Highlights of the Training Tool FOR MANAGERS

Chronic diseases and employment – some facts:

  • FACT 1: If there are at least 4 employees, ONE of them suffers from one or more health conditions

The number of people living with one or more chronic diseases (CDs) has dramatically increased in recent decades and this has significant social and economic implications for the employment sector.

  • FACT 2: Workplaces play a key role in improving employees’ health

Working for as long as possible for people affected by a chronic disease can represent a protective factor for improving the quality of life and wellbeing. It is fundamental to redesign the role of the workplace, addressing not only the physical but also the social working environment.

  • FACT 3: Planning Stay at work and Return to work of skilled employees is a benefit both for the person and the enterprise.

It is in everyone’s best interest to return the employee to work after a period of illness. A well-run Return to Work (RTW) program offers benefits to both employers and their employees. Keeping people with chronic diseases at work involves a number of adaptations that can be made to the working environment.



The concept of inclusive workplace refers to an organization that considers values and uses individual and intergroup differences within its work force, alleviates the needs of people with some health conditions and collaborates with individuals and groups within the organization.

The knowledge and understanding of the level of inclusiveness of a company allows managers to identify critical issues so they can overcome them with relevant actions. To measure the presence of inclusive attitudes at the organization a checklist is offered by the Training Tool, composed by the following sections:

  • Work environment: it represents the whole organization and its rules;
  • Reasonable accommodations: it regards possible adaptations of the workplace;
  • Management sector: it involves the management decisions and organization policies;
  • Teamwork: it includes the working dynamics between colleagues and the working performance.


Work ability is a dimension that evaluates whether an employee is able to do his/her job in the present and in the future, in relation to the demands of the job itself, to the work environment and to his/her own mental and physical resources.

Work ability can be assessed using the Work Ability Index (WAI, available here on Page 34), which is a self-assessment tool that measures the work ability of the employees by considering their interaction with the environment in which they work. Sections of the Work Ability Index are the following:

  • Current work ability compared with the lifetime best
  • Work ability in relation to the demands of the job
  • Number of current diseases diagnosed by a physician
  • Estimated work impairment due to diseases
  • Sick leave during the past year (12 months)
  • Own prognosis of work ability 2 years from now
  • Mental resources

Low WAI values do not indicate an individual deficiency but an incongruity between the work demands and the work capability of the employees. Managers should be able to improve work ability of each employee by changing the environmental barrier into facilitators. When WAI is low actions could include modification of the work organization, modification of the activities of employees, improving team support and cohesion of workers and defining interventions focused on reasonable accommodations.


The creation of an inclusive working environment is a continuous process that responds to changes in the working environment and in work policies. An inclusive working environment is created by the actions and attitudes of the individuals who belong to the working environment. Once managers have identified strengths and weaknesses through the tools presented above they can devise a plan of action that will help to strengthen inclusion and well-being in the workplace of all workers and, in particular, of those with one or more chronic condition. It has to be always kept in mind that it is costly to recruit and train new employees, while long-term employees possess valuable institutional knowledge and skill.

Establishing a return to work (RTW) policy and/or program of inclusion and stay at work is not difficult. Managers and people with responsibility should be trained to execute these programmes correctly. The 4 most common training modules of a successful RTW training program – which can be carried out either online or face-to-face – are presented in the Training Tool.

Employees with chronic diseases need continuous support to stay at work, to keep working. This support includes mental and physical manifestations. Communication about these issues and compassion within the company are critical. To improve organizational collaboration between employees with chronic diseases and employees without any health conditions, managers can benefit from the use of intranet on which a training package for all employees can be launched, or e-mail announcements, company newsletters and info-screens can also be used. Examples of reasonable accommodations for people with chronic diseases include

  • modified work schedule and flexitime,
  • modification or purchase of equipment and devices,
  • modifying physical working environment.


In order to improve productivity, wellness and inclusiveness, it is of paramount importance for a company to be informed about what having a chronic disease means for a person, and to be trained to handle the issue of having an employee with such a condition.

The Training Tool in its Appendix presents some brief case vignettes and fact sheets on the most frequent chronic diseases that might be encountered in the workplace and some suggestions for managing them at best.

Highlights of the Chrodis Plus Toolkit for workplaces

The CHRODIS PLUS Toolkit for Workplaces offers 127 evidence-based, concrete means to:

  • foster wellbeing, health, and work ability of all employees
  • prevent the development of chronic diseases
  • help individuals with chronic health problems to continue working

Read more about the development of the Toolkit.


A green thumb indicates means that are effortless to put into action.

The Toolkit is designed for everyone involved in fostering occupational wellbeing and health, in particular:

  • Management of workplaces and HR services
  • Occupational wellbeing and health services
  • Catering service providers
  • Policy-makers

The Toolkit is categorised into seven domains, each important to overall wellbeing and health: Nutrition, Physical Activity, Ergonomics, Mental Health and wellbeing, Recovery from Work, Community spirit and atmosphere, and Smoking cessation and reduction of excess alcohol consumption.

Every domain includes various types of approaches. These approaches aid to:

  • strengthen employees’ knowledge and skills
  • create supportive physical and social working environments
  • develop wellbeing-fostering organizational policies, and
  • incentivize beneficial behaviours.

The domains of the Toolkit are interconnected. Thus, to achieve the best effects, we suggest targeting various domains, using diverse approaches, and combining several means.

There are plenty of things that can be done with limited resources, and even the smallest measure can make a world of difference in creating supportive working environments for people with chronic conditions and in improving the health, quality of life, and job satisfaction of all employees.

Each action counts!


A workplace has excellent possibilities to support employees in adopting and maintaining healthy dietary patterns: eating regularly and making smart food and beverage choices. This Toolkit domain provides 34 suggestions for promoting healthy eating at the workplace.

For example, paying attention to details, such as the nutritional quality, presentation, and portion sizes of foods and beverages available at the workplace, can have a substantial impact on employees’ eating habits; be it in the workplace cafeteria, vending machine, recreation room, or meetings.


Research shows that being physically active benefits just about everyone: individuals of all ages and with or without chronic conditions or disabilities. Employers can do a lot to enhance physical activity at the workplace. This Toolkit domain provides 42 suggestions for encouraging movement that improves employee wellbeing and recovery from work.

For example, digital tools that automatically prompt to change working posture, stand up, and perform a couple of stretches within daily work tasks not only improve concentration and vitality, but can bring significant health effects as well.


Ergonomics is about designing or arranging workplaces, products, and systems so that they fit the people who use them. Ergonomics involves three main domains: physical, cognitive, and organizational ergonomics. These domains can be improved, for example, through focusing on healthy working postures, developing work processes that decrease mental workload, and enhancing communication within the workplace. This Toolkit domain comprises 20 means to promote ergonomics at the workplace.

For example, introducing ergonomic equipment, such as height-adjustable desks and lifting aids, and training employees to make the most of this equipment can prevent and reduce musculoskeletal problems. Smart shift schedules, on the other hand, promote shift workers’ workflow and recovery between work shifts.


Mental health refers to a state of wellbeing in which individuals realize their potential, can cope with normal stresses of life, work productively, and contribute to their community. Workplaces are recommended to aid employees reach their best possible performance by preventing and managing stress factors particularly related to work organization, work content, and working environment. This Toolkit domain offers 17 suggestions for implementing these recommendations.

Fostering supportive, inclusive, and respectful organizational climate, for example, is an inexpensive way to ensure everyone feels well at the workplace. All starts with small acts, such as remembering to thank colleagues for their help and acknowledging them for their efforts. Another example is providing employees a possibility to talk to a psychologist at the workplace and thus get low-threshold support for challenges in work or personal life. Introducing a quiet space at the workplace, in which laptops and telephones are not allowed, on the other hand, can help employees to release work-induced mental pressure.


An adequate balance between work and rest are prerequisites for a healthy, happy, and productive life. Recovery from work refers to the process of replenishing the physical, cognitive, and emotional resources that have been expended at work. This Toolkit domain provides 13 means to improve employees’ recovery from work.

Arranging recreational social events, such as collective coffee breaks or outdoor activities, are an example of inexpensive ways to enhance recovery during working hours. Providing employees a possibility for remote work, flexible working hours and schedules, or adjusted workload, on the other hand, can substantially improve employees’ coping.


Positive work climate elevates employees’ motivation and inspires them towards higher performance. A supportive work community and good relationships between coworkers also advance mental wellbeing and help getting through challenging periods both at work and in personal life. This Toolkit domain compiles 12 means to elevate workplace community spirit and atmosphere.

Cultivating constructive and open communication culture, for example, is an inexpensive way to create supportive social working environment in which all employees have the courage to express their thoughts and feelings. Team building and teamwork, in turn, can be supported with communication skills training. Employees with immigrant background, on the other hand, can be better included in the work community by providing them information, instructions, and training materials in their first languages.


Workplace can also provide an important setting for supporting employees to quit smoking and to reduce excess alcohol consumption, which are major risk factors of chronic diseases, such as cardiovascular diseases, lung diseases, and cancer. This Toolkit domain provides six suggestions for addressing the smoking and alcohol theme.

No smoking and no alcohol policies inside and outside workplace facilities are an effortless and inexpensive way to facilitate employees to refrain from smoking or using any alcohol during working hours. Together with occupational health care services, employers can also provide employees a possibility for motivational and empowering counselling that supports smoking cessation and/or reduction of excess alcohol consumption.

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