2016-08-01 12:00 - Messages

Use of Framingham Risk Score as a Clinical Tool for the Assessment of Fitness for Work

Results From a Cohort Study
Objective: The aim of this study is to validate the use of the Framingham Risk Score (FRS) as clinical tool to predict the risk of diagnosis of unsuitability for work in a cohort of Italian workers.
Methods: A cohort of workers has been observed from January 2006 to March 2014. FRS was calculated at each visit. Health surveillance diagnosis of unsuitability for work was selected as outcome.
Results: Two thousand eight hundred fifty seven workers were observed, 58.9% were men, mean age was 51.6 (±6.7), the mean FRS was 15.1% (±10.7%). Increased values of FRS at baseline were associated with increased rate of diagnosis of unsuitability for work (Hazard ratio [HR], 11.2, 95%CI, 3.3 to 37.8).
Conclusions: FRS is a strong predictor of diagnosis of unsuitability for work and should be used as a clinical tool for the assessment of fitness for work in health surveillance.

Source: Palladino, Raffaele; Caporale, Oreste; Nardone, Antonio; Fiorentino, Denise; Torre, Ida; Triassi, Maria. Journal of Occupational & Environmental Medicine: August 2016, Volume 58, Issue 8, p. 805-809.

Organizational justice and disability pension from all-causes, depression and musculoskeletal diseases

A Finnish cohort study of public sector employees
Work-related psychosocial factors that are measured once may not provide an accurate estimate of long-term exposure. Thus, we used repeated measures of organizational justice to evaluate its association with disability pension in a cohort of 24 895 Finnish public sector employees. High organizational justice was associated with lower risk of disability pension due to depression and musculoskeletal diseases.

Source: Juvani A, Oksanen T, Virtanen M, Elovainio M, Salo P, Pentti J, Kivimäki M, Vahtera J. Scand J Work Environ Health, 2016.

Screening instruments for predicting return to work in long-term sickness absence

BACKGROUND: Multiple somatic symptoms are common and may cause prolonged sickness absence (SA) and unsuccessful return to work (RTW). AIMS: To compare three instruments and their predictive and discriminative abilities regarding RTW. METHODS: A longitudinal cohort study of participants recruited from two municipal job centres, with at least 8 weeks of SA. The instruments used were the Symptom Check List of somatic distress (SCL-SOM) (score 0-48 points), the Bodily Distress Syndrome Questionnaire (BDSQ) (0-120 points) and the one-item self-rated health (SRH) (1-5 points). The instruments' predictive value was explored in a time-to-event analysis. Different cut-points were analysed to find the highest number of correctly classified RTW cases, identified in a register on public transfer payments. RESULTS: The study involved 305 subjects. The adjusted relative risk regarding prediction of RTW was 0.89 [95% confidence interval (CI) 0.83-0.95], 0.89 (95% CI 0.83-0.95) and 0.78 (95% CI 0.70-0.86) per 5-, 10- and 1-point increase in the SCL-SOM, BDSQ and SRH, respectively. After mutual adjustment for the three instruments, only the prediction of RTW from SRH remained statistically significant 0.81 (95% CI 0.72-0.92). The highest sensitivity (86%) was found by SRH at the cut-point.

Source: Momsen AH, Stapelfeldt CM, Nielsen CV, et al. Occupational Médicine, 2016.

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