title: Effectiveness of multidisciplinary primary prevention in decreasing the risk of work disability in a         low-risk population.
abstract: OBJECTIVE
  The aim of this study was to evaluate the effectiveness of a 4-week primary prevention program         (vocationally oriented multidisciplinary early rehabilitation or VOMR) in reducing the risk of long-term work         disability among public sector employees at risk of deteriorating work capacity because of work-related strain.
  
  
  METHODS
  As a part of the prospective Finnish public sector study, a follow-up study was carried out among 1394 public         sector employees who underwent VOMR and their 4146 propensity score-matched controls. Baseline characteristics of 41         488 employees with full data on all 25 matching variables, measured from survey responses and national health         registers, were used to calculate a propensity score for each employee to be granted rehabilitation. The cases were         compared with the controls using Cox proportional hazard models as regards the risk of long-term work disability (sick         leave >90 days or retirement on health grounds) after rehabilitation.
  
  
  RESULTS
  During a mean follow-up of 2.8 years         [standard deviation (SD) 1.49, range 0.04-5.0], incident all-cause work disability was observed for 6.1% of the         rehabilitants and 6.2% of the controls [hazard ratio (HR) 0.98, 95% confidence interval (95% CI) 0.76-1.25]. The         corresponding HR for the main causes of work disability stemming from musculoskeletal diseases and mental disorders         were 0.86 (95% CI 0.57-1.30) and 1.08 (95% CI 0.67-1.74), respectively.
  
  
  CONCLUSIONS
  VOMR was not         associated with a lowered risk of long-term work disability compared to the controls. No support was obtained for the         effectiveness of primary prevention for work disability in a low-risk cohort of employees.
authors.affiliation: Department of Rehabilitation, Turku University Hospital, Turku, Finland. mikhail.saltychev@tyks.fi
authors.forename: Mikhail
authors.initials: M
authors.lastname: Saltychev
authors.forename: Katri
authors.initials: K
authors.lastname: Laimi
authors.forename: Ashraf
authors.initials: A
authors.lastname: El-Metwally
authors.forename: Tuula
authors.initials: T
authors.lastname: Oksanen
authors.forename: Jaana
authors.initials: J
authors.lastname: Pentti
authors.forename: Marianna
authors.initials: M
authors.lastname: Virtanen
authors.forename: Mika
authors.initials: M
authors.lastname: Kivimäki
authors.forename: Jussi
authors.initials: J
authors.lastname: Vahtera
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000517:prevention & control*; D011322:Primary Prevention; D012050:Rehabilitation, Vocational