title: Health status, its perceptions, and effect on return to work and recurrent sick leave.
abstract: METHODS
  Prospective cohort study with 1-year follow-up.
  
  
  OBJECTIVE
  The purpose of this study is to describe the improvement in several health outcomes during sick leave resulting from musculoskeletal disorders and in the first months after return to work (RTW), and to evaluate the personal and work-related factors associated with these health outcomes, in order to provide some insight in the timing of RTW.
  
  
  BACKGROUND
  Although improvements in pain perception and functional disability appear to be associated with time of RTW, little is known about the required improvement enabling RTW, the additional health improvement after RTW, and whether the health status at the time of RTW is associated with the probability of a recurrence of sick leave.
  
  
  METHODS
  Workers were included when on sickness absence between 2 to 6 weeks due to musculoskeletal disorders. Self-administered questionnaires at baseline, after RTW, and at 12-month follow-up were used to collect information on changes in symptom status, functional status, and general health.
  
  
  RESULTS
  All health outcomes were improved significantly at the time of RTW, whereas perceived pain, functional disability, and physical health also improved significantly in the first months after RTW. Previous sick leave 12 months before study entry was significantly associated with the level of functional disability and general health at time of RTW and also predictive for recurrence of sickness absence. Personal and work-related factors showed little, if any, association with health status at RTW and improvement thereafter.
  
  
  CONCLUSIONS
  Being fully recovered is not a stipulation for regaining work activities. We hypothesize that workers with musculoskeletal disorders may need additional medical guidance shortly after RTW, especially those with a history of sick leave.
authors.affiliation: Department of Public Health, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands. f.lotters@erasmusmc.nl
authors.forename: Freek
authors.initials: F
authors.lastname: Lötters
authors.forename: Sheilah
authors.initials: S
authors.lastname: Hogg-Johnson
authors.forename: Alex
authors.initials: A
authors.lastname: Burdorf
mesh_terms: D000328:Adult; D015331:Cohort Studies; D004185:Disability Evaluation; D004651:Employment / Q000523:psychology*; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D009140:Musculoskeletal Diseases / Q000150:complications / Q000503:physiopathology* / Q000523:psychology*; D010146:Pain / Q000209:etiology / Q000523:psychology*; D011446:Prospective Studies; D012008:Recurrence; D018582:Sick Leave; D012803:Sick Role