Workplace interventions for preventing work disability

S.H. van Oostrom, M.T. Driessen, H.C.W. de Vet, R.L. Franche, E. Schonstein, P. Loisel, W. van Mechelen, J.R. Anema

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

BACKGROUND: Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.

OBJECTIVES: To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.

SEARCH STRATEGY: We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).

SELECTION CRITERIA: We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.

DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.

MAIN RESULTS: We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.

AUTHORS' CONCLUSIONS: 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.

Original languageEnglish
Article numberCD006955
Pages (from-to)CD006955
JournalCochrane Database of Systematic Reviews
Issue number2
DOIs
Publication statusPublished - 15 Apr 2009

Cite this

van Oostrom, S. H., Driessen, M. T., de Vet, H. C. W., Franche, R. L., Schonstein, E., Loisel, P., ... Anema, J. R. (2009). Workplace interventions for preventing work disability. Cochrane Database of Systematic Reviews, (2), CD006955. [CD006955]. https://doi.org/10.1002/14651858.CD006955.pub2
van Oostrom, S.H. ; Driessen, M.T. ; de Vet, H.C.W. ; Franche, R.L. ; Schonstein, E. ; Loisel, P. ; van Mechelen, W. ; Anema, J.R. / Workplace interventions for preventing work disability. In: Cochrane Database of Systematic Reviews. 2009 ; No. 2. pp. CD006955.
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title = "Workplace interventions for preventing work disability",
abstract = "BACKGROUND: Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.OBJECTIVES: To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.SEARCH STRATEGY: We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).SELECTION CRITERIA: We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.MAIN RESULTS: We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.AUTHORS' CONCLUSIONS: 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.",
keywords = "Absenteeism, Humans, Low Back Pain/prevention & control, Mental Disorders/prevention & control, Musculoskeletal Diseases/prevention & control, Occupational Diseases/prevention & control, Occupational Health, Randomized Controlled Trials as Topic, Workplace",
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Workplace interventions for preventing work disability. / van Oostrom, S.H.; Driessen, M.T.; de Vet, H.C.W.; Franche, R.L.; Schonstein, E.; Loisel, P.; van Mechelen, W.; Anema, J.R.

In: Cochrane Database of Systematic Reviews, No. 2, CD006955, 15.04.2009, p. CD006955.

Research output: Contribution to journalReview articleAcademicpeer-review

TY - JOUR

T1 - Workplace interventions for preventing work disability

AU - van Oostrom, S.H.

AU - Driessen, M.T.

AU - de Vet, H.C.W.

AU - Franche, R.L.

AU - Schonstein, E.

AU - Loisel, P.

AU - van Mechelen, W.

AU - Anema, J.R.

PY - 2009/4/15

Y1 - 2009/4/15

N2 - BACKGROUND: Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.OBJECTIVES: To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.SEARCH STRATEGY: We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).SELECTION CRITERIA: We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.MAIN RESULTS: We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.AUTHORS' CONCLUSIONS: 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.

AB - BACKGROUND: Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.OBJECTIVES: To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.SEARCH STRATEGY: We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).SELECTION CRITERIA: We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.DATA COLLECTION AND ANALYSIS: Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.MAIN RESULTS: We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.AUTHORS' CONCLUSIONS: 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.

KW - Absenteeism

KW - Humans

KW - Low Back Pain/prevention & control

KW - Mental Disorders/prevention & control

KW - Musculoskeletal Diseases/prevention & control

KW - Occupational Diseases/prevention & control

KW - Occupational Health

KW - Randomized Controlled Trials as Topic

KW - Workplace

U2 - 10.1002/14651858.CD006955.pub2

DO - 10.1002/14651858.CD006955.pub2

M3 - Review article

SP - CD006955

JO - Cochrane Database of Systematic Reviews

JF - Cochrane Database of Systematic Reviews

SN - 1469-493X

IS - 2

M1 - CD006955

ER -

van Oostrom SH, Driessen MT, de Vet HCW, Franche RL, Schonstein E, Loisel P et al. Workplace interventions for preventing work disability. Cochrane Database of Systematic Reviews. 2009 Apr 15;(2):CD006955. CD006955. https://doi.org/10.1002/14651858.CD006955.pub2