Obesity at the Coal Face
University of Newcastle, Australia
Obesity is a major problem in Australia, with over 70% of Australian’s being overweight or obese. Rates of obesity in NSW coal miners are significantly worse (83.4%). Workers who are obese have higher rates of absenteeism, reduced productivity, increased injury and illness, slower recovery rates and increased workers’ compensation costs.
To measure prevalence of overweight and obesity in NSW coal mining and investigate what weight management / workplace wellness interventions have been implemented at the workplace.
A mixed method pilot study was conducted including: a cross sectional survey of OHS and HR personnel from across NSW mines; focus groups with OHS committee members of 5 mine sites; analysis of the NSW coal health database.
Almost half of all the mine employees had a Body Mass Index (BMI) which classified them as overweight (47%) or obese (27%). When BMI was compared to a number of other characteristics, results indicated that those in the overweight BMI category had: elevated (50%), high (51%) or very high (44%) blood pressure; moderate (48%) or high (48%) cardiac risk factors; high risk alcohol dependence (51.0%); moderate (48%) or high/very levels of psychological distress (45%).
A variety of initiatives have been trialed at the workplace including health and education sessions, smoking cessation and subsidised gym membership, however few initiatives have been measured or sustained. Challenges include low health literacy, long working hours/shifts, sedentary nature of work, focus on individual behaviours and work culture, and sustainability of programs.
The workplace is an important setting for weight management and obesity prevention, however this requires strong leadership and a supportive culture and workplace environment. These findings provide insight into the prevention and management of overweight and obesity as a critical part of industry’s overall focus on the general health of its employees.
Physical Work Demands and Sickness Absence: Protocol for a Prospective Study Merging and Analysing Comprehensive Technical Measurements of Physical Activity at Work and Detailed Prospective Register Data on Sickness Absence
1National Research Centre for the Working Environment, Denmark; 2Ghent University, Belgium; 3Bispebjerg Hospital, Denmark; 4Aarhus University, Denmark; 5Holbæk Sygehus, Denmark; 6University of Copenhagen, Denmark; 7University of Southern Denmark, Denmark
Background: Different physical work demands have been linked with sickness absence. Many studies use self-reported data; however, technical measurements of physical work demands (such as stationary standing, sitting, forward bending of the trunk, arm elevation) have been shown to provide more accurate measurements. Furthermore, previous studies using sickness absence as the outcome measure have focused on state- and municipality-subsidised sickness absence, which tends to be long-term sickness absence; however, also short-term sickness absence may be affected by physical work demands.
Methods/design: The ‘Physical wOrk DEmands and Sickness Absence (PODESA)’ Study will combine comprehensive accelerometer data on body postures (e.g. sitting, standing still), movements (e.g. forward bending of back and arm elevation), physical activity types (e.g. walking and stair-walking), and survey data from the NOMAD-DPhacto cohorts with detailed register data on sickness absence for up to N=1,108 Danish primarily blue-collar workers. The study has access to prospective data on sickness absence since the individual worker baseline measurements between 2011 and 2014 with up until four years of follow-up sickness absence. These data enable analyses on complex physical work demands during workdays and prospective sickness absence.
Discussion: The PODESA Study has access to a previously unrivalled combination of detailed data on physical work demands and prospective sickness absence, enabling further analyses adding to the field’s knowledge as a whole on links between physical work demands and sickness absence. The results of the study can be used to inform policies and practice. Results are expected in 2019-2020.
An Online Tool to Help General Practitioners to Contact Occupational Physicians – Results of a Pilot Study
National Institute for Public Health and the Environment, the Netherlands
Cooperation between general practitioners (GPs) and occupational physicians (OPs) contributes to provide univocal advice and treatment for workers with health problems. As OPs in the Netherlands do not work within the same local area as GPs, GPs have difficulties in finding and contacting the OP of the worker. Therefore this pilot study was initiated to evaluate the implementation of an online communication tool in order to search and initiate contact with an OP.
A 3-month lasting pilot with the online communication tool was conducted in collaboration with the Netherlands Society of Occupational Medicine and the Dutch College of General Practitioners. To evaluate this pilot, semi-structured telephone interviews were conducted with 7 OPs and 8 GPs. Questions included satisfaction, added value, practical use, expectations for future use, and suggestions for improvement of the (implementation of the) online tool. The interviews were tape-recorded and analysed by two researchers using the framework analysis method. Registration data of the online tool provided insight in the number of registered OPs and the completeness of their registration.
OPs and GPs expected a positive contribution of the online communication tool to better collaboration and providing univocal advice to workers, but the actual number of contacts with the tool was very low. Experiences and satisfaction differed, GPs had difficulties to find the OPs they searched for and OPs struggled with the registration of employers. Both GPs and OPs felt the need for more instructions on obtaining consent of the worker.
Discussion and Conclusion
The pilot period with the online communication tool was too short and restricted to demonstrate increased contact between OPs and GPs. An overall positive attitude of the physicians is a basis for the national implementation of the online communication tool, but more attention for dissemination and instruction is needed.
A Descriptive Study of Public Safety Personnel Undergoing Treatment for Work-Related Post-Traumatic Stress Injuries
1University of Alberta, Canada; 2Workers' Compensation Board-Alberta, Canada; 3Alberta Health Services, Canada; 4Project Trauma Support, Canada
Background – Public safety personnel (PSP), such as police officers, firefighters, and paramedics, are frequently exposed to accidents, disasters, and trauma in the course of their work. These exposures can result in stress-related reactions that affect mental health and well-being. The broad set of persistent psychological difficulties is termed post-traumatic stress injury (PTSI). To improve treatment of PTSI, we need a better understanding of the workers experiencing these injuries and treatments received.
Objective – We studied the characteristics of injured workers undergoing PTSI treatment in Alberta, Canada to determine the proportion of PSP, types of treatment received, and return to work outcomes.
Methods – A descriptive study was conducted using clinical and administrative claims data from the Workers’ Compensation Board-Alberta (WCB Alberta). The database included all workers’ compensation claimants across Alberta undergoing PTSI treatment between January 1, 2014 and December 31, 2016. The database contained information on several variables including occupational group, treatment received, and return-to-work outcomes following treatment. Analysis included descriptive statistics.
Results –During the study period, 510 workers (mean age 40.2 years, 60.7% male) underwent treatment for PTSI. Of these, 114 (22.4%) were PSP which included 76 paramedics (66.7%), 21 police officers (18.4%), and 17 firefighters (14.9%). The majority (94.5%) received in-vivo exposure-based treatment from a community provider (46.9%) or in the context of interdisciplinary rehabilitation (47.6%). A minority (5.5%) received individual psychological treatment. Only 41.2% returned to pre-accident work after treatment.
Conclusions – PSP comprise almost a quarter of all PTSI treatment provided by WCB-Alberta with paramedics accounting for 2/3 of the PSP claimants.PSP workers with PTSI appear to most commonly receive exposure-based treatment, however, less than half successfully return to work. Future research should model prognostic factors associated with treatment success, which could stimulate more effective prevention approaches and development of novel therapy modalities.
Workplace Practices and Essential Activities Recommended in Literature for Preventing Prolonged Disability in Workers with Musculoskeletal Disorders
1Institut de recherche Robert Sauvé en santé et en securité du travail, Canada; 2bÉcole de réadaptation, Université de Sherbrooke, Longueuil, Québec, CANADA
Little efforts have been made until now to document what are the actual practices of the workplaces for a sustainable RTW in employees with work-related musculoskeletal disabilities (WRMDs) into the workplace, and how they are similar or different from what is recommended by the literature. The objective of this presentation is to compare how the workplace actual practices reflect the essential activities recommended by the literature.
A systematic and integrative literature review and a multiple case study (n = 4) in two sectors of activity were performed. The case was defined as all the RTW management procedures and practices of a specific organisation. Multiple sources of data were used: written policies and procedures and semi-structured interviews with key actors (e.g. human resources counsellor, manager, supervisor, union representative, worker, etc.). For each case, between 5 and 17 key actors involved in the RTW process of workers, absent from their regular work during more than 3 months, were interviewed. The actions performed by a category of key actors in order to accomplish RTW essential activities, by phase, were compared with the actions recommended in the literature for each case.
Similarities and discrepancies exist between what is recommended in the literature and the policies, procedures, and actions completed by the actors involved in the RTW process for all the companies. Many differences, specifically in terms of the application of these policies, procedures and actions by company will be presented.
Comparisons between the literature and the practice of the organisations upon the realisation of essential activities allow us to understand some gaps at the practical level between what is recommended and what is actually done into the workplace. The consideration of these gaps contributed to a better understanding of practical contexts’ realities in the workplaces and elaboration of some recommendations.
Beyond Medical Treatment After Minor Motor Vehicle Crash Injury: Perceptions Of Insurance Company Case Managers
1Bern University of Applied Sciences, Department of Health, Bern, Switzerland; 2Massachusetts General Hospital (MGH) Institute for Health Professions, PhD program in Rehabilitation Sciences, Charlestown, Boston, USA; 3Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA; 4Young Normandeau & Co., Hopkinton, MA, USA; 5Department of Quantitative Health sciences, University of Massachusetts Medical School, Worcester, MA, USA; 6John Walsh Centre for Rehabilitation Research, Kolling Institute, University of Sydney, St Leonards, NSW Australia; 7Netherlands Institute for the Study of Crime and Law enforcement. Faculty of Law, VU University Amsterdam, Amsterdam, The Netherlands
Background: Musculoskeletal disorders after minor motor vehicle crash injuries (MSD-MV) are common. In some cases, medical treatment offers little relief. Case managers (CMs) play a critical role in the recovery process due to their interaction with various stakeholders and longer-term perspective. Yet little is known about CMs perceptions, especially as it relates to helpful and unhelpful treatments for MSD-MV.
Methods: Semi-structured interviews were conducted with insurance company CMs in Australia and the USA (N=40). Participants were asked: “What do you believe are good or bad interventions for recovery?”. A framework analysis was applied to extract codes and develop overarching themes. Two co-authors performed the interviews, and six co-authors were involved in the data analysis.
Results: CMs talked about particular types of interventions, as well as components that could be found across a variety of interventions. Aggressive treatment – too much, too early, multiple specialties, surgery, overmedication, non-evidence based treatments focused on rest, prolonged work-absence certification, and diverging agendas of stakeholders were all perceived as unhelpful for recovery. Legal representation, in addition to excessive health care, was also perceived as detrimental. Staying active, performing home-based activities, resuming work after injury and allowing time to heal were perceived as enhancing recovery. The following overarching components emerged: treatment approach and intensity, timeliness of interventions, building positive recovery expectations, support of return-to-work, communication between stakeholders, and the influence of social context such as family and employer.
Conclusions: CMs demonstrated clear and detailed perceptions of key psychosocial and contextual issues influencing recovery from MSD-MV. In particular, their perceptions regarding overarching treatment components, has the potential to be informative to a wide variety of treatment providers. Their perceptions regarding treatment approach, timeliness, and the importance of facilitating positive relationships and expectations suggests that subtle changes to established treatment programs may result in improved recovery outcomes.
Practices of Occupational Health and Safety in Developing Countries
1GRANDE COTE OPERATIONS, Senegal; 2Ministry of Labour of Brazil, Labour Inspection Secretariat Brazil; 3Caisse Nationale de Securite Sociale, Djibouti; 4SGS, Bangladesh
The paper reviews the efficient tools for the management of occupational health and safety in developing countries. Their legislation and the ratification of various international conventions did not seem to reduce the number of fatalities, accidents and illnesses from the workplaces.
Proposing framework for managing Safety in developing countries. Many assertions from various researches have come to a conclusion that there is a correlation between the skills of the workers and the development of techniques and technologies in the work area.
For many decades, the ILO and other organizations has attempted a tripartite adoption of legislative instruments for the management of workplace health and safety. Still, workplace accidents and ill-health are still ravaging lives and economies in developing countries.
It is evidenced that there is correlation between the low level of risk management and the working environment of the country (work methods, the legislation, and the local resources).
The findings stemmed from field observation and the combination of case studies conducted by the authors in five different countries: Brazil, Bangladesh, Madagascar, Senegal, and Djibouti.
The authors intend to bring to practitioners a low-cost and culturally accepted tools that promote occupational health and safety in various workplace setting.
It is not expected that a one-size-fits-all solution is available. However, the authors advise on a practice model that can be widely adapted to many work setting.
Developing Basic Employment Skills by Using Mobile Technologies Early in the Worklife Course
1University of Montreal, Canada; 2CHU Ste-Justine Research Centre; 3CINBIOSE Research Centre
Pre-employment experiences such as “traineeships” are considered effective in developing employment skills among High School students with disabilities. These students often have benefited from technological aids as an accommodation measure in school, but lose it when they enter the labour market. We conducted an intervention study aimed at developing an attribution model to use Information and Communication Technologies (ICT) in the workplace. The intervention was based on two pilot studies and a theoretical approach in constructive ergonomics. It involves a coordinate approach, composed of four steps: 1) needs assessment based on work activity analysis; 2) planning means, products, functions, and context; 3) realizing pedagogical activity supported by ICT; and 4) integration and evaluation of outcomes. Eight teachers and 15 trainees with learning difficulties implemented the intervention; they realized 43 pedagogical activities over the school-year. Through multiple data sources, the implementation steps were monitored and an implementation process analysis was conducted to document the extent of the needs covered, as well as the scope and limitations of the intervention. In the workplace, the principal difficulties encountered were associated to tasks completion, gestures and work abilities; some needs were also related to impairments such weak memory, lack of space orientation or executive function difficulties. ICT were used in different ways. The study highlighted the importance of taking into account not only the student's characteristics but also the workplace context (tasks and requirements, means and conditions, social environment). Technological solutions do not need to be sophisticated, they can be mobilized at different times and places (work, school, home), and they can influence the learning process or support special needs. The active engagement of teachers, students and placement companies' stakeholders are key to success. The study led to the consolidation of the approach and the development of tools to help teachers using it.
The Role of Human Values and Relations in the Employment of People with Work-Relevant Disabilities
1University of Tilburg; Tilburg School of Social and Behavioral Sciences, Netherlands, The; 2VU University Amsterdam, The Netherlands, Health Sciences,
Purpose: The aim of this study is to discuss the role of human values and relations in the employment of people with work-relevant disabilities.
This was placed in the context of three complementary philosophical perspectives: 1) from Isaiah Berlin that stresses other than merely rationalistic values, 2) from Amartya Sen stressing the importance of values in work and 3) from Emmanuel Levinas in which the interpersonal perspective is central.
Methods: Semi-structured interviews were held with people with a working disability and with family, partner, colleagues and employers. All interviews were audio-taped and transcribed verbatim. A framework analysis was used to identify the different values in the interviews.
Results: Both non-rational and rational values and arguments were mentioned by employers in the context of hiring people with a work-relevant disability. Work values were very important for this group. The importance of human relations was emphasised and the interpersonal perspective played an important role in the employment process of people with a work-relevant disability. People asked their private network to help them and to provide emotional support.
Conclusion: People with a work-relevant disability need adjustments in order to work. The perspectives we used showed useful in structuring and interpreting our data. Employers who considered values as accessibility, inclusiveness and creating a better working atmosphere as even important as pure rational values, felt responsible that employees with a work-relevant disability could achieve the value of having work ad well as important values in work. This had more chance if values were in line with the mission and central value of the organisation. Nevertheless, there is a limit in money and time, changeable from case to case and over time.
This study can help to provide and select the right arguments if we want to introduce a person with a work-relevant disability for employment.
Chronicles Of Workplace Health Self-Management.
Loughborough University, United Kingdom
It is estimated that more than 17 million people in the UK will be affected by long-term health conditions in the coming decades, with implications for work participation. Long-term conditions can be self-managed and 70-80% of people can be supported to do so. Self-management is associated with positive health outcomes, less healthcare usage and support, is related to higher levels of self-management behaviour. Low levels of workplace support can be detrimental. Research has examined self-management support in formal return to work processes and from a patient perspective. Currently, self-management support is synonymous with the role of healthcare providers, GPs or charitable services but the role and influence of the employer remains unexplored nor defined. Two separate interview studies were designed to explore workplace self-management support from an employer and employee perspective. Adopting a purposive sampling approach, employers (n=12) utilising a 13-item semi-structured framework designed by the researcher to ensure specific topics were covered, shared their knowledge, understanding and views of workplace self-management behaviour. Contrarily, via a narrative framework utilising a SQUIN (single question designed at inducing narrative) taken from the biographic narrative interpretive method, employees (n=13) affected by mental, musculoskeletal and ‘other’ health conditions were asked to share their unique stories of workplace self-management. Narrative is a method used to elicit stories of life experiences. Accounts were littered with tales of self-management behaviour, support needs and experiences in a workplace context. Both studies, embedded in a broader mixed methods framework, could provide new insights into and understanding of workplace self-management and support needs. This could inform the design and testing of workplace interventions aimed at improving workability, continuing employment and health outcomes. A thematic and narrative approach will be adopted to analyses, results of which will be explored and presented.
Fostering Autonomy and Relationships: Mental Health Professionals and Work Reintegration
Trent University, Canada
With the rise in mental health work disability, mental health professionals (MHP's) are increasingly involved in work reintegration (WR) efforts. Few studies have focused on their involvement, and specifically on the strategies they employ to resolve work disability issues with their patients. The aim of this study was to look specifically at the strategies employed by MHP's when working with workers on sickness absence for common and trauma-related mental disorders.
A qualitative method was used, employing semi-structured interviews (X2) and a case review with each participant. Interviews were transcribed and progressively coded for the themes relating to clinical strategies, accommodation and interactions with stakeholders as well as barriers to implementing strategies.
Twelve therapists (6 master's level social workers, 4 psychologists, 2 master's level counsellors) participated in the study. As a clinical strategy, therapists fostered autonomy by encouraging the exercise of choice on the part of workers to return to their previous job or move on to a more suitable employment. In building accommodations, MHP's co-constructed accommodations with workers to ensure buy-in, but also challenged workers when avoidance was a barrier to WR. Managing relationships emerged as a major theme related to stakeholder interactions, reflecting efforts by MHP's to enable perspective taking on the part of workers and insurers with the other's perspective and establish credibility for the worker's mental health issue with the insurer.
Apart from using evidence-based therapeutic methods to treat workers, MHP's use pragmatic strategies that encourage worker autonomy and buy-in, foster a positive working relationship between stakeholders and reduce stigma and resistance toward work accommodation. For MHP's the findings from this study shed light on the importance of developing strong relationship management skills and allotting time to employ these skills with WR cases.
Improving the Early Prevention of Work Disability through a Better Legal Protection of the Impaired Workers
University of Glasgow, United Kingdom
In 2016, 20.8 millions of the employees in the EU-28 were disabled, representing 11% of the European workforce. Most of these workers became disabled after the age of 15, meaning once they were legally able to work. According to the wood sequence: a condition (e.g. a work accident) can lead to physical or mental disorders, then to limitations and finally to a recognised disability. Only the end of this sequence, the disability status, is protected by the EU with the Directive 2000/78/EC. However, the previous phases, when the worker is impaired but not disabled, are not covered by any specific European legal provisions.
Thus, this paper investigated how it would be possible to legally protect and improve the working conditions of the impaired workers as an attempt to prevent the evolution of their impairment into disability. Specifically, it re-examined the jurisprudence of work disability to identify the legal gaps, before addressing these gaps by analysing and suggesting a new application of the Directive 89/391/EEC (i.e., the main EU OHS directive).
This study argues that it would be possible to use the broader OHS legislation to address the needs of impaired workers. In this respect, it concludes that by focusing on the occupational origin of the impairment, it would be possible to develop a legal argument to advocate for an individual right of adaptation of the workplace for the impaired workers returning to work after a work accident based on art. 6 of Directive 89/391/EEC. This directive provides an obligation for employers to prevent the OHS of their workers. So far, this obligation has been predominantly used for preventing working accidents, but it would also be possible to extend it to the situation of return to work to prevent the potential worsening of an impairment into a chronic disability.
Developing An Integrated Organizational Intervention For Subcontractors In The Construction Industry: Findings From A Pilot Study
1Harvard Center for Work, Health and Wellbeing, Harvard T.H. Chan School of Public Health, Boston, MA, U.S.A.; 2Bouvé Health Sciences, Northeastern University, Boston, MA, U.S.A.
Interventions to improve construction worker safety, health and wellbeing can be challenging due to the multi-company structure on a worksite, the transient nature of construction workers on-off sites, competing high production pressures, and the unstable nature of employment. In addition, many small construction companies, such as the subcontractors, do not have the resources to develop their own safety management systems which further compound the problem. Previous research has identified that integrating health promotion and health protection programs into the way these companies do business can contribute to their success. Participatory approaches (i.e., those in which the key stakeholders are involved) to developing and implementing interventions have helped to bridge the gap between research to practice and have been found to contribute to intervention success in other industries. Using the Harvard Center for Work Health and Wellbeing’s Manual for implementing integrated organizational interventions, we developed a participatory integrated organizational intervention for subcontractors in the construction industry. The intervention was designed to develop a communication infrastructure and process to allow subcontracting companies to integrate strategies to promote worker safety, health and wellbeing into their daily operations. This intervention was piloted to examine its feasibility and acceptance to owners, managers and workers, prior to a full randomized controlled trial (currently underway). We will present the steps we used to develop the intervention, challenges faced (including barriers to implementation and how these were overcome) and our qualitative findings from the pilot’s interviews with managers and focus groups with workers. We will also describe how workers and managers were engaged to design, implement and evaluate the intervention, which helped with sustainability of the project after the research team had left the worksite.
- McLelland D et al. Implementing an Integrated Approach. Accessed: http://centerforworkhealth.sph.harvard.edu/resources/guidelines-implementing-integrated-approach
Workers on Prolonged Work Disability for Musculoskeletal Disorders do not worry for nothing
1Universite de Sherbrooke, Canada; 2Trent University; 3Institut de recherche Robert-Sauvé en santé et en sécurité du travail
Workers worry during prolonged work disability, but do their worries relate to their actual work disability situation? The aim of this study was to assess worries and their maintaining factors, while considering the margin of maneuver/leeway (MM) at work and their impact on return to work (RTW).
We conducted a descriptive study with a convenience sample of 79 (39 men and 40 women) workers having persistent (≥3 months) work-related musculoskeletal disorders causing absence from their regular work. Validated self-administered questionnaires (based on Dugas’ generalized anxiety disorder theory) were completed at the beginning and the end of the work rehabilitation program. Also, the questionnaire on type of worries (QTW) assessed specific types of worries and their relationship to work. Trained occupational therapists (n = 16) evaluated the MM of the participants. Multivariate analyses were performed on RTW predicted by workers’ indicators and occupational therapists’ MM.
Twenty-one workers did not RTW. Significant factors explaining not RTW were: lack of a margin of maneuver (OR = 8.5; p = .008); high intolerance for uncertainties (OR = 1.12; p = .01), perceived utility of worrying (OR = 1.11; p < .001), and for the QTW scores, a high mean intensity of worries (OR = 2; p = .004) seen as emerging from actual situations (OR = 17.15; p = .02) occurring at work (OR = 8.5) predicting 54% of the variance in RTW outcome(p < .0001). A posthoc analysis (pseudo R2 = .33; p = <.0001) shows that a lack of a margin of maneuver is associated with QTW scores of worries emerging from uncertainties at work.
When workers do not return to work, they report worrying about actual situations at work that co-occur with a low MM. Thus, RTW interventions need to focus on the work environment.
Music Cohort: Canadian Trial of Protocol to Assess Musicians' Health
1University of Alberta, Canada; 2Hochschuele Osnabrueck, Germany
Identifying pre-professional musicians who are at risk of physical and mental health problems is an important means of reducing the impact of these problems during their training, and in their future careers. We will present the results of a Canadian pilot validation and English translation of an assessment protocol for student musicians.
1. Successfully deploy the protocol in a Canadian setting and present the first results of this pilot sample.
2. Investigate the physical and psychological health profile of first-year Canadian university music students.
Methods: This study used a cross-sectional design with a control group. The protocol examined demographics and history of pain; pain intensity and interference; performance anxiety; and mental health concerns using valid and reliable paper-based tools (SF-12, DASS 21, Musculoskeletal Pain Intensity and Interference Questionnaire for Musicians, Kenny Music Performance Anxiety Inventory). Physical testing included pain perception (algometer), active range of motion of the upper extremity, cervical spine and hips, and hypermobility (Beighton). Statistical analysis was performed using IBM SPSS Statistics24.
Results: 15 student musicians and 40 non-music students have been tested in this pilot study, and recruitment continues at the time of abstract submission. Preliminary findings suggest that music students score lower on measures of core strength and mental health than their peers. Implementing the assessment in Canada was successful with minor adjustments.
Conclusions: The updated assessment protocol is feasible in Canada.
Negative Perceptions And Attitudes About Return To Work In Sick-listed Unemployed Workers With Psychological Problems
AMC, Netherlands, The
Mental disorders are highly prevalent and often lead to unemployment and work disability. Return to work expectations are often found to be prognostic for future work participation. A previous study identified three types of attitudes towards return to work among sick-listed unemployed workers with psychological problems. More insight on how to recognize these negative perceptions and attitudes is needed so that professionals can identify workers at risk for long term sickness absence.
This focus group study aimed to investigate if and how professionals working at the Dutch Social Security Institute (UWV) recognize negative perceptions and attitudes in sick-listed unemployed workers. The participants were recruited through managers of UWV. Four focus group sessions of 5-6 professionals working at UWV were held throughout the Netherlands. A thematic analysis was conducted using MAXQDA software.
The participants recognized negative perceptions and attitudes in unemployed workers. They often described a negative attitude as being passive and negative. They confirmed the three types of attitudes. However, a main theme was the shifting character of the attitudes. The participants also stated that most workers aren’t completely passive or completely active and that an active attitude is relatively rare. Personal contact enabling the observation of nonverbal signs while asking questions on return to work expectations was often mentioned as the best way to identify perceptions and attitudes. Some participants expressed the advantage of an additional questionnaire. In general they were convinced that every professional should assess the attitude during each consult because of the shifting character.
Professionals recognize negative perceptions and attitudes about return to work in sick-listed unemployed workers with psychological problems. These attitudes comprise three main types: passive, switching and active and can change over time. These attitudes should be identified through personal contact at every consultation.
Developing a Framework for the Evaluation of the Implementation Process of an Ergonomic Intervention: What Dimensions Should Be Considered?
1Université du Québec à Montréal, Canada; 2Université de Sherbrooke, Canada
In the meat and poultry transformation industry, knives’ efficiency is a preventive factor for musculoskeletal disorders. A knives sharpening and steeling training program was developed in a plant. It was a train the trainer program with the training of internal trainers by ergonomists and of workers by internal trainers. Ergonomists were also in charge of creating organizational and material conditions favorable to knowledge transfer. Objectives were 1) to develop a framework with relevant dimensions for the evaluation of the implementation process of this type of intervention, 2) to identify obstacles and facilitators.
We used the template analysis technic which allows to analyse the data with a pre-determined set of codes categorized by themes, while allowing codes to emerge from the data. Based on a literature review, we identified dimensions to analyze and produced an initial template. We then collected qualitative data (observation of the intervention, interviews with ergonomists). The final template was the result of a double coding process and presents a list of dimensions to consider when evaluating this type of intervention. Each dimension was associated with a value: negative for obstacles, positive for facilitators or neutral if related to factual dimensions.
Our framework had 6 themes (Initiation, Conception, Implementation, Stakeholders’ contribution, Intermediate effects and Internal context) and 62 dimensions. Among obstacles we identified the unavailability of adapted material and opportunities to put into practice new skills. Amongfacilitators, there was the time given to trainees to participate to training sessions. However, the continuous tailoring of the action plan to the organizational context by ergonomists and the sequence of events was difficult to describe using our framework. Our study sheds light on the challenge faced when elaborating an evaluation framework for the implementation process of this type of intervention and underlines the need for interdisciplinary studies in this field.
The Return To Work Assistance Of Occupational Musculoskeletal Injury Workers And Its Perspective In Taiwan
National Taiwan University Hospital Yun-Lin Branch, Taiwan
Service for the occupational injury and injury workers had been addressed since early this century in Taiwan, consequently many Center for Management of Occupational Injury and Disease (CMOID) were set up to offer island-wide service, there is 10 centers and 65 network occupational clinics. Under the principle of prevention, compensation and return to work (RTW) to deliver service to 10 million workers within 30 KM radius of the workers’ premise, this service had annual support by OSHA budget for more than 15 years.
Standard operation procedures, such as patient recruiting, clinical evaluation, incident investigation, reporting and case management model had been developed in CMOID, and one of the concerned items of case management is RTW assistance. We extract data from the reporting system from 2008-2015, the nationwide data showed that increased trend of clinic service amount e.g. in 2015 there was 7,374 first-visits, among them the musculoskeletal injury or disease account for 27 % . The workers receiving occupational rehabilitation service (990), and the number of successful RTW (442) also increased. Since 2016, many work strengthening centers were separately established, under the occupational rehabilitation programs.
We will discuss related regulation and policy, encountered difficulties, approaches and solutions. The report also illustrate the three important steps of successful RTW assistance from above experience, including functional capacity evaluation (FCE) by the occupational rehabilitation, sick note or fit note issued by the occupational medicine specialist and RTW implementation by a team collaboration.
Work Disability Due to Ocular Diseases in the Working Population of the Private Sector in Brazi
1Faculty of Medicine, University of São Paulo, Brazil, Brazil.; 2National Social Security Institute, São Paulo, Brazil.; 3ABC Medical School, São Paulo, Brazil
Introduction: Work-related injuries are a public health problem and can result in temporary or permanent work disability. Lower productivity at work and impairment on the living conditions are effects related to occupational sickness. Eye injuries at the workplace cost U$ 300 million a year in lost productivity, medical treatment and workers compensation. In Brazil, social security for private sector is public and workers are evaluated by medical-experts to grant a sickness benefit. Objective: To identify the profile of social security benefits due to ocular diseases and injuries granted to private sector workers in Brazil. Methods: Ecological study with secondary data from 2017 of the Social Security Yearbook. Disability benefits were classified as non-work related and work related. All benefits were analyzed and separated those classified in the ICD-10 H00-H59 (eye diseases and attachments) and S05 (eye trauma and ocular orbit). Results: The total benefits granted in Brazil in 2017 were 2,179,287, of which 2.2% were related to ophthalmologic diagnosis. Those were 40,545 benefits due to disease (98.3% non-work related) and 1,559 due to traumas (32.3% work-related). Among non-work-related ophthalmologic diseases, those more common were senile cataract (15.9%) and blindness and low vision (13.2%). About work-related diseases, the two most frequent were blindness and low vision (25.8%) and keratitis (18.3%). Conclusions: Work-related cases are more frequent in ocular trauma than in ophthalmological diseases among workers requesting a disability benefit in private sector in Brazil in 2017. Therefore is necessary to create educational and preventive strategies to reduce work-related ocular traumas, such as: improvements in working environment conditions and the correct use of personal protective equipment. For diseases, it is necessary to invest in the promotion of eye health to reduce the impact of early disability due to visual impairment or blindness.
Better Together – Effect of a Tailored Group Intervention to Improve Return to Work in Sick-listed Employees
1University of South-Eastern Norway, Norway; 2NORCE Norwegian Research Centre, Norway; 3The Arctic University of Norway, Norway
Background: Employees on sick leave often find the transition back to work challenging after weeks or months on sick leave. An intervention to ease this transition and prevent prolonged sick leave was compared to a physical exercise intervention to assess effect on sick leave. Methods: Employees on sick leave were recruited to the project and invited to an inclusion interview. Those fulfilling the inclusion criteria and willing to join the project were randomised to Better together, a tailored group intervention, or a 3 months membership at a local gym. Better together consisted of 16 group sessions of 2 hours over a 12 week period where the participants worked with their own goals using the SMART model. The sessions further had discussions on coping, presentation of a salutogenic perspective, and information from the health and insurance sector. Results: Sick leave at 3 and 15 months will be reported. The intervention group reported less health complaints both at 3 and 15 months. Self-rated health improved at 3 and 15 months in the intervention group and at 3 months in the control group. From the EQ5-D the score on ADL improved in the intervention group.
A Realist Evaluation Of A Multidisciplinary Intervention To Support Return To Work In Sick-listed Employees With Cancer
1Tilburg University; 2TNO; 3ArboNed; 4ArboUnie
Although the importance of work for cancer patients is nowadays widely acknowledged, interventions that are primarily aimed at enhancing return to work of this group of employees are still scarce. In this study, a new multidisciplinary intervention for return to work of employees with cancer is evaluated. One of the innovative aspects of this intervention is that it starts early after diagnosis. The individual tailored intervention is being adjusted to the different phases in curative and work-related care, i.e. the treatment, recovery-, and re-integration phase. Furthermore, a close involvement of the work environment, i.e. the line manager or HR manager, in the return to work of the employee is supported. The intervention is offered in an occupational healthcare setting.
The evaluation follows a realist evaluation (RE) design. One of the main implications of the realist perspective for evaluation is that it is not enough to simply view an intervention as a cause of outcomes but that the mechanisms connecting causes and their effects must also be identified. RE is based on the premise that aspects of context trigger particular mechanisms in response to an intervention, which result in observable outcomes. This is often expressed in the formula C+M=O. Contexts are defined as the conditions that an intervention operates in. Mechanism are underlying entities, processes, or structures which operate in particular contexts to generate outcomes of interest.
This poster presentation focuses on the results of phase 1 (initial intervention theory) and the preliminary results of phase 2 (testing intervention theory) of the realistic evaluation cycle. Using both quantitative and qualitative data, we will provide an explanatory account of how the intervention works, with whom, and under what circumstances.