Predictors of Poor Outcome Amongst Injured Workers Rebbecca Lilley ACHRF 2012
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Transcript of Predictors of Poor Outcome Amongst Injured Workers Rebbecca Lilley ACHRF 2012
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What are the barriers to work
participation following injury?
Results from the Prospective
Outcomes of Injury Study
Rebbecca Lilley
Injury Prevention Research Unit
9 November 2012
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What is known?
• Previous studies examining predictors of
poor outcomes have focused on:
– Mainly hospitalised injury
– Limited range of risk factors
• New Zealand’s context: Accident
Compensation Corporation (ACC)
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Research Focus
This study examines combined influences of
personal, work, health, lifestyle & injury
factors on work absence following injury in
the POIS study
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Working Cohort
• POIS worker cohort 2626 participants
• Injury type: lower (16%) & upper extremity
fracture (18%), lower (24%) & upper (14%)
extremity sprains & strains, and back
dislocation, sprain & strain (16%).
• 24% hospital admission within 7 days
• 36% work-related
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The good news….
• Majority (73%) are working at 3 months
• Of those still absent from work – the
majority (71%) anticipate recovery to usual
work
• However, 720 (27%) absent from work
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WORK STATUS – 3 MONTHS AFTER INJURY
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Outcome: Work status 3 months after injury
• Single item asked at 3 month interview
“Are you back at work?” Yes/No
• Considered “working” at time of interview
regardless of employer or
modified/part/full-time status
• Outcome of interest: “Not working”
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Pre-injury characteristics
Socio-demographic (10 factors)
Health (6 factors)
Lifestyle (5 factors)
Physical work (5 factors)
Psychosocial (7 factors)
Work organisation
(4 factors)
Injury (6 factors)
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Health
overall self-assessment for health, comorbidities, pain or discomfort, prior injury, prior disabling condition, work capacity
Lifestyle behaviours
alcohol consumption, current smoking status, body mass index (BMI), exercise, sleep quantity
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Summary of 3-month results
Socio-demographic (low income,
financial insecurity, manual occupation)
Health
Lifestyle (obesity)
Physical work (any painful work, any standing at work)
Psychosocial
Work organisation (long working
weeks, temporary employment)
Injury (perceived threat to life,
hospitalisation)
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Summary of 3-month results
Socio-demographic (low income,
financial insecurity, manual occupation)
Lifestyle (obesity)
Physical work (any painful work, any standing at work)
Work organisation (long working
weeks, temporary employment)
Injury (perceived threat to life,
hospitalisation)
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What factors were not included?
• Age
• Gender
• Pre-injury psychosocial factors
• Pre-injury health factors
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What do we need to do to get injured workers back to work?
• Pre-injury socio-demographic, workplace
& lifestyle factors could be targeted
• New findings:
– Obesity
– Temporary employment
– Long week work schedules
– Financial insecurity
• Need for broader intervention focus
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Current analyses
• Comparison of outcomes for workers with
Work-related & non-work-related injuries
– Provisional analysis indicates by 12 months workers with work-related injury have poorer recovery from injury compared
• Nested case-control study examining work
organisational factors
– Workers from small sized organisations associated with work absence
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Acknowledgements
Funders: The Health Research Council of New
Zealand (2007-2013) & the Accident
Compensation Corporation (2007-2010)
Co-investigators: Gabrielle Davie, Shanthi
Ameratunga, Sarah Derrett
Reference: Lilley R, Davie G, Ameratunga S,
Derrett S (2012) Factors predicting work status 3
months after injury: results from the Prospective
Outcomes of Injury Study. BMJ Open 2:e000400
http://bmjopen.bmj.com/content/2/e000400.full