“…As a multidimensional instrument, the work ability index (WAI) has been associated with musculoskeletal pain, chronic disease, productivity, sickness absence, early retirement and all-cause mortality (7)(8)(9)(10)(11). Additionally, workers exposed to highly repetitive and forceful exertion, lack of sufficient recovery, and awkward postures (12,13) have an elevated risk of both impaired work ability and musculoskeletal disorders (14)(15)(16). To prevent premature exit from the labor market, effective occupational interventions to prevent deterioration of work ability among employees with high physical work demands are warranted.…”