Occupational health research round-up

Integrated care limits back-related disability

An integrated approach to managing chronic back pain substantially reduces disability in patients’ working and private lives, according to this study of 134 adults with a history of low back pain-related sickness absence. The integrated care provided to those in the study consisted of a workplace intervention based on participatory ergonomics, involving a supervisor, and a graded activity programme based on cognitive behavioural principles. The researchers studied how long workers were off sick due to low back pain before they were able to return to work on a sustained basis. Secondary outcomes included function and the intensity of pain experienced. Workers taking part in the integrated care programme took a median 88 days to return to sustainable work, compared with a median 208 days for those receiving “usual” care. After 12 months, those in the integrated care group improved their functional status significantly more than those receiving usual care, although there was little difference in pain experienced.

Randomised controlled trial of integrated care to reduce disability from chronic low back pain in working and private life, Ludeke C et al, British Medical Journal 2010; 340: c1035.

Cancer risk for Chinese medicine practitioners

Practitioners of traditional Chinese medicine with frequent exposure to herbal medicines have a significantly increased risk of liver and bladder cancers, according to this study. The mortality and cancer incidence rates of 7,675 physicians practising Chinese medicine between 1985 and 2005 were compared with those of the general population in Taiwan. However, in most other health respects, the news for this group of alternative practitioners is good. Over the 20-year period, the study cohort showed significantly lower standardised mortality for all causes, and for deaths from infectious, circulatory, respiratory digestive diseases. The practitioners also had significantly lower incidence rates for most cancers other than those highlighted, although the authors suggest that the reasons for the higher rates of liver and bladder cancers among the group warrant “further investigation”.

Mortality and cancer incidence among physicians of traditional Chinese medicine: a 20-year national follow-up study, Shu-Hui Liu et al, Occupational and Environmental Medicine 2010; 67: p166-169.

Osteoarthritis increases employer absence costs

The cost to employers of staff with osteoarthritis are “quite substantial” when compared with the costs associated with other chronic diseases, according to this US study. Costs measured include the probability that workers with the condition will take time off, actual days missed from work, and the direct and indirect costs of this absence. Osteoarthritis increases the annual cost of absence per employee by around £306 in the case of women, and by £795 in the case of men. This represents around an additional three working days lost per employee a year, the authors of the study conclude.

Osteoarthritis and absenteeism costs: evidence from US national survey data, Kotlarz, H et al, Journal of Occupational and Environmental Medicine, March 2010, vol 52, issue 3, p263-268.

Health promotion boosts weight management

Workplace health promotion programmes help employees maintain weight and reduce health-risk behaviours, according to this evaluation of employee health interventions at Dow Chemicals in the US. The study, which reviews employees involved in the interventions after two years of the programme, finds that participants maintained their weight and body mass index, compared with a control group of employees, who gained 1.3lbs and increased their body mass index by 0.2 points on average over the two-year programme. Significant differences in blood pressure and cholesterol values were also observed between the two groups, and the improvements observed were more pronounced at those Dow Chemical sites that had implemented programmes on a more intensive basis.

In practice: the study provides further evidence of the return on investment that well-conceived and implemented health promotion programmes can yield.

Second-year results of an obesity prevention programme at the Dow Chemical company, Goetzel, R et al, Journal of Occupational and Environmental Medicine, March 2010, vol 52, issue 3, p291-302.

Obesity linked to higher sickness absence rates

An employee’s body mass index is linked in a linear way to the number of days’ work missed due to sickness absence, according to this study of London Underground workers. Further, obesity is a risk factor for both short-term (10 days or less) and long-term absence – obese workers typically took four days more sick leave a year than other employees. The additional long-term sick leave taken by obese employees appears to be associated with chronic medical conditions linked to obesity, whereas the excess short-term absence is not explained by obesity-related medical factors, psychiatric disorders or workplace factors.

In practice: there is growing evidence to support employers becoming more involved in tackling obesity – for example, through weight management and healthy eating initiatives, and actions designed to increase levels of physical fitness among ‘hard to reach’ groups in the workforce.

Obesity and sickness absence: results from the CHAP study, Harvey, Samuel B et al, Occupational Medicine advance access, published online 22 March 2010.

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