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Patterns of sick-leave and health outcomes in injured workers with back pain

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Abstract

Little is known about the sick-leave experiences of workers who make a workers’ compensation claim for back pain. Our objective is to describe the 1-year patterns of sick-leave and the health outcomes of a cohort of workers who make a workers’ compensation claim for back pain. We studied a cohort of 1,831 workers from five large US firms who made incident workers’ compensation claims for back pain between January 1, 1999 and June 30, 2002. Injured workers were interviewed 1 month (n = 1,321), 6 months (n = 810) and 1 year (n = 462) following the onset of their pain. We described the course of back pain using four patterns of sick-leave: (1) no sick-leave, (2) returned to worked and stayed, (3) multiple episodes of sick-leave and (4) not yet returned to work. We described the health outcomes as back and/or leg pain intensity, functional limitations and health-related quality of life. We analyzed data from participants who completed all follow-up interviews (n = 457) to compute the probabilities of transition between patterns of sick-leave. A significant proportion of workers experienced multiple episodes of sick-leave (30.2%; 95% CI 25.0–35.1) during the 1-year follow-up. The proportion of workers who did not report sick-leave declined from 42.4% (95% CI 39.0–46.1) at 1 month to 33.6% (28.0–38.7) at 1 year. One year after the injury, 2.9% (1.6–4.9) of workers had not yet returned to work. Workers who did not report sick-leave and those who returned and stayed at work reported better health outcomes than workers who experienced multiple episodes of sick-leave or workers who had not returned to work. Almost a third of workers with an incident episode of back pain experience recurrent spells of work absenteeism during the following year. Our data suggest that stable patterns of sick-leave are associated with better health.

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Acknowledgments

This research was supported by a grant, with full freedom to publish, from the National Chiropractic Mutual Insurance Company (NCMIC), a national insurer of doctors of chiropractic. The authors thank the ASU Healthy Back Study Advisory Committee, composed of: Troyen A. Brennan, M.D., L.L.D.; Scott Haldeman, D.C., M.D., Ph.D.; Robert Mootz, D.C.; John J. Triano, D.C., Ph.D.; Margaret A. Turk, M.D.; Robert J. Weber, M.D. and Frank A. Zolli, D.C., Ed.D., for their guidance throughout the project. Finally, we thank Amy Bartels, Diana Fedesoff, Jane Irvine, Tricia Johnson, Rebecca White and Shap Wolf for their assistance with coordination and management of the study. The study would not have been possible without the cooperation and dedication of the participating employers and their employees.

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Authors and Affiliations

  1. Centre of Research Expertise in Improved Disability Outcomes (CREIDO), University Health Network Rehabilitation Solutions, Toronto Western Hospital, Fell Pavilion, 4th Floor, 4-124, 399 Bathurst Street, Toronto, ON, Canada

    Pierre Côté

  2. Institute for Work and Health and Department of Public Health Sciences, University of Toronto, Toronto, ON, Canada

    Pierre Côté & John W. Frank

  3. School of Health Management and Policy, W. P. Carey School of Business, Arizona State University, Tempe, AZ, USA

    Marjorie L. Baldwin

  4. School of Computing and Informatics, Ira A. Fulton College of Engineering, Arizona State University, Tempe, AZ, USA

    William G. Johnson

  5. Institute of Population and Public Health, Canadian Institutes of Health Research, Toronto, ON, Canada

    John W. Frank

  6. Department of Economics, Brigham Young University, Provo, UT, USA

    Richard J. Butler

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  1. Pierre Côté
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  2. Marjorie L. Baldwin
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  3. William G. Johnson
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  4. John W. Frank
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  5. Richard J. Butler
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Correspondence to Pierre Côté.

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Côté, P., Baldwin, M.L., Johnson, W.G. et al. Patterns of sick-leave and health outcomes in injured workers with back pain. Eur Spine J 17, 484–493 (2008). https://doi.org/10.1007/s00586-007-0577-6

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  • DOI: https://doi.org/10.1007/s00586-007-0577-6

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