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Psychosocial job factors and return-to-work after compensated low back injury: A disability phase-specific analysis
Niklas Krause MD, MPH, PhD,
Lisa K. Dasinger PhD, Leo J. Deegan PhD,
Linda Rudolph MD, MPH,
Richard J. Brand PhD,
Corresponding Author
Niklas Krause MD, MPH, PhD
Division of Occupational and Environmental Medicine, School of Medicine, University of California, San Francisco
Public Health Institute, Berkeley
School of Public Health, Division of Epidemiology, 140 Warren Hall, University of California, Berkeley, CA 94720-7360.Search for more papers by this authorLeo J. Deegan PhD
Department of Demography, School of Public Health, University of California, Berkeley
Search for more papers by this authorLinda Rudolph MD, MPH
Division of Workers' Compensation, State of California
Search for more papers by this authorRichard J. Brand PhD
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
Search for more papers by this authorNiklas Krause MD, MPH, PhD,
Lisa K. Dasinger PhD, Leo J. Deegan PhD,
Linda Rudolph MD, MPH,
Richard J. Brand PhD,
Corresponding Author
Niklas Krause MD, MPH, PhD
Division of Occupational and Environmental Medicine, School of Medicine, University of California, San Francisco
Public Health Institute, Berkeley
School of Public Health, Division of Epidemiology, 140 Warren Hall, University of California, Berkeley, CA 94720-7360.Search for more papers by this authorLeo J. Deegan PhD
Department of Demography, School of Public Health, University of California, Berkeley
Search for more papers by this authorLinda Rudolph MD, MPH
Division of Workers' Compensation, State of California
Search for more papers by this authorRichard J. Brand PhD
Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco
Search for more papers by this authorAbstract
Background
Job characteristics may constitute a barrier to return-to-work (RTW) after compensated disabling low back pain (LBP). This study examines the impact of psychosocial job factors on time to RTW separately during the acute and subacute/chronic disability phases.
Methods
This is a retrospective cohort study of 433 LBP workers' compensation claimants with 1–4 years of follow-up. The association of psychosocial job factors with duration of work disability was estimated with Cox regression models, adjusting for injury history and severity, physical workload, and demographic and employment factors.
Results
High physical and psychological job demands and low supervisory support are each associated with about 20% lower RTW rates during all disability phases. High job control, especially control over work and rest periods, is associated with over 30% higher RTW rates, but only during the subacute/chronic disability phase starting 30 days after injury. Job satisfaction and coworker support are unrelated to time to RTW.
Conclusions
Duration of work disability is associated with psychosocial job factors independent of injury severity and physical workload. The impact of these risk factors changes significantly over the course of disability. Am. J. Ind. Med. 40:374–392, 2001. © 2001 Wiley-Liss, Inc.
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