Employment status, job characteristics, and work-related health experienceof people with a lower limb amputation in the Netherlands

Objectives: To describe the occupational situation of people with lower lim b amputations in The Netherlands and to compare the health experience of wo rkings and nonworking amputee patients with a nonimpaired reference populat ion. Design: Cross-sectional study in which patients completed a questionnaire a bout their job participation. type of job, workplace adjustments to their l imb loss, their position in the company, and a general health questionnaire . Setting: Orthopsdic workshops in The Netherlands with a population of lower limb amputees. Patients: Subjects were recruited from orthopedic workshops in the Netherla nds. They ranged in age from Is to 60 years (mean, 44.5yr) and had a lower limb amputated at least 2 years (mean, 19.6yr) before this study. Main Outcome measures: A self-report questionnaire, with 1 part concerning patient characteristics and amputation-related factors, and the other conce rning job characteristics, vocational handicaps, work adjustments, and work ing conditions; and a general health questionnaire (RAND-36) to measure hea lth status. Results: Responses were received from 652 of the 687 patients (response: ra te, 95%) who were sent the questionnaire. Sixty-foul percent of the respond ents were working at the rime of the study (comparable with the employment rate of the general Dutch population), 31 % had work experience but were no t presently working, and 5% had no work experience. After their amputations , people shifted to less physically demanding work. The mean delay between the amputation and the return to work was 2.3 years. Many people wished the ir work was better adjusted to the limitations presented by their disabilit y and they mentioned having problems concerning possibilities fur promotion . Seventy-eight percent of those who stopped working within 2 years after t he amputation said that amputation-related factors played a role in their d ecision. Thirty-four percent said that they might have worked longer if cer tain adjustments had been made. The health experience of people who were no longer working was significantly worse than that of the working people wit h amputations. Conclusions: Although amputee patients had a relatively good rate of job pa rticipation, they reported problems concerning the long delay between amput ation and return to work, problems in finding suitable jobs, fewer possibil ities for promotion, and problems in obtaining needed workplace modificatio ns. People who had to stop working because of the amputation showed a worse health experience than working people.