Duration of work disability is associated with psychosocial job factors independent of injury severity and physical workload. The impact of these risk factors changes significantly over the course of disability.

A fundamental question in aging research is whether humans and other species possess an immutable life-span limit. We examined the maximum age at death in Sweden, which rose from about 101 years during the 1860s to about 108 years during the 1990s. The pace of increase was 0.44 years per decade before 1969 but accelerated to 1. 11 years per decade after that date. More than 70 percent of the rise in the maximum age at death from 1861 to 1999 is attributable to reductions in death rates above age 70. The rest are due to increased numbers of survivors to old age (both larger birth cohorts and increased survivorship from infancy to age 70). The more rapid rise in the maximum age since 1969 is due to the faster pace of old-age mortality decline during recent decades.

Little is known about predictors of duration of work disability (DOD). This cohort study of 433 workers' compensation claimants estimated DOD for job, injury, and demographic factors during consecutive disability phases using Cox regression analysis. DOD was calculated from administrative records. Results show that DOD increases with the time spent bending and lifting or pushing or pulling heavy objects at work, but it is unrelated to sitting, standing, or vibration. Younger age, longer pre-injury employment, less severe injuries, and a previous back injury predicted shorter disability, the latter factor only during the subacute/chronic disability phases. The effect of injury severity decayed over time. This study demonstrates the usefulness of a phase-specific analysis and shows that physical job and injury factors have a significant and time-varying impact on DOD.

Background Studies of low back pain (LBP) disability remain largely incomparable because of different outcome definitions. To date, systematic comparisons of alternative outcome measures have not been made. Methods Duration of work disability was studied in a 3‐year cohort of 850 workers' compensation LBP claimants. Eleven administrative outcome measures were compared using Kaplan‐Meier estimates of the proportion of claimants still on disability benefits during 3.5 years of follow‐up. Results The estimated mean duration of work disability was 75 days for the first temporary disability (TD) episode, 108 days for cumulative time on TD, and 337 for total compensated days, which includes all types of wage replacement benefits during vocational rehabilitation, temporary and permanent disability. Conclusions Commonly used administrative measures of lost workdays—time to first return to work and time on temporary disability—substantially underestimate the duration of work disability compared to measures based on all wage replacement benefits. Am. J. Ind. Med. 35:604–618, 1999. © 1999 Wiley‐Liss, Inc.

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Background Workers' compensation wage replacement data have recently been used to estimate time to return to work (RTW) and the number of work days lost after occupational injury. The degree to which indemnity‐based measures reflect self‐reported work disability has until now not been studied. Method Kaplan‐Meier curves of administrative and self‐reported measures of duration of work disability were compared within a sample of 433 low back injury claimants followed up for 1 to 3.7 years. Results Administrative measures consistently and significantly underestimated the duration of disability when compared to self‐reported measures of RTW. The difference between the estimated mean number of work days lost for comparable administrative and self‐reported measures ranged from 142 to 334 days. Conclusions Number of work days lost after low back injury is substantially underestimated by measures based on the duration of wage replacement benefits. This calls into question the adequacy of indemnity benefits and underscores the need for disability prevention programs. Am. J. Ind. Med. 35:619–631, 1999. © 1999 Wiley‐Liss, Inc.

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