Skip to main content
Top
Published in: Journal of Occupational Rehabilitation 4/2012

01-12-2012

Gender Differences in Personal and Work-Related Determinants of Return-to-Work Following Long-Term Disability: A 5-Year Cohort Study

Authors: Valérie Lederer, Michèle Rivard, Samia Djemaa Mechakra-Tahiri

Published in: Journal of Occupational Rehabilitation | Issue 4/2012

Login to get access

Abstract

Objective To assess the differential effect of personal and work-related psychosocial, physical and organizational determinants by gender on time to return-to-work (RTW) following long-term disability. Methods Data come from a larger study conducted in the province of Quebec, Canada. A cohort of 455 adults on long-term disability due to work-related musculoskeletal disorders at the back/neck/upper limb was followed for 5 years through structured interviews and administrative databases. Left-truncated Cox regression modeling stratified by gender was used to assess time to a first partial or full RTW of at least 3 days. Results Survival curves of time to RTW were similar between men and women on long-term disability (log-rank test p value = 0.920) but many personal and occupational factors influencing RTW differed by gender. Women’s risk factors included older age (HR = 0.734—in 10 years unit), poor to very poor perceived economic status (HR = 0.625), working ≥40 h/week and having dependents (HR = 0.508) and awareness of workplace-based occupational health and safety program (HR = 0.598); higher gross annual income (in $10,000 s) was a facilitator (HR = 1.225). In men, being over 55 years old (HR = 0.458), poor perceived economic status (HR = 0.653), working ≥40 h/week and high perceived physical workload (HR = 0.720) and higher job insecurity (HR = 0.825) negatively influenced time to RTW. For both men and women, probabilities of not returning to work varied widely according to workers’ specific profile of personal and occupational factors (high or low risk profile). Conclusion Results confirm the importance of gender-sensitive strategies to investigate RTW determinants from a gender perspective.
Literature
1.
go back to reference Brooks PM. The burden of musculoskeletal disease: a global perspective. Clin Rheumatol. 2006;25(6):778–81.PubMedCrossRef Brooks PM. The burden of musculoskeletal disease: a global perspective. Clin Rheumatol. 2006;25(6):778–81.PubMedCrossRef
2.
go back to reference Commission de la Santé et Sécurité du Travail. Statistics on inflammations of the musculoskeletal system: 2004–2007 [Statistiques sur les lésions en “ite” du système musculo-squelettique: 2004–2007]. Quebec, CSST; 2008. Commission de la Santé et Sécurité du Travail. Statistics on inflammations of the musculoskeletal system: 2004–2007 [Statistiques sur les lésions en “ite” du système musculo-squelettique: 2004–2007]. Quebec, CSST; 2008.
3.
go back to reference Commission de la Santé et Sécurité du Travail. Statistics on vertebral disorders: 2004–2007 [Statistiques sur les affections vertébrales: 2004–2007]. Quebec, CSST; 2008. Commission de la Santé et Sécurité du Travail. Statistics on vertebral disorders: 2004–2007 [Statistiques sur les affections vertébrales: 2004–2007]. Quebec, CSST; 2008.
4.
5.
go back to reference Crook J, Moldofsky H. The probability of recovery and return to work from work disability as a function of time. Qual Life Res. 1994;3(Suppl 1):97–109.CrossRef Crook J, Moldofsky H. The probability of recovery and return to work from work disability as a function of time. Qual Life Res. 1994;3(Suppl 1):97–109.CrossRef
6.
go back to reference Gjesdal S, Bratberg E, Maeland J. Gender differences in disability after sickness absence with musculoskeletal disorders: five-year prospective study of 37,942 women and 26,307 men. BMC Musculoskelet Disord. 2011;12(1):37.PubMedCrossRef Gjesdal S, Bratberg E, Maeland J. Gender differences in disability after sickness absence with musculoskeletal disorders: five-year prospective study of 37,942 women and 26,307 men. BMC Musculoskelet Disord. 2011;12(1):37.PubMedCrossRef
7.
go back to reference Coutu MF, Durand MJ, Loisel P, Goulet C, Gauthier N. Level of distress among workers undergoing work rehabilitation for musculoskeletal disorders. J Occup Rehabil. 2007;17(2):289–303.PubMedCrossRef Coutu MF, Durand MJ, Loisel P, Goulet C, Gauthier N. Level of distress among workers undergoing work rehabilitation for musculoskeletal disorders. J Occup Rehabil. 2007;17(2):289–303.PubMedCrossRef
8.
go back to reference Mäntyselkä PT, Kumpusalo EA, Ahonen RS, Takala JK. Direct and indirect costs of managing patients with musculoskeletal pain–challenge for health care. Eur J Pain. 2002;6(2):141–8.PubMedCrossRef Mäntyselkä PT, Kumpusalo EA, Ahonen RS, Takala JK. Direct and indirect costs of managing patients with musculoskeletal pain–challenge for health care. Eur J Pain. 2002;6(2):141–8.PubMedCrossRef
9.
go back to reference Hirsh A, Waxenberg L, Atchison J, Gremillion H, Robinson M. Evidence for sex differences in the relationships of pain, mood, and disability. J Pain. 2006;7(8):592–601.PubMedCrossRef Hirsh A, Waxenberg L, Atchison J, Gremillion H, Robinson M. Evidence for sex differences in the relationships of pain, mood, and disability. J Pain. 2006;7(8):592–601.PubMedCrossRef
10.
go back to reference Gjesdal S, Bratberg E. The role of gender in long-term sickness absence and transition to permanent disability benefits. Results from a multiregister based, prospective study in Norway 1990–1995. Eur J Public Health. 2002;12(3):180–6. Gjesdal S, Bratberg E. The role of gender in long-term sickness absence and transition to permanent disability benefits. Results from a multiregister based, prospective study in Norway 1990–1995. Eur J Public Health. 2002;12(3):180–6.
11.
go back to reference Messing K, Stock S, Tissot F. Should studies of risk factors for MSDs be stratified by gender? Lessons from analyses of musculoskeletal disorders among respondents to the 1998 Québec health survey. Scand J Work Environ Health. 2009;35(2):96–112.PubMedCrossRef Messing K, Stock S, Tissot F. Should studies of risk factors for MSDs be stratified by gender? Lessons from analyses of musculoskeletal disorders among respondents to the 1998 Québec health survey. Scand J Work Environ Health. 2009;35(2):96–112.PubMedCrossRef
12.
go back to reference Harrold L, Savageau J, Pransky G, Benjamin K. Understanding the role of sex differences in work injuries: implications for primary care practice. Disabil Rehabil. 2008;30(1):36–43.PubMedCrossRef Harrold L, Savageau J, Pransky G, Benjamin K. Understanding the role of sex differences in work injuries: implications for primary care practice. Disabil Rehabil. 2008;30(1):36–43.PubMedCrossRef
13.
go back to reference Messing K, Mager Stellman J. Sex, gender and women’s occupational health: the importance of considering mechanism. Environ Res. 2006;101(2):149–62.PubMedCrossRef Messing K, Mager Stellman J. Sex, gender and women’s occupational health: the importance of considering mechanism. Environ Res. 2006;101(2):149–62.PubMedCrossRef
14.
go back to reference Leijon M, Hensing G, Alexanderson K. Sickness absence due to musculoskeletal diagnoses: association with occupational gender segregation. Scand J Public Health. 2004;32(2):94–101.PubMedCrossRef Leijon M, Hensing G, Alexanderson K. Sickness absence due to musculoskeletal diagnoses: association with occupational gender segregation. Scand J Public Health. 2004;32(2):94–101.PubMedCrossRef
15.
go back to reference Feuerstein M, Berkowitz S, Peck C Jr. Musculoskeletal-related disability in US army personnel: prevalence, gender, and military occupational specialties. J Occup Environ Med. 1997;39(1):68–78.PubMedCrossRef Feuerstein M, Berkowitz S, Peck C Jr. Musculoskeletal-related disability in US army personnel: prevalence, gender, and military occupational specialties. J Occup Environ Med. 1997;39(1):68–78.PubMedCrossRef
16.
go back to reference De Rijk A, Janssen N, Alexanderson K, Nijhuis F. Gender differences in return to work patterns among sickness absentees and their associations with health: a prospective cohort study in The Netherlands. Int J Rehabil Res. 2008;31(4):327–36.PubMedCrossRef De Rijk A, Janssen N, Alexanderson K, Nijhuis F. Gender differences in return to work patterns among sickness absentees and their associations with health: a prospective cohort study in The Netherlands. Int J Rehabil Res. 2008;31(4):327–36.PubMedCrossRef
17.
go back to reference Alexanderson K, Borg K, Hensing G. Sickness absence with low-back, shoulder, or neck diagnoses: an 11-year follow-up regarding gender differences in sickness absence and disability pension. Work. 2005;25(2):115–24.PubMed Alexanderson K, Borg K, Hensing G. Sickness absence with low-back, shoulder, or neck diagnoses: an 11-year follow-up regarding gender differences in sickness absence and disability pension. Work. 2005;25(2):115–24.PubMed
18.
go back to reference Kaptein S, Gignac M, Badley E. Differences in the workforce experiences of women and men with arthritis disability: a population health perspective. Arthritis Rheum. 2009;61(5):605–13.PubMedCrossRef Kaptein S, Gignac M, Badley E. Differences in the workforce experiences of women and men with arthritis disability: a population health perspective. Arthritis Rheum. 2009;61(5):605–13.PubMedCrossRef
19.
go back to reference Ahlgren C, Hammarstrom A. Back to work? Gendered experiences of rehabilitation. Scand J Public Health. 2000;28(2):88–94.PubMed Ahlgren C, Hammarstrom A. Back to work? Gendered experiences of rehabilitation. Scand J Public Health. 2000;28(2):88–94.PubMed
20.
go back to reference De Rijk A, Nijhuis F, Alexanderson K. Gender differences in work modifications and changed job characteristics during the return-to-work process: a prospective cohort study. J Occup Rehabil. 2009;19(2):185–93.PubMedCrossRef De Rijk A, Nijhuis F, Alexanderson K. Gender differences in work modifications and changed job characteristics during the return-to-work process: a prospective cohort study. J Occup Rehabil. 2009;19(2):185–93.PubMedCrossRef
21.
go back to reference Hooftman W, van der Beek A, Bongers P, van Mechelen W. Is there a gender difference in the effect of work-related physical and psychosocial risk factors on musculoskeletal symptoms and related sickness absence? Scand J Work Environ Health. 2009;35(2):85–95.PubMedCrossRef Hooftman W, van der Beek A, Bongers P, van Mechelen W. Is there a gender difference in the effect of work-related physical and psychosocial risk factors on musculoskeletal symptoms and related sickness absence? Scand J Work Environ Health. 2009;35(2):85–95.PubMedCrossRef
22.
go back to reference Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL III. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447–85.PubMedCrossRef Fillingim RB, King CD, Ribeiro-Dasilva MC, Rahim-Williams B, Riley JL III. Sex, gender, and pain: a review of recent clinical and experimental findings. J Pain. 2009;10(5):447–85.PubMedCrossRef
23.
go back to reference Bekker M. Investigating gender within health research is more than sex disaggregation of data: a multi-facet gender and health model. Psychol Health Med. 2003;8(2):231–43.CrossRef Bekker M. Investigating gender within health research is more than sex disaggregation of data: a multi-facet gender and health model. Psychol Health Med. 2003;8(2):231–43.CrossRef
24.
go back to reference Punnett L, Herbert R. Work-related musculoskeletal disorders: is there a gender differential, and if so, what does it mean. Women Health. 2000;38(6):474–92.CrossRef Punnett L, Herbert R. Work-related musculoskeletal disorders: is there a gender differential, and if so, what does it mean. Women Health. 2000;38(6):474–92.CrossRef
25.
go back to reference Artazcoz L, Borrell C, Cortàs I, Escribà-Agüir V, Cascant L. Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research. J Epidemiol Community Health. 2007;61(Suppl 2):39–45. Artazcoz L, Borrell C, Cortàs I, Escribà-Agüir V, Cascant L. Occupational epidemiology and work related inequalities in health: a gender perspective for two complementary approaches to work and health research. J Epidemiol Community Health. 2007;61(Suppl 2):39–45.
26.
go back to reference Hammarström A. A tool for developing gender research in medicine: examples from the medical literature on work life. Gend Med. 2007;4 suppl B:123–32. Hammarström A. A tool for developing gender research in medicine: examples from the medical literature on work life. Gend Med. 2007;4 suppl B:123–32.
27.
go back to reference Rivard M, Lederer V, Rossignol M, Contandriopoulos AP, Sainte-Marie G. Les lombalgies et lésions musculo-squelettiques chroniques, un coût pour la santé: résultats d’une étude coûts-avantages d’une intervention de réadaptation au travail. Rev Rhum. 2011;78(Suppl 2):87–91.CrossRef Rivard M, Lederer V, Rossignol M, Contandriopoulos AP, Sainte-Marie G. Les lombalgies et lésions musculo-squelettiques chroniques, un coût pour la santé: résultats d’une étude coûts-avantages d’une intervention de réadaptation au travail. Rev Rhum. 2011;78(Suppl 2):87–91.CrossRef
28.
go back to reference Loisel P, Durand P, Abenhaim L, Gosselin L, Simard R, Turcotte J, et al. Management of occupational back pain: the Sherbrooke model. Results of a pilot and feasibility study. J Occup Environ Med. 1994 Sep;51(9):597–602.CrossRef Loisel P, Durand P, Abenhaim L, Gosselin L, Simard R, Turcotte J, et al. Management of occupational back pain: the Sherbrooke model. Results of a pilot and feasibility study. J Occup Environ Med. 1994 Sep;51(9):597–602.CrossRef
29.
go back to reference Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Gosselin L, et al. A population-based, randomized clinical trial on back pain management. Spine. 1997;22(24):2911–8.PubMedCrossRef Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Gosselin L, et al. A population-based, randomized clinical trial on back pain management. Spine. 1997;22(24):2911–8.PubMedCrossRef
30.
go back to reference Steenstra IA, Anema JR, Bongers PM, De Vet HCW, Knol DL, Van Mechelen W. The effectiveness of graded activity for low back pain in occupational healthcare. J Occup Environ Med. 2006;63(11):718–25.CrossRef Steenstra IA, Anema JR, Bongers PM, De Vet HCW, Knol DL, Van Mechelen W. The effectiveness of graded activity for low back pain in occupational healthcare. J Occup Environ Med. 2006;63(11):718–25.CrossRef
31.
go back to reference Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001;40(4):464–84.PubMedCrossRef Krause N, Frank JW, Dasinger LK, Sullivan TJ, Sinclair SJ. Determinants of duration of disability and return-to-work after work-related injury and illness: challenges for future research. Am J Ind Med. 2001;40(4):464–84.PubMedCrossRef
32.
go back to reference de Vet H, Heymans M, Dunn K, Pope D, van der Beek A, Macfarlane G, et al. Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine. 2002;27(21):2409–16.PubMedCrossRef de Vet H, Heymans M, Dunn K, Pope D, van der Beek A, Macfarlane G, et al. Episodes of low back pain: a proposal for uniform definitions to be used in research. Spine. 2002;27(21):2409–16.PubMedCrossRef
33.
go back to reference Fuller S. Investigating longitudinal dimensions of precarious employment: conceptual and practical issues. In: Vosko LF, MacDonald M, Campbell I, editors. Gender and the contours of precarious employment. New York: Routledge; 2009. p. 226–31. Fuller S. Investigating longitudinal dimensions of precarious employment: conceptual and practical issues. In: Vosko LF, MacDonald M, Campbell I, editors. Gender and the contours of precarious employment. New York: Routledge; 2009. p. 226–31.
34.
go back to reference Silverstein B, Fan Z, Smith C, Bao S, Howard N, Spielholz P, et al. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk? Scand J Work Environ Health. 2009;35(2):113–26.PubMedCrossRef Silverstein B, Fan Z, Smith C, Bao S, Howard N, Spielholz P, et al. Gender adjustment or stratification in discerning upper extremity musculoskeletal disorder risk? Scand J Work Environ Health. 2009;35(2):113–26.PubMedCrossRef
35.
go back to reference Klein JP, Moeschberger ML. Survival analysis: techniques for censored and truncated data. 2nd ed. New York: Springer; 2003. Klein JP, Moeschberger ML. Survival analysis: techniques for censored and truncated data. 2nd ed. New York: Springer; 2003.
36.
go back to reference Stata Statistical Software [computer program]. Version 11. College Station, TX: StataCorp; 2010. Stata Statistical Software [computer program]. Version 11. College Station, TX: StataCorp; 2010.
37.
go back to reference Messing K, Punnett L, Bond M, Alexanderson K, Pyle J, Zahm S, et al. Be the fairest of them all: challenges and recommendations for the treatment of gender in occupational health research. Am J Ind Med. 2003;43(6):618–29.PubMedCrossRef Messing K, Punnett L, Bond M, Alexanderson K, Pyle J, Zahm S, et al. Be the fairest of them all: challenges and recommendations for the treatment of gender in occupational health research. Am J Ind Med. 2003;43(6):618–29.PubMedCrossRef
38.
go back to reference Durand MJ, Loisel P, Hong QN, Charpentier N. Helping clinicians in work disability prevention: the work disability diagnosis interview. J Occup Rehabil. 2002;12(3):191–204.PubMedCrossRef Durand MJ, Loisel P, Hong QN, Charpentier N. Helping clinicians in work disability prevention: the work disability diagnosis interview. J Occup Rehabil. 2002;12(3):191–204.PubMedCrossRef
Metadata
Title
Gender Differences in Personal and Work-Related Determinants of Return-to-Work Following Long-Term Disability: A 5-Year Cohort Study
Authors
Valérie Lederer
Michèle Rivard
Samia Djemaa Mechakra-Tahiri
Publication date
01-12-2012
Publisher
Springer US
Published in
Journal of Occupational Rehabilitation / Issue 4/2012
Print ISSN: 1053-0487
Electronic ISSN: 1573-3688
DOI
https://doi.org/10.1007/s10926-012-9366-0

Other articles of this Issue 4/2012

Journal of Occupational Rehabilitation 4/2012 Go to the issue