2013-03-01 12:00 - Messages

Work-related psychosocial and mechanical risk factors for work disability

A 3-year follow-up study of the general working population in Norway

Objectives This study examines the impact of work-related psychosocial and mechanical risk factors for work disability in the general working population. Methods A randomly drawn cohort from the general population in Norway aged 18–66 years was followed for 3 years (N=12 550, 67% response rate at baseline). Eligible respondents were in paid work for ≥10 hours per week in 2006 and were still in paid work or had quit working because of health problems (work disability) in 2009 (N=6745). Five work-related psychosocial factors and eight mechanical exposures were measured. The outcome of interest was self-reported work disability at 3-year follow-up. Results In total, 2.6% (176 individuals) reported work disability at the 3-year follow-up. Disability rates were higher among women, older workers, and those with fewer years of education and higher levels of psychological distress and musculoskeletal complaints. After adjusting for these factors, work-related psychosocial predictors of disability were low levels of supportive leadership [odds ratio (OR) 1.61, 95% confidence interval (95% CI) 1.02–2.56] and monotonous work (OR 1.53, 95% CI 1.09–2.16). Mechanical factors were neck flexion (OR 2.49, 95% CI 1.36–4.56), prolonged standing (OR 1.79, 95% CI 1.21–2.46), whole-body vibration (OR 4.15, 95% CI 1.77–9.71), and heavy physical work (OR 2.23. 95% CI 1.08–4.57). The estimated population risk attributable to these factors was about 45%. Conclusion Monotonous work, prolonged standing, neck flexion, and whole-body vibration appear to be the most consistent and important predictors of work disability.

 Sterud T. Work-related psychosocial and mechanical risk factors for work disability. Scand J Work Environ Health, [online first; 17 December 2012] http://dx.doi.org/10.5271/sjweh.3359

Internal consistency and construct validity of the Revised Illness Perception Questionnaire adapted for work disability following a musculoskeletal disorder

To assess internal consistency and construct validity of the French version of the Revised Illness Perception Questionnaire adapted for Work Disability (IPQR-WD). Method: A cross sectional study was conducted in rehabilitation centers and private clinics in the Montreal region of Canada, involving 43 men and women, French speaking, absent from work between 3 months and a year due to musculoskeletal disorders. The 9 dimension IPQR-WD and the following eight-related instruments for construct validity were administered: Tampa Scale for Kinesiophobia (TSK), Pain Catastrophizing Scale (PCS), Psychological Distress Index (PDI-14), Pain Disability Index (PDI), Self-Efficacy for Return to Work Scale (SERWS), Pain Beliefs and Perceptions Inventory (PBPI), Implicit Models of Illness Questionnaire (IMIQ) and a Visual Analog Scale for pain intensity (VAS) [...] Conclusions: Moderate to strong correlations were found with six-related instruments which support the multidimensional nature of the IPQR-WD and its unique contribution as one simple questionnaire that can assess representations related to work disability. Certain unhelpful beliefs related to the worker's own understanding (i.e. representation) of his/her current health condition may lead to behaviours that are poorly adapted to reducing the work disability following a musculoskeletal disorder. The Revised Illness Perception Questionnaire adapted for Work Disability (IPQR-WD) is the only questionnaire available in French that can specifically assess the worker's representation following a musculoskeletal disorder.
The use of this questionnaire will facilitate a systematic evaluation of the worker's representation according to a biopsychosocial approach, which may contribute to a clinical practice based on the latest scientific evidences available in the work disability field.

Source : Albert, Valérie; Coutu, Marie-France; Durand, Marie-José. Disability and Rehabilitation, Volume 35, Number 7, April 2013 , pp. 557-565

The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims

OBJECTIVE: To determine the incidence and impact of recurrent workplace injury and disease over the period 1995-2008. DESIGN: Population-based cohort study using data from the state workers' compensation system database. SETTING: State of Victoria, Australia. PARTICIPANTS: A total of 448 868 workers with an accepted workers' compensation claim between 1 January 1995 and 31 December 2008 were included into this study. Of them, 135 349 had at least one subsequent claim accepted for a recurrent injury or disease during this period. MAIN OUTCOME MEASURES: Incidence of initial and recurrent injury and disease claims and time lost from work for initial and recurrent injury and disease. RESULTS: Over the study period, 448 868 workers lodged 972 281 claims for discrete occurrences of work-related injury or disease. 53.4% of these claims were for recurrent injury or disease. On average, the rates of initial claims dropped by 5.6%, 95% CI (-5.8% to -5.7%) per annum, while the rates of recurrent injuries decreased by 4.1%, 95% CI (-4.2% to -0.4%). In total, workplace injury and disease resulted in 188 978 years of loss in full-time work, with 104 556 of them being for the recurrent injury. CONCLUSIONS: Recurrent work-related injury and disease is associated with a substantial social and economic impact. There is an opportunity to reduce the social, health and economic burden of workplace injury by enacting secondary prevention programmes targeted at workers who have incurred an initial occupational injury or disease.

Source : Ruseckaite R, Collie A. The incidence and impact of recurrent workplace injury and disease: a cohort study of WorkSafe Victoria, Australia compensation claims. BMJ Open 2013; 3(3): 12-002396. http://dx.doi.org/10.1136/bmjopen-2012-002396


Predicting return to work following treatment of chronic pain disorder

Background: The care of injured workers with chronic pain remains an important public health issue given its increasing prevalence. The consequences often include loss of self-esteem and stress in family relationships.Aims: To report our interdisciplinary approach to the care of chronic pain disorder (CPD) and describe the predictors associated with a successful return to work (RTW). Methods: Relevant covariates, including demographic data, time from injury, and functional scores were recorded for clients injured at work in Ontario, Canada. Our primary outcome, RTW, was assessed at 3 months post-discharge. Descriptive statistics and logistic regression were used to identify those factors predicting a successful RTW. Results: Of the injured workers who participated in the interdisciplinary CPD treatment programme, 1002 clients met our inclusion criteria and were included in the study. Fifty-five per cent were male with a mean age of 46 years. Median time from injury to treatment was 720 days. At 3 months post-treatment, 136 (14%) of the participants were working. Multivariable logistic regression revealed that earlier time since injury (OR = 0.71, 95% CI 0.55-0.92) and presence of an RTW coordinator (RTWC) (OR = 3.42, 95% CI 2.08-5.63) were significant predictors of successful RTW. There was also a significant interaction between RTWC involvement and time since injury. The latter did not appear to influence the likelihood of RTW when an RTWC was present. Conclusions: Workers compensation boards should refer injured workers with CPD to treatment programmes as early as possible to achieve a successful RTW. Additionally, RTWCs play an important role in improving work outcomes.

Source :H. Hamer, R. Gandhi, S. Wong, and N. N. Mahomed. Predicting return to work following treatment of chronic pain disorder. Occup Med (Lond) first published online March 14, 2013 http://occmed.oxfordjournals.org/content/early/2013/03/13/occmed.kqt019.long

Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR)

The purpose of the Center on Knowledge Translation for Disability and Rehabilitation Research (KTDRR) is to make it easier to find, understand, and use the results of research that can make a positive impact on the lives of people with disabilities. In collaboration with several national and international partners, the Center on KTDRR carries out integrated training, dissemination, utilization, and technical assistance activities to (a.) increase use of valid and relevant evidence-based research findings that inform decision-making and (b.) increase the understanding and application of knowledge translation principles.

Source : http://www.ktdrr.org/index.html

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