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Christopher B Mcleod - One of the best experts on this subject based on the ideXlab platform.
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return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
PLOS ONE, 2018Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:Introduction Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a Work-Related Musculoskeletal Disorder (MSD). Methods We used administrative workers’ compensation data to identify injured workers with an accepted MSD lost-time claim between 2010–2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. Results MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Conclusions Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers’ compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.
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0350 return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
Occupational and Environmental Medicine, 2017Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:The objective of this study is to examine the association between multiple jobholding and return-to-work (RTW) for workers with a Work-Related Musculoskeletal Disorder (MSD). We hypothesise that multiple jobholders (MJHs) are less likely to RTW compared to single jobholders (SJHs), due to their higher sickness absence threshold, more unstable employment contracts, and higher workload. We used administrative workers’ compensation data to identify workers with accepted MSD lost-time claims and an injury date between 2010–2014 in British Columbia, Canada (n=125,639 SJHs and 9,029 MJHs). The outcome was time until RTW within one year following the first time-loss day. The MJH and SJH cohorts were balanced using coarsened exact matching, which yielded a matched cohort of 8,992 MJHs and 8,992 SJHs. The outcome was estimated using cox proportional hazard models. MJHs were less likely to RTW within one year after the first time-loss day compared to SJHs (Hazard Ratio (HR) 0.78; 95% confidence interval (CI) 0.76–0.81). This applied to men and women, but the reduced likelihood to RTW was larger for male MJHs (HR 0.73; 95% CI 0.70–0.77) than for female (HR 0.83; 95% CI 0.79–0.87). Furthermore, this result was stronger for those with ≤ five pre-injury weekly workdays (HR 0.76; 95% CI 0.73–0.79), compared to those with six or seven days pre-injury weekly workdays (HR 0.94; 95% CI 0.86–1.02). MJHs are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD. Identifying differences between MJHs and SJHs is the first step to improve RTW outcomes for this vulnerable segment of the workforce.
Esther T Maas - One of the best experts on this subject based on the ideXlab platform.
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return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
PLOS ONE, 2018Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:Introduction Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a Work-Related Musculoskeletal Disorder (MSD). Methods We used administrative workers’ compensation data to identify injured workers with an accepted MSD lost-time claim between 2010–2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. Results MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Conclusions Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers’ compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.
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0350 return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
Occupational and Environmental Medicine, 2017Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:The objective of this study is to examine the association between multiple jobholding and return-to-work (RTW) for workers with a Work-Related Musculoskeletal Disorder (MSD). We hypothesise that multiple jobholders (MJHs) are less likely to RTW compared to single jobholders (SJHs), due to their higher sickness absence threshold, more unstable employment contracts, and higher workload. We used administrative workers’ compensation data to identify workers with accepted MSD lost-time claims and an injury date between 2010–2014 in British Columbia, Canada (n=125,639 SJHs and 9,029 MJHs). The outcome was time until RTW within one year following the first time-loss day. The MJH and SJH cohorts were balanced using coarsened exact matching, which yielded a matched cohort of 8,992 MJHs and 8,992 SJHs. The outcome was estimated using cox proportional hazard models. MJHs were less likely to RTW within one year after the first time-loss day compared to SJHs (Hazard Ratio (HR) 0.78; 95% confidence interval (CI) 0.76–0.81). This applied to men and women, but the reduced likelihood to RTW was larger for male MJHs (HR 0.73; 95% CI 0.70–0.77) than for female (HR 0.83; 95% CI 0.79–0.87). Furthermore, this result was stronger for those with ≤ five pre-injury weekly workdays (HR 0.76; 95% CI 0.73–0.79), compared to those with six or seven days pre-injury weekly workdays (HR 0.94; 95% CI 0.86–1.02). MJHs are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD. Identifying differences between MJHs and SJHs is the first step to improve RTW outcomes for this vulnerable segment of the workforce.
Donald D Mcgeary - One of the best experts on this subject based on the ideXlab platform.
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unremitting health care utilization outcomes of tertiary rehabilitation of patients with chronic Musculoskeletal Disorders
Journal of Bone and Joint Surgery American Volume, 2004Co-Authors: Timothy J Proctor, Robert J. Gatchel, Tom G. Mayer, Donald D McgearyAbstract:Background: Unremitting health-care-seeking behaviors have only infrequently been addressed in the literature as an outcome of treatment for chronic disabling Work-Related Musculoskeletal Disorders. The limited research has never focused on the patient as the “driver” of health-care utilization, to our knowledge. As a result, little attention has been paid to the differences between treated patients who seek additional health care from a new provider and those who do not. The purpose of this project was to examine the demographic and socioeconomic outcome variables that characterize patients with a chronic disabling Work-Related Musculoskeletal Disorder who pursue additional health-care services from a new provider following the completion of a tertiary rehabilitation treatment program. A prospective comparison cohort design was employed to assess characteristics and outcomes of these patients, all of whom were treated with the same interdisciplinary protocol. Methods: A cohort of 1316 patients who had been consecutively treated with a rehabilitation program for functional restoration was divided into two groups on the basis of whether they had sought treatment from a new health-care provider in the year following completion of treatment. Group 0 (966 patients) did not visit a new health-care provider for treatment of their original occupational injury, and Group 1 (350 patients) visited a new provider on at least one occasion. A structured clinical interview to assess socioeconomic outcomes was carried out one year after discharge from the treatment program; this interview addressed pain, health-care utilization, work status, recurrent injury, and whether the Workers' Compensation case had been closed. Results: The percentage of Group-0 patients who had undergone pre-rehabilitation surgery was significantly lower than the percentage of Group-1 patients who had done so (12% compared with 21%, odds ratio = 1.9 [95% confidence interval = 1.3, 2.7]; p < 0.001). One year after treatment, 90% of the Group-0 patients had returned to work compared with only 78% of the Group-1 patients (odds ratio = 2.6 [95% confidence interval, 1.9, 3.6]; p < 0.001). Similarly, 88% of the Group-0 patients were still working at one year compared with only 62% of the patients in Group 1 (odds ratio = 4.5 [95% confidence interval, 3.3, 6.0]; p < 0.001). Whereas 96% of the Group-0 patients had resolved all related legal and/or financial disputes by one year, only 77% of the Group-1 patients had done so (odds ratio = 6.9 [95% confidence interval, 4.5, 10.5]; p < 0.001). Only a negligible percentage (0.4%) of the patients in Group 0 had undergone a new operation at the site of the original injury, whereas 12% of the Group-1 patients had done so (odds ratio = 31.0 [95% confidence interval, 11.0, 87.3]; p < 0.001). When the above outcome variables were analyzed by dividing Group 1 according to the number of visits to a new service provider, there was a trend for poorer socioeconomic outcomes to be associated with an increasing number of health-care visits. Conclusions: To our knowledge, the present study represents the first large-scale examination of patients with a chronic disabling Work-Related Musculoskeletal Disorder who persist in seeking health-care following the completion of tertiary rehabilitation. The results demonstrate that about 25% of patients with a chronic disabling Work-Related Musculoskeletal Disorder pursue new health-care services after completing a course of treatment, and this subgroup accounts for a significant proportion of lost worker productivity, unremitting disability payments, and excess health-care consumption. Level of Evidence: Prognostic study, Level I-1 (prospective study). See Instructions to Authors for a complete description of levels of evidence.
Mary F Barbe - One of the best experts on this subject based on the ideXlab platform.
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joint inflammation and early degeneration induced by high force reaching are attenuated by ibuprofen in an animal model of work related Musculoskeletal Disorder
BioMed Research International, 2011Co-Authors: Jeffrey B Driban, Ann E Barr, Mamta Amin, Michael R Sitler, Mary F BarbeAbstract:We used our voluntary rat model of reaching and grasping to study the effect of performing a high-repetition and high-force (HRHF) task for 12 weeks on wrist joints. We also studied the effectiveness of ibuprofen, administered in the last 8 weeks, in attenuating HRHF-induced changes in these joints. With HRHF task performance, ED1+ and COX2+ cells were present in subchondral radius, carpal bones and synovium; IL-1alpha and TNF-alpha increased in distal radius/ulna/carpal bones; chondrocytes stained with Terminal deoxynucleotidyl Transferase- (TDT-) mediated dUTP-biotin nick end-labeling (TUNEL) increased in wrist articular cartilages; superficial structural changes (e.g., pannus) and reduced proteoglycan staining were observed in wrist articular cartilages. These changes were not present in normal controls or ibuprofen treated rats, although IL-1alpha was increased in reach limbs of trained controls. HRHF-induced increases in serum C1,2C (a biomarker of collagen I and II degradation), and the ratio of collagen degradation to synthesis (C1,2C/CPII; the latter a biomarker of collage type II synthesis) were also attenuated by ibuprofen. Thus, ibuprofen treatment was effective in attenuating HRHF-induced inflammation and early articular cartilage degeneration.
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induction of periostin like factor and periostin in forearm muscle tendon and nerve in an animal model of work related Musculoskeletal Disorder
Journal of Histochemistry and Cytochemistry, 2009Co-Authors: Shobha Rani, Ann E Barr, Mary F Barbe, Judith LitvinAbstract:Work-Related Musculoskeletal Disorders (WMSDs), also known as repetitive strain injuries of the upper extremity, frequently cause disability and impairment of the upper extremities. Histopathological changes including excess collagen deposition around myofibers, cell necrosis, inflammatory cell infiltration, and increased cytokine expression result from eccentric exercise, forced lengthening, exertion-induced injury, and repetitive strain-induced injury of muscles. Repetitive tasks have also been shown to result in tendon and neural injuries, with subsequent chronic inflammatory responses, followed by residual fibrosis. To identify mechanisms that regulate tissue repair in WMSDs, we investigated the induction of periostin-like factor (PLF) and periostin, proteins induced in other pathologies but not expressed in normal adult tissue. In this study, we examined the level of PLF and periostin in muscle, tendon, and nerve using immunohistochemistry and Western blot analysis. PLF increased with continued task performance, whereas periostin was constitutively expressed. PLF was located in satellite cells and/or myoblasts, which increased in number with continued task performance, supporting our hypothesis that PLF plays a role in muscle repair or regeneration. Periostin, on the other hand, was not present in satellite cells and/or myoblasts.
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periostin like factor and periostin in an animal model of work related Musculoskeletal Disorder
Bone, 2009Co-Authors: Shobha Rani, Ann E Barr, Mary F Barbe, Judith LitvinAbstract:Work-Related Musculoskeletal Disorders (WMSDs), also known as overuse injuries, account for a substantial proportion of work injuries and workers' compensation claims in the United States. However, the pathophysiological mechanisms underlying WMSDs are not well understood, especially the early events in their development. In this study we used an animal model of upper extremity WMSD, in which rats perform a voluntary repetitive reaching and pulling task for a food reward. This innovative model provides us an opportunity to investigate the role of molecules which may be used either as markers of early diagnosis of these Disorders, and/or could be targeted for therapeutic purposes in the future. Periostin-like-factor (PLF), and Periostin were examined in this study. Both belong to a family of vitamin K-dependent gamma carboxylated proteins characterized by the presence of conserved Fasciclin domains and not detected in adult tissues except under conditions of chronic overload, injury, stress or pathology. The spatial and temporal pattern of PLF and Periostin localization was examined by immunohistochemistry and western blot analysis in the radius and ulna of animals performing a high repetition, high force task for up to 12 weeks and in controls. We found that PLF was present primarily in the cellular periosteum, articular cartilage, osteoblasts, osteocytes and osteoclasts at weeks 3 and 6 in all distal bone sites examined. This increase coincided with a transient increase in serum osteocalcin in week 6, indicative of adaptive bone formation at this time point. PLF immunoexpression decreased in the distal periosteum and metaphysis by week 12, coincided temporally with an increase in serum Trap5b, thinning of the growth plate and reduced cortical thickness. In contrast to PLF, once Periostin was induced by task performance, it continued to be present at a uniformly high level between 3 and 12 weeks in the trabeculae, fibrous and cellular periosteum, osteoblasts and osteocytes. In general, the data suggest that PLF is located in tissues during the early adaptive stage of remodeling but not during the pathological phase and therefore might be a marker of early adaptive remodeling.
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median nerve trauma in a rat model of work related Musculoskeletal Disorder
Journal of Neurotrauma, 2003Co-Authors: Brian D Clark, Ann E Barr, Fayez F Safadi, Lisa Beitman, Talal A Alshatti, Mamta Amin, John P Gaughan, Mary F BarbeAbstract:Anatomical and physiological changes were evaluated in the median nerves of rats trained to perform repetitive reaching. Motor degradation was evident after 4 weeks. ED1-immunoreactive macrophages were seen in the transcarpal region of the median nerve of both forelimbs by 5–6 weeks. Fibrosis, characterized by increased immunoexpression of collagen type I by 8 weeks and connective tissue growth factor by 12 weeks, was evident. The conduction velocity (NCV) within the carpal tunnel showed a modest but significant decline after 9–12 weeks. The lowest NCV values were found in animals that refused to participate in the task for the full time available. Thus, both anatomical and physiological signs of progressive tissue damage were present in this model. These results, together with other recent findings indicate that Work-Related carpal tunnel syndrome develops through mechanisms that include injury, inflammation, fibrosis and subsequent nerve compression.
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dose response relationship between reach repetition and indicators of inflammation and movement dysfunction in a rat model of work related Musculoskeletal Disorder
Proceedings of the Human Factors and Ergonomics Society Annual Meeting, 2002Co-Authors: Ann E Barr, Marata Amin, Mary F BarbeAbstract:The purpose of this study was to compare the effects of a high or low repetition reaching and grasping task on serum levels of interleukin-1α (IL-1α) and IL-1β and on reach performance in a rat model of Work-Related Musculoskeletal Disorder (MSD). Forty-seven rats reached repetitively for 2 hours/day, 3 days/week for 6–8 weeks at a high or low rate. Reach rate and abnormal movement patterns were recorded. Serum was collected at 6 and 8 weeks for ELISA assay of IL-1α and IL-1β. High repetition animals experienced a 2-fold decline in reach rate, strong emergence of a raking movement, and increased IL-1α. IL-1α decreased in the low repetition group. IL-1β decreased in both groups. This model provides evidence that inflammation increases with repetition. At the higher reach rate, persistent IL-1α serum levels indicate chronic inflammation that is attenuated at the lower reach rate. These findings support the use of risk reduction in MSD prevention.
Mieke Koehoorn - One of the best experts on this subject based on the ideXlab platform.
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return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
PLOS ONE, 2018Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:Introduction Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a Work-Related Musculoskeletal Disorder (MSD). Methods We used administrative workers’ compensation data to identify injured workers with an accepted MSD lost-time claim between 2010–2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories. Results MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months. Conclusions Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers’ compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.
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0350 return to work for multiple jobholders with a work related Musculoskeletal Disorder a population based matched cohort in british columbia
Occupational and Environmental Medicine, 2017Co-Authors: Esther T Maas, Mieke Koehoorn, Christopher B McleodAbstract:The objective of this study is to examine the association between multiple jobholding and return-to-work (RTW) for workers with a Work-Related Musculoskeletal Disorder (MSD). We hypothesise that multiple jobholders (MJHs) are less likely to RTW compared to single jobholders (SJHs), due to their higher sickness absence threshold, more unstable employment contracts, and higher workload. We used administrative workers’ compensation data to identify workers with accepted MSD lost-time claims and an injury date between 2010–2014 in British Columbia, Canada (n=125,639 SJHs and 9,029 MJHs). The outcome was time until RTW within one year following the first time-loss day. The MJH and SJH cohorts were balanced using coarsened exact matching, which yielded a matched cohort of 8,992 MJHs and 8,992 SJHs. The outcome was estimated using cox proportional hazard models. MJHs were less likely to RTW within one year after the first time-loss day compared to SJHs (Hazard Ratio (HR) 0.78; 95% confidence interval (CI) 0.76–0.81). This applied to men and women, but the reduced likelihood to RTW was larger for male MJHs (HR 0.73; 95% CI 0.70–0.77) than for female (HR 0.83; 95% CI 0.79–0.87). Furthermore, this result was stronger for those with ≤ five pre-injury weekly workdays (HR 0.76; 95% CI 0.73–0.79), compared to those with six or seven days pre-injury weekly workdays (HR 0.94; 95% CI 0.86–1.02). MJHs are disadvantaged compared to SJHs in terms of RTW following a Work-Related MSD. Identifying differences between MJHs and SJHs is the first step to improve RTW outcomes for this vulnerable segment of the workforce.
