| Health is a basic human right. It is an important aim to gain a high health level for the social developing in global dimensions. As a special social group, the work force have a great effect on developing of economy, society and all human due to their changing on psychology, physiology, culture, ethic and life style. At present, it has been attracted as an attention problem by the workgroup of occupational health how to evaluate the health on physical and mental health in workers correctly.This current study utilized comprehensive work ability index (CWAI) to estimate the status of work ability and carried out occupational stress inventory revised edition (OSI-R) to measure the occupational stress level, then used the lab examination to test the blood lead level and the blood serum immunoglobulin level in workers. The purpose of this study is to explore the relationships between work ability and personal factors, or work ability and occupational stress, or work ability and blood lead level and to ascertain the risk factors of work ability. Getting along with the problem of lead exposure and occupational stress in the global dimensions, it is a benefit for workers' health and work ability to find out the problems of physical and mental health in workers and the risk factors of work ability according to investigation a large cluster. At the same time, this study can provide a reference for keeping a well-being health status and a perfect quality of the professional life according to adjusting the risk factors of work ability decline, and the resultscan help to measure for promoting workers' work ability and work efficiency. 1 Individual factors and the evaluation of comprehensivework abilityThe method of cluster random sampling trial was adopted. Work ability was measured using the method of comprehensive work ability index (CWAI) in 2041 workers (1117 males, 924 females).The cross-sectional study was confirmed that the CWAI scale had good reliability and validity and could be applied to assess the workers' work ability very well. According to the standard degrees of the CWAI scale, the mean score of CWAI belonged to moderate degree in all investigators (male=45.05±5.81, female=44.53±5.51, total=44.81±5.68). The result showed that the work ability of the current workers should be improved.The remarkable significance of the CWAI score were tested in different individual factors in the workers by hypothesis testing of ANOVA. The results of multiple linear regression and correlation analysis revealed that there were remarkably negative correlation between the work ability and age and length of service. The work ability was decreased with the increase of age and length of service. There were positively correlation between cultural level, income, work type and work ability, the work ability was increased with going up of the education and income, and the workers of the mental and mixed work type had the higher work ability than those of physical work type. Analysis according to the standard partial regression coefficient, the work type showed significant difference with the scores of self-rating work ability domain, psychological domain and work ability prediction domain; The length of service revealed significant difference with scores of physiological domain (there are the collinearity between the age and length of service); Education level showed significant difference with the scores of social functional capacity domain. The result unveiled that there weredifferent effects on the scores of the five items of the CWAI in the various individual factors.The result of logistic regression analysis suggested that the individual factors of length of service, work type, changing vocation, education level and income were related the risk factors for the work ability. Therein, the regression coefficient of work type was the biggest and its odd rate (OR) was the smallest than other factors (B values are -0.687 and 0.664, OR values are 0.503 and 0.515, respectively,/?<0.01). The result revealed that the work type could affect the work ability more, and mental and mixed work type might ease the work ability from being declined. The higher education and income also could prevent the work ability from being declined (OR values were 0.761 and 0.809). The OR values of the factors of length of service and changing vocation were more than 1(OR values are 1.162 and 1.416) and regression coefficient were 0.150 and 0.348, the results showed that they were the risk factors for the work ability, another words that the work ability would be remarkably declined when the changing vocation was turned so frequently and as the length of service was increased so fast. However, the result revealed that it was more important to consider sufficiently the effect of the various individual factors on the evaluations of work ability when the workgroup of occupational health would carry out measuring the workers' health care and evaluating their work ability level. They should pay more attention to the special workers who had been 15 years of the length of service, often changing vocations, low education level, less income, belonged to physical work type and middle age workers. So, improving work condition, enhancing health protection and balancing work demands and the work ability, might be helpful to prevent the work ability from being declined and to heighten the quality of professional life in workers.2 Occupational stress and the evolution of comprehensivework abilityOccupational stress was investigated by the questionnaire of occupational stress inventory revised edition (OSI-R) in 2041 workers. The results showed that the scores of the occupational role questionnaire (ORQ=140.86±19.86) was lower, and the personal strain questionnaire (PSQ=91.48± 17.05) was higher than the occupational stress total norm on the professionals (ORQ=144.44±17.53, PSQ=84.78±18.16). In the other hand, the scores of personal resources questionnaire (PRQ=130.52±18.30) was the same as the occupational stress total norm of the professionals (PRQ=130.02±17.39).Analysis of variance and partial correlation showed that there were the relationship between the occupational stress and comprehensive work ability in the work force while controlling the individual factors. There were negative relation between the scores of the ORQ and the CWAI, the poorer work ability level having the higher occupational stress degrees, and this negative relation were also showed remarkably in sub-items of ORQ of role insufficiency (RI), role ambiguity (RA), role boundary (RB) and physical environment (PE). There were negative relation between the scores of the PSQ and the CWAI, the poorer work ability level having the higher personal strain response level, and this negative relation was significant different among the sub-items of the PSQ of vocational strain (VS), psychological strain (PSY), interpersonal strain (IS) and physical strain (PHS). Whereas, there were positive relation between the scores of the PRQ and the CWAI, the better work ability level having the higher personal resource, and this positive relation was showed particularly in the sub-items of the PRQ of recreation (RE), self-care (SC), social support (SS) and rational/cognitive (RC).The risk factors of work ability were classified as the four main factors by factor analysis and multivariate logistic regression analysis. Among external stress and strain factors, the items of tired for job, the poison substance in workshop environment, fear on duty, feeling repression, poor sleep, physical pain and poor energy were the risk factors of the work ability. Among internal stress and strain factors, the items of no good at the works, incompetent the job, poor work quality and new mission confusion were the risk factors of the work ability. Among the work adjustment stress and strain factors, the items of been requested work in various of domain, straggling of work, work accident, lacking for sense of humor and coping with many persons had affected the work ability remarkably. Among the personal adjustment factors, the items of watching performing, taking part in various activity, medical examination punctually were the protective factors of work ability. The result suggested that it had been the first important task to adjust the external stress and strain factors during improving the health care and work ability in workers, so as to reform poor workshop environment, to regulate the role insufficiency and to change overload. Meanwhile, it was also important to pay attention to the psychological and physiological strain, and to adjust the factors of internal stress and strain gradually, so as to enhance the personal internal quality. To strengthen the factors of the work adjustment was an important thing so as to enhance the job passion and satisfaction. It might be a schedule to adjust the workers' leisure time, so as to enhance copying with the resource of workers and to serve for promoting the work ability.3 Blood lead level and the evolution of comprehensivework abilityThe blood lead level is a sensitive sign for reflecting the lead load. This current study was based upon the investigation of the CWAI and OSI-Rscales. Taking out 124 workers to form the study group among the unit whose scores of the CWAI were lower, and taking out 127 workers to be the control group according to the unit whose scores of the CWAI were higher, there were 251 workers in all to be tested the blood lead level and serum immunoglobulin concentration. The results of lab tests showed that the threshold of the blood lead level was 7.31-352.80ug/L, the mean of the blood lead level was 47.52ug/L and the median was 39.87ug/L. The mean of the blood level of the male workers was 51.94ug/L (10.61-352.80) and the mean of the blood level of the female workers was 43.20ug/L (7.31-329.07). The male workers was no significance different with the female of that (p>0.05).Controlling the effect of the factors of gender and nationality, the results showed that there had been remarkable significance between the groups of the study and control groups on the blood lead level and the serum immunoglobulin IgM, IgG level(p<0.05). The blood lead level of study group was higher than the control group, but the IgM, IgG level were lower than the control groups. So the results revealed that the lead load level of the body of workers were remarkable higher when their work ability were decreased, but their immunity function were lower than the control group. After controlling the personal factors, the analysis of partial correlation showed that the blood lead level were remarkable related to the items of psychological domain, social function domain and work ability prediction domain (p<0.05). The blood lead level was also remarkable related to the immunoglobulin IgM, IgG and also to the stress factor of physical environment (p<0.05). The analysis of multiple linear regression also showed that there had been some relationships between the blood lead level and the work ability level, occupational stress degrees and immunity function.The logistic regression analysis showed that the blood lead level enteredinto the regression equation and was the risk factor of the work ability(OR=3.546, p<0.0\) . The result revealed that the external environmentallead exposure had affected on the evaluation of the work ability in workers. The blood lead level had been an important factor to relate to the health states and the work ability in the work force. Therefore, the first step must be to control the environmental lead exposure, to improve workshop condition, to enhance the comprehending on the lead harm, so as to decrease the blood lead level and to improve the work ability and work efficiency of workers.This current study revealed that the personal factors, occupational stress and the blood lead level had affected on the evaluation of the comprehensive work ability in some sense. The result implied that the task of evaluating health care and work ability in workers must base on the different individual factors, different occupational stress degrees and different blood lead level. Therefore, finding out the risk factors may be favorable for improving the work ability in workers. Meanwhile, advancing and spreading the health knowledge, enhancing and measuring the blood lead level, easing down occupational stress and improving the coping resources in workers, are so beneficial to promote the work ability and the quality of professional life in workers so as to prevent the work ability from being declined.
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