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Predictors of delayed return to work after back injury: a case-control analysis of union carpenters in Washington State.

Authors
Kucera-KL; Lipscomb-HJ; Silverstein-B; Cameron-W
Source
Am J Ind Med 2009 Nov; 52(11):821-830
NIOSHTIC No.
20036428
Abstract
METHODS: Union administrative records identified 20,642 union carpenters who worked in Washington State from 1989 to 2003. The Department of Labor and Industries provided records of workers' compensation claims and associated medical care. Work-related back claims (n = 4,241) were identified by ANSI codes (back, trunk, or neck/back) or ICD-9 codes relevant to medical care consistent with a back injury. Cases (n = 738) were defined as back injury claims with >90 days of paid lost time; controls (n = 699) resulted in return to work within 30 days. Logistic regression models estimated odds ratios and 95% confidence intervals (OR, 95% CI) of delayed return to work (DRTW). RESULTS: Thirty percent of case claims and 8% of control claims were identified by an ICD-9 code. DRTW after back injury was associated with being female (2.7, 95% CI: 1.3-5.5), age 30-44 (1.2, 95% CI: 0.9-1.7) and age over 45 (1.6, 95% CI: 1.1-2.3), four or more years union experience (1.4, 95% CI: 1.1-1.8), previous paid time loss back claim (1.8, 95% CI: 1.3-2.5), and >or=30-day delay to medical care (3.6, 95% CI: 2.1, 6.1). Evidence of more acute trauma was also associated with DRTW. CONCLUSIONS: Use of ICD-9 codes identified claims with multiple injuries that would otherwise not be captured by ANSI codes alone. Though carpenters of younger age and inexperience were at increased risk for a paid lost time back injury claim, older carpenters and more experienced workers, once injured, were more likely to have DRTW as were those who experienced acute events.
Keywords
Accident-statistics; Age-factors; Back-injuries; Back-injuries; Biomechanics; Construction; Construction-industry; Construction-workers; Demographic-characteristics; Health-care; Health-services; Injuries; Mathematical-models; Musculoskeletal-system; Musculoskeletal-system-disorders; Occupational-hazards; Risk-analysis; Risk-factors; Sex-factors; Statistical-analysis; Work-analysis; Work-environment; Work-operations; Work-performance; Workplace-studies; Work-practices; Author Keywords: workers' compensation; back injury claim; paid lost work time; delayed return to work
Contact
Kristen L. Kucera, Division of Occupational & Environmental Medicine, Department of Community & Family Medicine, Duke University, 2200 W Main St, Suite 400, Durham, NC 27705
CODEN
AJIMD8
Publication Date
20091101
Document Type
Journal Article
Email Address
kristen.kucera@duke.edu
Funding Type
Grant
Fiscal Year
2010
NTIS Accession No.
NTIS Price
Identifying No.
Grant-Number-R01-OH-008007
Issue of Publication
11
ISSN
0271-3586
Priority Area
Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
Source Name
American Journal of Industrial Medicine
State
NC; MD; WA
Performing Organization
Duke University
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