2012-06-01 12:00 - Messages

Dose–response relation between perceived physical exertion during healthcare work and risk of long-term sickness absence

Objective : An imbalance between physical work demands and physical capacity of the worker may be a risk factor for poor health. Perceived physical exertion provides information about the individual perception of the work demands relative to the capacity to perform the work. This study estimates the risk for long-term sickness absence (LTSA) from perceived physical exertion among healthcare workers.
Methods : This prospective cohort study comprises 8592 Danish healthcare workers who responded to a baseline questionnaire in 2004–2005, and subsequently were followed for one year in the Danish Register for Evaluation of Marginalization (DREAM), a national register of social transfer payments. Using Cox regression hazard ratio (HR) analysis controlled for age, gender, body mass index (BMI), smoking, tenure, leisure-time physical activity, psychosocial working conditions, and LTSA during one year prior to baseline, we modeled risk estimates of moderate and strenuous (reference: light) perceived physical exertion during healthcare work for onset of LTSA (receiving sickness absence compensation for ≥8 consecutive weeks) during 1-year follow-up.
Results : At baseline, 35.1%, 39.4% and 25.5% of the healthcare workers experienced, respectively, light, moderate, and strenuous physical exertion during healthcare work. During follow-up, the 12-month prevalence of LTSA was 4.6%, 6.4% and 8.9%, respectively, in these three exertion groups. A dose–response pattern between physical exertion and the risk for LTSA was found (trend test P<0.0001). In the multi-adjusted model, the risk for LTSA was 1.31 [95% confidence interval (95% CI) 1.04–1.64] for healthcare workers reporting moderate and 1.57 (95% CI 1.23–2.01) for those reporting strenuous physical exertion, referencing those reporting light physical exertion during healthcare work.
Conclusion : Moderate and strenuous perceived physical exertion during healthcare work increases – in a dose–response manner – the risk for LTSA. The possible preventive effect of balancing work demands with the capacity of the worker, to thereby avoid excessive physical exertion, should be tested in randomized controlled trials.

Source : Andersen LL, Clausen T, Persson R, Holtermann A. Scand J Work Environ Health. 2012.

Posttraumatic and depressive symptoms in victims of occupational accidents

The present descriptive study was aimed at evaluating posttraumatic and depressive symptoms and their cooccurrence, in a sample of victims of workplace accidents. Also, posttraumatic negative cognitions were assessed. Eighty-five injured workers were evaluated, using the PTSD Symptom Scale, the Beck Depression Inventory II, and the posttraumatic Cognitions Inventory. 49.4% of injured workers reported both depressive and posttraumatic symptoms of clinical relevance. 20% only reported posttraumatic, but not depressive, symptoms, and 30.6% did not report either type of symptoms. The group with both posttraumatic and depressive symptoms displayed greater symptom severity and more negative cognitions about the self and about the world than the other two groups. The obtained findings indicate that workplace accidents can have a major impact upon the mental health of victims. Early interventions should be focused not only on the prevention or reduction of posttraumatic and depressive symptoms but also on restructuring specific maladaptive trauma-related cognitions.

Source : Buodo G, Novara C, Ghisi M, Palomba D. Depress. Res. Treat. 2012.

Current situation and issue of industrial accident compensation insurance

Industrial Accident Compensation Insurance (IACI) has a history of about 50 yr, and is the oldest social insurance system in Korea. After more than 20 times of revision improvements in benefits, its contents and claim systems have been upgraded. It became the protector of injured workers and their families, and at the same time became the system which could cope with both financial burden of employers and their responsibilities. However, there are some issues to be reformed to upgrade the IACI: 1) the problems in the approval system of occupational diseases, 2) quality improvement of workers' compensation medical care, 3) vocational rehabilitation and return to work, 4) workers' compensation premiums and out-of-pocket money of injured workers, 5) issues in application of IACI. Growth of IACI cannot be achieved by an effort of an individual. Efforts by workers, owners, and government, in addition to physicians and welfare professionals toward the same goal are required for the next level improvement of IACI.

Source : Kim I, Rhie J, Yoon JD, Kim J, Won J. J. Korean Med. Sci. 2012; 27(Suppl.): S47-S54.

Systematic Reviews for Informing Rehabilitation Practice

An Introduction
The research literature that rehabilitation clinicians need to be familiar with has become too large for anyone to read, and numerous published studies are too complex for many practitioners to understand and fruitfully use. One method to keep up with new findings is through systematic reviews. Systematic reviews can be effective tools that help guide rehabilitation practice by identifying the best research that provides the evidence for enhanced clinical decision-making. This article describes how systematic reviews are created, indicates where rehabilitation clinicians may find them, and refers to a resource that may be of use in evaluating their quality and applicability.

Source : Dijkers MP, Bushnik T, Heinemann AW, Heller T, Libin AV, Starks J, Sherer M, Vandergoot D. Archives of Physical Medicine and Rehabilitation. Volume 93, Issue 5, May 2012, Pages 912–918.

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