Abstract

The objective of this study is to examine the association between multiple jobholding and return-to-work (RTW) for workers with a work-related musculoskeletal disorder (MSD). We hypothesise that multiple jobholders (MJHs) are less likely to RTW compared to single jobholders (SJHs), due to their higher sickness absence threshold, more unstable employment contracts, and higher workload.

We used administrative workers’ compensation data to identify workers with accepted MSD lost-time claims and an injury date between 2010–2014 in British Columbia, Canada (n=125,639 SJHs and 9,029 MJHs). The outcome was time until RTW within one year following the first time-loss day. The MJH and SJH cohorts were balanced using coarsened exact matching, which yielded a matched cohort of 8,992 MJHs and 8,992 SJHs. The outcome was estimated using cox proportional hazard models.

MJHs were less likely to RTW within one year after the first time-loss day compared to SJHs (Hazard Ratio (HR) 0.78; 95% confidence interval (CI) 0.76–0.81). This applied to men and women, but the reduced likelihood to RTW was larger for male MJHs (HR 0.73; 95% CI 0.70–0.77) than for female (HR 0.83; 95% CI 0.79–0.87). Furthermore, this result was stronger for those with ≤ five pre-injury weekly workdays (HR 0.76; 95% CI 0.73–0.79), compared to those with six or seven days pre-injury weekly workdays (HR 0.94; 95% CI 0.86–1.02).

MJHs are disadvantaged compared to SJHs in terms of RTW following a work-related MSD. Identifying differences between MJHs and SJHs is the first step to improve RTW outcomes for this vulnerable segment of the workforce.