Back to Annual Meeting Page		American Public Health Association 133rd Annual Meeting & Exposition December 10-14, 2005 Philadelphia, PA

Abstract #113935

Pierre Côté, DC, PhD, Institute for Work and Health, University of Toronto, 481 University Avenue, Suite 800, Toronto, ON M5G 2E9, Canada, Marjorie L. Baldwin, PhD, W. P. Carey School of Business, Arizona State University, School of Health Management and Policy, PO Box 874506, Tempe, AZ 85287-4506, 480-965-7868, marjorie.baldwin@asu.edu, and William G. Johnson, PhD, School of Health Management & Policy and Department of Economics, Arizona State University, W. P. Carey School of Business, Box 874506, Tempe, AZ 85287-4506.

BACKGROUND: Occupational back pain is the most common compensated work-related injury in the industrialized world. Numerous interventions have not proven to be effective in reducing the disability burden associated with back pain, perhaps because we continue to characterize the condition as a single episode that resolves in recovery or permanent disability, rather than a chronic condition characterized by recurrent episodes of potentially disabling pain. METHODS: We describe patterns of employment experienced by injured workers during the first year after onset of back pain. Data come from a sample of 1,931 workers who filed claims for occupational back injuries between 1999 and 2002. Workers were interviewed four times over the year. We present frequency distributions of employment patterns and conditional transition probabilities at each interview. RESULTS: We observe four basic post-injury employment patterns: no absence; single absence-return and stay; multiple absence spells; not yet return. There is considerable movement among patterns even for those with apparently low-severity injuries. For example, among workers who report no work absence at one month, there is an 18% transition probability to spells of work absence by six months. Conversely, we observe efforts to return to work even among those with apparently high-severity injuries: Among those who have not returned at one month, only 29% have not returned at one year. IMPLICATIONS: The evidence suggests that researchers and clinicians must look beyond the first return to work in designing strategies to minimize the disability burden associated with occupational back pain.

Learning Objectives: At the conclusion of this session, the participant will be able to

• Describe patterns of return to work observed among a cohort of workers with occupational back pain in the first year after onset.
• Cite data to show that a first return to work is not a good indicator of recovery from an episode of back pain.
• Understand and interpret a matrix showing how workers transition from one employment pattern to another over time.

Keywords: Occupational Health Care, Injury

Presenting author's disclosure statement:

I wish to disclose that I have NO financial interests or other relationship with the manufactures of commercial products, suppliers of commercial services or commercial supporters.