What are the barriers to work

participation following injury?

Results from the Prospective
Outcomes of Injury Study
Rebbecca Lilley
Injury Prevention Research Unit

9 November 2012

What is known?
Previous studies examining predictors of
poor outcomes have focused on:
Mainly hospitalised injury
Limited range of risk factors

New Zealands context: Accident

Compensation Corporation (ACC)

Research Focus
This study examines combined influences of
personal, work, health, lifestyle & injury
factors on work absence following injury in
the POIS study

Working Cohort
POIS worker cohort 2626 participants

Injury type: lower (16%) & upper extremity

fracture (18%), lower (24%) & upper (14%)
extremity sprains & strains, and back
dislocation, sprain & strain (16%).
24% hospital admission within 7 days
36% work-related

The good news.

Majority (73%) are working at 3 months
Of those still absent from work the
majority (71%) anticipate recovery to usual
work

However, 720 (27%) absent from work

WORK STATUS
3 MONTHS AFTER INJURY

Outcome:
Work status 3 months after injury
Single item asked at 3 month interview
Are you back at work? Yes/No
Considered working at time of interview
regardless of employer or
modified/part/full-time status
Outcome of interest: Not working

Pre-injury characteristics
Sociodemographic
(10 factors)
Injury (6
factors)

Health (6
factors)

Work
organisation
(4 factors)

Psychosocial
(7 factors)

Lifestyle (5
factors)

Physical work
(5 factors)

Health
overall self-assessment for health, comorbidities,
pain or discomfort, prior injury, prior disabling
condition, work capacity
Lifestyle behaviours
alcohol consumption, current smoking status, body
mass index (BMI), exercise, sleep quantity

Summary of 3-month results

Socio-demographic
(low income,
financial insecurity,
manual occupation)
Injury (perceived
threat to life,
hospitalisation)

Work organisation
(long working
weeks, temporary
employment)

Health

Lifestyle (obesity)

Psychosocial

Physical work (any

painful work, any
standing at work)

Summary of 3-month results

Socio-demographic
(low income,
financial insecurity,
manual occupation)

Injury (perceived
threat to life,
hospitalisation)

Work organisation
(long working
weeks, temporary
employment)

Lifestyle (obesity)

Physical work (any

painful work, any
standing at work)

What factors were not included?

Age
Gender
Pre-injury psychosocial factors
Pre-injury health factors

What do we need to do to get

injured workers back to work?
Pre-injury socio-demographic, workplace
& lifestyle factors could be targeted
New findings:
Obesity
Temporary employment
Long week work schedules
Financial insecurity

Need for broader intervention focus

Current analyses
Comparison of outcomes for workers with
Work-related & non-work-related injuries
Provisional analysis indicates by 12 months
workers with work-related injury have poorer
recovery from injury compared

Nested case-control study examining work

organisational factors
Workers from small sized organisations associated
with work absence

Acknowledgements
Funders: The Health Research Council of New
Zealand (2007-2013) & the Accident
Compensation Corporation (2007-2010)
Co-investigators: Gabrielle Davie, Shanthi
Ameratunga, Sarah Derrett
Reference: Lilley R, Davie G, Ameratunga S,
Derrett S (2012) Factors predicting work status 3
months after injury: results from the Prospective
Outcomes of Injury Study. BMJ Open 2:e000400
http://bmjopen.bmj.com/content/2/e000400.full