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APHA Scientific Session and Event Listing

Recorded presentation

Marjorie L. Baldwin, PhD, School of Health Management and Policy, Arizona State University, PO Box 874506, Tempe, AZ 85287-4506, 480-965-7868, marjorie.baldwin@asu.edu and Richard J. Butler, PhD, Depatment of Economics, Brigham Young University, 183 Faculty Office Building, Provo, UT 84602-2363.

BACKGROUND: Cumulative trauma disorders of the upper extremities are a small but increasingly important proportion of workers' compensation claims. Compared to back pain, upper extremity disorders are relatively under-studied. We do not have good estimates of the costs of the disorders, nor do we have extensive analyses of return to work and duration of work absence across different worker populations. METHODS: We apply methods we have used to study the costs and outcomes of occupational back pain to upper extremity disorders. Data come from the 1989-90 Survey of Ontario Workers with Permanent Impairments. The study sample includes 1,317 workers with permanent impairments related to an upper extremity disorder. We analyze work outcomes with: a logistic model of return to work, a multinomial logistic model of employment patterns after the first return, and Kaplan-Meier survival curves for up to four spells of work absence. RESULTS: Most workers with upper extremity disorders, even with more severe injuries, return to work at least once after injury, but two-thirds of those who return experience subsequent injury-related absences. Across a five-year period, focusing on the first spell of work absence underestimated cumulative work loss days for upper extremity cases by approximately 33 percent, compared to 25 percent for back cases. IMPLICATIONS: Upper extremity cases appear to be even more susceptible to multiple spells of work absence than back cases. Workers with upper extremity disorders who are returning to work are prime targets for job accommodations to reduce the risk of re-injury and repeated work absences.

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