Predicting Adaptation Outcomes to Occupational Load in Working-Age Men with Disabilities

BACKGROUND: Employment for individuals with disabilities serves not only as a means of rehabilitation and social integration but also represents a stress-inducing factor involving a combination of technogenic and socio-psychological influences. Given the specific self-perception of their status, persons with disabilities develop a dynamic system of adaptive-compensatory mechanisms in response to occupational load. Therefore, the study of labor adaptation processes should encompass not only psychosocial aspects, as emphasized in most scientific data, but also consider the functional state of the body’s regulatory systems.

AIM: To assess the possibility of predicting adaptation outcomes to occupational load in working-age men with disabilities.

METHODS: The study group consisted of 59 working-age men with disabilities. The participants underwent employment-based practice in specialized rehabilitation and habilitation centers. The assessment included the Rogers–Diamond method for socio-psychological adaptation, morphometric parameters (weight, height, vital lung capacity, blood pressure, heart rate), and cardiointervalography with analysis of wave-related parameters (SI, HF, LF, VLF, LF/HF).

RESULTS: A comparative over-time analysis of cardiointervalography wave parameters revealed a statistically significant increase in the LF/HF ratio (p <0.001), indicating increased strain on adaptive mechanisms and a shift in autonomic tone toward sympathetic dominance. However, the increase in the VLF% index (p=0.045), recorded during further analysis, indicated the involvement of suprasegmental regulation of visceral functions. No significant changes were observed in socio-psychological adaptation. Morphometric parameters were assessed in relation to a composite index of regulatory system strain, determined after occupational load based on cardiointervalography data. ROC curve analysis was used to identify critical threshold values for age and body mass index in individuals with disabilities. Accordingly, these parameters can be regarded as predictors of unfavorable regulatory system responses to occupational exposure. Thus, if a person with a disability is employed at the age of 35 years or older, there is an 80% probability (p=0.005) of developing strain on adaptive mechanisms mechanisms as a response to occupational exposure. A similar correlation was identified with respect to body mass index: if, upon employment, the BMI is equal to or exceeds 26, there is an 80% probability (p=0.004) that an employed individual with a disability will develop autonomic imbalance.

CONCLUSION: The study identified specific features of adaptive responses to occupational load in working-age men with disabilities. The obtained data can be used to predict strain on the regulatory systems of internal organs in response to occupational exposure, as well as, from a practical standpoint, to design an effective work-rest schedule, weekly work timetable, and to determine the appropriate level of occupational load. A comprehensive biopsychosocial approach is required for a thorough evaluation of adaptive mechanisms, ensuring that employment serves a rehabilitative role for individuals with disabilities and delivers cost-effective results for employers.