Early workplace intervention for employees with musculoskeletal-related absenteeism: a prospective controlled intervention study. A randomised controlled trial on whether a participatory ergonomics intervention could prevent musculoskeletal disorders. Reducing long term sickness absence by an activating intervention in adjustment disorders: a cluster randomised controlled design. Effectiveness of an intervention to reduce sickness absence in patients with emotional distress or minor mental disorders: a randomized controlled effectiveness trial. A workplace intervention for sick-listed employees with distress: results of a randomised controlled trial. A randomized prospective study of vocational outcome in rehabilitation of patients with non-specific musculoskeletal pain: a multidisciplinary approach to patients identified after 90 days of sick-leave. The effectiveness of a work style intervention and a lifestyle physical activity intervention on the recovery from neck and upper limb symptoms in computer workers. A randomised controlled trial of postural interventions for prevention of musculoskeletal symptoms among computer users. A comprehensive work injury prevention program with clerical and office workers: phase I.
Sickness absenteeism caused by musculoskeletal disorders (MSDs) is a persistent and costly occupational health challenge. In a prospective controlled trial, we compared the effects on sickness absenteeism of a more proactive role for insurance case managers as well as workplace ergonomic interventions with that of traditional case management. Patients with physician-diagnosed MSDs were randomized either to the intervention group or the reference group offered the traditional case management routines. Participants filled out a comprehensive questionnaire at the initiation of the study and after 6 months. In addition, administrative data were collected at 0.6, and 12 months after the initiation of the project. For the entire 12-month period, the total mean number of sick days for the intervention group was 144.9 (SEM 11.8) days/person as compared to 197.9 (14.0) days in the reference group (P < 0.01). Compared with the reference group, employees in the intervention group significantly more often received a complete rehabilitation investigation (84% versus 27%). The time for doing this was reduced by half (59.4 (5.2) days versus 126.8 (19.2), P < .01). The odds ratio for returning to work in the intervention group was 2.5 (95% confidence interval 1.2-5.1) as compared with the reference group. The direct cost savings were USD 1195 per case, yielding a direct benefit-to-cost ratio of 6.8. It is suggested that the management of MSDs should to a greater degree focus on early return to work and building on functional capacity and employee ability. Allowing the case managers a more active role as well as involving an ergonomist in workplace adaptation meetings might also be beneficial. To examine the efficacy of a participatory ergonomics intervention in preventing musculoskeletal disorders among kitchen workers. Participatory ergonomics is commonly recommended to reduce musculoskeletal disorders, but evidence for its effectiveness is sparse.
                A cluster randomised controlled trial among the 504 workers of 119 kitchens in Finland was conducted during 2002-2005. Kitchens were randomised to an intervention (n = 59) and control (n = 60) group. The duration of the intervention that guided the workers to identify strenuous work tasks and to seek solutions for decreasing physical and mental workload, was 11 to 14 months. In total, 402 ergonomic changes were implemented. The main outcome measures were the occurrence of and trouble caused by musculoskeletal pain in seven anatomical sites, local fatigue after work, and sick leave due to musculoskeletal disorders. Individual level data were collected by a questionnaire at baseline and every 3 months during the intervention and 1-year follow-up period. All response rates exceeded 92%.
                No systematic differences in any outcome variable were found between the intervention and control groups during the intervention or during the 1-year follow-up.
                The intervention did not reduce perceived physical work load and no evidence was found for the efficacy of the intervention in preventing musculoskeletal disorders among kitchen workers. It may be that a more comprehensive redesign of work organisation and processes is needed, taking more account of workers' physical and mental resources. To compare an innovative activating intervention with "care as usual" (control group) for the guidance of employees on sickness leave because of an adjustment disorder. It was hypothesised that the intervention would be more effective than care as usual in lowering the intensity of symptoms, increasing psychological resources, and decreasing sickness leave duration.
                A prospective, cluster randomised controlled trial was carried out with 192 patients on first sickness leave for an adjustment disorder. Symptom intensity, sickness duration, and return to work rates were measured at 3 months and 12 months. Analyses were performed on an intention to treat basis.
                At 3 months, significantly more patients in the intervention group had returned to work compared with the control group. At 12 months all patients had returned to work, but sickness leave was shorter in the intervention group than in the control group. The recurrence rate was lower in the intervention group. There were no differences between the two study groups with regard to the decrease of symptoms. At baseline, symptom intensity was higher in the patients than in a normal reference population, but decreased over time in a similar manner in both groups to approximately normal levels.
                The experimental intervention for adjustment disorders was successful in shortening sick leave duration, mainly by decreasing long term absenteeism. The purpose of this study was to evaluate the effectiveness of an activating intervention designed to reduce sick leave duration in patients with emotional distress or minor mental disorders.
                In a 1.5-year randomized controlled trial, 194 patients with minor mental disorders received either an experimental intervention by social workers or general practitioners' usual care. The intervention focused on understanding causes, developing and implementing problem-solving strategies and promoting early work resumption. Outcome measures were sick leave duration, mental health and physical health (questionnaires included the Hospital Anxiety and Depression Scale, the Four-Dimensional Symptom Questionnaire and SF-36), all measured at baseline at and 3, 6 and 18 months later. Multilevel analyses were used to evaluate differences between groups.
                The groups did not differ significantly on any of the outcome measures, except that the experimental group reported higher satisfaction with treatment.
                Although the intervention has benefits, it was not successful at its primary goal (i.e., to reduce sick leave duration in patients with emotional distress or minor mental disorders). Programs aimed at the reduction of sick leave duration may yield better results if targeted at patients with more severe emotional problems than at those with exclusively emotional distress or minor mental disorders, or if delivered by caregivers who are closer to the work environment than are social workers, such as occupational physicians. To evaluate the effectiveness of a participatory workplace intervention compared with usual care for sick-listed employees with distress, with regard to return to work (RTW) within the 12-month follow-up.
                Employees with distress and sick-listed for 2-8 weeks were randomised to a workplace intervention (n=73) or to usual care (n=72). The participatory workplace intervention is a stepwise process involving the sick-listed employee and their supervisor, aimed at reducing obstacles for RTW by reaching consensus about an action plan for RTW. Outcome variables were lasting RTW, cumulative sickness absence and stress-related symptoms.
                Overall, an HR of 0.99 (95% CI 0.70 to 1.39) indicated no effect of the workplace intervention on lasting RTW. However, the workplace intervention significantly reduced the time until lasting RTW for employees who at baseline intended to return to work despite symptoms with an HR of 2.05 (95% CI 1.22 to 3.45). Employees who intended to return to work despite symptoms returned to work after 55 days in the workplace intervention group and 120 days in the usual care group. No such effect of the intervention was found for employees without baseline intentions to return to work despite symptoms (HR=0.78, 95% CI 0.47 to 1.28).
                No overall effect of the participatory workplace intervention on lasting RTW was found. The workplace intervention appeared effective on lasting RTW for employees who at baseline intended to return to work despite symptoms. For employees who showed no baseline intention to return to work, the intervention did not have any effect. Other approaches are needed for this subgroup. This trial has been registered at the Dutch National Trial Register ISRCTN92307123. This study was designed to evaluate the effectiveness of a multidisciplinary rehabilitation programme offered to a general population with 90 days of sick-leave due to non-specific musculoskeletal pain. The results concerning return to work and re-sick-listing during a follow-up period of five years were evaluated for Swedes and immigrants separately. Compared to a control group, the rehabilitation offer resulted in improved work stability after work return among the Swedes. The immigrants, as a group, did not benefit from the programme compared to the controls in primary care. This study assessed the effectiveness of a single intervention targeting work style and a combined intervention targeting work style and physical activity on the recovery from neck and upper limb symptoms. Computer workers with frequent or long-term neck and upper limb symptoms were randomised into the work style group (WS, n=152), work style and physical activity group (WSPA, n=156), or usual care group (n=158). The WS and WSPA group attended six group meetings. All meetings focused on behavioural change with regard to body posture, workplace adjustment, breaks and coping with high work demands (WS and WSPA group) and physical activity (WSPA group). Pain, disability at work, days with symptoms and months without symptoms were measured at baseline and after 6 (T1) and 12 months (T2). Self-reported recovery was assessed at T1/T2. Both interventions were ineffective in improving recovery. The work style intervention but not the combined intervention was effective in reducing all pain measures. These effects were present in the neck/shoulder, not in the arm/wrist/hand. For the neck/shoulder, the work style intervention group also showed an increased recovery-rate. Total physical activity increased in all study groups but no differences between groups were observed. To conclude, a group-based work style intervention focused on behavioural change was effective in improving recovery from neck/shoulder symptoms and reducing pain on the long-term. The combined intervention was ineffective in increasing total physical activity. Therefore we cannot draw conclusions on the effect of increasing physical activity on the recovery from neck and upper limb symptoms. To examine the effect of two workstation and postural interventions on the incidence of musculoskeletal symptoms among computer users.
                Randomised controlled trial of two distinct workstation and postural interventions (an alternate intervention and a conventional intervention) among 376 persons using computer keyboards for more than 15 hours per week. The incidence of neck/shoulder symptoms and hand/arm symptoms during six months of follow up among individuals in the intervention groups was compared to the incidence in computer users who did not receive an intervention (comparison group). For individuals in the intervention groups, study staff adjusted workstations, where possible, and trained individuals to assume the intervention postures. Individuals reported musculoskeletal symptoms in a weekly diary. Participants who reported discomfort intensity of 6 or greater on a 0-10 visual analogue scale or who reported musculoskeletal symptoms requiring use of analgesic medication were considered symptomatic.
                There were no significant differences in the incidence of musculoskeletal symptoms among the three intervention groups. Twenty two (18.5%) participants in the alternate intervention group, 25 (20.2%) in the conventional intervention group, and 25 (21.7%) in the comparison group developed incident arm or hand symptoms. Thirty eight (33.3%) participants in the alternate intervention group, 36 (31.0%) in the conventional intervention group, and 33 (30.3%) in the comparison group developed incident neck or shoulder symptoms. Compliance with all components of the intervention was attained for only 25-38% of individuals, due mainly to the inflexibility of workstation configurations.
                This study provides evidence that two specific workplace postural interventions are unlikely to reduce the risk of upper extremity musculoskeletal symptoms among computer users. The risk for the development of musculoskeletal disorders and associated conditions in clerical and office workers is well documented. The majority of work injury prevention programs for this population were single-faceted (education, workstation redesign, or task modification) and yielded both positive and negative findings. This pilot study was conducted with 16 full-time clerical and office workers at a small private college. In a randomized control trial, the intervention group received four hours of individualized training through a multi-faceted injury prevention program. Between group differences in musculoskeletal symptom frequency and intensity and perceived stress and energy levels existed, although were statistically insignificant. There was a statistically significant decrease in Lower Back ache/pain from pre to post measures for the intervention group.
As a result of the few available studies, no convincing conclusions can be formulated about the effectiveness of workplace interventions on work-related outcomes and health outcomes regardless of the type of work disability. The pooled data for the musculoskeletal disorders subgroup indicated that workplace interventions are effective in the reduction of sickness absence, but they are not effective in improving health outcomes. The evidence from the subgroup analysis on musculoskeletal disorders was rated as moderate-quality evidence. Unfortunately, conclusions cannot be drawn on the effectiveness of these interventions for mental health problems and other health conditions due to a lack of studies.