Demographic ageing poses the challenge of how to keep people in employment for longer without negatively affecting their health and well-being. The solutions are particularly critical for workers engaged in arduous work. This report examines how mid-career reviews can play a key role by clarifying workers’ options for remaining in work until a later retirement age. Following an exploration of career trajectories and transitions, the report focuses on arduous jobs: their incidence across Europe and the implications of such work for career and work sustainability. It examines various tools and strategies used by public authorities and social partners to keep workers in arduous jobs in employment longer. Finally, three case studies – from Belgium, France and the UK – of mid-career reviews undertaken either as pilot projects or as a legislative reform are presented. An executive summary is available - see Related content.