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Butt JH, Kragholm K, Kruuse C, Christensen H, Iversen HK, Johnsen SP, Rørth R, Vinding NE, Yafasova A, Christiansen CB, Gislason GH, Torp-Pedersen C, Køber L, Fosbøl EL. Workforce Attachment after Ischemic Stroke - The Importance of Time to Thrombolytic Therapy. J Stroke Cerebrovasc Dis 2021; 30:106031. [PMID: 34450481 DOI: 10.1016/j.jstrokecerebrovasdis.2021.106031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 06/23/2021] [Accepted: 08/01/2021] [Indexed: 12/09/2022] Open
Abstract
OBJECTIVES The ability to remain in employment addresses an important consequence of stroke beyond the usual clinical parameters. However, data on the association between time to intravenous thrombolysis and workforce attachment in patients with acute ischemic stroke are sparse. MATERIALS AND METHODS In this nationwide cohort study, stroke patients of working age (18-60 years) treated with thrombolysis (2011-2016) who were part of the workforce prior to admission and alive at discharge were identified using the Danish Stroke Registry. The association between time to thrombolysis and workforce attachment one year later was examined with multivariable logistic regression. RESULTS The study population comprised 1,329 patients (median age 51 years [25th-75th percentile 45-56], 67.3% men). The median National Institutes of Health Stroke Scale score at presentation was 4 (25th-75th percentile 2-8), and the median time from symptom-onset to initiation of thrombolysis was 140min (25th-75th percentile 104-196min). The proportion of patients who were part of the workforce at one-year follow-up was 64.6%, 64.3%, 64.9%, and 60.0% in patients receiving thrombolysis within 90min, between 91-180min, between 181-270min, and after 270min, respectively. In adjusted analysis, time to thrombolysis between 91-180min, 181-270min, and >270min was not significantly associated with workforce attachment compared with thrombolysis received ≤90min of symptom-onset (ORs 0.89 [95%CI 0.60-1.31], 0.93 [0.66-1.31], and 0.80 [0.43-1.52], respectively). CONCLUSIONS In patients of working age admitted with stroke and treated with thrombolysis, two out of three were part of the workforce one year after discharge. There was no graded relationship between time to thrombolysis and the likelihood of workforce attachment.
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Affiliation(s)
- Jawad H Butt
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark.
| | | | - Christina Kruuse
- Department of Neurology, Herlev-Gentofte University Hospital, Denmark
| | - Hanne Christensen
- Department of Neurology, Bispebjerg Hospital, Copenhagen University Hospital, Denmark
| | - Helle K Iversen
- Department of Neurology, Rigshospitalet, Copenhagen University Hospital, Denmark
| | - Søren Paaske Johnsen
- Danish Center for Clinical Health Services Research, Department of Clinical Medicine, Aalborg University, Denmark
| | - Rasmus Rørth
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Naja Emborg Vinding
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Adelina Yafasova
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | | | - Gunnar H Gislason
- Department of Cardiology, Herlev-Gentofte University Hospital, Denmark
| | | | - Lars Køber
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
| | - Emil L Fosbøl
- Department of Cardiology, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, Copenhagen 2100, Denmark
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Davie G, Lilley R. Financial impact of injury in older workers: use of a national retrospective e-cohort to compare income patterns over 3 years in a universal injury compensation scheme. BMJ Open 2018; 8:e018995. [PMID: 29703849 PMCID: PMC5922494 DOI: 10.1136/bmjopen-2017-018995] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
OBJECTIVE The study aims to quantify the impact of injury on the financial well-being of older workers. The hypothesis was that injured older workers have substantially reduced income from work following injury, but that New Zealand's (NZ) universal injury compensation scheme mitigates the difference for total income. DESIGN, SETTING AND PARTICIPANTS An e-cohort of 617 722 workers aged 45-64 years old was created using de-identified linked administrative data in NZ's Integrated Data Infrastructure. Person-level data from numerous government agencies were used to compare 21 639 with an injury-related entitlement claim in 2009 with the remaining 596 133. Event date was the date of injury, or for the comparison group, a randomly selected date in 2009. PRIMARY AND SECONDARY OUTCOME MEASURES Geometric mean ratios (GMRs) were used to compare income from work and total income from all taxable sources between those injured and the comparison group. Adjusted GMRs estimated income differences up to 36 months following the event date. RESULTS Differences in total income increased over time. In the third year, those injured received 6.7% less (adjusted GMR 0.933 (95% CI 0.925 to 0.941)) than the comparison group, equivalent to an average loss of $NZ2628. Restricting to income from work, those injured received 29.2% less than the comparison group at 3 years (adjusted GMR 0.708 (95% CI 0.686 to 0.730)). For both men and women, those injured at 45-49 years consistently had the greatest relative income loss compared with those aged 50-54, 55-59 or 60-64 years. CONCLUSIONS Although the substantial impacts of injury on income were mainly mitigated by public income transfers, relative losses in income in those aged 45-64 years increased in the 3 years following injury. Policies focused on adequate compensation and reducing the time away from employment could reduce these financial impacts in older workers.
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Affiliation(s)
- Gabrielle Davie
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
- Administrative Data for Health Research Hub, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Rebbecca Lilley
- Injury Prevention Research Unit, Department of Preventive and Social Medicine, University of Otago, Dunedin, New Zealand
- Administrative Data for Health Research Hub, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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Alavi SS, Makarem J, Abbasi M, Rahimi A, Mehrdad R. Association between upper extremity musculoskeletal disorders and mental health status in office workers. Work 2016; 55:3-11. [PMID: 27612063 DOI: 10.3233/wor-162382] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Musculoskeletal Disorders (MSDs) can lead to potential adverse consequences for individuals and their organizations, and in various research, its relationship to physical and mental health of workforce has been studied. OBJECTIVE The purpose of this study was to determine the prevalence of MSDs of upper extremities among office workers and its association with mental health status. METHODS In this cross sectional study, 1488 out of 1630 office workers completed the Standardized Nordic Musculoskeletal Disorders Ques-tionnaire and General Health Questionnaire (GHQ-28) (response rate = 91.3%). RESULTS Upper extremity MSDs were reported in 410 (27.5%) office workers, including 269 (18.1%) shoulder, 79 (5.3%) elbow and 207 (13.9%) hand/wrist symptoms. Based on GHQ-28, 254 (17.1%) participants were found to be at risk of developing a psychiatric disorder that were observed in 26.7% of workers with MSDs symptoms. Shoulder (p < 0.001), elbow (p < 0.001) and hand/wrist (p < 0.001) MSDs were associated with poor mental health. Among the four GHQ-28 subscales (somatic symptoms, anxiety/insomnia, social dysfunction, and depression), anxiety/insomnia was strongly correlated with shoulders (P < 0.001), elbows (P = 0.002), and hands/wrists (P < 0.001) symptoms. CONCLUSION Office workers with upper extremity MSDs were more likely to be experiencing mental distress. This indicates a need for greater emphasis on preventive programs at workplace to support their psychological well-being.
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Affiliation(s)
- Seyedeh Shohreh Alavi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Jalil Makarem
- Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahya Abbasi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Azin Rahimi
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
| | - Ramin Mehrdad
- Center for Research on Occupational Diseases, Tehran University of Medical Sciences, Tehran, Iran
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Besen E, Young AE, Pransky G. Exploring the relationship between age and tenure with length of disability. Am J Ind Med 2015; 58:974-87. [PMID: 26010587 PMCID: PMC5032995 DOI: 10.1002/ajim.22481] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2015] [Indexed: 12/21/2022]
Abstract
Background The aging of the workforce, coupled with the changing nature of career tenure has raised questions about the impact of these trends on work disability. This study aimed to determine if age and tenure interact in relating to work disability duration. Methods Relationships were investigated using random effects models with 239,359 work disability claims occurring between 2008 and 2012. Results A 17‐day difference in the predicted length of disability was observed from ages 25 to 65. Tenure moderated the relationship between age and length of disability. At younger ages, the length of disability decreased as tenure increased, but at older age, the length of disability increased as tenure increased. Discussion Results indicate that although there is a relationship between length of disability and tenure, age makes a greater unique contribution to explaining variance in length of disability. Future research is needed to better understand why specifically age shows a strong relationship with length of disability and why that relationship varies with age. Am. J. Ind. Med. 58:974–987, 2015. © 2015 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Elyssa Besen
- Center for Disability ResearchLiberty Mutual Research Institute for SafetyHopkintonMassachusetts
| | - Amanda E. Young
- Center for Disability ResearchLiberty Mutual Research Institute for SafetyHopkintonMassachusetts
| | - Glenn Pransky
- Center for Disability ResearchLiberty Mutual Research Institute for SafetyHopkintonMassachusetts
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King P, Huddleston W, Darragh AR. Work-related musculoskeletal disorders and injuries: differences among older and younger occupational and physical therapists. JOURNAL OF OCCUPATIONAL REHABILITATION 2009; 19:274-283. [PMID: 19504176 DOI: 10.1007/s10926-009-9184-1] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2009] [Accepted: 05/13/2009] [Indexed: 05/27/2023]
Abstract
INTRODUCTION Occupational and physical therapists are at significant risk of work-related musculoskeletal disorders and injuries. As the therapy workforce ages, and shortages of therapists are predicted, it is important to evaluate differences in injuries and injury behaviors between older and younger therapists. METHODS Half of all occupational and physical therapists practicing in Wisconsin were randomly selected for a cross sectional study examining the relationship between aging and characteristics of self-reported work injuries and musculoskeletal symptoms. RESULTS Data from a sample of 1,158 therapists revealed older workers to have similar injury incidence rates, however, days away from work due to injury were higher among older workers. Overall, older and younger therapists were more similar than different, especially in regards to work behaviors. Older therapists tended to report more severe pain symptoms than younger therapists and were two and a half times more likely to report that they changed jobs due to their pain symptoms. CONCLUSIONS Older and younger therapists have similar work-related injury experiences. Older workers may be more vulnerable to lost work time and may experience more severe pain symptoms. Many interventions exist to prevent work-related injuries to therapists and more guidance in the best way to integrate these interventions (e.g., mechanical lift devices) into therapy practice is needed.
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Affiliation(s)
- Phyllis King
- College of Health Sciences, Department of Occupational Therapy, University of Wisconsin-Milwaukee, P.O. Box 413, Milwaukee, WI 53201, USA.
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Zuhosky JP, Irwin RW, Sable AW, Sullivan WJ, Panagos A, Foye PM. Industrial Medicine and Acute Musculoskeletal Rehabilitation. 7. Acute Industrial Musculoskeletal Injuries in the Aging Workforce. Arch Phys Med Rehabil 2007; 88:S34-9; quiz S40-8. [DOI: 10.1016/j.apmr.2006.12.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Lerman Y, Ribak J. The Need for Consistent Criteria for Impairment and Disability. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 1997; 3:273-276. [PMID: 9891128 DOI: 10.1179/oeh.1997.3.4.273] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Medical committees that are responsible for pension funds (FMCs) rarely agree with decisions taken by occupational physicians to displace workers from their workplaces and to certify their eligibility for retirement on medical grounds. The major reason for this substantial disagreement, as demonstrated in this article, is a difference between the definition of disability used by the FMCs and that used by the employers or the occupational physicians. The dispute is usually about the evaluation of the worker's ability to function well in an alternative suitable job or with some modification in the customary job. It is also obvious that work options that existed in the past and were offered to disabled workers are diminishing nowadays due to technological and economic advances. The meaning of this disagreement to employers is that they can find their enterprises stuck with disabled workers who are unable to continue their jobs but are not entitled to pensions from the fund because they are considered suitable to cope with another theoretical job. The authors conclude with several approaches to avoiding certain dilemmas concerning the medical aspects associated with the displacement of disabled workers.
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Affiliation(s)
- Y Lerman
- Occupational Health Center, Kupat-Holim, 101 Arlozorov Street, Tel-Aviv 62098, Israel.
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