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Relationships between medical care and paid lost time from work after work-related back injury among Washington State union carpenters.

Kucera-KL; Lipscomb-HJ; Silverstein-B
NOIRS 2008-Abstracts of the National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania. Morgantown, WV: National Institute for Occupational Safety and Health, 2008 Oct; :H1.4
Introduction: Back injuries cause significant lost work time in construction. Beyond older age, differentiating those at risk of prolonged lost work time is difficult. We examined relationships between medical care provided for work-related back injuries due to overexertion and time off work among a cohort of carpenters. Methods: Union records identified a dynamic cohort of 20,642 union carpenters who worked in Washington State from 1989-2003. These data were linked to Department of Labor and Industries workers' compensation files; data from this state-run program included records of medical care with diagnoses and provider type. Patterns of care received were examined by paid time loss status. Results: Over 75,000 visits for medical care were identified over 15 years resulting from 2959 back injuries. Chiropractors (37%) and primary care providers (33%) were most frequent first providers followed by specialists (10%) and hospital/ER (9%); number of lost days differed significantly by first provider (p < 0.05). Thirty-eight percent of those out 31-90 days and 24% out > 90 days never received physical therapy (PT). Individuals out of work for > 90 days were less likely to see a PT in the 30 days post injury (prevalence ratio = 1.7); mean days to first therapy increased with increasing time away from work (25, 50, and 114 days, respectively, for < 30 days, 30-90 days and > 90 days). Mean number of PT visits in the 30 days after injury was greater among those out longer. Discussion: Differences in cases based upon treatment in the first month after injury are worthy of further exploration. Although seeing a specialist as first provider was associated with delayed time away from work, being seen in an ER was not. Individuals with prior history of back problems may seek specialist care immediately after injury.
Age-factors; Back-injuries; Biomechanics; Construction-workers; Ergonomics; Health-care; Injuries; Medical-monitoring; Medical-surveys; Medical-treatment; Musculoskeletal-system; Musculoskeletal-system-disorders; Quantitative-analysis; Risk-factors; Statistical-analysis; Worker-health; Work-operations; Workplace-studies; Work-practices
Kristen Kucera, PhD, Assistant Professor Duke University, 2200 West Main Street, Suite 400, Durham, NC 27705
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Disease and Injury: Musculoskeletal Disorders of the Upper Extremities
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NOIRS 2008-Abstracts of the National Occupational Injury Research Symposium, October 21-23, 2008, Pittsburgh, Pennsylvania
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Duke University