Objectives: To evaluate the effectiveness of two occupational health intervention programmes, both compared with usual care.
Methods: Based on a health survey, 1341 employees (88% males) in construction, service and maintenance work were classified into three groups: “low risk” (n = 386), “intermediate risk” (n = 537) and “high risk” (n = 418) of sickness absence. Two separate randomised trials were performed in the groups “high risk” and “intermediate risk”, respectively. Those high risk subjects that were allocated to the intervention group (n = 209) were invited to occupational health service for a consultation. The intervention included, if appropriate, a referral to specialist treatment. Among the intermediate risk employees those in the intervention group (n = 268) were invited to call a phone advice centre. In both trials the control group received usual occupational health care. The primary outcome was sickness absence during a 12-month follow-up (register data).
Results: The high risk group, representing 31% of the cohort, accounted for 62% of sickness absence days. In the trial for the high risk group the mean sickness absence was 30 days in the usual care group and 19 days in the intervention group; the mean difference was 11 days (95% CI 1 to 20 days). In the trial for the intermediate risk group the mean sickness absence was 7 days in both arms (95% CI of the mean difference –2.3 to 2.4 days).
Conclusions: The identification of high risk of work disability was successful. The occupational health intervention was effective in controlling work loss to a degree that is likely to be economically advantageous within the high risk group. The phone advice intervention for the intermediate risk group was not effective in controlling work loss primarily due to poor adherence.
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Funding: Finnish Funding Agency for Technology and Innovation (TEKES); the Finnish National Fund for Research and Development (SITRA); Pfizer Oy. The authors’ work was independent of the funders.
Competing interests: ST and JT are shareholders of and SJ is employed by Evalua International, which was responsible for the screening instrument used in the study. EL, AM, HS and TA have no competing interests to declare.
Ethics approval: The Helsinki University Research Ethics Board for Occupational Health reviewed the study plan and gave their approval in advance. Record number (DNRO): 28/e2/04; date: 23.04.2004. All subjects received written information regarding the study according to the principles of the Declaration of Helsinki. Only subjects who gave their signed informed consent were included in the study. The consent letters are stored with other study material.
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