-values for age, gender, changes in
by subtracting the values of the year 2003 from the values of the work ability and baseline factors adjusted linear regression models.
year 2007. Descriptive statistics of physical strain, mental strain, The change in mental strain was linearly associated with the change
work ability, physical working conditions and environmental ex- in physical strain among younger workers (p ¼ 0.02) and also with
posures in the cohort were performed in means and standard the changes in physical working conditions among both younger
deviation (SD) stratified by age. Distributions of the change from and older workers. However, the significant factors explained the
the year 2003e2007 were shown as means and standard low variance of the change, which is from 5 to 9%. As to the change

Table 2
Descriptive statistics of the participants (n ¼ 248) and means of the variables stratified by age at baseline in 2003 and at follow-up in 2007.

Variables <45 years (n ¼ 170) 45 years (n ¼ 78)

Baseline Follow-up p-value Baseline Follow-up p-valuea

Gender
Men 34% e 25% e
Women 66% e 75% e

Work ability (mean, SD) (0e10) 8.38 (1.26) 8.45 (1.33) 0.63 8.45 (1.05) 8.23 (1.20) 0.04

Working conditions (mean, SD)

Physical (3e15) 9.38 (2.96) 9.17 (2.95) 0.33 8.10 (2.53) 8.24 (2.81) 0.66
Environmental (6e30) 17.43 (4.13) 17.61 (4.16) <0.01 16.48 (4.38) 15.83 (4.20) <0.01

Strain (mean, SD)

Physical (6e20) 14.44 (3.01) 14.66 (3.08) 0.33 13.89 (3.21) 13.74 (3.34) 0.69
Mental (0e10) 3.66 (2.48) 4.17 (2.73) 0.02 3.51 (2.57) 4.05 (3.06) 0.18
a
P-value tested from paired sample t-test.
 S. Neupane et al. / Applied Ergonomics 45 (2014) 586e591 589

Table 3
Spearman’s correlations (r) with p-values (p) of changes in mental and physical strain during the follow-up with the changes of physical factors, environmental factors and
strain variables.

Change in mental strain Change in physical strain

<45 yrs (n ¼ 170) 45 yrs (n ¼ 78) <45 yrs (n ¼ 170) 45 yrs (n ¼ 78)
a b
r (p ) r (P) r (P) r (P)

Change during follow-up in

e Mental strain 1 1 0.17 0.02 0.25 0.02
e Physical strain 0.17 0.02 0.25 0.02 1 1
e Physical working conditions 0.20 <0.01 0.20 0.08 0.22 <0.01 0.20 0.07
e Environmental factors 0.14 0.05 0.02 0.81 0.17 0.02 0.14 0.22
a
Correlation coefficient.
b
P-value; the level of significance is 5%.

in physical strain, statistically significant associations were found
with the changes in physical working conditions among both young
and older workers, and there was also a significant association with
the change in environmental factors among the younger em-
ployees. For the change in physical strain due to significant factors
was comparatively low as well and ranged from 6 to 14%. Positive
change in mental strain explained positive change of physical strain
among younger employees but the effect was nearly significant
among older ones.
4. Discussion
The result of this study supports our first hypothesis partly;
deteriorating physical working conditions increases perceived
physical and mental strain. We found (in this study) an association
between deteriorating physical working conditions and increased
physical strain among both the young and the older workers,
whereas the associations of environmental factors with perceived
mental and physical strain proved out as non-significant except for
the association with physical strain among younger workers.
Moreover, our analysis revealed that the change in physical strain
was associated with the change in mental strain, especially among
younger workers, which confirmed our second hypothesis. Due to
the limited number of earlier studies looking into the parallel
changes in physical and mental strain, a meaningful comparison
with the results of the present study is warrant.
The last finding is noteworthy: it indicates that among the
younger workers an increase of poor physical working conditions
not only increased physical strain but also increased mental strain.
A possible explanation could be that the older people are less
exposed than their younger colleagues to the most adverse physical
factors in the workplace, such as physical strain, vibrations,
extreme temperatures, etc. (Agathocleous, 2004). In our study, the
prevalence of mental strain at baseline was 18.1% while at follow-
up it was increased by 7% (data not shown). Our results are com-
parable with the results of the study by Sein et al. (2010) among
rubber-glove factory workers in Thailand which found that the
prevalence of job strain was 27.5%. Stress factors (physical working
environment) were found to predict future strain in personnel on
ships that can have adverse effect one year later (Bridger et al.,
2011). Risk due to physical working conditions such as poor phys-
ical working conditions at work in Finland is above EU27 average
and exposures to poor physical working conditions in industrial
sector are also high compared to other industrial sector (Eurofound,
2012). Some researchers also assume that environmental condi-
tions may be the prime cause of increasing mental strain (Cooper
and Roden, 1985). For older employees the actual working
method applied may be considered as an important instrument in
order to compensate for increasing strain and declining work
ability and also an increase in mental strain. In our study working
conditions are the factor that can affect physiological strain. In
particular, an increase in heat stress results in an increase in heart
rate, even during rest. In blue-collar occupation in the food in-
dustry, workers are exposed to a wide range of ambient conditions.
Thus, monitoring of physiological strain is important as it reflects
both the effect of physical work but also the strain provided by any

Table 4
Associations of the change of mental or physical strain, change of physical factors and environmental factors for change of mental and physical strain from 2003 to 2007
separately for workers under 45 and older than 45 years. Adjusteda linear regression models (N ¼ 248).

Change in mental strain

<45 yrs (n ¼ 170) 45 yrs (n ¼ 78)

Unstandardized coefficient b (95% CI) for b pb R2 Unstandardized coefficient b (95% CI) for b p R2

Change in working conditions

Physical 0.27 0.09e0.45 <0.01 0.07 0.34 0.006e0.69 0.05 0.09
Environmental 0.03 0.07e0.14 0.56 0.05 0.03 0.25e0.19 0.79 0.06
Change in physical strain 0.15 0.01e0.29 0.02 0.05 0.20 0.03e0.43 0.09 0.12

Change in physical strain

<45 yrs (n ¼ 170) 45 yrs (n ¼ 78)

Unstandardized coefficient b (95% CI) for b p R 2

Unstandardized coefficient b (95% CI) for b p R2

Change in working conditions

Physical 0.24 0.05e0.44 0.01 0.10 0.54 0.24e0.85 <0.01 0.14
Environmental 0.17 0.05e0.29 <0.01 0.08 0.06 0.13e0.26 0.51 0.06
Change in mental strain 0.19 0.02e0.36 0.02 0.06 0.20 0.03e0.44 0.09 0.11
a
The linear regression model was adjusted for age, gender and changes in work ability and baseline factors (work ability, physical working conditions, environmental
factors, physical and mental strain).
b
P-value; the level of significance is 5%.
590 S. Neupane et al. / Applied Ergonomics 45 (2014) 586e591
working conditions (Gertner et al., 1984). Furthermore, physical
capacity deteriorates earlier with age than mental capacity (Nygård
et al., 2005; Savinainen et al., 2004). Mental capacity may also
decline in middle age, but this seldom occurs before the age of 65,
and even thereafter the drop is individual and depends partly on
how much mental stimulation an individual receives. It is very
important to notice in the female dominated food factory branch
that women are more sensitive to environmental factors, and tend
to perceive their health problems more intensely, and to report
more problems than men do (Verbrugge, 1985).
In a study by Tuomi et al. (1991) people over 45 years working in
jobs with high physical demands, poor physical environment and
poor work postures were physically more stressed than people in
jobs with mental or mixed mental and physical demands. This may
be explained by the fact that older employees may be more sen-
sitive to changes in the environment than younger employees and
also due to a decline in capacity and work ability with increasing
age. In another study (Myrtek et al., 1999) it has been postulated
that blue-collar workers are subjected to higher physical workload
than white-collar workers but the latter are subjected to higher
mental workload (Nerell and Wahlund, 1981). In this study too,
physical factors were found to be an important tool for changing
mental and physical strain among both younger and older workers.
By contrast, perceived workloads of the aged and young construc-
tion workers and vehicle inspectors (blue-collar workers) were not
age dependent (Louhevaara, 1999).
Kalimo and Mejman (1987) showed that exposure to adverse
physical conditions in the working environment plays a role in
shaping the psychosocial environment, and quite often the exis-
tence of such adverse conditions leads to poor health. In another
study by Rusli et al. (2008) found that poor working conditions
were associated to the higher self-perceptions of stress and
depression. In our study too, increase of physical working condi-
tions for e.g. uncomfortable work posture and repetitive work task
was positively correlated to changes in physical strain. One study
among rubber glove factory workers in Thailand found the preva-
lence of high strain was associated with psychosocial working
conditions (Sein et al., 2010). The employees in the food factory
often stand for long periods and may be required to lift heavy ob-
jects or use cutting, slicing, grinding, and other dangerous tools and
machines, which may be physically more demanding. In occupa-
tions with comparable work demands for all employees, individual
differences e.g. in actual working methods may finally result in a
variation in the working postures (Burdorf, 1992; Kilbom and
Persson, 1987) and add to the strain.
The high physical strain among the food industry workers must
be noted. Physical strain had not changed during follow-up despite
possible technical changes in the working environment intended to
improve the physical working conditions during the follow-up
years, for instance modernization of the production lines. Howev-
er, detailed registration of changes e.g. in the product lines was not
done in the present study. Thus, awareness of physical risk factors is
important, in particular because food processing work includes
many females and older workers. One recent study concluded that
the perception of female and male of their work environment
differed significantly in magnitude and occasionally in direction
(Brunette et al., 2011). Generally females perceive higher physical
strain than men in the same kind of work (Nygård et al., 1997). Male
workers in manufacturing and construction are much more likely
to be regularly exposed to physical risk than women in these sec-
tors (Eurofound, 2012). Among blue-collar female workers a
decrease in functional capacity may occur especially after the age of
45 years (Savinainen et al., 2004; Nygård et al., 1988). It has been
shown in an earlier study (Nygård et al., 1997) that older employees
experience higher strain than younger employees. By contrast,
Pailhe (2005) reported that younger cohorts are exposed to phys-
ical strain more frequently than older cohorts. However, the pre-
sent study also showed higher perceived physical strain among
younger employees than their older counterparts. Also, for the
similar occupational group, perceived high strain was more prev-
alent among females than males irrespective of age (Butler et al.,
2005).
In this study, the employees showed on average relatively good
work ability (Gould et al., 2008). However, it was appropriate to
adjust the regression analyses for work ability, as stress may be
associated with higher strain when work ability is low, according to
the theoretical model of our study. Relatively good work ability can
also be explained by the healthy worker effect in this relatively
tough branch of industry.
The strength of the study is a four-year follow-up of the popu-
lation in a prospective design where we could follow up the
changes in individuals and the changes in the work environment
and their relationships. Moreover, some variables e.g. work ability
was measured by single questions, asking respondents to range
their current work ability on 5- or 10-point Likert scale which is one
of the commonly used methods (Bobko, 2002). Due to the theo-
retical complexity and practical issues, the single-item question on
work ability has often replaced e.g. the WAI in clinical work and
research (Sluiter and Frings-Dresen, 2008). In our survey we used a
single-item question to measure physical working conditions
which have already been used in scientific research since 1977 in
Statistics Finland (Lehto and Sutela, 2009; Virtanen et al., 2008).
The study concerned only the food processing industry, and the
specific environment homogenous employee group and longitu-
dinal setting are one of the strengths of the study but this may also
limit the generalization of the results.
This study may have some bias because all the information
regarding mental and physical strain and perception of physical
working conditions were collected by questionnaire, i.e. no objec-
tive measurements for the physical working condition were carried
out. Response rate for the first survey was satisfactory; while, it
considerably improved at follow-up to 71%. The respondents who
participated in the baseline survey but did not answer at follow-up
(N ¼ 430) were involved in both blue and white-collar professions,
may cause systematic underestimations and bias the association
between exposure and outcome. The selection during the follow-
up might also have affected our results: the drop-out subjects
were relatively young and more exposed to poor working condi-
tions, and this may have reduced the amount of variance explained.
Furthermore, it is likely that the low correlations and explained
variances were attributed to the adjustments for the model, which
means that the covariates in the regression models were actually
the main explained factors for the changes in mental and physical
strain. Selection out of the workforce is more likely to occur among
the workers with most health problems, as well as the highest
exposure levels, leaving healthiest workers at the workplaces and
being selected in cohort studies as ours. Such biases diminish the
associations between workplace exposures and health outcomes.
There is a need for future research with corresponding design, as
other types of workplaces may pose different challenges to the
physical environment and different physical environment-strain
interaction.
Despite the low level of changes in the work factors (physical
and environmental), increases in mental or physical strain were
found to be significantly correlated with increases in the work
factors (i.e. poorer working conditions) after adjusting for age,
gender, and several baseline work factors related to work ability
and working conditions. Deteriorated physical working conditions
were associated with high mental and physical strain of the em-
ployees and this could ultimately lead to early retirement or higher
 S. Neupane et al. / Applied Ergonomics 45 (2014) 586e591
sick leave rates. It is therefore important to monitor the conse-
quences of changes in the workplace.
Acknowledgment
This study was supported by the Finnish Work Environment
Fund, grant no. 102308 and 105365.
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