title: A new pre-employment functional capacity evaluation predicts longer-term risk of musculoskeletal injury in healthy workers: a prospective cohort study.
abstract: METHODS
  Prospective cohort study.
  
  
  OBJECTIVE
  To determine if a job-specific pre-employment functional assessment (PEFA) predicts musculoskeletal injury risk in healthy mineworkers.
  
  
  BACKGROUND
  Traditional methods of pre-employment screening, including radiography and medical screenings, are not valid predictors of occupational musculoskeletal injury risk. Short-form job-specific functional capacity evaluations are increasing in popularity, despite limited evidence of their ability to predict injury risk in healthy workers.
  
  
  METHODS
  Participants were recruited from an Australian coal mine between 2002 and 2009 as part of the hiring process. At baseline, participants were screened with the JobFit System PEFA, and classified as PEFA 1 if they met job demands and PEFA>1, if not. Males who completed the PEFA and were employed were included. Injury data from company records were coded for body part, mechanism, and severity. The relationship between PEFA classification and time to first injury was analyzed using Cox proportional hazards regression with adjustments for department and post hoc stratification for time (0-1.3 yr, 1.3-6 yr).
  
  
  RESULTS
  Of the 600 participants (median age, 37 yr, range, 17.0-62.6 yr), 427 scored PEFA 1. One hundred ninety-six sprain/strain injuries were reported by 121 workers, including 35 back injuries from manual handling. Significant differences between PEFA groups were found in time to first injury for all injury types during the long term (any injury: adjusted hazard ratio [HR] = 2.3, 95% confidence interval [CI] = 1.4-3.9; manual handling injury: HR = 3.3, CI = 1.6-7.2; any back injury: HR = 3.3, CI = 1.6-6.6; back injuries from manual handling HR = 5.8, CI = 2.0-16.7), but not during the short term. An area under the receiver operator curve value of 0.73 (CI = 0.61-0.86) demonstrated acceptable predictive ability for back injuries from manual handling during the long term.
  
  
  CONCLUSIONS
  JobFit System PEFAs predict musculoskeletal injury risk in healthy mineworkers after 1.3 years of employment. Future research should assess whether use of these assessments as part of a holistic risk management program can decrease workplace musculoskeletal injuries.
authors.affiliation: *School of Human Movement Studies †Minerals Industry Safety and Health Centre, and ‡Schools of Human Movement Studies and Population Health, The University of Queensland, Brisbane, Australia.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Legge
authors.forename: Robin
authors.initials: R
authors.lastname: Burgess-Limerick
authors.forename: Geeske
authors.initials: G
authors.lastname: Peeters
mesh_terms: D000293:Adolescent; D000328:Adult; D001315:Australia; D019567:Back Injuries / Q000503:physiopathology / Q000517:prevention & control*; D015331:Cohort Studies; D004651:Employment; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000517:prevention & control*; D009784:Occupational Diseases / Q000503:physiopathology / Q000517:prevention & control*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D018570:Risk Assessment; D055815:Young Adult
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