The effectiveness of two occupational health intervention programmes in reducing sickness absence among employees at risk. Two randomised controlled trials

Abstract

Objectives:To evaluate the effectiveness of two occupational health intervention programmes, both compared with usual care.Methods:Based on a health survey, 1341 employees (88% males) in construction, service and maintenance work were classified into three groups: “low risk” (n = 386), “intermediate risk” (n = 537) and “high risk” (n = 418) of sickness absence. Two separate randomised trials were performed in the groups “high risk” and “intermediate risk”, respectively. Those high risk subjects that were allocated to the intervention group (n = 209) were invited to occupational health service for a consultation. The intervention included, if appropriate, a referral to specialist treatment. Among the intermediate risk employees those in the intervention group (n = 268) were invited to call a phone advice centre. In both trials the control group received usual occupational health care. The primary outcome was sickness absence during a 12-month follow-up (register data).Results:The high risk group, representing 31% of the cohort, accounted for 62% of sickness absence days. In the trial for the high risk group the mean sickness absence was 30 days in the usual care group and 19 days in the intervention group; the mean difference was 11 days (95% CI 1 to 20 days). In the trial for the intermediate risk group the mean sickness absence was 7 days in both arms (95% CI of the mean difference –2.3 to 2.4 days).Conclusions:The identification of high risk of work disability was successful. The occupational health intervention was effective in controlling work loss to a degree that is likely to be economically advantageous within the high risk group. The phone advice intervention for the intermediate risk group was not effective in controlling work loss primarily due to poor adherence.

The EASY (Early Access to Support for You) sickness absence service: a four-year evaluation of the impact on absenteeism

“…These have ranged from minimal postal intervention, OH phone intervention to multidisciplinary approaches involving workplace assessment, work modifications and importantly case management involving all stakeholders (22)(23)(24)(25). However, to our knowledge there are far fewer studies or reviews of very early intervention under two weeks (26,27), despite the fact that there are a number of commercially successful companies offering sickness absence management services to employers, which involve the employee being telephoned on day one (28,29).…”

Face-to-face information combined with a booklet versus a booklet alone for treatment of mild low-back pain: a randomized controlled trial

“…A population-based study in Denmark showed that a psychosocially oriented educational booklet without personal contact was not successful in reducing work absence due to general musculoskeletal pain (48). Interventions in two other studies (46,47) were more intensive than provision of simple patient information and the study subjects were already at risk of work disability.…”

“…The few prior RCT of non-sick-listed populations in an OH setting (45)(46)(47)(48) have dealt with more intensive patient education and focused on general symptoms or risk of work disability. A population-based study in Denmark showed that a psychosocially oriented educational booklet without personal contact was not successful in reducing work absence due to general musculoskeletal pain (48).…”

Screening manual and office workers for risk of long-term sickness absence: cut-off points for the Work Ability Index

“…Furthermore, interventions may alter the prognosis and consequences of LTSA. Taimela et al (14) showed that preventive consultations reduced sickness absence, although such consultations were cost-effective only among high-risk workers (15). The cost-effectivity of preventive consultations may increase when only high-risk workers are referred, which accentuates the need to screen for risk of LTSA.…”