Few risk prediction scores are available to identify people at increased risk of work disability, particularly for those with an existing morbidity. We examined the predictive performance of disability risk scores for employees with chronic disease. We used prospective data from 88,521 employed participants (mean age 43.1) in the Finnish Public Sector Study which included people with chronic disorders: musculoskeletal disorder, depression, migraine, respiratory disease, hypertension, cancer, coronary heart disease, diabetes and comorbid depression and cardiometabolic disease. 105 predictors were assessed at baseline and participants were linked to a national disability pension register. During a mean follow-up of 8.6 years, 6836 (7.7%) participants got a disability pension, the incidence varying between 9.9% among participants with migraine and 27.7% in those with comorbid depression and cardiometabolic disease. C-statistics for an 8-item risk score, comprising age, self-rated health, number of sickness absences, socioeconomic position, number of chronic illnesses, sleep problems, BMI, and smoking at baseline, was 0.80 (95%CI: 0.80-0.81) for musculoskeletal disorders (N=33,601), 0.83 (0.82-0.84) for migraine (N=22,065), 0.82 (0.81-0.83) for respiratory disease (N=15,372) and exceeded 0.72 for other disease groups. With 30% estimated risk as a threshold, a positive test detection rate and false positive rate ranged from 42.2% and 18.8% (cancer) to 79.8% and 45.2% (comorbid depression and cardiometabolic disease). Predictive performance was not improved in models with a new set of predictors or re-estimated coefficients. In conclusion, the 8-item work disability risk score may serve as a scalable screening tool in identifying individuals with increased risk for work disability.

This study was supported by Finnish Work Environment Fund (190424) and Academy of Finland (329202). STN was supported by NordForsk (75021) and Finnish Work Environment Fund (190424), JP was supported by the Academy of Finland (311492), JV by Academy of Finland (321409 and 329240), GDB by the MRC (MR/P023444/1) and NIA (1R56AG052519-01) and MK by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (329202, 350426), and the Finnish Work Environment Fund (190424). The funders played no role in the design or conduct of the study; the collection, management, analysis, or interpretation of the data; the preparation, review, or approval of the manuscript; or in the decision to submit the manuscript for publication.

This study was supported by Finnish Work Environment Fund (190424) and Academy of Finland (329202). STN was supported by NordForsk (75021) and Finnish Work Environment Fund (190424), JP was supported by the Academy of Finland (311492), JV by Academy of Finland (321409 and 329240), GDB by the MRC (MR/P023444/1) and NIA (1R56AG052519-01) and MK by the Wellcome Trust (221854/Z/20/Z), the UK Medical Research Council (MR/S011676/1), the US National Institute on Aging (R01AG056477), and the Academy of Finland (329202, 350426), and the Finnish Work Environment Fund (190424).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval was obtained from the ethics committee of the Helsinki-Uusimaa Hospital District Ethics Committee (HUS/1210/2016).

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable.

Yes

Pseudonymised questionnaire data from the FPS study can be shared upon request to the investigators. Linked health records require separate permission from the Findata, the Health and Social Data Permit Authority in Finland.