Conference Agenda

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Session Overview
Poster Viewing I: Poster Viewing I
Wednesday, 05/Jun/2019:
10:45am - 11:30am

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Self-reported Health Problems and Obesity Assessed with Health Risk Appraisal Predict Sickness Absence During a 12-month Follow-up: A Prospective Cohort Study in 21608 Employees from Different Industry Fields

Minna Pihlajamäki1, Jukka Uitti1,2,3, Heikki Arola4, Jyrki Ollikainen5, Mikko Korhonen5, Tapio Nummi5, Simo Taimela6,7

1University of Tampere, Finland, Faculty of Medicine and Life Scences, Occupational Medicine; 2Clinic of Occupational Medicine, Tampere University Hospital, Finland; 3Finnish Institute of Occupational Health, Tampere, Finland; 4Terveystalo, Jaakonkatu 3b, 00100 Helsinki, Finland; 5Faculty of Natural Sciences, University of Tampere, Finland; 6University of Helsinki, Department of Orthopedics and Traumatology; 7Evalua International, PO Box 35, FIN-02661 Espoo, Finland

Aim: The present study evaluates, how the Health Risk Appraisal (HRA) results predict sickness absence (SA) in respondents from various industry fields and occupation, and the potential additive roles of self-reported health problems, age, and obesity.

Introduction: Structured questionnaires are increasingly used as part of targeted health surveillance. The study evaluate whether health inspections can be supplemented by the HRA.

Methodologies: The study design is a retrospective analysis of prospectively collected register data. The research utilizes the results of the HRA (N=21608) collected in 2012-2015 and archival data of SA covering 2011-2016 from a large nationwide database of one OH service provider. Explanatory variables were self-reported symptoms, age, body mass index, occupational group and the number of SA days before the survey. The outcome measure was accumulated SA days during 12-month follow-up. A Hurdle model with negative binomial response was used to analyze zero-inflated count data of SA separately for males and females.

Results and discussion: Work disability (WD) risk factors as defined in the HRA predicted the number of accumulated SA days during the 12-month follow-up, regardless of occupational group and gender. The ratio of means of SA days varied between 2.6 and 6.1 among those with WD risk factors and the reference category with no findings, depending on gender and occupational group. The lower limit of the 95% confidence interval (CI) was at the lowest 1.6. In the Hurdle model, WD risk factors, SA days prior to the HRA and obesity were additive predictors of the propensity for SA and/or the accumulated SA days in all occupational groups.

Conclusion: Self-reported health problems in a HRA, obesity, and prior SA predict higher total count of SA days in an additive fashion. These findings have implications for both management of the health care system and in the prevention of WD.

Obtaining Person-related Information From Employees With Chronic Health Problems: A Focus Group Study

Mariska de Wit, Haije Wind, Carel T. J. Hulshof, Judith K. Sluiter, Angela G. E. M. de Boer

Coronel Institute of Occupational Health, Amsterdam Public Health research institute, Academic Medical Center/University of Amsterdam, Amsterdam, The Netherlands


Person-related factors, such as cognitions and perceptions of employees, can influence work participation of employees with health problems. This makes them important factors for occupational physicians (OPs) and insurance physicians (IPs) to intervene upon. There is however a lack of knowledge about the best way for physicians to obtain information about person-related factors, according to employees.


To assess what according to employees with chronic health problems, is the best way for OPs and IPs to obtain information about person-related factors.


Three focus group discussions were conducted with in total 23 employees with work limitations due to chronic health problems. During these meetings employees discussed the best ways to obtain information about ten person-related factors: expectations regarding recovery or return to work, optimism/pessimism, self-efficacy, motivation, feelings of control, perceived health, coping strategies, fear-avoidance beliefs, perceived work-relatedness, and catastrophizing. De discussions were recorded, transcribed verbatim and analyzed through qualitative content analysis.


The employees indicated that information about person-related factors can best be obtained by discussing them during consultations, instead of using questionnaires or diaries. Important mentioned prerequisites for these conversations are: understanding of the physician, interest and mutual trust between employee and physician. The participants mentioned different positive and negative influences for the course of the conversation. Examples of positive influences are: the knowledge of the physician about the employee and his condition and the presence of a pleasant ambiance during the conversation. Examples of negative influences are: feelings of anxiety of the employee and limited time for the conversation.


Information about person-related factors of employees can best be obtained by discussing them during consultations. However there has to be understanding, mutual trust and interest, before employees feel free to talk about these factors. OPs and IPs should consider this when asking about person-related factors during consultations.

Better Macroeconomic Performance is Associated with Shorter Disability Duration in Canadian Workers’ Compensation Claimants

Douglas Paul Gross1, Michele Crites Battié2, Thomas Lo3

1University of Alberta, Canada; 2University of Western Ontatio; 3Institute of Health Economics

Background - Better macroeconomic performance (ie. Gross Domestic Product, GDP) is associated with increased number of disability benefit applications. Association between macroeconomic performance and duration of disability claims is unknown. We hypothesized that better economic performance would lead to more job availabilities and thus shorter durations of disability claims.

Objectives - We studied associations between macroeconomic indicators and disability duration in Canadian workers’ compensation claimants.

Methods Exploratory correlational analysis was conducted using 18 years of publically available data from the Association of Workers’ Compensation Boards of Canada (AWCBC) and Statistics Canada (StatsCan). AWCBC tracks key statistical measures from provincial compensation boards and since 1999 has reported average composite claim duration defined as estimated total number of lost time calendar days compensated for temporary total disability. StatsCan reports GDP for each province measured at basic and market prices (constant 2007 dollars). These datasets included complete data for each province except Ontario and Quebec (which do not report duration) and Manitoba (which stopped reporting duration in 2014). For Alberta claimants we also examined correlations in claimants with back injury reported in annual reports. Analysis included Spearman’s rho correlation examining associations between GDP and disability duration.

Results A statistically significant negative correlation was observed between GDP and disability duration (rs = -0.42, p<0.001). Differences were observed across provinces with the largest negative correlations observed in Alberta (rs = -0.55, p=0.02) and Manitoba (rs = -0.61, p=0.01) while significant positive correlations were observed in Nova Scotia and PEI. Within Alberta, the negative correlation was particularly large for back claims (rs = -0.80, p<0.001).

Conclusions Bettermacroeconomic performance (ie. GDP) appears associated with shorter disability duration within some Canadian workers’ compensation contexts. This may be due to increased job availability in better economies, but further research is needed using other economic indicators and across regions.

The Construct Validity of Short-Form Functional Capacity Evaluation in Workers' Compensation Claimants

Tamseela Chughtai1, Patricia Manns2, Iain Muir2, Douglas Paul Gross2

1CBI Health Centre, Fort McMurray, Canada; 2University of Alberta, Edmonton, Canada

Purpose: Functional Capacity Evaluations (FCE) are performance-based assessments used to make recommendations for participation in work and other activities of daily living. Short-form FCE decreases burden of testing but validity is uncertain. We examined factors associated with performance during short-form FCE in injured workers with musculoskeletal conditions.

Methods A cross-sectional study design was used. A secondary analysis was conducted on data previously collected for examining effectiveness of short-form-FCE. Participants were workers’ compensation claimants assessed between October 18, 2004 through May 6, 2005, at a workers’ compensation rehabilitation facility in Edmonton, Canada. Measures included demographic variables (i.e. age, sex), patient reported outcomes (i.e. pain intensity, self-reported disability, recovery expectations), and measures of FCE performance (number of ‘failed’ items and floor-to-waist lift performance). Analysis included univariate correlation coefficients and multivariable linear regression.

Results The dataset included 450 workers’ compensation claimants with a variety of musculoskeletal disorders. The majority of claimants were employed (74%) and male (70%). Self-reported disability, age, and sex were independently associated with floor-to-waist lift performance, with self-reported disability having the largest standardized beta coefficient (-0.55). Self-reported disability, expectations of recovery, and duration of FCE (one or two sessions) had significant, independent influences on the number of failed FCE items, and again self-reported disability had the highest standardized beta coefficient (-0.34).

Conclusions Better performance on short-form FCE was consistently and moderately associated with lower self-reported disability. Results support the construct validity of this short-form FCE protocol. Further research is needed to evaluate the validity of short-form FCE in other contexts.

Occupational Physicians’ Perspectives On Supporting Workers With A Chronic Disease In Strengthening Self-control: A Needs Assessment

Astrid Bosma, Cécile Boot, Frederieke Schaafsma, Han Anema

Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam, The Netherlands.

Objective: Self-control by workers with a chronic disease can prevent work related problems and facilitate sustainable work participation. Occupational physicians could play a key role in supporting these workers in exerting self-control. It is important to understand occupational physicians’ perspectives on this preventive task and possible ways of providing support. The aim of this needs assessment is to explore barriers and facilitators for supporting workers with a chronic disease in exerting self-control according to the perspectives of occupational physicians.

Methods: Two focus groups were held in February and June 2018 with 17 occupational physicians. The occupational physicians were self-employed or employed within the occupational health services department of a large company. Data were analysed using thematic content analysis.

Results: The preliminary results show that occupational physicians mainly focus on reducing absenteeism. An occupational physician can carry out preventive tasks as long as workers with a chronic disease, that do not take sick leave, take the initiative to visit the occupational physician. However, these workers, who are still at work, rarely consult an occupational physician. Fitting the job to the capacities of the worker and discussing future disease-related scenarios are mentioned as ways of providing support.

Discussion: According to occupational physicians’ perspectives, the work environment and health care system play a facilitating role in supporting workers with a chronic disease in exerting self-control. These insights are helpful in developing an intervention for occupational physicians that enables them to support workers with a chronic disease in exerting self-control.

Work Disability In Australia: A Mixed Methods Study Of Prevalence, Expenditure, Support Systems and Services

Alex Collie, Ross Iles, Michael Di Donato

Monash University, Australia


This study sought to describe Australian systems of income support for people with work disability. Specific aims were to summarise and compare the features of income support systems, including the healthcare and employment services, and to estimate the prevalence of work disability and the national expenditure on income support.


Mixed methods involving collation and analysis of existing publicly available documentation, and interviews with twenty-five experts across ten major systems of income support. The prevalence of work disability and expenditure was estimated using publicly accessible data sources. System features and service models were summarized, tabulated and compared qualitatively.


In Australia during the 2015/16 financial year an estimated 786,000 people with work disability received income support from a national, state or private source. An additional 6.5 million people accessed employer provided leave entitlements for short periods of work incapacity. A total of $37.2 billion Australian dollars was spent on income support for these people during the year. This support was provided through a complex array of government authorities, private insurers and employers. Case management was the only service provided across all systems. Healthcare and return to work services were provided in some systems, although models differed markedly. Income support ranged from 19% to 100% of earnings for a person earning the average weekly wage pre-disability. There is limited data or publicly available information regarding movement of people with long periods of work disability between systems of support.


This study demonstrates the substantial financial and human impact of work disability on Australian society. Findings indicate multiple opportunities for reducing the burden of work disability, including aligning case management and healthcare service models, and engaging employers in prevention and rehabilitation. The findings suggest a need for greater interrogation and evaluation of Australian work disability support systems.

Determining the Reliability and Convergent Validity of a Return-to-Work Status Questionnaire

Eleanor Boyle1, J David Cassidy2, Pierre Côté2,3,4

1University of Southern Denmark, Denmark; 2Dalla Lana School of Public Health, University of Toronto; 3Faculty of Health Sciences, University of Ontario Institute of Technology; 4UOIT-CMCC Centre for Disability Prevention and Rehabilitation

Background: In occupational rehabilitation programs, return-to-work is a key outcome measure; however, the studies either used different definitions for return-to-work or do not provide their definition. In order to provide a solution to this issue, we developed a self-report return-to-work measure.

Objective: We investigated the reliability and validity of a self-report return-to-work questionnaire in a cohort of workers with a work-related injury.

Methods: Two research assistants independently administered the baseline questionnaires and a follow-up questionnaire. The questionnaires contained work-related questions (e.g., currently working, if duties changed) that were used to create a four-category work status measure. Pain-related and a recovery questions were also asked. We obtained loss of earnings data from the compensation board. The short-term reliability and convergent validity were assessed.

Results: We recruited 75 workers, and 57 completed the test-re-test baseline questionnaire, and 51 completed the follow-up. The mean age was 45.4 years and 57% were female. The participants had a mixture of musculoskeletal injuries. Most were in the acute stage, but 17% of the participants were injured for more than a year. The short-term reliability of current working status had a kappa value of 0.90. Participants who were not working had higher levels of pain-related disability than those who were working. The kappa value for the agreement between self-reported working status and administrative data on receiving any loss of earnings payment was around 0.65.

Conclusions: Our study provides evidence of reliability and validity for a new return-to-work measure.

An International Online Work Disability Policy Course: How A University Partnership Became A Facilitator.

Åsa Tjulin1, Ellen MacEachen2, Robert Larsson3, Philip Bigelow2, Stig Vinberg1, John Selander1, Darcy White2

1Mittuniversitetet/Mid Sweden University, Sweden; 2University of Waterloo, Canada; 3Mälardalen University, Sweden

So what?

Our Masters and PhD students within the field of work disability prevention are part of a global economy where challenges and commonalities between nations need to be addressed. International learning collaborations can facilitate student movement from theory (e.g. about different social security systems) to praxis, through interactive knowledge exchange amongst peers (Loisel et al, 2009).

An international on-line course can facilitate participation without the need for travel and additional related expenses is a way to foster student equity in higher education.

What is the innovation?

Our annual 10-week course, “What is fair? International perspectives on equity on work and health”, was first implemented in January 2019.

The course, based on cooperation between Mid-Sweden University, University of Waterloo and Mälardalen University in Sweden and Canada, provides the students with unique learning opportunities to work with international peers on course work and group activities while learning about international systems and policy in relation to health, work and equity.

Our partnership (with aims to expand) goes beyond the intention to provide an international learning environment; it also includes knowledge exchange between the universities. That is, the partnership includes co-operative development not only between faculty members, but also among pedagogical developers, international relations office administrators and librarians.

The outcome?

When we meet at the conference, we will have more to tell you about the specific course and experiences gained from faculty members, administrative members but foremost students who have undertaken the course.


Loisel, P., Hong, Q.N., Imbeau, D., Lipel K., Guzman, J., MacEachen, E Corbière, M., Santos, R.B., Anema, R.A. (2009) The Work Disability Prevention CIHR Strategic Training Program: Program Performance After 5 Years of Implementation. Occupational Rehabilitation 19:1 p. 1-7.

Interpersonal Skills of Psychologists in Counseling Employees with Psychological Complaints; Psychometric Quality of the Facilitative Interpersonal Skills (FIS) Instrument.

Sabine J. van Thiel1, Arno van Dam1, Evelien P.M. Brouwers1, Kim de Jong2, Jac J.L. van der Klink1, Margot C.W. Joosen1

1Tranzo Tilburg University, Netherlands, The; 2Universiteit Leiden, Netherlands, The


Although there are indications that relationship building plays a role in successfully counseling an employee in return to work [1], there is little or no research that has focuses on the effect of the practitioner itself and their skills on the recovery of psychological complaints and the process of returning to work. The aim of this research is to investigate the psychometric quality of the FIS instrument to measure interpersonal skills of practitioners in counseling employees with psychological complaints.


To measure interpersonal skills, the Facilitative Interpersonal Skills (FIS) instrument was used in which psychologists’ responses to a video simulation of a client counseling situation are assessed. The FIS measure has been shown to be highly predictive of client treatment outcomes such as symptom reduction, social role and interpersonal functioning [2,3]. To apply this instrument in an occupational health setting it was translated into Dutch and content validity and reliability were measured. Adequate content validity of the Dutch FIS clips was met when clients in the stimulus clips represent a variety of interpersonal stances [4]. Using the IMI-C [5,6] and the PANAS [7] the authors determine the diversity of the interpersonal affect between the clients and whether there is diversity to the extent of challenge in the client situations. To ensure reliability, the degree of consistency between assessors on the IMI-C and the PANAS of the simulated client in clips will be determined.

Results and implications.

The FIS clips transcripts were translated into Dutch including forward translation, synthesis, back translation and an expert committee meeting. The presented study is currently running. Results will be available end of 2018.

Conducting this study the authors envisage that the FIS will facilitate research purposes on practitioner’s effects in counseling employees with psychological complaints. The FIS will also be interesting for training purposes.

EHealth Interventions in workplaces Or Health Care Settings And Work-related Outcomes: A Scoping Review

Irene Øyeflaten1,2, Thomas Johansen1, Claus Vinther Nielsen3,4, Tone Langjordet Johnsen2,5, Torill Helene Tveito2,6, Anne-Mette Hedeager Momsen4

1National Centre for Occupational Rehabilitation, Rauland, Norway; 2Uni Research Health, Bergen, Norway; 3Department of Public Health, Section of Clinical Social Medicine and Rehabilitation, Aarhus University, Denmark; 4DEFACTUM - Social & Health Services and Labour Market, Central Denmark Region, Denmark; 5Division of Physical Medicine and Rehabilitation, Vestfold Hospital Trust, Tønsberg, Norway; 6Department of Health, Social and Welfare Studies, University South-Eastern Norway, Horten, Norway


eHealth technologies have been proposed as a promising solution to better manage the process of returning to work (RTW) among sick-listed employees. The aims are to map the existing literature of different types of eHealth technologies, tools and approaches used in workplaces and health care settings among sick-listed employees aiming at RTW, and for randomized controlled trials (RCTs) to report the effectiveness.

Research questions:

For which patient groups are eHealth interventions, supporting the RTW process, developed?

In which settings and by which stakeholders are work-related eHealth interventions offered?

Which types and modes of eHealth technologies and tools are used to facilitate the RTW-process?

Are choice of eHealth technology theory-driven or based on empirical evidence?

For RCTs what is the effectivenss?


To guide the review process, the Joanna Briggs Institute (JBI) approach will be employed using the framework by Arksey and O`Malley, enhanced to eight stages, and recommended in the JBI reviewers` manual.

The databases searched will be PubMed, Scopus, Embase, the WHO clinical registry and the The search will be limited to studies published in the last 10 years. The JBI three-phase search process will be utilized.

The review will include primary research studies with both qualitative and quantitative data published in English, Norwegian, Swedish, and Danish.

Studies that include employees/patients in working age (18-65 years) receiving sickness benefits (full or graded) due to any type of diagnoses/disabilities will be considered for inclusion.


Results will be presented at the conference

Detailed key information on: authors, year of publication, country, aims, methods, study population/sample size, setting (e.g. primary health care, occupational health service, workplace), stakeholders, eHealth intervention type (eventual comparator intervention), duration, eventual theory or evidence, and outcomes and results in details will be drafted. A narrative summary will accompany the charted results.


Will be presented.

Development of an Employer Support for Preventing Sickness Absence

Isa Moldvik, Christian Ståhl

Linköping University, Sweden

Introduction: Sickness absence can lead to negative consequences, not only for the individual but also for the workplace. The workplace has a central part in preventing sickness absence by focusing on good working conditions and systematic work environment management. The connection between the workplace and health outcome is strong, both in terms of rehabilitation and prevention. Despite that, these are usually separate processes within the organization, which also falls under different areas of responsibility.

Aim: The aim of the study is to develop an employer support for prevention of sickness absence and to integrate the rehabilitating and preventative actions. The goal is to help create sustainable workplaces and minimize production losses by supporting employers to implement best practice and knowledge into the management system. This is an ongoing project and the purpose of presenting it during the conference is to get valuable inputs regarding our approach.

Method: The study has an interactive approach and consists of multiple case-studies. The purpose of the study and questions of interest was developed in close collaboration with representatives from municipalities, health care representatives, the Swedish Social Insurance Agency and private companies. The first phase is conducted in three municipalities and consist of interviews with relevant stakeholders such as unit managers, HR-departments, union- and health and safety representatives. The main focus during the interviews is organizational factors and processes for preventing sickness absence. The analyses will investigate local praxis in relation to previous research.

Results: Preliminary results will be available at the time of the conference.

Pregnancy And Work-related Risk Factors For Sick Leave - A Danish Cohort Study

Pernille Pedersen1, Anne-Mette Hedeager Momsen1, Merete Labriola1,2, Claus Vinther Nielsen1,2, Dorte Raaby Andersen3, Ellen Aagaard Nøhr4, Rikke Damkjær Maimburg5

1DEFACTUM, Central Denmark Region, Denmark; 2Department of Public Health, Section of Clinical Social Medicine and Rehabilitation, Aarhus University, Denmark; 3Department of Occupational Medicine – University Research Clinic, Regional Hospital West Jutland, Denmark; 4Research Unit for Gynaecology and Obstetrics, Institute of Clinical Research, University of Southern Denmark; 5Department of Clinical Medicine, Aarhus University and Department of Gynaecology Obstetrics, Aarhus University Hospital, Denmark


The prevalence of sickness absence among pregnant employees is increasingly high in Nordic countries and has increased during the last decades.

Industry-specific work conditions have a large impact on the degree of sickness absence. The number of sickness absence days is highest among women working in retail, hotels, health care and as a cleaner or pedagogue, while it is lowest among women in public administration. The reason for the higher number of sickness absence days in some industries may be due to demanding work conditions and lack of job adjustments, however, little is known in this field.

The aim of this study was to identify work related reasons for sickness absence among pregnant women in different industries, and to identify work environmental risk factors.


The cohort study was based on a longitudinal survey involving pregnant employees. Participants were recruited at six maternal care clinics in the Central Denmark Region. During March-May 2018 all pregnant women, who were invited to a regular scanning in 12th gestational week received information about the study and a link to a questionnaire. A link to a follow-up questionnaire was sent by mail to the participants in 27th-29th gestational week.


Results will be presented at the conference.


Results from this study will be used to design and implement an intervention study aiming to reduce sickness absence among pregnant women.

A Framework For Comprehensive Risk Analysis Approaches, Interpretation, And Use In Occupational Safety And Health

Paul A. Schulte1, Thomas J. Lentz2, Sudha P. Pandalai3, John E. Snawder4

1CDC, United States of America; 2CDC, United States of America; 3CDC, United States of America; 4CDC, United States of America

Increasingly there is a realization that workers are exposed to multiple hazards at work and broader consideration of risks is warranted. Comprehensive risk analyses approaches that could affect workers include exposomic analysis and cumulative risk assessment (CRA). Aggregate, lifetime, and mixtures risk assessment methodologies, and total work health principles are also important for comprehensive evaluation of occupational risks. However, there is no systematic way described to consider comprehensive risk analysis so this paper provides an initial framework. This framework is a 4 x 4 matrix. One axis includes contemporary risk assessment steps of hazard identification, exposure assessment, exposure-response analysis, and risk characterization. The other axis includes different functional attributes or aspects of comprehensive risk assessment: exposomic analysis, CRA, output interpretation and communication, and preventive and control intervention. Issues arising in individual cells at the intersection of each axis, and needed actions to address them, are discussed.

Exposomic analysis involves assessing all hazards workers are exposed to throughout their lives, can measured both externally and internally, and can include environmental and occupational chemical, physical, biological factors, as well as psychosocial-cultural, economic and political determinants. Exposomic analysis can have hazard identification and risk determination objectives. CRA may be broader because it includes both non-genetic, genetic and epigenetic determinants; it involves efforts to identify and quantify the nature and extent of risk. In both exposomic analysis and CRA, temporal considerations are implicit and life span risk assessment, with aggregate, lifetime, and mixtures risk assessment and total worker health principles playing significant roles, is the ideal. A framework for comprehensive risk analysis is a step toward greater focus on the working-life continuum and hazards implicit in each job a person has, the time between jobs, and the psychosocial hazards attendant to them, all issues central to occupational safety and health.

Preventive Initiatives Among Violinists to Change Their Workload Demands: A Phd Protocol

Stephanie Mann1, Helene Martina Paarup2, Lotte Nygaard Andersen1, Lars Brandt3, Karen Søgaard1

1Dept. of Sports Science and Clinical Biomechanics, University of Southern Denmark; 2Dept. of Clinical Immunology, Odense University Hospital, Denmark.; 3Dept. of Occupational and Environmental Medicine


Classical musicians are a profession well-known for its frequent musculoskeletal complaints compared to the general Danish workforce.

Violinists are the biggest group among classical musicians and have the highest prevalence of musculoskeletal complaints. Still, no biomechanical studies have described the workload of violinists nor tested preventive initiatives such as tailored training and ergonomic adjustments.

The aim of this PhD project is to develop a training programme combined with relevant ergonomic improvements performed as a feasibility study amongst violinists.

Methods and results

The exposure study will map the biomechanical muscular working conditions based on surface electromyography during standardized violin playing with different aggravating factors such as specific techniques.

Preliminary results show high static activity levels in shoulder and neck muscles caused by the awkward working posture with the instrument clenched between left chin and shoulder.

To reduce the load on these muscles we will evaluate ergonomic chinrests that claim to reduce and change violinists’s workload demands and kinematics without interfering with their performances.

The aggravating factors affected mainly the forearm muscles and will therefore be specifically targeted in the suggested training programme.

The main part of the PhD project will be conducting of a prospective 12weeks cohort study to indicate the feasibility of the tailored training programme combined with the most appropriate ergonomic chinrest. The chinrest will be chosen based on the capability to lower the muscular workload in the upper body. This study will use a mixed-methods approach using both qualitative interviews combined with feasibility outcomes.


This PhD project will contribute with new knowledge about violinists’s workload demands. This may be crucial for understanding their work-related disorders and to recommend any exercise or ergonomic advises.

The intent is to reduce pain and improve performance among violinists and thereby improve professional musicians work and life.

Inclusive Working Life in Norway, a Qualitative Study of Employers’ Experiences with Employing People with Diverse Background.

Irene Øyeflaten1,2, Tonje Fyhn2, Torill Helene Tveito2,3

1Norwegian National Advisory Unit on Occupational Rehabilitation, Norway; 2Uni Research Health, Uni Research, Bergen, Norway; 3University of South-Eastern Norway


Successful work rehabilitation may depend on workplaces’ willingness to include workers with disabilities. In Norway, a more inclusive working life has long been on the political agenda. Despite this priority, the level of long-term sickness absence and disability pension is undesirably high, and there are justifiable concerns about the school-to-work transition process among young people. The aim of the current study was to assess employers’ experiences and risk assessments with employing and retaining young people and people with disabilities or culturally diverse background.

Material and methods

Individual semi-structured interviews with six employers were conducted, three HMS-leaders, two managers and one CRS leader, three women and men. We used systematic text condensation for the analysis.


The employers had broad experiences hiring young job seekers with various types of disabilities as well as people with culturally diverse background. They experienced that workplace diversity often lead to a better working environment and positive colleague involvement. Communication difficulties and cultural differences could however be challenging. Preliminary results indicate that successful inclusion depend on both the employer and the employees efforts. Trust and openness between the parties facilitate dialogue and a good climate for solutions. The employers motivation for employing people with diverse background were based on a moral obligation, social involvement, trust in peoples willingness to participate, and in a belief that workplace inclusion is profitable for the company, in the long run. They did however ask for solutions and support schemes that are more flexible, from The Norwegian Labour and Welfare Administration.


The employers felt a moral obligation to engage, and had mainly positive experiences with employing young people and people with disabilities or culturally diverse background. Still they often felt alone and wanted more flexible solutions and long lasting support schemes from the government.

Factors Related To Stay At Work Among Employees with Common Mental Health Problems: A Systematic Review

Suzanne van Hees1, Bouwine Carlier1, Shirley Oomens1, Roland Blonk2

1HAN University of Applied Sciences, Netherlands, The; 2Tilburg University: School of Social and Behavioral Sciences, Netherlands, The

Purpose: Common mental health problems (CMHP) in the workplace and their effect on long term disability, absenteeism and productivity loss are a growing concern among organizations and policymakers. CMHP are the leading cause of sickness absence in the western world with one-sixth of the working age population that suffers at any one time from CMHP and a lifetime risk of at least two in five. Therefore, there is a strong argument for more research emphasis on addressing CMHP in preventative strategies to stay at work rather than just reactive strategies. There is remarkably limited evidence about the concept ‘Stay at work’ among employees with CMHP and the role of the employer. Insight in enabling and impeding factors is needed to provide useful advice towards employers being responsible for interventions on workplace health and (inter)national policies. The aim of this literature review is to create a robust overview of current knowledge regarding factors that enable employees with common mental disorders to stay at work.

Methods: a systematic literature search in seven electronic databases (Pubmed, Medline, PsycInfo, Embase, Cochrane, Cinahl, Web of Science) is conducted in august 2018.

Results: 1855 titles are screened independently by two researchers on title, abstract and full text. The reviewers used an independent narrative synthesis to understand factors with regard to the individual, job design, team, employer and society. Preliminary results are expected by the end of 2018.

Tailoring The Participatory Approach To The Needs, Wishes And Abilities Of Workers With A Low Socioeconomic Position

Rosanne Schaap, Frederieke Schaafsma, Maaike Huijsmans, Cécile Boot, Han Anema

Amsterdam UMC, location VUmc, Amsterdam, The Netherlands


Workers with a low socioeconomic position (SEP) have a larger risk for health deterioration, and therefore they are at risk for premature dropout from the labor market. The Participatory Approach (PA) has the potential to prevent work disability among low SEP workers, as it aims to improve functioning at work. The PA encompasses the identification of problems in work functioning and the possible solution for these problems, guided by an occupational health professional. The PA currently focuses only on solving problems at the workplace. However, especially among low SEP workers, problems outside the workplace may also play a role in work functioning. Moreover, the current way of applying the PA might be too complex for low SEP workers and their supervisors. Therefore, this study aims to examine how the PA can be tailored to the needs, wishes and abilities of low SEP workers.


A needs assessment will be conducted in which evidence from literature will be combined with data collected from focus groups with low SEP workers, occupational health professionals and employers. Literature will be used to examine how the PA can enable workers to solve problems both in- and outside the workplace. The material of the PA will optimized and tested in two focus groups with 8-12 participants.


The PA will be extended towards a broader perspective on health making use of the Self-determination theory (SDT) as a theoretical framework for determinants of behaviour. This study is now being executed, and the results of the focus groups are expected by the end of 2018.


The needs assessment will provide valuable information on how to integrate a broader perspective on health, optimize the materials of the PA to this target group and to offer suggestions for optimal implementation of the PA in practice.

Experiences With Individual Placement And Support And Employment – A Qualitative Study Among Participants And Employment Specialists

Miljana Vukadin1, Frederieke G. Schaafsma1, Harry W.C. Michon2, Johannes R. Anema1

1Amsterdam UMC, Vrije Universiteit Amsterdam, Netherlands, The; 2Trimbos Institute, The Netherlands Institute of Mental Health and Addiction


Individual Placement and Support (IPS) is an evidence-based, effective approach to help people with severe mental illness achieve competitive employment. Although the effectiveness of IPS has been well established, little is known about the experiences of participants and employment specialists with IPS and employment. Moreover, no research has been conducted on participants’ and employment specialists’ experiences with IPS, offered with a multifaceted strategy. The goal of this strategy was to improve IPS implementation by improving collaboration between mental health care and vocational rehabilitation stakeholders, and realizing a secured IPS funding with a ‘pay for performance’ element. The aim of the present study is to explore experiences with IPS, offered with a multifaceted strategy, and to identify facilitators and barriers with regard to successfully finding and maintaining competitive employment.


A qualitative, explorative study among IPS participants (n=15) and their employment specialists (n=5) will be performed using semi-structured interviews to collect rich information about their experiences with IPS, offered with the multifaceted strategy, and to explore possible facilitators and barriers with regard to finding and maintaining competitive employment. A stratified purposeful sampling technique will be used to increase heterogeneity among participants. The stratification concerns including participants who either had been working successfully (> 12 hours per week for one month or longer) or had not been working successfully during IPS. The interviews will be recorded and transcribed verbatim. Thematic content approach will be used for data analysis.


The results are expected begin 2019.


We expect that the results of this qualitative study will provide in depth insight about the experiences of IPS participants and employment specialists with IPS, offered with a multifaceted strategy, and facilitators and barriers with regard to competitive employment. This will help to improve the IPS model and the outcomes of IPS.

Cost-Effectiveness of a Decision Aid about Disclosure of Mental Health Problems for Job Seekers.

Kim Janssens1, Jaap van Weeghel1,2, Claire Henderson3, Margot Joosen1, Evelien Brouwers1

1Tranzo, Scientific Center for Care and Welfare, Tilburg School of Social and Behavioral Sciences, Tilburg University, Tilburg, the Netherlands; 2Kenniscentrum Phrenos, the Netherlands; 3King’s College London Institute of Psychiatry, Psychology and Neuroscience, UK

Background: Finding and keeping paid employment is more difficult for people with mental health problems compared to those without mental health problems. One barrier to paid employment is the stigma attached to mental health problems. This study focuses on the health, well-being and job seeking activities of unemployed people with mental health problems who receive social benefits from Dutch municipalities. This clustered RCT evaluates whether use of the Dutch version of the decision aid ‘Conceal or Reveal’ (CORAL), developed originally in the UK, about disclosure of mental health problems is more cost-effective in finding and keeping paid employment compared to a control group.

Methods: Subjects are recruited by 72 job coaches working at Dutch municipalities, of which 35 job coaches receive training in using the decision aid. Inclusion criteria for subjects are (1) suffering from mental health problems and (2) searching for paid employment. Subjects fill out a questionnaire about health, well-being, job seeking activities and disclosure of mental health problems at baseline and 3, 6 and 12 months. In addition, these results are combined with personal income data from the registration administration of Dutch municipalities and Statistics Netherlands.

Results and conclusion: Data collection started in March 2018 and the first results of T0 are expected in March 2019. At the conference, we will present preliminary results of T0. With descriptive statistics we will present subjects’ (self-)stigma, attitudes towards disclosure of mental health problems and (experienced and expected) consequences of disclosure in the work environment.

Prevalence Of Interfering Musculoskeletal Complaints In Sonographers And Association With Personal, Work-related And Psychosocial Factors

Yanfei Xie1, Brooke Coombes2, Lucy Thomas1, Christopher Edwards3, Venerina Johnston1

1The University of Queensland, Australia; 2Griffith University, Australia; 3Queensland University of Technology, Australia


In many industries and professions, including sonography, musculoskeletal complaints are a ubiquitous and universal problem. High burdens are placed on the individual and industry when musculoskeletal complaints interfere with home or work activities. This study aimed to investigate 1) the 1-year prevalence of musculoskeletal ache, discomfort or pain limiting sonographers from doing home or work activities (interfering complaints); and 2) risk factors associated with interfering neck-shoulder complaints and neck disability.


A cross-sectional online survey was conducted among 175 sonographers (age: 22-65 years, females: 142, males: 33) working within Australia and New Zealand. Presence of musculoskeletal complaints was recorded using the Standardized Nordic questionnaire. Neck disability was measured using the Neck Disability Index (NDI). Related risk factors were measured using standardized questionnaires, including personal, work-related and psychosocial factors. Elastic Net was used to select important independent variables to develop the final multiple linear regression model for NDI and logistic regression for the presence of interfering neck-shoulder complaints.


Sixty percent of sonographers reported complaints in at least one body region. Of all the body regions surveyed, neck and shoulder regions were the most commonly reported which were 33.1% and 37.7%, respectively. Depression (adjusted OR=1.15) and sustained neck twisted posture ˃2 hours/day (OR=3.81) were significantly associated with interfering neck-shoulder complaints. Forty-six percent (adjusted R-squared) of the variance in the NDI was explained by age (β=0.07, p=0.013), sustained arm forward reach posture for 4-8 hours/day (β= 3.88, p=0.036) and sustained neck forward posture ˃2 hours/day (β=3.50, p<0.001), anxiety (β=0.44, p<0.001), helplessness (subscale of pain catastrophizing) (β=0.40, p<0.001), and fear avoidance belief (β=0.37, p=0.001).


A substantial proportion of sonographers reported interfering complaints, particularly in the neck and shoulder. Interfering neck-shoulder complaints and disability are associated with awkward postures and psychological distress which could be important elements in developing preventive strategies in sonographers.

Attitudes to Including Employees with Minority Background, Mental Illness or Physical Disabilities

Tonje Fyhn

Norce Research, Norway

Background: An increasing amount of young people in Norway have trouble entering the workforce due to health-related or social issues. This is reflected in unemployment statistics and increased welfare imbursements to this group. The current study aims at gaining more insight into the employer perspective on including employees in their workplace that have a mental disorder, a physical disability or of a cultural minority.

Method: A survey was distributed to leaders and employees at workplaces all over Norway. 875 employees and 280 leaders responded to the survey. The survey presented cases of potential employees without stating a diagnosis. Respondents were asked to rate how well the person would fit in their work group, and asked for main barriers for employment. Respondents were also asked about benefits and threats of diversity at the workplace.
Results: Among both employees and leaders, visual impairment, psychological disorders and using a wheelchair received lowest ratings, while minorities received highest ratings. However, when respondents were broken down into industries, the ratings of the cases varied widely. Employees rated both benefits and threats of diversity higher than the leaders. These diversity perspectives showed weak but significant correlations with the cases of minorities, mental disorders and the single mother.

The Effectiveness of Workplace Health Promotion Interventions to Prevent Chronic Diseases – a Systematic Meta-review

Sandra H van Oostrom1, Karin I Proper1, Jaana Lindström2

1National Institute for Public Health and the Environment, Netherlands, The; 2National Institute for Health and Welfare, Helsinki, Finland


Considering the aging working population, prevention of chronic diseases is essential. The workplace offers an appropriate setting for this. As part of the Joint Action CHRODIS PLUS project, the aim of this study was to systematically review the available literature on workplace health promotion interventions to prevent chronic diseases.


A systematic meta-review was performed. A search to reviews from 2009 onwards was performed in multiple electronic databases. Inclusion criteria were (1) a review on the effectiveness of worksite health promotion interventions and (2) outcomes had to involve one of the following chronic diseases: diabetes type 2, cardiovascular diseases, lung diseases, musculoskeletal disorders, depression, or identified risk factors for chronic conditions (such as elevated blood lipids or cholesterol). Selection was done by two reviewers independently from each other. The AMSTAR checklist was used to assess the methodological quality of the reviews.


Of the 374 reviews identified, 23 were finally included in this meta-review, of which 9 were of high quality. Three high quality and 11 low quality reviews summarized the effect of workplace health promotion programs on weight-related outcomes, indicating some evidence for positive, though small effects on weight-related outcomes. Five low quality reviews showed mixed findings for the effect of workplace health promotion interventions on other metabolic risk factors. Two high quality reviews showed a small but positive effect of workplace psychological interventions on mental health. Four high quality reviews on musculoskeletal disorders were consistent in that they all concluded limited to moderate evidence for a positive effect of the workplace interventions under review, some stronger evidence was reported for resistance exercise training.


There seems to be moderate evidence for small but favorable effects of interventions at the workplace on weight-related outcomes, mental health and musculoskeletal disorders.