I Brus1, E Speklé1,2, P P Kuijer1, M Hardenberg1, P Coenen1. 1. Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam UMC, Amsterdam 1081 BT, The Netherlands. 2. Arbo Unie, Occupational Health Service, Utrecht 3508 AC, The Netherlands.
Abstract
BACKGROUND: Low back pain (LBP) is a world leading cause of disability and has substantial impact on individuals and society as a whole. The largest part of the societal burden of LBP is caused by indirect costs, including sick leave. AIMS: We aimed to describe occupational recovery and associated costs for workers consulting an occupational physician (OP) with LBP, and to determine to what extent this differs by diagnoses: non-specific favourable LBP, non-specific unfavourable LBP, lumbosacral radicular syndrome (LRS) and specific LBP. METHODS: We analysed longitudinal dynamic cohort data from an occupational health service, representing ~1.2 million workers from various companies and sectors throughout the Netherlands. The OP registered data on sick leave and LBP diagnoses. A survival analysis was performed on sick leave duration to determine recovery and a linear regression analysis on cost per episode, adjusting for sex, age and working hours. RESULTS: We analysed 5951 LBP episodes from 5472 workers who consulted an OP, with a median and mean duration sick leave of 95 and 151 days, respectively. The probability of not recovering was 82% at 30 days and 10% at 1 year. The mean cost per episode was €15 350. Specific LBP (€22 999; beta (95% confidence interval [CI]): 16 278 (13 325-19 165)) and LRS (€20 111; beta (95% CI): 13 589 (12 527-14 659)) had the longest and most costly episodes, compared to non-specific favourable LBP (€6745; reference group). CONCLUSIONS: With LRS and non-specific unfavourable LBP accounting for over 83% of LBP-associated sick leave costs, the work-directed care of workers with these two diagnoses deserves increased attention.
BACKGROUND: Low back pain (LBP) is a world leading cause of disability and has substantial impact on individuals and society as a whole. The largest part of the societal burden of LBP is caused by indirect costs, including sick leave. AIMS: We aimed to describe occupational recovery and associated costs for workers consulting an occupational physician (OP) with LBP, and to determine to what extent this differs by diagnoses: non-specific favourable LBP, non-specific unfavourable LBP, lumbosacral radicular syndrome (LRS) and specific LBP. METHODS: We analysed longitudinal dynamic cohort data from an occupational health service, representing ~1.2 million workers from various companies and sectors throughout the Netherlands. The OP registered data on sick leave and LBP diagnoses. A survival analysis was performed on sick leave duration to determine recovery and a linear regression analysis on cost per episode, adjusting for sex, age and working hours. RESULTS: We analysed 5951 LBP episodes from 5472 workers who consulted an OP, with a median and mean duration sick leave of 95 and 151 days, respectively. The probability of not recovering was 82% at 30 days and 10% at 1 year. The mean cost per episode was €15 350. Specific LBP (€22 999; beta (95% confidence interval [CI]): 16 278 (13 325-19 165)) and LRS (€20 111; beta (95% CI): 13 589 (12 527-14 659)) had the longest and most costly episodes, compared to non-specific favourable LBP (€6745; reference group). CONCLUSIONS: With LRS and non-specific unfavourable LBP accounting for over 83% of LBP-associated sick leave costs, the work-directed care of workers with these two diagnoses deserves increased attention.
Authors: Jan Hartvigsen; Mark J Hancock; Alice Kongsted; Quinette Louw; Manuela L Ferreira; Stéphane Genevay; Damian Hoy; Jaro Karppinen; Glenn Pransky; Joachim Sieper; Rob J Smeets; Martin Underwood Journal: Lancet Date: 2018-03-21 Impact factor: 79.321
Authors: Joel M Stevans; Anthony Delitto; Samannaaz S Khoja; Charity G Patterson; Clair N Smith; Michael J Schneider; Janet K Freburger; Carol M Greco; Jennifer A Freel; Gwendolyn A Sowa; Ajay D Wasan; Gerard P Brennan; Stephen J Hunter; Kate I Minick; Stephen T Wegener; Patti L Ephraim; Michael Friedman; Jason M Beneciuk; Steven Z George; Robert B Saper Journal: JAMA Netw Open Date: 2021-02-01
Authors: Gwenllian Wynne-Jones; Jemma Cowen; Joanne L Jordan; Olalekan Uthman; Chris J Main; Nick Glozier; Danielle van der Windt Journal: Occup Environ Med Date: 2013-11-01 Impact factor: 4.402
Authors: J W H Luites; P P F M Kuijer; C T J Hulshof; R Kok; M W Langendam; T Oosterhuis; J R Anema; V P Lapré-Utama; C P J Everaert; H Wind; R J E M Smeets; Y van Zaanen; E A Hoebink; L Voogt; W de Hoop; D H Boerman; J L Hoving Journal: J Occup Rehabil Date: 2021-07-27