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PubMed2003

Return to work outcomes after work-related hand trauma: the role of causal attributions.

PURPOSE: This study examined the relationship between workers' judgments of responsibility for their accidents (causal attributions) and work-site avoidance after work-related injuries. METHODS: Ninety-two hand-injured workers referred for psychologic treatment of posttraumatic stress and depressive symptoms were assessed for their beliefs about the cause(s) of their accidents. Causal attributions were obtained before and after psychologic intervention. RESULTS: Workers who blamed coworkers or equipment for their injuries were more likely to resist returning to former work activities than workers who judged themselves responsible for their accidents. In addition those with relatively minor injuries were as much at risk for work-site avoidance as those with more severe injuries. Age, gender, and length of employment with current employer were unrelated to avoidance. CONCLUSIONS: These results suggest the importance of causal attributions as potential predictors of work-site avoidance after traumatic work-related hand injuries, and support the risk for psychologic symptom development after less-severe injuries.

Absenteeism↗
PubMed1997

[Return to work after occupational accidents and occupational diseases].

The key formula "by all suitable means" is a structural support for successful occupational reintegration. In this respect, the special system of accident insurance administered primarily through the "Berufsgenossenschaften" (BG), differs from the other branches of social security. This system's roots in civil law do not allow any comparison with the principle of public law insurance underlying the other branches of social security in Germany. Under the statutory accident insurance scheme, the employer, i.e., the liable party within the employment relationship, has to compensate any health damage incurred by an employee, subject to the principles of compensation for damages under civil law, in a manner enabling the employee to return to his position in worklife and in society as unscathed as possible. From this general mandate by the legislator, the social partners involved within the self-management of the BGs draw their strength and their dynamics in arranging for organizational methods within the-administrative offices and in cooperation with the health care providers. This control of rehabilitation, i.e., the accident insurance system's share of the responsibility for successful rehabilitation, contributes a great deal to reentergrating insured persons into work and career, returns valuable workers to the employers, thus having a favourable effect for the gross national product of a society, and last but not least provides a support for the social state.

Accidents, Occupational↗
PubMed1964

LOCAL ANESTHESIA FOR HERNIOPLASTY. IMMEDIATE AMBULATION AND RETURN TO WORK: A PRELIMINARY REPORT.

In 50 cases in which hernioplasty was carried out with atraumatic technique under local anesthesia, the patients walked away from the operating table, then through the corridors, without assistance. They usually drove home the next day and returned to their regular occupations immediately. Few had pain necessitating more than mild analgesia. In a period of follow-up ranging from six months to three years at the time of this report, two patients had recurrence.

Aged↗
PubMed2004

Preventing disability from occupational musculoskeletal injuries in an urban, acute and tertiary care hospital: results from a prevention and early active return-to-work safely program.

OBJECTIVE: Healthcare workers are at high risk for musculoskeletal injuries. A program was developed to decrease the incidence of musculoskeletal injuries and the duration of associated time loss. METHODS: A program combining primary prevention and on-site early intervention was implemented at a large, urban hospital. Incidence rates were compared using Poisson regression. Cox regression was used to analyze the time to return to regular duties. RESULTS: Although there was no reduction in incidence, the program was effective in returning injured employees to work more promptly for registered nurses and health science professionals (therapists, technicians), although not for facility support staff. CONCLUSIONS: Overall savings in time loss and compensation payments were realized. However, better integration of prevention and follow-up efforts are needed, and greater attention to the sociopolitical environment is required to improve outcomes for facility support staff.

Absenteeism↗
PubMed1994

Direct and indirect cost of percutaneous transluminal coronary angioplasty.

A prospective study of 53 patients employed in the 6-month period before coronary angioplasty was performed to determine the direct and indirect costs of lag time in work resumption. The total direct costs calculated were $273,480; indirect costs for this sample were $150,944. When these costs are generalized to all patients in the US undergoing uncomplicated percutaneous transluminal coronary angioplasty, the costs are more than $1.2 billion. This study demonstrated that even in patients with a high a priori probability of work return, delay in work resumption results in a greater cost to the individual and society through absence from the labor force.

Adult↗
PubMedDate not supplied

Moderating factors in return to work and job stability after traumatic brain injury.

OBJECTIVE: To examine job stability moderating variables and develop a postinjury work stability prediction model. DESIGN: Multicenter analysis of individuals with traumatic brain injury (TBI) who returned for follow-up at 1, 2, and 3, or 4 years postinjury, were of working age (between 18 and 62 years of age at injury), and were working preinjury. SETTING: Six National Institute on Disability and Rehabilitation Research TBI Model System centers for coordinated acute and rehabilitation care. PARTICIPANTS: A total of 186 adults with TBI were included in the study. MAIN OUTCOME MEASURES: Job stability was categorized as stably employed (employed at all 3 follow-up intervals); unstably employed (employed at one or two of all three follow-up intervals); and unemployed (unemployed at all three follow-up intervals). RESULTS: After injury, 34% were stably employed, 27% were unstably employed, and 39% were unemployed at all three follow-up intervals. Minority group members, people who did not complete high school, and unmarried people were more likely to be unemployed. Driving independence was highly influential and significantly related to employment stability. A discriminant function analysis, which included age, length of unconsciousness and Disability Rating Scale scores at 1 year postinjury, accurately predicted job stability groupings. CONCLUSION: Data analysis provided evidence that employment stability is predictable with a combination of functional, demographic, and injury severity variables. Identification of people at risk for poor employment outcomes early on can facilitate rehabilitation planning and intervention.

Adult↗
PubMed1989

Return to work following back surgery: a review.

Nineteen articles published between 1980 and 1986 were reviewed to determine the prognosis for returning to previous employment following back surgery. Seventy-seven percent of the cases reviewed returned to their previous level of employment. Nearly 11% of cases had additional back surgery during the period of follow-up. Data from three articles suggest that 82% of patients are able to return to their previous level of employment following primary back surgery compared to 59% of patients who have had multiple back surgeries. Recommendations for work activity following back surgery should be individualized for each patient. A work-hardening program including assessment of cardiovascular fitness and task performance can be used to progressively increase activity to the highest achievable level. Prevention of back injuries in the workplace will increase employee morale and reduce employee turnover and workers' compensation costs.

Back Pain↗
PubMed1999

Return to work after heart transplantation: 12-year follow-up.

BACKGROUND: Current statistics show that 50% of heart transplantation recipients survive 10 years or more. Emphasis on cost containment has renewed interest in the employment status of these long-term survivors. METHODS: We have identified 62 patients operated on at one United Kingdom center and evaluated their employment and clinical status by interview at 1, 5, and 12 years from surgery. RESULTS: Employment pattern was good, with 69%, 69% (of 55 survivors), and 57% (of 35 survivors) of the group working at 1, 5, and 12 years, respectively. Blue-collar work status per se was not a deterrent to employment, but older patients with a poor presurgical work history were less successful in finding work, and trade and legislative restrictions forced some, who were willing and capable of returning to their previous employment, into lower paid, less satisfactory jobs. CONCLUSIONS: Subgroups of patients who are likely to be unemployed can be identified prior to surgery. Steps can be taken prior to surgery to anticipate future problems, and establish realistic employment goals.

Adult↗
PubMed1999

Injuries from construction falls. Functional limitations and return to work.

Finding a measure that distinguishes well between the severity levels of less serious injuries such as those found in occupational settings has been problematic. In this study of 255 construction workers who sustained nonfatal falls at work, two measures of injury severity were used--the Injury Severity Score (ISS) and the disability index of the Stanford Health Assessment Questionnaire (HAQ), a functional limitation measure. The HAQ scores were more normally distributed than the ISS and provided useful information about the degree to which workers were disabled from falls during their first week of recovery. The mean HAQ score was 1.46 (SD = 0.75) on a scale of 0 to 3, with higher numbers representing more limited functioning. With regard to individual tasks, participants reported having the most difficulty performing heavy chores (mean = 1.89; SD = 1.02), dressing themselves (mean = 1.54; SD = 1.05), and bending to pick up clothing from the floor (mean = 1.40; SD = 1.02). The HAQ scores were significantly and moderately correlated with days lost from work (r = .52; p < .001). Unexpectedly, 97 workers reported that they were able to return to light or modified duty following their falls.

Absenteeism↗
PubMed1996

Factors affecting first return to work following a compensable occupational back injury.

Occupational back injuries produced $27 billion in direct and indirect costs in 1988. Predictors of prolonged disability have generally been identified in selected clinical populations, but there have been few population-based studies using statewide registries from workers' compensation systems. This study uses a 1986 cohort of 8,628 Michigan workers with compensable back injuries followed to March 1, 1990. Cox proportional hazards analyses with nine categorical covariates identified factors predicting missed worktime for the first disability episode following the injury. The model distinguished factors affecting the acute (< or = 8 weeks) and chronic disability periods (> 8 weeks). The first disability episode following injury contains 69.6% of the missed worktime observed through follow-up. In the acute phase, which contributes 15.2% of first episode missed worktime, gender, age, number of dependents, industry (construction), occupation, and type of accident predict continued work disability. Marital status, weekly wage compensation rate, and establishment size do not. Beyond 8 weeks, age, establishment size and, to a lesser degree, wage compensation rate predict duration of work disability. Graphs show the predicted disability course for injured workers with specific covariate patterns. Future efforts to reduce missed worktime may require modifications in current clinical practice by patient age group and the development of new strategies to encourage small and medium-size employers to find ways to return their injured employees to work sooner. Recent federal statutes covering disabled workers will only partially correct the strong effect of employer establishment size.

Adolescent↗
PubMed2000

Factors predicting return to work following mild traumatic brain injury: a discriminant analysis.

Studies of mild traumatic brain injury (MTBI) suggest that most individuals recover rapidly and return to their everyday activities. However, a percentage of MTBI patients report persistent problems with cognitive, physical, and emotional symptoms. There is also evidence that some experience changes in occupational functioning following MTBI. The current study used a stepwise discriminant function analysis (DFA) to examine the role of injury severity variables, cognitive performance, and ratings of symptoms of TBI in predicting work status following MTBI. Subjects included 121 MTBI patients who were all active-duty military personnel. The stepwise DFA revealed that age and three cognitive variables (verbal memory, verbal fluency, and a speed test of planning and strategy) were predictive of work status 3-15 months following a documented MTBI, correctly classifying work status 68.8% of the time. A cross-validation DFA was conducted, with a 66.1% correct classification rate. These findings highlight the importance of cognitive impairments in identifying those at risk for occupational impairment following MTBI.

Activities of Daily Living↗
PubMed2004

Return-to-work programs.

Injury and illness related to the work environment are inevitable. The development and implementation of a back-to-work program is beneficial to everyone. Regardless of how an injury or related health issue occurs, returning the affected person back to his preexisting condition is paramount.

Accidents, Occupational↗
PubMed1997

Mild traumatic brain injury. A primer for understanding its impact on employee return to work.

1. Mild head injuries are common occurrences in the United States. 2. If not properly understood and managed, mild head injuries can be unnecessarily costly in terms of lost work days, financial expenditures, and human suffering. 3. If properly understood and treated, most victims of mild head injuries can return to productive lifestyles. 4. Factors that place persons at high risk for more severe symptoms and/or more lengthy recovery periods are easy to conceptualize.

Brain Injuries↗