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How to predict workers' risk of chronic disability
Will an employee suffer from long-term disability after a back injury? The answer depends on many factors, according to a recent study.1
Researchers interviewed 1,885 workers who submitted a worker's compensation claim for lost work time due to a back injury about three weeks after the injury occurred. They identified these risk factors for long-term disability:
severity of the injury, especially workers with pain spreading down into the leg;
workers who rated their initial disability higher;
those who had pain at more sites;
those who had previous injuries resulting in more than one month off work; and
workers who rated their jobs as "very hectic."
Screen workers for these risk factors to help determine who to target for special attention to prevent disability, recommends lead author Judith A. Turner, PhD, a professor of psychiatry and behavioral sciences, and of rehabilitation medicine, at the University of Washington in Seattle.
To reduce the risk of long-term disability, Turner recommends:
offering job accommodations, such as light duty and reduced hours, to enable injured workers to return to work as soon as possible;
offering graded exercise programs to help injured employees return to normal activities;
gradually and systematically increasing activity levels of injured employees.
Turner says she was surprised that patients whose first health care visit for the injury was to a chiropractor were less likely to be disabled one year later, even after controlling for other baseline characteristics associated with outcomes. "Patients who see chiropractors for back pain differ in important ways from patients who see medical physicians. It is possible that workers who saw chiropractors differed in important ways that were not measured in this study," says Turner. "However, it is also possible that chiropractic care was more effective in improving pain and disability and/or promoting return to work."
1. Turner JA, Franklin G, Fulton-Kehoe D, et al. Early predictors of chronic work disability: A prospective, population-based study of workers with back injuries. Spine 2008; 33:2,809-2,818.
For more information on identifying workers at risk for chronic disability, contact:
Judith Turner, PhD, Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle. Phone: (206) 543-3997. Fax: (206) 685-1139. E-mail: email@example.com.