Work Ability Index and its Correlates among Police Officers in a District of South Kerala

Abstract

Work ability, crucial for health and productivity, hinges on the balance between work demands and personal resources and is impacted by evolving factors. Effective occupational health practices and stress management significantly influence workforce well-being, especially in professions such as the police force. This study aimed to assess the work ability index (WAI) of police officers in a district of South Kerala and explore its correlation with the occupational stress index (OSI). The secondary objective was to find the sociodemographic factors associated with WAI and OSI. In this community-based cross-sectional study conducted from August 2018 to July 2019, 124 police officers in Kerala’s Kollam district were selected via multistage cluster sampling. An interviewer-administered questionnaire was used to collect data on WAI and OSI and analyzed using appropriate statistical methods. The study involved participants with a mean age (SD) of 44.56 (5.98) years, of whom 56.5% were males. It was found that 2.4% had poor, 33.1% moderate, 37.9% good, and 26.6% had excellent WAI. The mean OSI score was 141.2 (SD: 20.8), exhibiting a significant association with the WAI. Police officers identified strenuous working conditions, role ambiguity, overload, unprofitability, and low status as major stressors. The poor WAI was also linked to multimorbidity. The study found that subjects generally exhibited good work ability based on their average WAI score, which correlated negatively with high work stress levels. It underscores the importance of training police officers in communication skills and implementing preventive measures to enhance workplace health and safety.

INTRODUCTION

The concept of “work ability” is vital for many sciences related to working life. It is a key concept in legislation governing sickness insurance.[1] Work ability depends on the balance between work and personal resources, which changes over time, with personal resources including health, values, and education, and work resources encompassing the work environment and the nature of work itself.[2]

Addressing barriers to a sustainable working life improves the health of the entire working population. Involving employers, managers, and workers is key to creating a secure and healthy work environment.[3,4]

The work ability index (WAI) is an instrument used in occupational health care and research, aiming to define necessary actions to maintain and promote work ability. It includes questions about workers’ health conditions and capabilities, as well as the mental and physical demands and the nature of the job.[1,5]

The work ability of employees is significantly affected by job stress. A healthy working environment is not only free from harmful conditions but also abundant in health-promoting factors.[6,7,8]

Maintaining workforce health and extending working life is crucial. Enhancing work ability, the ability to meet mental and physical health demands and productivity, is a potential solution.[9,10] Police officers’ work ability is vital for the smooth operation of the department and public well-being.[11] This study aimed to assess police officers’ WAI in a South Kerala district, explore correlations between the WAI and occupational stress index (OSI), and identify sociodemographic factors related to both indices.

METHODOLOGY

The study was conducted as a community-based cross-sectional study. The study was conducted during the period of August 2018 to July 2019. Police officers working in a police station in the Kollam district and those who had a service period of at least 6 months were included in the study. IPS officers and those who were not willing to give consent were not part of the study. We could not find a previous study among policemen. However, in a study among working-class people of Iran by Gharibi et al.,[9] the mean (SD) score of WAI among workers was 38.04 (6.3). The sample size was calculated using the formula:

n = Z1-α/2 2 SD²/d²*Design effect,

where α is the level of significance taken as 5% and the corresponding Z value = 1.96. SD is standard deviation = 6.3. d is the relative precision of the estimate and is taken as 5% of mean = 1.9. Design effect = 1 + p (m - 1) is taken to account for cluster sampling. p is intra-cluster correlation = 0.2. m is the average size of the cluster = 10. Design effect = 2.8. The sample size thus calculated was 124.

Multistage cluster sampling was used for the study. Kollam city police had three subdivisions. Out of the three subdivisions of Kollam City Police, two subdivisions (1^st stage) were selected using simple random sampling by lottery method. Two circles from each subdivision were selected randomly by lottery method (2^nd stage). Police stations of the selected circles were selected as the 3^rd stage and the eligible police officers were enrolled to the study as a cluster of average size 10. Data were collected from the police officers using an interviewer-administered semi-structured questionnaire. Occupational stress and work ability were assessed using the OSI and WAI, respectively. Work ability was measured by the WAI questionnaire, which had seven dimensions (type of work, current work ability, work ability in relation to demands, current diseases, estimated work impairment due to disease, illness within last year, estimation of own work ability in 2 years, and mental capacity) The work ability was calculated by summing up the scores obtained for the seven dimensions. The best possible estimate of the index had 49 points, and the worst estimate had 7 points.

The OSI questionnaire includes 46 questions that measure the subscales related to the components of job indicate stress such as role overload, role ambiguity, role conflict, unreasonable group, political pressure, powerless, poor peer relationship, intrinsic improvement, low status, strenuous working condition, and unprofitability. Scoring the answers was based on a 5-option Likert scale. A measuring tape was used to measure height. A standard weighing machine was used to measure weight.

Data analysis

The data were analyzed using SPSS version 23. Descriptive statistical methods were used to demonstrate the characteristics of the study population. Based on the scores obtained, work ability was classified into one of the four categories of poor (7–27), moderate (28–36), good (37–43), and excellent (44–49). Occupational stress was categorized as low (score: 46–122), moderate (score: 123–155), and high (score: 156–230) levels of stress. T-test and ANOVA were used to find the association between quantitative and qualitative variables. Chi-square was used to find the association between categories of work ability and occupational stress and with sociodemographic variables. Spearman correlation coefficient was used to examine the correlations between subscales of OSI and the WAI score.

Ethical considerations

The study protocol was approved by the institutional research and ethics committee, ensuring compliance with ethical standards. Informed consent was obtained from all participants, and confidentiality was strictly upheld throughout the study.

RESULTS

The sociodemographic characteristics of the study participants are shown in Table 1. Most of the study participants were graduates (86, 69.4%).

Table 1.

Sociodemographic characteristics of the study participants (n=124)

Variable	Category	Frequency	Percentage
Gender	Male	70	56.45
	Female	54	43.55
Religion	Hindu	79	63.7
	Christian	26	21
	Muslim	19	15.3
Educational qualification	Professional	6	4.8
	Graduate	86	69.4
	Diploma	14	11.3
	High school	18	14.5
Rank of the police officers	Civil police officers	99	79.8
	Inspector	25	20.2
Type of family	Nuclear	88	71
	Joint	32	25.8
	Extended	4	3.2

The proportion of police officers consuming alcohol was 16.9% (21). The corresponding figure for the habit of smoking was 9.7% (12) [Supplementary Table 1].

Supplementary Table 1.

Addictions and habituations among the study participants (n=124)

Variable	Frequency	Percentage
Police officers with the habit of smoking habit of Smoking	12	9.7
Police officers who consume alcohol	21	16.9

Almost half of the study participants were obese (63,50.8%). Cardiovascular disorders, diabetes, and musculoskeletal disease (joint or muscle pain, arthritis) were also very prevalent in the study population [Supplementary Table 2].

Supplementary Table 2.

Morbidity profile of the study participants

Variable	Frequency	Percentage
BMI
Normal	24	19.4
Overweight	36	29
Obese	63	50.8
Underweight	1	0.8
Cardiovascular disease (CAD, Hypertension)	31	25
Diabetes	24	19.4
Musculoskeletal disease (joint or muscle pain, arthritis)	22	17.7
Injury due to an accident	14	11.3
Genitourinary disease	11	8.9
Neurological or sensory disease	9	7.3
Respiratory disease	8	6.5
Skin disease	7	5.6
Digestive disease	6	4.8
Blood disorders	3	2.4
Mental disorder	2	1.6
Cancer	1	0.8

Table 2 displays the WAI and its dimensions for 124 study subjects. The majority (37.9%, 47) achieved good scores, while only 3 (2.4%) had poor scores. A significant proportion (33.1%, 41) obtained moderate scores.

Table 2.

Work ability index and its various dimensions

Variable	Category	Frequency	Percentage
Work ability index	Poor	3	2.4
	Moderate	41	33.1
	Good	47	37.9
	Excellent	33	26.6
Current work ability compared to lifetime best	Very poor	1	0.8
	Rather poor	3	2.4
	Moderate	54	43.5
	Rather good	48	38.7
	Very good	18	14.5
Current work ability in relation to Physical demands of work	Very poor	6	4.8
	Rather poor	8	6.5
	Moderate	57	46
	Rather good	48	36.3
	Very good	8	6.5
Work impairment due to diseases	In my opinion, I am entirely unable to work	7	5.6
	I feel I am able to do only part- time work	6	4.8
	I must often slow down my work pace or change my work methods	5	4
	I must sometimes slow down my work pace or change my work methods	9	7.3
	I am able to do my job, but it causes some symptoms	33	26.6
	There is no hindrance/I have no disease	64	51.6
Estimation of own work ability in two years by the study subjects	Relatively certain	81	65.3
	Not certain	29	33.1
	Unlikely	14	11.6
Enjoy regular daily activities	Never	13	10.5
	Rather seldom	10	8.1
	Sometimes	39	31.5
	Rather often	30	24.2
	Often	32	25.8
Activeness and alertness in the last three months	Never	3	2.4
	Rather seldom	1	0.8
	Sometimes	45	36.3
	Rather often	42	33.9
Full of hope about the future considering the last three months	Continuous	16	12.9
	Rather often	9	7.3
	Sometimes	21	16.9
	Rather seldom	27	21.8
	Never	51	41.1

Out of 124 study participants, 15 (12.1%) police officers took leave for over 100 days in the past year. A small percentage, 1.6%, worked only 9 days, while 6.5% worked for 10–24 days, and 4% for 25–99 days. To assess mental capacity, three questions inquired about enjoying daily activities, being active and alert, and having hope for the future; 25.5% often enjoyed daily activities, while 10.5% never did. Furthermore, 26.6% were consistently active and alert, but 2.4% were not. Moreover, 41.1% expressed full hope for the future, while 12.9% had lost hope.

Table 3 displays the OSI and its domains. Approximately one-fourth of the participants had high OSI scores. Strenuous working conditions had the highest number of participants (93, 75%) in the high-score category, while “Role Ambiguity” saw 71 participants (57.3%) with high scores.

Table 3.

Occupational stress index and its various domains

Variable	Category	Frequency	Percentage
Occupational stress index	Low	22	17.7
	Moderate	78	62.9
	High	24	19.4
Role overload	Low	16	12.9
	Moderate	62	50.0
	High	46	37.1
Role ambiguity	Low	14	11.3
	Moderate	39	31.5
	High	71	57.3
Role conflict	Low	30	24.2
	Moderate	80	64.5
	High	14	11.3
Political pressure	Low	32	25.8
	Moderate	67	54
	High	25	20.2
Responsibility	Low	30	24.2
	Moderate	75	60.5
	High	19	15.3
Under participation	Low	52	41.9
	Moderate	39	31.5
	High	33	26.6
Powerlessness	Low	62	50
	Moderate	54	43.5
	High	8	6.5
Poor peer relations	Low	21	16.9
	Moderate	69	55.6
	High	34	27.4
Intrinsic impoverishment	Low	27	21.8
	Moderate	76	61.3
	High	21	16.9
Low status	Low	9	7.3
	Moderate	76	61.3
	High	39	31.5
Strenuous working condition	Low	3	2.4
	Moderate	28	22.6
	High	93	75
Unprofitability	Low	19	15.3
	Moderate	65	52.4
	High	40	32.3

Table 4 shows the association between WAI and levels of occupational stress. An inverse relationship could be discerned, and it was found to be statistically significant.

Table 4.

Association between work ability index and levels of occupational stress

Occupational Stress Index	Work Ability Index				P $
	Poor (%)	Moderate (%)	Good (%)	Excellent (%)
Low	0 (0)	5 (12.2)	10 (21.3)	7 (21.2)	0.008
Moderate	1 (33.3)	33 (80.5)	22 (46.8)	22 (66.7)
High	2 (66.7)	41 (7.3)	15 (31.9)	4 (12.1)

^$Chi-square Test

The study found no significant correlation between the domains under the occupational stress scale and the WAI [Supplementary Table 3].

Supplementary Table 3.

Correlation between various domains under the occupational stress scale and the workability index

Domain under the occupational stress scale	Mean score	Correlational coefficient	P #
Role overload	20.67	0.036	0.689
Role ambiguity	12.99	-0.052	0.564
Role conflict	14.37	-0.066	0.466
Unreasonable group or politicalpressure	11.55	-0.045	0.617
Responsibility for persons	9.15	0.020	0.824
Under participation	10.3	0.087	0.338
Powerlessness	7.4	-0.053	0.562
Poor peer relations	11.46	0.055	0.54
Intrinsic impoverishment	11.4	-0.073	0.421
Low status	10.6	-0.027	0.770
Strenuous working condition	14.87	-0.009	0.919
Unprofitability	6.43	-0.041	0.651

^#Spearmann correlation coefficient

We also investigated the association between various sociodemographic factors and the WAI and the association between various demographic factors and occupational stress levels. No statistically significant associations could be made in both instances.

DISCUSSION

We found that the majority of the study participants had good scores on the WAI. Approximately one-fourth of the participants had high OSI scores. An inverse relationship was obtained between WAI and levels of occupational stress. Police officers identified strenuous working conditions, role ambiguity, overload, unprofitability, and low status as major stressors. Working under severe pressure and stress may make police officers alcohol and smoking-dependent[12] In the present study, 9.7% and 16.9% of police officers had the habit of smoking and consumption of alcohol, respectively. Among male police officers, 15.7% were smokers and 25.7% were consumers of alcohol. The prevalence of smoking and alcoholism was 23% and 45.7%, respectively, in the study done by Ramakrishna et al.[13] and 22.6% and 31.1%, respectively, in a study done in Chennai.[14] A study done in Gujarat[15] found that 7.64% of police personnel had the habit of smoking and 3.16% consumed alcohol.

Body mass index (BMI) cut-off values for the Asian population were used, and 50.8% of police personnel were found to be obese (BMI ≥25 kg/m²). Similarly, the prevalence of overweight (based on a BMI greater than 23 kg/m²) in our study was similar (79.8%) to that observed in the study done by Ramakrishna et al.[13] (75.8%).

The present study suggests a high burden of health complaints among police personnel: 21.8% had at least one disease, and 29.8% were reported to have two or more diseases. WHO reported the overall prevalence of hypertension and diabetes among the general population in India as 24% and 8%, respectively.[16] Cardiovascular diseases, including hypertension, were the most common, seen in 25% of the police officers, diabetes in 19.4%, and musculoskeletal disorders in 17.7%, which was similar to the study done by Walvekar et al.[17] Meena et al.[18] reported in their study that 36.2% had cardiovascular problems and 12% had diabetes. A study done in Puducherry reported that 33.6% and 30.5% had diabetes and hypertension respectively.[13] This hints at increased levels of morbidity among police personnel.

Among those 124 police personnel, 41 (33.1%) with moderate WAI should have their work ability improved, and 2.4% with poor WAI should have their work ability restored, according to the classification proposed by the instrument creators. The WAI in the current study is comparable to the WAI observed among police personnel from other countries.[19,20]

The WAI among police personnel ranks low when compared to other professions like stone quarry workers[5] and refinery workers.[9] When analyzing the subquestions under the WAI calculation 41% (51 study participants) said that they never had hope about the future considering the last 3 months. A sizeable proportion of the study participants (23 study participants, 18.6%) said that they enjoyed their daily activities either “never” or “rather seldom.” Given that the job of police personnel can be emotionally and physically taxing, it becomes clear from our study that the proportion of police personnel who do not find enjoyment and hope in the work they do is rather substantial.

When the occupational stress of the police officers was assessed, we found that 62.9% of the police officers had moderate stress, 19.4% had high stress, and 17.7% had low stress. The stress levels are comparable to those reported by other studies done in India.[21,22] Strenuous working conditions (75%), role ambiguity (57.3%), role overload (37.1%), unprofitability (32.3%), and low status (31.5%) were the major stressors reported by them. This high prevalence of stress among police personnel can impair their judgment and discharge of duties.

Our study could find an inverse correlation between WAI and occupational stress levels. Both factors can act as the cause of the other, and it is also possible that the existing work environment in the profession can be the contributor to the two factors. The various sociodemographic factors were not statistically associated with either WAI or occupational stress levels.

Limitations

The study was conducted only in Kollam city area police stations. This can affect the generalizability of the results. Stress was assessed by a self-reported questionnaire. Social desirability bias could have occurred. As the study is a cross-sectional study temporality could not be established.

CONCLUSION

The work ability of the police personnel is comparable internationally, but many report health issues, notably diabetes mellitus, hypertension, smoking, alcohol consumption, and obesity. Occupational stress, assessed by the occupational stress scale, is notably high, with an inverse link to work ability level. Sociodemographic factors showed no statistical association with either WAI or stress levels. The reasons for stress should be further studied, and means to improve work ability must be put in place. Further research should also investigate the relationship and direction between occupational stress and work ability.

Conflicts of interest

There are no conflicts of interest.

Funding Statement

Nil.