Marjan Vidmar

The Prevalence and Incidence of Work Absenteeism Involving Neck Pain : A Cohort of Ontario Lost-Time Claimants

Study Design. Cohort study. Objective. To measure the prevalence and incidence of work absenteeism involving neck pain in a cohort of claimants to the Ontario Workplace Safety & Insurance Board (WSIB). Summary of Background Data. According to workers’ compensation statistics, neck pain accounts for a small proportion of lost-time claims. However, these statistics may be biased by an underenumeration of claimants with neck disorders. Methods. We studied all lost-time claimants to the Ontario WSIB in 1998 and used 2 methods to enumerate neck pain cases. We report the prevalence and incidence of neck pain using 2 denominators: (1) annual number of lost-time claimants and (2) an estimate of the Ontario working population covered by the WSIB. Results. The estimated percentage of lost-time claimants with neck pain ranged from 2.8% (95% CI 2.5–3.3) using only codes specific for neck pain to 11.3% (95% CI 9.5–13.1) using a weighted estimate of codes capturing neck pain cases. The health care sector had the highest percentage of claims with neck pain. The annual incidence of neck pain among the Ontario working population ranged from 6 per 10,000 full-time equivalents (FTE) (95% CI 5–6) to 23 per 10,000 FTE (95% CI 20–27) depending on the codes used to capture neck pain. Male workers between the ages of 20 and 39 years were the most likely to experience an episode of work absenteeism involving neck pain. Conclusion. Neck pain is a common and burdensome problem for Ontario workers. Our study highlights the importance of properly capturing all neck pain cases when describing its prevalence and incidence.

The impact of early workplace-based return-to-work strategies on work absence duration : A 6-month longitudinal study following an occupational musculoskeletal injury

Objectives: To examine, using administrative and self-reported data, the relationship between early return-to-work (RTW) strategies and work absence duration. Methods: Using a cohort of 632 claimants with work-related musculoskeletal injuries, Cox proportional hazard analyses were performed with RTW strategies measured 1 month after injury as predictors. Outcomes were 6-month self-reported work absence duration and time receiving wage replacement benefits from an administrative database. Results: Work accommodation offer and acceptance and advice from health care provider (HCP) to the workplace on re-injury prevention were significant predictors of shorter work absence duration indexed by both self-report and administrative data. Receiving an ergonomic visit was a significant predictor of shorter duration receiving benefits only. Conclusions: Analyses using administrative and self-reported indices of work absence generally converged. Work accommodation and targeted HCP communication with the workplace are critical for effective early RTW interventions.

Impact of menstrual phase on false-negative mammograms in the canadian national breast screening study

The efficacy of breast carcinoma screening should be enhanced if false‐negative mammography were reduced. Prospectively collected data from the Canadian National Breast Screening Study were used to examine whether menstrual cycle phase was associated with false‐negative outcomes for mammographic screening.

Relationship between Preoperative Patient Characteristics and Expectations in Candidates for Total Knee Arthroplasty.

PURPOSE The purpose of this study was to determine the relationship between patient expectations for improvement following primary total knee arthroplasty (TKA) and patient preoperative characteristics. METHODS This was a cross-sectional analysis of preoperative expectations. Expectations for improvement were evaluated in six distinct domains. The baseline factors used as independent variables were age, gender, presence of comorbidity, sub-domains of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC; pain, stiffness, physical limitation related to lower extremity), and SF-36 physical and mental health component scores. Stepwise logistic regression analysis was applied to examine the relationships between dependent and independent variables. RESULTS The study cohort consisted of 236 candidates for TKA (154 women and 82 men, mean age 67, SD = 9.98). Expectations were high on average. Presence of comorbidity was associated with expectations of pain relief. Preoperative mental health was related to expectations for a return to activities of daily living; age, gender, physical health, and mental health were related to expectations for improved leisure, recreational, and sports activities. Preoperative physical health was related to expectations for potential return to full recovery. No baseline factors were associated with expectations for improved range of motion or for providing care to and interacting with others. CONCLUSION Expectations related to recovery from surgery appeared to have distinct dimensions and were associated with patient baseline characteristics.

Prevalence of lost-time claims for mild traumatic brain injury in the working population: Improving estimates using workers compensation databases

Primary objective: To test the usefulness of a method to improve the measurement of prevalent mild traumatic brain injury (MTBI) among injured workers with a workers compensation claim. Methods: Database codes were selected to identify MTBI cases in the Ontario workers compensation lost-time claims database. A random sample of 210 claims was selected, classified as MTBI or not, and used to calculate proportions with MTBI among code groups. The annual prevalence of MTBI in 1997 and 1998 was calculated by weighting the numerators with the appropriate proportions of MTBI within each code group. Results: Four code groups were created: the head region, cranial region, concussion code group and the brain region. The proportion of MTBI in each group was 29%, 19%, 92% and 32%, respectively. The 1997 prevalence depended on the codes used, from 39/10 000 (95% confidence interval (CI): 35–44) for a weighted version of the ‘concussion’ code to 58/10 000 (95% CI: 50–65) for inclusion of all identified MTBI codes. Conclusions: Restricting the enumeration of MTBI to specific ‘concussion’ codes can lead to under-estimation of the prevalence of MTBI in epidemiological studies using workers compensation data. Approximately six out of every 1000 lost-time claims are associated with MTBI. Given lost-time estimates of disability under-estimate the prevalence of this mild injury, MTBI, is an important workplace injury.