An intervention to reduce disability in injured workers.
Evanoff-B; Bohr-P; Wolf-L
NIOSH 2002 Dec; :1-29
To evaluate the effectiveness of an ergonomic intervention in reducing days lost from work among persons with work-related musculoskeletal disorders. Workers from health care, airline ground crew, and a university were eligible for enrollment if they had an accepted claim for an acute or chronic musculoskeletal disorder that resulted in five or more days away from usual work (lost days or restricted duty). After recruitment, workers were randomized to usual care, or to an intervention consisting of ergonomic evaluation of the subject's work with tailored recommendations for changes to be made by the worker and the employer. The intervention also included a case coordinator, who communicated medical and ergonomic issues to the employer, employee, and treating physician. Time loss data were obtained from OSHA 200 logs; analysis was by intention-to-treat, with follow up for one year from time of injury. Work loss data were available for 278 workers (145 control, 133 intervention). Onset of symptoms was acute in 86% of cases; sites included the low back (46%), the lower extremities (18%), and the upper extremities or neck (36%). Workers in the intervention group experienced fewer days of lost time with the initial injury (mean 10.4 vs. 18.0 days, p =.07). The total number of days lost and restricted from the initial injury was similar (mean 32.2 vs. 31.1). The proportion of workers with recurrent injury in the year following the index injury was 18% in both groups. At six months following injury, there were few differences in functional status or satisfaction with work or medical care between the two groups. Many workers reported continuing disability following return to full duty work. Measures of health-related quality of life improved over six months, but bodily pain and physical functioning scores remained lower than expected based on national averages. An intervention consisting of an ergonomic evaluation and work change recommendations for the worker and employer reduced days lost from work at the time of initial injury and over the next year. Total days lost and restricted were not reduced. Recommendations for job changes were not universally implemented, which may have limited the effectiveness of the intervention. Following return to work, many workers experienced re-injury or reported persistent limitations in function six months following injury. National statistics may under-represent the full burden of disability following work injury.
Musculoskeletal-system-disorders; Ergonomics; Workplace-studies; Injuries; Disabled-workers
Division of General Medical Sciences, Department of Medicine, Washington Unversity, School of Medicine, Campus Box 8005, 660 S. Euclid Avenue, St. Louis, MO 63110
Final Grant Report
NTIS Accession No.
Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
National Institute for Occupational Safety and Health
Barnes-Jewish Hospital, St. Louis, Missouri