Purpose There is growing awareness that the employer plays an important role in preventing early labor market exit of workers with poor health. This systematic review aims to explore the employer characteristics associated with work participation of workers with disabilities. An interdisciplinary approach was used to capture relevant characteristics at all organizational levels. Methods To identify relevant longitudinal observational studies, a systematic literature search was conducted in PubMed, Web of Science, PsycINFO and EconLit. Three key concepts were central to the search: (a) employer characteristics, (b) work participation, including continued employment, return to work and long-term work disability, and (c) chronic diseases. Results The search strategy resulted in 4456 articles. In total 50 articles met the inclusion criteria. We found 14 determinants clustered in four domains: work accommodations, social support, organizational culture and company characteristics. On supervisor level, strong evidence was found for an association between work accommodations and continued employment and return to work. Moderate evidence was found for an association between social support and return to work. On higher organizational level, weak evidence was found for an association between organizational culture and return to work. Inconsistent evidence was found for an association between company characteristics and the three work outcomes. Conclusions Our review indicates the importance of different employer efforts for work participation of workers with disabilities. Workplace programs aimed at facilitating work accommodations and supervisor support can contribute to the prevention of early labor market exit of workers with poor health. Further research is needed on the influence of organizational culture and company characteristics on work participation.

Purpose Employers play an important role in facilitating sustainable return to work (RTW) by workers with disabilities. The aim of this qualitative study was to explore how employers who were successful in retaining workers with disabilities at work fulfilled their supportive role, and which facilitators were essential to support these workers throughout the RTW process. Methods We conducted a semi-structured interview study among 27 employers who had experience in retaining workers with disabilities within their organization. We explored the different phases of RTW, from the onset of sick leave until the period, after 2-years of sick-leave, and when they can apply for disability benefit. We analyzed data by means of thematic analysis. ResultsWe identified three types of employer support: (1) instrumental (offering work accommodations), ( 2) emotional (encouragement, empathy, understanding) and ( 3) informational (providing information, setting boundaries). We identified three facilitators of employer support (at organizational and supervisor levels): (1) good collaboration, including (in)formal contact and (in)formal networks; (2) employer characteristics, including supportive organizational culture and leadership skills; and (3) worker characteristics, including flexibility and self-control. Conclusions Employers described three different possible types of support for the worker with disabilities: instrumental, emotional, and informational. The type and intensity of employer support varies during the different phases, which is a finding that should be further investigated. Good collaboration and flexibility of both employer and worker were reported as facilitators of optimal supervisor/worker interaction during the RTW process, which may show that sick-listed workers and their supervisors have a joint responsibility for the RTW process. More insight is needed on how this supervisor/worker interaction develops during the RTW process.

Familial primary hyperparathyroidism is the main feature of 2 familial endocrine neoplasia syndromes: multiple endocrine neoplasia type 1 (MEN 1) and hyperparathyroidism-jaw tumor syndrome (HPT-JT). The latter is a recently described syndrome that has been associated with ossifying fibroma of the jaw and various types of renal lesions, including benign cysts, Wilms' tumor, and hamartomas. To further illustrate the natural history of this syndrome, we describe a large, previously unreported Dutch kindred in which 13 affected members presented with either parathyroid adenoma or carcinoma; in 5 affected individuals, cystic kidney disease was found. Additionally, pancreatic adenocarcinoma, renal cortical adenoma, papillary renal cell carcinoma, testicular mixed germ cell tumor with major seminoma component, and Hürthle cell thyroid adenoma were also identified. Linkage analysis of the family using MEN1-linked microsatellite markers and mutation analysis excluded the involvement of the MEN1 gene. Using markers from the HPT-JT region in 1q2531, cosegregation with the disease was found, with a maximum logarithm of odds score of 2.41 obtained for 6 markers using the most conservative calculation. Meiotic telomeric recombination between D1S413 and D1S477 was identified in 3 affected individuals, and when combined with previous reports, delineated the HPT-JT region to 14 centimorgan. Combined comparative genomic hybridization and loss of heterozygosity data revealed complex genetic abnormalities in the tumors, suggesting different possible genetic mechanisms for the disease. In conclusion, we report a family with hyperparathyroidism linked to chromosome 1q, and exhibiting several types of renal and endocrine tumors that have not been previously described.

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Background Employers play an important supportive role in facilitating sustainable Return to Work (RTW) of workers with disabilities. Little is understood about how employers deal with their supportive role, what kind of support they offer and which facilitators of employer support are important to successful RTW. Methods A semi-structured interview study was conducted among 27 employer representatives (e.g. supervisors, HR managers, case managers) of companies in the Netherlands who had experience in retaining at least one disabled workers within their company. Participants were included through purposive sampling on sector and company size. Data was analyzed by means of thematic analysis. Results We identified three different types of employer support: 1. instrumental support (offering work accommodations), 2. emotional support (encouragement, empathy, understanding) and 3. informational support (providing information, setting boundaries). Facilitators of employer support were categorized into three main themes: 1. good collaboration, with subthemes (in)formal contact, trustful relationships, mutual responsibilities and (in)formal networks, 2. employer characteristics, including supportive organizational culture, leadership skills and flexibility, and 3. employee characteristics including flexibility and resilience. Conclusions Different types of employer support are considered as important in the RTW process of disabled workers. Besides offering work accommodations, also emotional and informational support are necessary. In addition, good collaboration and flexibility of both employer and employee may be viewed as facilitators for optimizing supervisor and employee interaction during the RTW process. Key messages Instrumental, emotional and informational support by the employer are important in the RTW process of disabled workers. Facilitating factors include collaboration, flexibility and leadership.

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Background The aims of this study were: (1) to explore the frequency of discrepancies in work accommodations reported by workers and their supervisors, and (2) to investigate whether these discrepancies are associated with full return to work (RTW). Methods We used data from a longitudinal survey study of long-term sick-listed workers and their supervisors (n = 406). Discrepancies in reports on implementing eight types of work accommodations were explored. Logistic regression analyses were conducted to test associations between discrepancies in reported work accommodations and odds of full RTW 27 months after the sick-leave onset. Results Discrepancies were the lowest for the work accommodation therapeutic RTW (53%) and the highest (85%) for job training or education and reimbursement of therapy or treatment. Four out of eight types of work accommodations were more often reported by workers than by their supervisors. Only a discrepancy on a job reassignment within the organization was associated with lower odds of full RTW (OR 0.56, 95%-CI 0.36–0.88). Conclusion We found substantial discrepancies in the reported implementation of work accommodations between workers and their supervisors. Future research should focus on disentangling mechanisms that lead to discrepancies to avoid inefficiencies in the RTW process.