Organizational characteristics as predictors of work disability: a prospective study among sick employees of for-profit and not-for-profit organizations

Pilot implementation of MiLES: a web-based intervention targeted at managers with the aim of enhancing the successful return to work of employees with cancer

BACKGROUND

MiLES is a web-based intervention targeted at managers with the aim of enhancing the successful return to work (RTW) of employees with cancer. The purpose of this study was to identify barriers to and facilitators of implementing MiLES in organizations, from a manager's perspective.

MATERIAL AND METHODS

MiLES was implemented as a pilot in four organizations for six weeks. Sixteen managers were included, of which fourteen were interviewed regarding their perceived barriers to and facilitators of implementation of MiLES in their organization. Interviews were recorded, transcribed verbatim and analyzed with content analysis.

RESULTS

The managers experienced barriers to and facilitators of implementation related to: (1) implementation responsibilities, (2) the intervention's content, and (3) organizational characteristics. Regarding implementation responsibilities, management board approval and an organizational infrastructure with distinct described implementation responsibilities were perceived as facilitators. Regarding the intervention's content, its accessibility, user-friendliness and completeness were perceived as facilitators. If the content did not meet the manager's specific needs, this was perceived as a barrier. Regarding organizational characteristics, several intangible (e.g., added value of MiLES within different organizations) and tangible (e.g., integration into absenteeism registration) organizational characteristics were perceived as facilitators. The absence of a quiet place to use MiLES was perceived as barrier.

CONCLUSION

Implementation of MiLES in organizations may benefit from an infrastructure within the organization that defines responsibilities regarding intervention delivery to managers of employees with cancer. Such an infrastructure should be aligned to existing organizational structures. As per interviewed managers, MiLES has added value in diverse organizations.

The Role of the Employer in Supporting Work Participation of Workers with Disabilities: A Systematic Literature Review Using an Interdisciplinary Approach

Purpose There is growing awareness that the employer plays an important role in preventing early labor market exit of workers with poor health. This systematic review aims to explore the employer characteristics associated with work participation of workers with disabilities. An interdisciplinary approach was used to capture relevant characteristics at all organizational levels. Methods To identify relevant longitudinal observational studies, a systematic literature search was conducted in PubMed, Web of Science, PsycINFO and EconLit. Three key concepts were central to the search: (a) employer characteristics, (b) work participation, including continued employment, return to work and long-term work disability, and (c) chronic diseases. Results The search strategy resulted in 4456 articles. In total 50 articles met the inclusion criteria. We found 14 determinants clustered in four domains: work accommodations, social support, organizational culture and company characteristics. On supervisor level, strong evidence was found for an association between work accommodations and continued employment and return to work. Moderate evidence was found for an association between social support and return to work. On higher organizational level, weak evidence was found for an association between organizational culture and return to work. Inconsistent evidence was found for an association between company characteristics and the three work outcomes. Conclusions Our review indicates the importance of different employer efforts for work participation of workers with disabilities. Workplace programs aimed at facilitating work accommodations and supervisor support can contribute to the prevention of early labor market exit of workers with poor health. Further research is needed on the influence of organizational culture and company characteristics on work participation.

Company-level determinants of disability retirement: a multilevel study of Finnish private sector workplaces

BACKGROUND

We examined whether the risk for disability retirement varies between companies over and above the individual-level characteristics of their employees and which company-level characteristics are associated with the risk for any, full or partial disability retirement.

METHODS

A 30% random sample of Finnish private sector companies with at least 10 employees was used (5567 companies and 301 313 employees). The risk for disability retirement over 6 years was analyzed using multilevel logistic regression. Company size and industry, as well as gender, age, education and social class measured both at the individual- and the company-level were used as explanatory variables.

RESULTS

3.8% of the variance in the risk for disability retirement was attributed to the company level after controlling for individual-level characteristics of the employees. Company-level variance was much larger in partial (11.7%) than in full (4.2%) disability retirement. After controlling for all individual- and company-level characteristics, those working in health and social work activities had increased risk for both full and partial disability retirement. The risk for full disability retirement increased by decreasing educational level of the company. The risk for partial disability retirement increased by increasing company size and was elevated in companies with the highest proportion of women.

CONCLUSIONS

After controlling for the individual-level characteristics, variation in the risk for disability retirement between companies was modest. The more substantial variation in partial disability pension suggests that companies have a marked role in advancing working with partial disabilities.

Workers’ experience with work-related musculoskeletal disorder and worker’s perception of organisational policies and practices

Purpose

Different organisations have developed policies and programmes to prevent workplace injuries and facilitate return to work. Few multiple workplace studies have examined workers’ perceptions of these policies and programmes. The purpose of this paper is to compare workers’ perception and experience of workplace policies and practices on injury prevention, people-oriented work culture, and return to work.

Design/methodology/approach

This study recruited 118 workers from three healthcare facilities through an online and paper survey.

Findings

Work-related musculoskeletal injury was experienced by 46 per cent of the workers, with low back injuries being most prevalent. There were significant differences in perception of policies and practices for injury prevention among occupational groups, and between workers who have had previous workplace injury experience and those without past injury.

Research limitations/implications

Selection bias is possible because of voluntary participation. A larger sample could give stronger statistical power.

Practical implications

The perception of workplace policies can vary depending on workers’ occupational and injury status. Organisational managers need to pay attention to the diversity among workers when designing and implementing injury prevention and return to work policies.

Social implications

Risks for workplace injuries are related to multiple factors, including workplace policies and practices on health and safety. Workers’ understanding and response to the policies, programmes, and practices can determine injury outcomes.

Originality/value

No previous study has reported on workers’ perceptions of workplace policies and practices for injury prevention and return in Manitoba healthcare sector.

A survey of support systems for return to work in Japanese companies: a cross-sectional study

The present study aimed to survey systems in Japanese companies for supporting workers returning to work from sickness absence due to mental illness. A questionnaire survey was mailed to 3,545 companies. Support systems for return to work, sick leave, and multiple sick-listed (MSL) workers were examined. A total of 161 companies responded to the survey (response rate: 4.5%). About 80% of the companies expressed difficulty in dealing with workers with mental health problems. About half of all companies reported having reset period and financial compensation systems, as well as gradual resumption and trial attendance systems. Most large companies tended to have reset period and trial attendance systems. No association was found between company size and MSL rates. The most frequent diagnosis among workers was depression, and the mean number of sick leave days was 275.3. Although there might have been a selection bias due to the low response rate, the results of this study are expected to be useful for companies when formulating employment systems.

Prevention and management of work disability in Asia Pacific: challenges and opportunities

INTRODUCTION

The economic growth in Asia Pacific brings with it challenges and opportunities in many areas of work and health. As economies grow and work demands increase so do accidents, injures and work disability.

METHODS

Burns, chemical exposures, and construction related injuries are often catastrophic in severity and lead to work disability, major acute medical and subsequent rehabilitation efforts. In addition to these acute injuries, musculoskeletal and chronic illnesses are also sources of work disability.

RESULTS

Industrial injuries and health problems are often explained and managed based on the classic unidimensional hazard prevention model. In contrast, work disability is a multi-factorial problem and requires more complex conceptualizations than an exposure outcome model. The economic impact of disability, limitations of the widely used impairment based disability determination method, lack of adherence to wide scale implementation of evidence based clinical approaches, the need for meaningful stakeholder involvement and the potential of a multivariable view of work disability, in all aspects of work disability prevention, management and policy are discussed in the context of Asia Pacific economic growth.

CONCLUSIONS

With ideal alignment of diverse goals and incentives along with consideration of past efforts in disability prevention and management, new models, processes and policies can be created as commerce in these countries continues to grow.

The contribution of high levels of somatic symptom severity to sickness absence duration, disability and discharge

INTRODUCTION

The primary objectives were to compare the duration of sickness absence in employees with high levels of somatic symptom severity (HLSSS) with employees with lower levels of somatic symptom severity, and to establish the long-term outcomes concerning return to work (RTW), disability and discharge. Secondary objective was to evaluate determinants of the duration of sickness absence in employees with HLSSS.

METHODS

489 sick-listed employees registered with five Occupational Health Physician (OHP) group practices were included in this study. We measured their baseline scores for somatic symptoms severity, depressive disorders, anxiety disorders, health anxiety, distress and functional impairment. The OHPs filled in a questionnaire on their diagnosis. A prospective 2-year follow-up was carried out to assess the long-term outcomes concerning sickness absence, and retrospective information was gathered with regard to sickness absence during the 12 months before the employees were sick-listed.

RESULTS

The median duration of sickness absence was 78 days longer for employees with HLSSS. They more often remained disabled and were discharged more often, especially due to problems in the relationship between the employer and the employee. HLSSS, health anxiety and older age contributed to a longer duration of sickness absence of employees.

CONCLUSION

High levels of somatic symptom severity are a determinant of prolonged sickness absence, enduring disabilities and health-related job loss. Occupational health physicians should identify employees who are at risk and adhere to guidelines for medically unexplained somatic symptoms.

The psychological consequences of occupational blood and body fluid exposure injuries

PURPOSE

This article describes the psychological impact of occupational blood and body fluid (BBF) exposure injuries and provides suggestions for improving clinical practice.

METHOD

A literature review was conducted to search for articles relating to the psychological consequences and management of these work injuries.

RESULTS

Acute psychological symptoms including posttraumatic stress, anxiety and depression are frequently experienced postexposure, which appear to be the major contributing factors of time loss from work. Furthermore, a subgroup is at risk for chronic symptoms and disability that persists beyond notification that no disease transmission occurred. Distressed workers often go unrecognised and untreated, and their assistance needs are largely unknown. Accordingly, this article draws upon the posttraumatic stress literature to offer suggestions for advancing the postexposure management of these injuries.

CONCLUSIONS

This clinical commentary underscores the serious yet understudied secondary psychological effects of occupational BBF exposure injuries. Postexposure management programmes need to place greater emphasis on psychosocial and educational initiatives to improve the identification and treatment of symptomatic workers.

Vocational rehabilitation: A multidisciplinary intervention

Vocational rehabilitation is by definition a multidisciplinary intervention in a process linked to the facilitation of return to work or to the prevention of loss of the work. Clinical staff in contact with a person who has lost his job (general practitioner, specialized physician) must promote vocational rehabilitation. Medical rehabilitation for those with disabilities, whether new or old, has to be followed without delay by vocational rehabilitation. It is even better if these two intertwined processes are overlapping. They involve many professionals including physiotherapists, occupational therapists, psychologists, vocational trainers, job counsellors, teachers, case-managers, job placement agencies. Vocational rehabilitation has a financial cost, borne by many state organizations (security, social system, social affairs) as well as by employers and private insurances, which are in case of accident, concerned by this process. However, the evidence suggests that this is recouped 2- to 10-fold as suggested by the British Society of Rehabilitation Medicine.

Regions, hospitals and health outcomes over time: A multi-level analysis of repeat prevalence among a cohort of health-care workers

BACKGROUND

The relative importance of region, workplace, and individual determinants of health burden is debated.

OBJECTIVE

To model the contribution of hospital characteristics to employee mental and musculoskeletal disorders.

METHODS

We linked employment records of nurses and support services' staff with health records, neighbourhood census, and hospital administrative data. We conducted multi-level logistic regression analyses with three levels: year (I), employee characteristics (II), and hospital characteristics (III).

RESULTS

Northern region hospitals experienced lower disorder prevalences (odds ratios (OR) 0.58, 95% confidence intervals (0.40, 0.82) for mental and 0.56 (0.44, 0.73) for musculoskeletal disorders). Hospitals with yearly workloads of the highest versus lowest quintiles of inpatient days/1000 employee hours (>86.0 vs. <42.6) and surgical cases/1000 employee hours (>10.5 vs. <3.9) had greater odds of mental (1.29 (1.05, 1.57); 1.22 (1.05, 1.42)) and musculoskeletal (1.38 (1.21, 1.58); 1.21 (1.09, 1.34)) disorders.

CONCLUSION

Opportunities exist for reduction in burden with hospital workload reduction. Further exploration of regional effects is needed.