2014-01-01 12:00 - Messages

Heavy work and disability pension

A long term follow-up of Swedish construction workers
Objectives : The objective of this study was to investigate the occurrence of disability pensions over time among workers with physically demanding jobs.
Methods : The occurrence of disability pension was prospectively studied between 1980–2008 among 325 549 Swedish construction workers. The risks for disability pension and years lost of working life were compared among 22 occupational groups, adjusting for age, body mass index, height, and smoking habits.
Results : The risk varied considerably among blue-collar workers. For example, rock workers had double the risk of disability pension [relative risk (RR) 2.16, 95% confidence interval (95% CI) 1.96–2.39] compared to electricians. Most working years lost due to disability pensions (about 75%) were found among men >50 years, mainly due to musculoskeletal and cardiovascular diseases. The years of working life lost due to disability pension varied from 0.7 (salaried employees) to 3.2 years (rock workers) among occupational groups.
Conclusion : Work environment is an important predictor for disability pension among construction workers with those in physically heavy jobs having the highest burden of disability. If the purpose is to increase labor force participation for workers with heavy jobs, strategies to reduce physical demands at work among elderly workers are important.

Source : Järvholm B, Stattin M, Robroek SJW, Janlert U, Karlsson B, Burdorf A. Scand J Work Environ Health. 2014

Evaluation of Functional Restoration Outcomes for Chronic Disabling Occupational Lower Extremity Disorders

Objective: To compare patients with chronic low back pain (LBP) with those with chronic lower extremity (LE) disorders.
Methods: Participants were 2164 consecutive patients with either LE or LBP disorders, admitted to a functional restoration program (FRP). Analyses compared demographic, psychosocial, and work-related factors and 1-year post-FRP socioeconomic outcomes.
Results: Patients with LE disorders initially reported lower symptom levels of depression, pain, and disability and were also less likely to have a substance use or opioid dependence disorder, relative to LBP patients. Both groups improved on measures of pain, disability, and depression after the FRP. Patients in both groups also displayed similarly high return-to-work and work-retention rates 1-year post-FRP.
Conclusions: This FRP seems to be effective equally for patients with chronic LE disorders and those with LBP disorders.

Source : Mayer, Tom G. MD; Choi, YunHee MA; Howard, Krista J. PhD; Gatchel, Robert J. PhD. Journal of Occupational & Environmental Medicine:
December 2013 - Volume 55 - Issue 12 - p 1489–1494.

Effect of the Danish return-to-work program on long-term sickness absence

Results from a randomized controlled trial in three municipalities
Objectives : The aim of this study was to evaluate the effect of the Danish return-to-work (RTW) program on long-term sickness absence in a randomized controlled trial in three municipalities.
Methods : The intervention group comprised 1948 participants while the control group comprised 1157 participant receiving ordinary sickness benefit management (OSM). Study participants were working-age adults receiving long-term (≥8 weeks or more) benefits, included regardless of reason for sickness absence or employment status. Each beneficiary was followed-up for a maximum period of 52 weeks. Cox proportional hazards model was used to estimate hazard ratios (HR) for return to work (RTW) with 95% confidence intervals (95% CI).
Results : The intervention effect differed significantly between the municipalities (P=0.00005). In one municipality (M2) the intervention resulted in a statistically significant increased rate of recovery from long-term sickness absence (HR 1.51, 95% CI 1.31–1.74). In the other two municipalities, the intervention did not show a statistically significant effect (HRM1 1.12, 95% CI 0.97–1.29, and HRM3 0.80, 95% CI 0.63–1.03, respectively). Adjustment for a series of possible confounders only marginally altered the estimated HR.
Conclusion : The effect of the intervention differed substantially between the three municipalities, indicating that that contextual factors are of major importance for success or failure of this complex intervention.

Source : Poulsen OM, Aust B, Bjorner JB, Rugulies R, Hansen JV, Tverborgvik T, Winzor G, Mortensen OS, Helverskov T, Ørbæk P, Nielsen MBD. Scand J Work Environ Health. 2014; 40 (1): 47-56.

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