Workplace interventions for preventing work disability.Cochrane Database Syst Rev. 2009 Apr 15CD
Work disability has serious consequences for all stakeholders and society. Workplace interventions are considered appropriate to facilitate return to work by reducing barriers to return to work, involving the collaboration of key stakeholders.
To determine the effectiveness of workplace interventions compared to usual care or clinical interventions on work-related outcomes and health outcomes; and to evaluate whether the effects differ when applied to musculoskeletal disorders, mental health problems, or other health conditions.
We searched the Cochrane Occupational Health Field Trials Register, CENTRAL, MEDLINE and EMBASE (EMBASE.com), and PsycINFO databases (to November 2007).
We included randomized controlled trials of workplace interventions aimed at return to work for workers where absence from work because of sickness was reported as a continuous outcome.
DATA COLLECTION AND ANALYSIS
Two authors independently extracted data and assessed risk of bias of the studies. Meta-analysis and qualitative analysis (using GRADE levels of evidence) were performed.
We included six randomized controlled trials (749 workers): three on low back pain, one on upper-extremity disorders, one on musculoskeletal disorders, and one on adjustment disorders. Five studies were rated as having low risk of bias for the sickness absence outcome. The results of this review show that there is moderate-quality evidence to support the use of workplace interventions to reduce sickness absence among workers with musculoskeletal disorders when compared to usual care. However, workplace interventions were not effective to improve health outcomes among workers with musculoskeletal disorders. The lack of studies made it impossible to investigate the effectiveness of workplace interventions among workers with mental health problems and other health conditions. A comparison of a workplace intervention with a clinical intervention, in one study only, yielded similar results for sickness absence and symptoms for workers with mental health problems.