The association between workers' compensation claims involving neck pain and future health care utilization: a population-based cohort study.

PURPOSE: To describe the health care utilization of injured workers who made a workers' compensation claim for neck pain. METHODS: We conducted a cohort study of injured workers who made an incident claim involving neck pain to the Ontario Workplace Safety and Insurance Board between 1997 and 1998. We linked their workers' compensation and Ontario Health Insurance Plan files to collect all health care services accrued during the year prior to and 2 years after the claim was initiated. We report the 7 day simple moving average of health care services per 1,000 claimants per day. We stratified our analysis by age, sex, the pre-claim level of health care utilization, diagnostic category and health care specialty. RESULTS: 58.1 % of claimants were males and 35.1 % were between the ages of 35 and 44 years. The cumulative rate of health care utilization was stable (mean = 60.80 services/1,000 claimants/day; 95 % CI: 59.7-62.0) throughout the year prior to the claim. However, it peaked during the first 4 days following the onset of the claim (mean = 473.3 services/1,000 claimants/day) and remained on average 311 % higher than baseline during the first month post-claim. On average in our sample, the health care utilization remained 11 % higher in the second year after the claim compared to the pre-claim level. This sustained increase was attributable to 6 % of claimants. CONCLUSIONS: We report a long-term increase in the average number of health care services utilized by injured workers who make a workers' compensation claim involving neck pain. This increase was attributable to a minority of claimants. The health reasons for this increase deserve further investigation.

A pilot randomised control trial of the effectiveness of a biofeedback mouse in reducing self-reported pain among office workers.

A pilot study examined the effectiveness of a biofeedback mouse in reducing upper extremity pain and discomfort in office workers; in addition, relative mouse use (RMU), satisfaction and the feasibility of running a randomised controlled trial (RCT) in a workplace setting were evaluated. The mouse would gently vibrate if the hand was idle for more than 12 s. The feedback reminded users to rest the arm in neutral, supported postures. Analysis showed a statistically significant reduction in shoulder pain and discomfort for the intervention group at T2 (38.7% lower than controls). Statistically significant differences in RMU time between groups were seen post intervention (-7% at T1 and +15% at T2 for the intervention group). Fifty-five percent of the intervention group was willing to continue using the mouse. It appears feasible to perform an RCT for this type of intervention in a workplace setting. Further study including more participants is suggested. PRACTITIONER SUMMARY: The study findings support the feasibility of conducting randomised control trials in office settings to evaluate ergonomics interventions. The intervention resulted in reduced pain and discomfort in the shoulder. The intervention could be a relevant tool in the reduction of upper extremity musculoskeletal disorder. Further research will better explain the study's preliminary findings.

The prevalence and incidence of work absenteeism involving neck pain: a cohort of Ontario lost-time claimants.

STUDY DESIGN: Cohort study. OBJECTIVE: To measure the prevalence and incidence of work absenteeism involving neck pain in a cohort of claimants to the Ontario Workplace Safety & Insurance Board (WSIB). SUMMARY OF BACKGROUND DATA: According to workers' compensation statistics, neck pain accounts for a small proportion of lost-time claims. However, these statistics may be biased by an underenumeration of claimants with neck disorders. METHODS: We studied all lost-time claimants to the Ontario WSIB in 1998 and used 2 methods to enumerate neck pain cases. We report the prevalence and incidence of neck pain using 2 denominators: (1) annual number of lost-time claimants and (2) an estimate of the Ontario working population covered by the WSIB. RESULTS: The estimated percentage of lost-time claimants with neck pain ranged from 2.8% (95% CI 2.5-3.3) using only codes specific for neck pain to 11.3% (95% CI 9.5-13.1) using a weighted estimate of codes capturing neck pain cases. The health care sector had the highest percentage of claims with neck pain. The annual incidence of neck pain among the Ontario working population ranged from 6 per 10,000 full-time equivalents (FTE) (95% CI 5-6) to 23 per 10,000 FTE (95% CI 20-27) depending on the codes used to capture neck pain. Male workers between the ages of 20 and 39 years were the most likely to experience an episode of work absenteeism involving neck pain. CONCLUSION: Neck pain is a common and burdensome problem for Ontario workers. Our study highlights the importance of properly capturing all neck pain cases when describing its prevalence and incidence.

Integrative interventions for MSDs: nature, evidence, challenges & directions.

BACKGROUND: When applied to workplace interventions, integrative may be seen in various ways, requiring elucidation. METHODS: Identification of primary studies through systematic reviews, limited bibliographic literature searches, the Cochrane Occupational Health Field database on intervention studies, and authors' files. Focus was 2000 on. Categorization according to the Cochrane classes and lenses on integrative. Synthesis as narrative review. RESULTS: Examples of each lens on integrative were uncovered: biomechanical and psychosocial, multiple component, primary and secondary prevention, organizational, and system. Each contributed different understanding to the potential impacts on different knowledge, exposure, behavior, health and administrative outcomes. CONCLUSIONS: Considerable opportunities exist to expand the range of integrative interventions, particularly at the organizational and system levels, and incorporate a combination of knowledge transfer and exchange with intervention evaluation.