Journal of occupational rehabilitation
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Purpose The main aim of this study was to assess changes in perceived demand, control and support at work of neck and back pain patients over 1 year. We also hypothesised that perceived changes in demand, control and support at work were associated with clinical improvement, reduced fear-avoidance beliefs and successful return to work. Methods Four hundred and five sick-listed patients referred to secondary care with neck or back pain were originally included in an interventional study. ⋯ At the individual level, the regression analyses showed that decreases in fear-avoidance beliefs about work were consistently related to decreases in demand and increases in control, whereas decreases in disability, anxiety and depression were related to increases in support subscales. Conclusions The perception of demand, control and support appear to be stable over 1 year in patients with neck and back pain, despite marked improvement in pain and disability. Disability, anxiety, depression and fear-avoidance beliefs about work were significantly associated with the perception of the work environment, whereas neck and back pain were not.
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Acute work-related trauma is a leading cause of death and disability among U.S. workers. Existing methods to estimate injury severity have important limitations. This study assessed a severe injury indicator constructed from a list of severe traumatic injury diagnosis codes previously developed for surveillance purposes. Study objectives were to: (1) describe the degree to which the severe injury indicator predicts work disability and medical cost outcomes; (2) assess whether this indicator adequately substitutes for estimating Abbreviated Injury Scale (AIS)-based injury severity from workers' compensation (WC) billing data; and (3) assess concordance between indicators constructed from Washington State Trauma Registry (WTR) and WC data. ⋯ Severe traumatic injuries can be directly identified when diagnosis codes are available. This method provides a simple and transparent alternative to AIS-based injury severity estimation.
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To determine how the economy affects psychosocial and socioeconomic treatment outcomes in a cohort of chronic disabling occupational musculoskeletal disorder (CDOMD) patients who completed a functional restoration program (FRP). ⋯ CDOMD patients who completed an FRP in a PE year were less likely to return to, or retain, work 1-year after discharge, demonstrating that a PE can be an additional barrier to post-discharge work outcomes. A difference in State unemployment rates of <3% (7 vs. 5%) had a disproportionate effect on patients' failure to return to (19 vs. 6%) or retain (28 vs. 15%) work.
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We conducted a systematic review to critically appraise and synthesize literature on the effectiveness of work disability prevention (WDP) interventions in workers with neck pain, whiplash-associated disorders (WAD), or upper extremity disorders. ⋯ At present, no firm conclusions can be drawn regarding the effectiveness of WDP interventions for managing neck pain, WAD, and upper extremity disorders. Our review suggests a return-to-work coordination program is more effective than clinic-based work hardening. Also, adding computer-prompted breaks to ergonomic and workplace interventions benefits workers' recovery. The current quality of evidence does not allow for a definitive evaluation of the effectiveness of ergonomic interventions.
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To investigate the Work Ability Index (WAI) as tool for identifying workers at risk of premature work exit in terms of disability pension, unemployment, or early retirement. ⋯ The WAI can be used to identify construction workers <50 years of age at increased risk of disability pension and invite them for preventive interventions.