Notification of occupational disease and the risk of work disability: a two-year follow-up study.

OBJECTIVES: The aim of this study was to analyze if notification of an occupational disease increases the risk of work disability. METHODS: We included 2304 patients examined at the Department of Occupational Medicine, Aarhus University Hospital, 1998-2005 and followed them for two years. A total of 564 patients were notified of an occupational disease when they were examined at baseline and 1740 patients were not. We obtained weekly information on sick payment, unemployment payment, disability pension, rehabilitation benefit, and other social benefits during the two years of follow-up from a national register. Using Cox regression models, we analyzed notification and adjusted hazard ratios (HRadj) of work disability (defined as >12 weeks of social benefits during the first or second year of follow-up). RESULTS: Prior to notification, notified patients had higher levels of clinical, occupational, and social characteristics that predict poorer vocational prognosis. Analyses that adjusted for these differences showed an increased risk of work disability following notification for patients who were working when notified at baseline (HRadj 1.46, 95% CI 1.17-1.82). No effect was seen for patients who were not working. CONCLUSIONS: Notification of an occupational disease may, as an unintended side effect, increase the risk of work disability. A cautious interpretation is warranted because data analyses may not fully have accounted for the poorer vocational prognosis already present at baseline.