Psychosocial job factors and return-to-work after compensated low back injury: A disability phase-specific analysis

Background Job characteristics may constitute a barrier to return-to-work ( RYW) after compensated disabling low back pain (LBP). This study examines t he impact of psychosocial job factors on time to RTW separately during the acute and subacute/ chronic disability phases. Methods This is a retrospective cohort study of 433 LBP workers' compensati on claimants with 1-4 years of follow-up. The association of psychosocial j ob factors with duration of work disability was estimated with Cox regressi on models, adjusting for injury history and severity, physical workload, an d demographic and employment factors. Results High physical and psychological job demands and low supervisory sup port are each associated with about 20% lower RTW rates during all disabili ty phases. High job control, especially control over work and rest periods, is associated with over 30% higher RTW rates, but only, during the subacut e/chronic disability phase starting 30 days after injury. Job satisfaction and coworker support are unrelated to time to RTW. Conclusions Duration of work disability, is associated with psychosocial jo b factors independent of injury, severity and physical workload. The impact of these risk factors changes significantly over the course of disability. (C) 2001 Wiley-Liss, Inc.