Low-back disability and sick-leave of more than 5 weeks' duration
Bonde, J.P.
Ugeskrift for Laeger 143(4): 232-237
1981
ISSN/ISBN: 0041-5782 PMID: 6455001 Document Number: 172224
A retrospective study of a random sample of 103 patients who had sick-leave for more than 5 wk duration with diagnoses concerned with low-back disability, was used to illustrate the interaction between low-back disability and the occupational situation. The 1 yr frequency of recurrence of low-back disability was 45%. The extent of the patients' total sick-leave was assessed on the basis of information from the patients and information concerning the duration of the low-back disability. The average frequency of sick-leave on account of low-back disability was 3 periods of sick-leave per 5 yr period with history of low-back disability per patient which is undoubtedly an underestimate. The majority of the patients (80%) stated that low-back disability was a slight to considerable problem in daily work. Where men were concerned, considerable occupational migration towards physically less strenuous work could be demonstrated in the period from the commencement of the disability until the follow-up investigation. The condition must presumably be considered as an expression of the profound influence of the back condition on the occupational situation as a great number of the patients stated that they had changed their occupation on account of low-back disability. The investigation reveals a massive and unfulfilled need for support and advice among these patients and for improved economical assistance in connection with change of employment or possibly rehabilitation. The patients were of the opinion thrice as frequently as the general practitioners that the low-back disability was due to conditions at work. In 84% out of the 63 (73%) cases in which the onset was acute, this occurred in connection with stress at the place of work. The significance of the working conditions for the etiology of low-back disability, which is undoubtedly multifactorial, cannot be considered to be elucidated. There is a considerably more uniform relationship between physically stressful work of various types and sick-leave on account of low-back disability. More active efforts are necessary, e.g., in connection with the social medical follow-up of these prolonged maintenance allowance cases determined by law with the object of altering the working processes or contributing towards selective occupational placing. A decisive cooperative partner for the social authorities and the practitioner in this connection could be the safety organization and the occupational health service at the place of work.