O22.1 FACTORS AFFECTING RETURN TO WORK AFTER WORK RELATED WRIST AND ANKLE FRACTURES REPORTED TO THE ALBERTA WORKERS’ COMPENSATION BOARD, 1998–2002

J. Beach, K. Seland, N. Cherry.Occupational Health, Department of Public Health Sciences, University of Alberta, Edmonton, Alberta, Canada

Introduction: Factors that predict duration of work disability following work related injury remain unclear.

Objective: To use an existing administrative database to develop a predictive model of duration of disability following work related wrist and ankle fractures.

Methods: Claims information for all wrist and ankle fractures between 1998 and 2002 was acquired from the Alberta Workers Compensation Board (WCB). All claims that had sustained one or more days of temporary disability (TD) were included. Analyses of TD duration were undertaken using Cox multivariate survival analysis. Three models were developed on the basis of the temporal nature of the variables. Model 1 included pre-injury factors (age, sex, sector, occupation, ‘partners in injury reduction scheme’ participation, worker insurable earnings, industry rate), Model 2 included peri-injury factors (accident description, fracture site), and Model 3 included post-injury factors (provision of modified work, provision of rehabilitation). A fourth model included all these factors. Subsequent models were also developed including medical aid costs within 30 days of injury as a proxy for severity.

Results: Lower probability of successful return to work at any given time was associated with older age, female sex, work in the construction sector, smaller company size, higher industry rates, a fall/jump from height, ankle fractures (compared with wrist fractures), and the provision of rehabilitation. Shorter TD duration was associated with fractures due to ‘overexertion’ and the provision of modified work. Inclusion of the proxy for severity in the models reduced the significance of work in construction, and increased the relationship between female sex and longer periods away from work.

Conclusions: These …