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Predictors of lower work ability among emergency medicine employees: the Croatian experience
  1. Antonio Klasan1,
  2. Goran Madzarac2,
  3. Milan Milosevic3,
  4. Jadranka Mustajbegovic3,
  5. Slobodanka Keleuva4
  1. 1Clinic for Orthopedics and Traumatology, Klinikum Fichtelgebirge gGmbH, Marktredwitz, Germany
  2. 2Clinic for Thoracic Surgery Jordanovac, University Hospital Zagreb, Zagreb, Croatia
  3. 3University of Zagreb, School of Medicine, Andrija Štampar School of Public Health, Department of Environmental and Occupational Health, Zagreb, Croatia
  4. 4Institute of Emergency Medicine the City of Zagreb, Zagreb, Croatia
  1. Correspondence to Antonio Klasan, Klinik für Orthopaedie, Unfall- und Handchirurgie, Klinikum Fichtelgebirge gGmbH, Schillerhain 1-8, 95615 Marktredwitz, Germany; klasan.antonio{at}


Background Worldwide research has indicated that emergency medicine employees and particularly ambulance personnel have symptoms related to traumatic events, and experience more chronic stressors in their work than workers in other health service settings. Unlike other countries which conducted similar studies, no specialty branch in emergency medicine exists in Croatia.

Study objectives To identify possible predictors of low work ability, including occupational stress and quality of life, among emergency medicine employees.

Methods A cross-sectional study was conducted from May 2010 till July 2010 in the Institute of Emergency Medicine in the City of Zagreb. Questionnaires were distributed to all employees with gathered total sample of 125 subjects (39 physicians, 38 medical nurses /technicians and 48 drivers). Data were collected using the socio-demographic questions, occupational stress assessment, work ability index (WAI) and WHO quality of life (WHOQOL-BREF) questionnaires.

Results Emergency physicians were significantly more exposed to public criticism (p=0.008) but drivers had more exposure to hazards at workplace (p=0.001) regarding other employee groups. Binary logistic regression model showed two significant predictors of lower work ability (WAI score <37): lower physical WHO-BREF domain (OR=0.78; 95% CI 0.68 to 0.89; p<0.001) and the professional and intellectual demands (OR=1.09; 95% CI 1.01 to 1.19; p=0.043).

Conclusion Strenuous physical activity should be reduced in order to increase the overall work ability of the emergency medicine employees and better structural organisation and introduction of a residency in emergency medicine should significantly improve total work ability among emergency physicians.

  • Emergency medicine
  • work ability
  • occupational stress
  • predictors
  • quality of life
  • trauma
  • statistics

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  • This study is a part of a project of Croatian Ministry of Science, Education and Sports. Project title: Health at work and healthy environment; Project no: 108-1080316-0300.

  • Lower work ability predictors among emergency medicine employees: the Croatian story.

  • Funding Croatian Ministry of Science, Education and Sports. 108-1080316-0300.

  • Competing interests None.

  • Ethics approval This study was approved by the Ethical Council of Institute of Emergency Medicine the City of Zagreb, Heinzelova 88, 10000 Zagreb, Croatia.

  • Provenance and peer review Not commissioned; externally peer reviewed.