Katy Benjamin

Work-related outcomes in occupational low back pain: a multidimensional analysis.

Objectives. This pilot study explored a broad range of work-related outcomes for occupational low back injuries. Methods. A model of occupational outcomes and a survey instrument were developed on the basis of interviews, expert opinion, and literature reviews. New Hampshire workers who had an occupational back injury a year before the study were sampled from first reports of injury and sent a mailed survey about their postinjury experiences and related factors. Results. Of 251 randomly selected cases, a valid address could be identified for 121, and 99 patients responded. Almost 60% of the respondents had lost 1 week of work or more. At 1 year after injury, half of the respondents had returned to their preinjury job and employer, and 20% were unemployed, half of them because of the injury. Most working respondents reported no decrease in their work capacity. However, 68% still had pain exacerbated by work, and 47% worried that their condition would worsen with continued work. Reinjury occurred in 42% of the respondents. The work-related outcome measures were largely independent of each other. Exploratory multivariate analyses demonstrated unique patterns of factors associated with each outcome. Reinjury risk was significantly greater in respondents whose employers offered accommodations or whose postinjury jobs had greater ergonomic risk. The small sample size limited the ability to achieve statistically significant results in multivariate analyses. Conclusions. Simply measuring return to work did not appear to capture the full range of job-related consequences from occupational back injuries in this pilot evaluation. Timing of return to work, occupational ergonomic risks, and appropriate job modifications appeared to be particularly important in a safe return to the job after an occupational low back injury. Results suggest opportunities to address risk factors that may improve work outcomes.

Occupational upper extremity conditions: a detailed analysis of work-related outcomes.

While work-related upper extremity conditions (WRUECs) cause almost 25% of lost time cases in the US, little is known about their long-term occupational consequences. A self-report survey was mailed to New Hampshire workers reporting a WRUEC one year prior to the study. Of the 72 (52%) valid respondents, 60% had lost ≥1 week of work and 90% had returned to work. Almost 70% reported acute injury onset, and 26% had experienced a recurrence of their WRUEC. Both gradual-onset injuries and recurrences had worse outcomes. Recurrence was related to shorter job tenure, lower job satisfaction, and less satisfaction with medical care and insurer responses. Results imply that a single measure is insufficient to assess occupational outcomes subsequent to a WRUEC. The importance of secondary prevention was highlighted. There is a need for focus on gradual-onset injuries, as well as those acute-onset injuries with risk for recurrence.

Factors associated with retirement-related job lock in older workers with recent occupational injury

Purposes. Job lock (inability to leave a job due to financial or benefits needs) has been found to significantly restrict job mobility. However, it has not been studied in terms of inability to retire. This study evaluated the relationship between health, work environment, and retirement-related job lock in workers ≥55 with recent occupational injuries. Methods. Workers completed a mailed, self-report survey about their pre- and post-injury health and functioning, work environment, and retirement plans. Bivariate and multivariate analyses determined those factors associated with retirement-related job lock. Results. Over half of the respondents wanted to retire but could not because they needed job-related income or benefits. Factors associated with retirement-related job lock were indicative of poorer health and mental function and dissatisfaction with the workplace social environment. No injury-related factors were significant. Conclusions. Retirement-related job lock was common in older workers with occupational injuries, and appears to be primarily due to difficulties at work, combined with health conditions that may impair work abilities. Workers wishing to retire but unable to do so may be at risk for work-related injuries, as well as decrements in work function and premature retirement resulting in insufficient income and health benefits.

Understanding the role of sex differences in work injuries: Implications for primary care practice

Purpose. Primary care physicians care for work-injured women and men, yet there is little information on sex differences in outcomes and factors contributing to post-injury outcomes to guide their evaluation and recommendations. Methods. Two self-administered questionnaires were sent to a large sample of women and men with work injuries reported to the New Hampshire (USA) Department of Labour between November 2000 and March 2002. Factors associated with the work injury and outcomes were assessed. Results. A total of 3001 persons (1448 women and 1553 men) completed the first questionnaire and 67% completed the second questionnaire. Work-injured women were significantly younger, more educated, more likely to be single, had more pre-injury comorbidities, and worked in less physically demanding occupations as compared to work-injured men. Womens injuries were more often a result of routine job tasks and of gradual onset. Women had worse long-term outcomes including job stability and post-injury income. In multivariate analyses, being female was independently associated with a negative employer response and greater future work concerns. Conclusions. Women and men differ in terms of work injury circumstances and factors contributing to post-injury outcomes. Primary care providers should consider sex when evaluating and treating work-injured adults.