Predictors of chronic disability in injured workers: a systematic literature synthesis

Abstract

Background: Loss of productive life among injured workers potentially could be prevented by clearer knowledge of disability risk factors. Despite the number of studies that have examined predictors of disability, there have been no systematic literature reviews integrating multiple risk factor domains. Such a synthesis could help to define important gaps in knowledge, inform future study designs most likely to successfully address these gaps, and highlight the importance of secondary (disability) prevention to public health policy. A systematic synthesis of the literature on risk factors for chronic or recurrent disability in injured workers was performed to meet this need.

Methods: Articles were identified through a MEDLINE search, personal file searches, and requests to experts. Information concerning study methods and results was abstracted from 20 articles that met the inclusion criteria (population-based or prospective cohort studies).

Results: The most frequently identified predictors of prolonged disability were older age and greater baseline pain and functional disability. Lumbar symptoms, smaller company size, and construction work were significant predictors in several, but not all, studies. Risk factors did not appear to differ for back versus mixed injuries.

Conclusions: Several risk factors for prolonged disability were identified. Research is needed to develop and test multivariate models of worker, workplace, health care, and administrative risk factors for prolonged and recurrent disability in order to refine and target interventions.