Psychosocial job factors and return-to-work after compensated low back injury: a disability phase-specific analysis.
BACKGROUND
Job characteristics may constitute a barrier to return-to-work (RTW) after compensated disabling low back pain (LBP). This study examines the impact of psychosocial job factors on time to RTW separately during the acute and subacute/chronic disability phases.


METHODS
This is a retrospective cohort study of 433 LBP workers' compensation claimants with 1-4 years of follow-up. The association of psychosocial job factors with duration of work disability was estimated with Cox regression models, adjusting for injury history and severity, physical workload, and demographic and employment factors.


RESULTS
High physical and psychological job demands and low supervisory support are each associated with about 20% lower RTW rates during all disability phases. High job control, especially control over work and rest periods, is associated with over 30% higher RTW rates, but only during the subacute/chronic disability phase starting 30 days after injury. Job satisfaction and coworker support are unrelated to time to RTW.


CONCLUSIONS
Duration of work disability is associated with psychosocial job factors independent of injury severity and physical workload. The impact of these risk factors changes significantly over the course of disability.
Krause
N
N
Division of Occupational and Environmental Medicine, School of Medicine, University of California, San Francisco, USA. nkrause@uclink4.berkeley.edu
Dasinger
L K
LK
Deegan
L J
LJ
Rudolph
L
L
Brand
R J
RJ
D000328:Adult; D019567:Back Injuries / Q000191:economics / Q000523:psychology* / Q000534:rehabilitation; D002140:California / Q000453:epidemiology; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007389:Internal-External Control; D007587:Job Description; D007588:Job Satisfaction; D017116:Low Back Pain / Q000453:epidemiology / Q000209:etiology / Q000523:psychology*; D008297:Male; D009784:Occupational Diseases / Q000191:economics / Q000453:epidemiology / Q000523:psychology*; D012189:Retrospective Studies; D012307:Risk Factors; D013312:Stress, Physiological; D014938:Work Capacity Evaluation; D014940:Work Schedule Tolerance / Q000523:psychology; D014942:Workers' Compensation