• I A Steenstra, J H Verbeek, M W Heymans, and P M Bongers.
• Institute for Research in Extramural Medicine and Department of Public and Occupational Health, VU University Medical Center, Amsterdam, Netherlands. i.a.steenstra@amc.uva.nl
• Occup Environ Med. 2005 Dec 1;62(12):851-60.

BackgroundThe percentages of patients with acute low back pain (LBP) that go on to a chronic state varies between studies from 2% to 34%. In some of these cases low back pain leads to great costs.AimsTo evaluate the evidence for prognostic factors for return to work among workers sick listed with acute LBP.MethodsSystematic literature search with a quality assessment of studies, assessment of levels of evidence for all factors, and pooling of effect sizes.ResultsInclusion of studies in the review was restricted to inception cohort studies of workers with LBP on sick leave for less than six weeks, with the outcome measured in absolute terms, relative terms, survival curve, or duration of sick leave. Of the studies, 18 publications (14 cohorts) fulfilled all inclusion criteria. One low quality study, four moderate quality studies, and nine high quality studies were identified; 79 prognostic factors were studied and grouped in eight categories for which the evidence was assessed.ConclusionsSpecific LBP, higher disability levels, older age, female gender, more social dysfunction and more social isolation, heavier work, and receiving higher compensation were identified as predictors for a longer duration of sick leave. A history of LBP, job satisfaction, educational level, marital status, number of dependants, smoking, working more than 8 hour shifts, occupation, and size of industry or company do not influence duration of sick leave due to LBP. Many different constructs were measured to identify psychosocial predictors of long term sick leave, which made it impossible to determine the role of these factors.

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