title: Patterns of sick-leave and health outcomes in injured workers with back pain.
abstract: Little is known about the sick-leave experiences of workers who make a workers' compensation claim for back pain. Our objective is to describe the 1-year patterns of sick-leave and the health outcomes of a cohort of workers who make a workers' compensation claim for back pain. We studied a cohort of 1,831 workers from five large US firms who made incident workers' compensation claims for back pain between January 1, 1999 and June 30, 2002. Injured workers were interviewed 1 month (n = 1,321), 6 months (n = 810) and 1 year (n = 462) following the onset of their pain. We described the course of back pain using four patterns of sick-leave: (1) no sick-leave, (2) returned to worked and stayed, (3) multiple episodes of sick-leave and (4) not yet returned to work. We described the health outcomes as back and/or leg pain intensity, functional limitations and health-related quality of life. We analyzed data from participants who completed all follow-up interviews (n = 457) to compute the probabilities of transition between patterns of sick-leave. A significant proportion of workers experienced multiple episodes of sick-leave (30.2%; 95% CI 25.0-35.1) during the 1-year follow-up. The proportion of workers who did not report sick-leave declined from 42.4% (95% CI 39.0-46.1) at 1 month to 33.6% (28.0-38.7) at 1 year. One year after the injury, 2.9% (1.6-4.9) of workers had not yet returned to work. Workers who did not report sick-leave and those who returned and stayed at work reported better health outcomes than workers who experienced multiple episodes of sick-leave or workers who had not returned to work. Almost a third of workers with an incident episode of back pain experience recurrent spells of work absenteeism during the following year. Our data suggest that stable patterns of sick-leave are associated with better health.
authors.affiliation: Centre of Research Expertise in Improved Disability Outcomes, University Health Network Rehabilitation Solutions, Toronto Western Hospital, Toronto, ON, Canada. pcote@uhnresearch.ca
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.forename: Marjorie L
authors.initials: ML
authors.lastname: Baldwin
authors.forename: William G
authors.initials: WG
authors.lastname: Johnson
authors.forename: John W
authors.initials: JW
authors.lastname: Frank
authors.forename: Richard J
authors.initials: RJ
authors.lastname: Butler
mesh_terms: D000041:Absenteeism; D000062:Accidents, Occupational; D000328:Adult; D001416:Back Pain / Q000150:complications / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015601:Injury Severity Score; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D017063:Outcome Assessment, Health Care / Q000379:methods / Q000706:statistics & numerical data*; D010146:Pain / Q000209:etiology; D011379:Prognosis; D011446:Prospective Studies; D011788:Quality of Life; D018582:Sick Leave / Q000706:statistics & numerical data*; D014481:United States; D014942:Workers' Compensation / Q000706:statistics & numerical data*