Work disability after whiplash: a prospective cohort study

Abstract

Study design: Prospective cohort study.

Objective: To investigate the consequences of neck pain after motor vehicle accidents in terms of disability for work and the relationship this has with symptom and work-related factors.

Summary of background data: Previous studies on work disability related to whiplash are very heterogeneous, are often limited in sample size and show a wide variability in terms of results. A relationship has been suggested between poor recovery from or persistent work disability after whiplash and female gender, older age, marital status, heavy manual work, self-employment, prior psychological problems, subjective complaints of poor concentration, pain catastrophizing, and kinesiophobia.

Methods: Individuals with neck complaints after involvement in traffic accidents, who initiated compensation claim procedures with a Dutch insurance company (n = 879), were sent questionnaires (Q1) concerning the accident, the injuries that they had sustained, their complaints at that time, and questions regarding work and disability. The course of complaints and work disability was monitored at 6 (Q2) and 12 months (Q3) after the accident.

Results: A total of 58.8% of the population with neck complaints studied was work-disabled after the accident. Age and impaired concentration complaints after 1 month were found to be related to work disability at 1 year, independent of physical complaints and work characteristics.

Conclusion: Age and concentration complaints were important independent predictors of long-lasting work disability, whereas no evidence emerged to indicate that the degree of manual labor (blue or white collar work) or educational level was involved in persistent work disability in postwhiplash syndrome. The current results suggest that work disability could benefit most from interventions related to recovery from cognitive complaints and less from physically related interventions.