Early Workplace Intervention for Employees With Musculoskeletal-Related Absenteeism: A Prospective Controlled Intervention Study

Abstract

Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled trial, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0.6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days/person as compared to 197.9 (14.0) days in the reference group (P < 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2), P < .01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2-5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial.

Behavioral Determinants as Predictors of Return to Work After Long-Term Sickness Absence: An Application of the Theory of Planned Behavior

“…In the review of Krause et al [1], studies about attitude were split up in groups which used different definitions of attitude: (1) individual prediction of continued disability, which prolonged duration of work disability [28][29][30], (2) perception of inability to change job, which prolonged duration of work disability [30], and (3) Willingness to initiate behavior (high) 424 (47.6) 25 (22)(23)(24)(25)(26)(27)(28) understanding of medical condition, which shortened the duration of work disability [31]. In the intervention study of Arnetz [17], attitude was assessed by asking reasons why the respondents had chosen to RTW (after 6 months follow-up). Arnetz et al [17] used specific questions about attitude to RTW, in our study we used a questionnaire which contains rather general statements about work attitude.…”

“…In the intervention study of Arnetz [17], attitude was assessed by asking reasons why the respondents had chosen to RTW (after 6 months follow-up). Arnetz et al [17] used specific questions about attitude to RTW, in our study we used a questionnaire which contains rather general statements about work attitude. Although the results of the present study are strongly related to results of other studies [16,17], in further research it is recommendable to explore the theoretical construct of work attitude to RTW and to identify the specific definition of attitude to RTW which should be used.…”

“…In the work context, a few studies have been found using the TPB model (or the derived ASE-model (Attitude, Social influence and self-Efficacy) [12], in developing preventive interventions to reduce occupational injuries and health problems [13][14][15]. Furthermore, several studies showed that a positive attitude to RTW [16][17][18], high social support [16,19] and a high level of self-efficacy [3,20] are all positively associated with RTW.…”

Job stress interventions and the organization of work

“…Such participative approaches may combine both the work situation and the person as targets in a very "personalized" way. Thus, in a study by Arnetz et al (73), each individual workplace of people that had musculoskeletal problems was analyzed from an ergonomic point of view, and both physical and psychological stressors were assessed as well. This approach resulted in interventions that were tailored to the individual's work situation, including, for instance, ergonomic improvements, but also coaching for conflict resolution, where necessary.…”

Quebec Research on Work-related Musculoskeletal Disorders

“…MSDs limit the quality of life of affected workers and also diminish workplace productivity (Arnetz et al, 2003;Palmer et al, 2012;Vermeulen et al, 2010) and have personal, social and economic consequences (Baldwin and Butler, 2006;Feuerstein and Loisel, 2011). Our group aims to improve multi-level and multicomponent interventions around WMSDs.…”