Objective: To determine the contribution of specific psychological, social, and mechanical work exposures to the self-reported low level of work ability. Methods: Employees from 48 organizations were surveyed over a 2-year period (n = 3779). Changes in 16 work exposures and 3 work ability measures—the work ability index score, perceived current, and future work ability—were tested with Spearman rank correlations. Binary logistic regressions were run to determine contribution of work exposures to low work ability. Results: Role conflict, human resource primacy, and positive challenge were the most consistent predictors of low work ability across test designs. Role clarity and fair leadership were less consistent but prominent predictors. Mechanical exposures were not predictive. Conclusions: To protect employee work ability, work place interventions would benefit from focusing on reducing role conflicts and on promoting positive challenges and human resource primacy.

Journal of Occupational and Environmental Medicine 57(3): 300–314
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