Keys to Re-Injury Prevention and Sustained Return-to-Work for Disabled Workers

Details

• Personal Author:
  Fulton-Kehoe D ; Sears JM
• Description:
  Annually, about 300,000 U.S. workers incur serious work injuries resulting in permanent impairment and a permanent partial disability (PPD) award. The aims of this study were to: (1) characterize the first year of labor market participation after claim closure with a PPD award; (2) quantify time-varying risks of return-to-work (RTW) interruption and reinjury for workers with permanent impairments, comparing to risks for injured workers without permanent impairments, and assessing the impact of worker, injury, and job characteristics; and (3) prioritize modifiable workplace and workers' compensation (WC)-based contextual factors for future intervention development. WC and state wage data were used to measure long-term RTW patterns and reinjury outcomes for a retrospective cohort of workers with and without permanent impairments (N=43,968). A representative cross-sectional survey of workers with permanent impairments (N=599) was conducted to measure self-reported reinjury, health, workplace factors, and workers' suggestions for workplace and WC system improvements. This study documented long-term challenges related to health limitations, chronic pain, work reintegration, and economic impacts among workers with permanent impairments. Compared to other injured workers, workers with permanent impairments were at substantially higher risk of delayed RTW, RTW interruption, and reinjury. The first six months after RTW was identified as a particularly important window of opportunity for prevention efforts. Several modifiable workplace factors were associated with safe and sustained RTW, including safety climate, supervisor/coworker support, absence of stigmatization by supervisors/coworkers, health and safety committees, ability to take time off work for personal/family matters, adequate employer/health care provider communication, comfort reporting unsafe situations at work, and low job strain. Workers suggested numerous workplace improvements that could potentially support safe and sustained RTW. Suggested improvements most frequently fell into the major theme of work organization/arrangements/conditions, closely followed by the major theme of safety and safety climate. Many workers reported that their input was not sought or valued, and linked communication deficiencies to preventable deficiencies in safety practices, safety climate, and RTW practices. Most survey respondents appraised WC-based RTW programs favorably; however, responses also portrayed substantial room for WC system improvement. Reduce delays/ simplify process/improve efficiency was the most frequent theme with respect to the WC system overall. More worker choice/input into the vocational retraining plan was the most frequent theme with respect to vocational rehabilitation. Workers often directly linked administrative burdens to negative impacts on health and recovery. This study also made several methodological contributions: (1) it demonstrated the value of using state wage files to identify long-term RTW patterns and to measure work-time at-risk to improve reinjury rate estimates, (2) a two-factor safely climate scale was validated for this population, and (3) updated diagnosis code lists for the Functional Comorbidity Index were produced. In summary, this study documented the magnitude and elevated risk of RTW interruption and reinjury among workers with permanent impairments. It also identified workplace and WC-based contextual factors that may be amenable to WC system-level intervention. These findings may motivate and support investment in policy changes and prevention opportunities targeted at safe and sustained RTW for this priority population. [Description provided by NIOSH]
• Subjects:
  Economics Occupational Health Preventive Medicine Risk Assessment Risk Factors Safety Workplace
• Keywords:
  Disabled Workers Economic Impact Health Effects Injuries Intervention Preventive Measures Return To Work Risk Factors Safety Climate Work-life Balance Work Environment Workers Workers Compensation Work Practices

  More +
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  OSHA Region 10 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-84
• NIOSHTIC Number:
  nn:20064522
• NTIS Accession Number:
  PB2022-100404
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R21-OH-011355, 2021 Oct; :1-84
• Contact Point Address:
  Jeanne M. Sears, Box 357660, Department of Health Systems and Population Health, University of Washington, Seattle, WA 98195
• Email:
  jeannes@uw.edu
• Federal Fiscal Year:
  2022
• Performing Organization:
  University of Washington
• Peer Reviewed:
  False
• Start Date:
  20180901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20200831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:fee4a29ff5bdaf897b0a9d1fbb184714b4c6816069f7959237cf7ecc216cf6a65224f2c436c460234e3d520120fbae5a665aff45eb8368a250f2c7cf9472e12b
• Download URL:
  https://stacks.cdc.gov/view/cdc/219098/cdc_219098_DS1.pdf
• File Type:
  [PDF - 1019.10 KB ]