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WORK: A Journal of Prevention, Assessment & Rehabilitation is an interdisciplinary, international journal which publishes high quality peer-reviewed manuscripts covering the entire scope of the occupation of work. The journal's subtitle has been deliberately laid out: The first goal is the prevention of illness, injury, and disability. When this goal is not achievable, the attention focuses on assessment to design client-centered intervention, rehabilitation, treatment, or controls that use scientific evidence to support best practice.
WORK occasionally publishes thematic issues, but in general, issues cover a wide range of topics such as ergonomic considerations with children, youth and students, the challenges facing an aging workforce, workplace violence, injury management, performing artists, ergonomic product evaluations, and the awareness of the political, cultural, and environmental determinants of health related to work.
Dr. Karen Jacobs, the founding editor, and her editorial board especially encourage the publication of research studies, clinical practice, case study reports, as well as personal narratives and critical reflections of lived work experiences (autoethnographic/autobiographic scholarship),
Sounding Board commentaries and
Speaking of Research articles which provide the foundation for better understanding research to facilitate knowledge dissemination.
Narrative Reflections on Occupational Transitions, a new column, is for persons who have successfully transitioned into, between, or out of occupations to tell their stories in a narrative form. With an internationally renowned editorial board,
WORK maintains high standards in the evaluation and publication of manuscripts. All manuscripts are reviewed expeditiously and published in a timely manner.
WORK prides itself on being an author-friendly journal.
WORK celebrates its 25th anniversary in 2015.
*WORK is affiliated with the Canadian Association of Occupational Therapists (CAOT)* *WORK is endorsed by the International Ergonomics Association (IEA)* *WORK gives out the yearly Cheryl Bennett Best Paper Award*
Abstract: Carpal tunnel syndrome (CTS) is often work-related and associated with prolonged disability. While surgical treatment is common, an alternative endoscopic procedure has been promoted as a way of achieving better outcomes. However, little is known about typical use of the procedure and whether it actually achieves outcomes in community settings. From workers' compensation claims reported to an insurer in six jurisdictions during 1995–1999, we identified 1697 individuals with a single CTS surgery, 17% were treated using…the endoscopic procedure. Bivariate analyses of post-surgical outcomes demonstrated that post-surgical work disability was shorter for those with endoscopic procedures (median 27 vs. 34 days, mean 62 vs. 85 days; p< 0.01). Medical costs following the procedure were also lower in the case of endoscopic procedure for those with any post-surgical medical costs (median $1,201 vs. $1,717, mean $5,733 vs. $7,084; p< 0.01). However, controlling for jurisdiction and other factors, these differences disappeared, suggesting that in CTS the type of care received was not a major determinant of outcomes. These findings reinforce the importance of community-based evaluations which include potential confounders to accurately evaluate the impact of medical technologies on work disability in occupational conditions.
Keywords: Carpal tunnel, endoscopic release, return to work, medical costs, workers' compensation
Abstract: Objective: We investigated the association between clinician-assessed performance-based measures of improvement in lifting ability and workplace tolerance and patient self-reported improvement in pain and perceived disability following work conditioning (WC). Methods: A sample of 76 patients (42 ± 9 yrs, 21 to 60 yrs, 74% male) was selected from a retrospective database because they had lumbar spine impairments and received treatment in a WC program. Patients completed self-report surveys for perceived disability (Oswestry), pain intensity…(visual analog pain scale – VAS), and pain concerns (McGill short form) before initial functional capacity evaluation (FCE) and after termination of the WC program. During the FCE and during the WC, therapists assessed patient workplace tolerance (WT) and ability to lift from floor to waist (PDL). Results: Over the WC program that averaged 19 (6 SD) days, Oswestry and VAS scores improved (P< 0.05), but the McGill scores did not (P=0.334). 72% of patients improved their PDL, and 64% met their WT goals. None of the associations between patient self-report scores and performance-based measures were significant (P>0.05). Conclusions: In spite of continuing pain complaints, patients decreased their perceived disability and pain intensity, increased their lifting ability, and improved their workplace tolerance while participating in a work-conditioning program.
Keywords: Functional capacity evaluation, work conditioning, perceived disability, pain
Abstract: The purpose of this qualitative study was to explore from an environmental perspective the experiences of returning to work of former unemployed sickness absentees. Five separate focus-group interviews were carried out with themes concerning different environmental areas. The findings showed that the participants in their process of being off work and then attempting returning to work experienced a personal transition manifesting itself as a negative self-image, change of life-rhythm and restrictions in…their roles and activities. In their progression, the participants experienced a need for reorientation and expressed feelings of alienation, and for that reason felt need of support from a network, especially a professional one. Regarding attitudes in society, the participants reported experiences of social stigmatization, both in mass media and in their immediate social environment, and an increasing egocentricity among their fellow-workers. They perceived their progression back to work as a 'time quarantine' and as a long and destructive wait for support. The findings indicate that the phenomenon of 'returning to work' after unemployment and sick leave could not be reduced to a single issue. It should rather be seen as a dynamic problem with individual and structural, environmental aspects.
Keywords: Attitudes, coherence, focus group, former unemployed, vocational rehabilitation, personal transition, reorientation, sick-listed absentees, time
Abstract: Work-related health has been a focus of research since the rate of sickness-related absences began to increase in Sweden. The incidence of sickness-related absences and early retirement is higher among female immigrants than among others in the total population. This study is based on a questionnaire survey which was conducted in a municipality in Sweden. The study population consisted of 2 429 native and immigrant female employees. The aim was to study work-related health factors…for female immigrants. The results of this study show that about 20% of female immigrants who participate in the survey have temporary employment while the proportion is 8% for native women. The perception of ethnic discrimination among female immigrants was three times as much as among native females. The results also show that 69% of female immigrants report having received no opportunity to discuss their wages with managers, in comparison to 63% of native females. About 40% of female immigrants and 35% of native women report that they do not get opportunities to upgrade their skills. Female immigrants over the age of 50 experience gender and ethnic discrimination and lack of access to skills training programs more often than younger immigrants. They also participate in health-care activities more often.
Keywords: Work, health, female immigrants, discrimination, Sweden
Abstract: Low back pain is one of the most prevalent work related injuries in the physical therapy profession. New graduates and therapists working in rehabilitation and acute care hospitals are at the highest risk for developing low back pain . Although physical therapists are trained in maintaining proper body mechanics and preventing work related injuries, between 30% and 63% of therapists will experience low back pain at some point in their careers [2,4,9]. The culture of physical…therapy is one of the primary factors contributing to this problem, with many therapists reporting that their decision to use back pain preventive strategies depends on their colleagues' use of these strategies. The authors will use Green and Kreuter's PRECEDE-PROCEED model to identify behavioral, environmental, educational and ecological factors contributing to the problem; then will propose a health promotion intervention using the social action theory at the community level to decrease work-related low back pain in physical therapists while simultaneously addressing the culture of physical therapy.
Abstract: A problem attracting considerable attention in Sweden today is the substantial regional differences in sickness absence. The aim of the study was to investigate and compare how people, from a random sample of the population in both a rural area in the north of Sweden and the Swedish capital Stockholm, perceive their health, and what their attitudes are to work, leisure time and social welfare systems. Results showed that a larger proportion of those answering in…Stockholm considered their health status to be "very good", compared with those in the rural area (p<0.0001). A majority in the rural area compared to the city of Stockholm reported a high or very high level of aches/pain (p<0.0001) and that work causes them physical problems p<0.0001). The population in both Stockholm and the rural area is of the opinion that the increase in sickness absence is mainly due to deterioration in the work environment. Almost half of the individuals in both the rural area and in Stockholm are of the opinion that many of those sick-listed are not actually ill. It may be that in the rural area in north Sweden people are more inclined to put their opinions to practice than those in Stockholm are.
Abstract: Accidents are a common occurrence in the fishing industry. Despite this observation, there has been limited research on the factors contributing to this high rate of accidents and no research on the experience of disability among fish harvesters. This paper reports a narrative analysis of the accounts of fish harvesters who became disabled as a result of their work, and could no longer work in the industry. Four primary narrative structures were identified in their accounts:…disability as devastation, disability as challenge, disability as phenomenon and disability as opportunity. These narratives represent different temporal orientations to the disability. The findings are discussed with reference to other narrative work on adjustment to illness and the implications for disability rehabilitation for fish harvesters and other workers.
Keywords: Fish harvesters, injury, disability, narrative
Abstract: Background: Workplace injuries cause considerable morbidity, requiring intervention programs with strong stakeholder support and effective interdisciplinary practitioner involvement. Such a program, called Prevention and Early Active Return-to-Work Safely (PEARS), decreased time loss and costs in a large Canadian hospital. However, it only attracted 39% of workers who reported injuries. This triggered a study of utilization and satisfaction with PEARS to determine areas to further enhance the program. Methods: The hospital's occupational health department records…identified 758 workers who reported a musculoskeletal injury (MSI) during the first year of PEARS, along with demographic and injury details. All were telephoned regardless of participation in the PEARS program. Results: Of the 335 survey respondents, 136 had used PEARS. The most common reason justifying non-participation was perception of the injury as minor (45%). PEARS participants accessed significantly more resources than non-participants – including accessing physiotherapy (82.8% of participants versus 33.3% of non-participants) and physicians (74.8% versus 64.3%), and workplace assessments (37.9% versus 11.4%). Workplace assessment was the only component of the program that was perceived to be significantly more successful by PEARS participants (64.9%) versus non-participants (35.3%) (p=0.002). Conclusion: The fact that the only significant difference in satisfaction of services between those who accessed PEARS versus those who did not related to the workplace assessments underscores the value of proving workplace assessments in the context of an integrated approach to primary and secondary prevention, in which there is a direct link to knowledgeable medical and rehabilitation professionals who provide clinical advice that dovetails with the reality of the workplace setting. A program that emphasizes workplace assessment as an important complement to medical advice and physiotherapy is, therefore, advisable to decrease work disability.
Abstract: This paper describes the physical exposures required to perform a sawmill job associated with a high incidence of upper extremity musculoskeletal injury. Exposure variables are described by multiple posture, exertion and frequency definitions and the comparability of those definitions are examined. Effective industrial prevention efforts require an accurate assessment of risk. Surface electromyography and electrogoniometry were used to quantify the physical exposures of 29 trim-saw operators in four sawmill facilities. Average…wrist ranges of motion of 32, 57 and 58 degrees in wrist radial/ulnar deviation, flexion/extension and pronation/supination respectively were required to perform the job. Defining wrist range of motion by the peak postures observed versus those required to perform the primary task resulted in significantly different ranges of motion (p<0.05). Job performance required an average of 33% of maximum voluntary contraction. Repetitions per day ranged from 3,549 to 14,460. Percentage of maximum voluntary contraction was not associated with psychophysical measures of exertion.
Keywords: Field study, job analysis, physical ergonomics