Occupational disorders and return to work: a randomized controlled study.

OBJECTIVE: Goal setting and motivational factors are strongly associated with maintaining a job and return to work after sick leave, but research into the effects of interventions targeting these factors is limited. We conducted a randomized controlled study to examine the vocational effect of intervention focusing on motivation, goal setting and planning for return to work. DESIGN AND METHODS: Of 243 patients at risk of long-term sick leave or job dropout, 184 (76%) provided complete baseline information for the study. After randomization to an intervention group (n=92) and a reference group (n=92), occupational physicians examined the participants in accordance with standard guidelines. The intervention group received additional support from a social worker in order to enhance goal setting, motivation and planning for return to work. After 1 year 163 participants (89%) provided data on general health and employment status. The risk of not being gainfully employed was analysed by logistic regression analysis with adjustment for several covariates. RESULTS: The intervention did not increase the likelihood of gainful employment after 1 year or reduce the average number of days of sick leave. CONCLUSION: A low-cost counselling program addressing motivation, goal setting and planning for return to work did not improve vocational outcomes or reduce sick leave among patients with work-related disorders.

Correlation between sperm motility and sperm chromatin structure assay parameters.

OBJECTIVE: To evaluate the association between chromatin structure and sperm motility. DESIGN: Cross-sectional prospective study. SETTING: Scanian Andrology Centre, Malmö, Sweden; ENEA Casaccia, Rome, Italy; and Department of Occupational Medicine, Aarhus University, Aarhus, Denmark. PATIENT(S): One hundred seventy-one males from Danish first pregnancy planner couples (group 1) and 278 Swedish military conscripts (group 2). MAIN OUTCOME MEASURE(S): Sperm chromatin structure assay (SCSA) parameters, DNA fragmentation index (DFI), high DNA stainable (HDS), and sperm motility, which was evaluated manually and by use of computer-aided sperm analysis (CASA). RESULT(S): A statistically significant negative correlation between DFI and the CASA percentage of motile sperms (group 1: r = -0.53; group 2: r = -0.38) was found. For the manual motility assessment, the correlation coefficients were slightly lower. Furthermore, HDS correlated negatively with CASA sperm motility (group 1: r = -0.39; group 2: r = -0.36) and percentage of World Health Organization category A motile sperm. In multiple linear regression analysis, concentration and SCSA parameters, but not the time of abstinence, were statistically significant predictors of sperm motility. CONCLUSION(S): There is a moderate correlation between sperm motility and SCSA parameters. The study supports the assumption that both SCSA and motility can be relatively independent predictors of male fertility.