Barriers for early return-to-work of workers with musculoskeletal disorders according to occupational health physicians and human resource managers.

Recent studies have indicated positive effects of modified work for workers with musculosceletal complaints. The question remains how effectively modified work can be implemented in companies. This study describes barriers for introducing modified work for workers on sickness absence due to musculoskeletal complaints. Modified work was defined as gradually increasing the physical demands at work until the worker is ready for full duty in his regular job. In order to describe barriers in implementation of modified work, a model based on health education was used, consisting of six successive stages. A questionnaire derived from this model was sent to human resource managers of different companies and their occupational health physicians. The internal consistency was estimated with the Cronbach's alpha. The results showed a large number of barriers for modified work. According to 52% of the company management and 54% of the occupational health physicians evident barriers were found due to lack of knowledge on modified work and negative attitudes of the employees. Both companies and physicians reported a barrier in the possibilities to change the work tasks (45-54%) or the organization of the work (45-38%). About 62% of the companies reported barriers due to a mismatch between the education of the sick worker and the specific requirements of modified work. Despite the assumed positive effects of modified work, the implementation process is hampered by a large number of barriers. A maximum effort from all parties involved is required for a successful rehabilitation process.