Intervention Review

Workplace interventions for preventing work disability

  1. Sandra H van Oostrom1,
  2. Maurice T Driessen1,
  3. Henrica CW de Vet2,
  4. Renée-Louise Franche3,
  5. Eva Schonstein4,
  6. Patrick Loisel5,
  7. Willem van Mechelen1,
  8. Johannes R Anema1,*

Editorial Group: Cochrane Injuries Group

Published Online: 15 APR 2009

Assessed as up-to-date: 12 MAR 2008

DOI: 10.1002/14651858.CD006955.pub2


How to Cite

van Oostrom SH, Driessen MT, de Vet HCW, Franche RL, Schonstein E, Loisel P, van Mechelen W, Anema JR. Workplace interventions for preventing work disability. Cochrane Database of Systematic Reviews 2009, Issue 2. Art. No.: CD006955. DOI: 10.1002/14651858.CD006955.pub2.

Author Information

  1. 1

    VU University Medical Center, Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, Amsterdam, Netherlands

  2. 2

    EMGO Institute for Health and Care Research, Department of Epidemiology and Biostatistics, Amsterdam, Netherlands

  3. 3

    Occupational Health and Safety Agency for Healthcare (OHSAH), Disability Prevention Program, Vancouver, BC, Canada

  4. 4

    University of Sydney, Faculty of Health Sciences, Lidcombe, NSW, Australia

  5. 5

    Department for Community Health Sciences, Sherbrooke University & PREVICAP Occupational Rehabilitation Centre, Centre for Action in Work Disability and Prevention, Rehabilitation Department, QC, Canada

*Johannes R Anema, Department of Public and Occupational Health and the EMGO Institute for Health and Care Research, VU University Medical Center, Van der Boechorststraat 7, Amsterdam, 1081 BT, Netherlands. h.anema@vumc.nl.

Publication History

  1. Publication Status: New
  2. Published Online: 15 APR 2009

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Background

Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.

Objectives

To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.

Search methods

We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).

Selection criteria

We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.

Data collection and analysis

Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.

Main results

We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.

Authors' conclusions

As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

Workplace interventions for preventing work disability

Six randomized controlled trials involving 749 workers were included in this systematic review. In five studies the workers had musculoskeletal disorders and in one study they had mental health problems. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. Considering all the types of work disability together, the results showed low-quality evidence that workplace interventions are more effective than usual care in reducing absence from work because of sickness. Unfortunately, no conclusions could be drawn regarding interventions for people with mental health problems and other health conditions due to a lack of studies. In conclusion, care providers could implement workplace interventions in guiding workers disabled with musculoskeletal disorders if the main goal is return to work.

 

摘要

  1. Top of page
  2. Abstract
  3. Plain language summary
  4. 摘要

背景

工作地點的介入措施以預防工作失能

工作失能對於利益相關者及社會有嚴重的結果。工作地點的介入措施被認為可以妥善的促進重返工作,藉由主要利益相關人的合作來減少重返工作的障礙。

目標

確定工作地點的介入措施相較於一般照謢或臨床介入措施對於工作相關結果及健康結果的效果;及評估應用於肌肉骨骼疾病,心理健康問題,或其他健康狀況時效果是否不同。

搜尋策略

我們檢索the Cochrane Occupational Health Field Trials Register,CENTRAL,MEDLINE及EMBASE (EMBASE.com),及 PsycINFO databases (至2007年11月止)。

選擇標準

為使工作者重返工作,我們納入有關工作地點介入措施的隨機對照試驗,因為生病請假之報告為連續性結果。

資料收集與分析

兩名作者分別摘錄資料並評估研究的偏差風險。進行統合分析(metaanalysis)及質化分析(qualitative analysis)(採用證據的GRADE levels)。

主要結論

我們納入六篇隨機對照試驗(749名工作者):三篇有關下背痛,一篇有關上肢疾病,一篇有關肌肉骨骼疾病,及一篇有關適應性疾病。五篇研究在病假結果方面被評價為有低度的偏差風險。這篇回顧的結果顯示相較於一般照護,有中等品質的證據支持使用工作地點之介入措施,以減少肌肉骨骼疾病工作者的病假。然而,工作地點介入措施對於促進肌肉骨骼疾病工作者的健康結果沒有效果。由於缺少相關研究使得無法研究工作地點介入措施對於心理健康問題及其他健康狀況工作者的效果。只有一篇研究比較工作地點介入措施與臨床介入措施,研究結果發現對於心理健康問題工作者的病假及症狀其結果相似。

作者結論

由於可取得的研究很少,因此有關工作地點介入措施對於工作相關及健康結果之效果,不論工作失能的型態,無法建構使人信服的結論。對於肌肉骨骼疾病子群體之加總資料指出,工作地點介入措施對於減少病假是有效的,但對於促進健康結果是無效的。來自於肌肉骨骼疾病子群體分析的證據被評價為中等品質的證據。不幸的是,由於缺少相關研究,這些介入措施對於心理健康問題及其他健康狀況者效果的結論無法推斷。

翻譯人

本摘要由高雄榮民總醫院金沁琳翻譯。

此翻譯計畫由臺灣國家衛生研究院(National Health Research Institutes, Taiwan)統籌。

總結

六篇隨機對照試驗,共749名工作者被納入這篇系統性回顧。五篇研究中其工作者有肌肉骨骼疾病,一篇其工作者有心理健康問題。這篇回顧的結果顯示,相較於一般照護,有中等品質的證據支持使用工作地點介入措施以減少肌肉骨骼疾病工作者的病假。然而,工作地點介入措施對於促進肌肉骨骼疾病工作者的健康結果無效。就所有形態的工作失能而言,結果顯示低度品質的證據認為工作地點介入措施比一般照護對於減少病假有效。不幸的是,由於缺少相關研究,沒有結論推斷有關介入措施對於心理健康問題者及其他健康狀況者之效果。總而言之,如果主要目的是重返工作,照護提供者可以實行工作地點介入措施藉以引導失能的肌肉骨骼疾病工作者。