Predicting job loss in those off sick.

BACKGROUND: Evidence shows incapacity benefit claimants (those off sick >26 weeks) are at greatest risk of long-term job loss. AIM: To develop a screening tool to select those at risk of job loss, defined as failure to return to work among those off sick. The screening tool was for use in the Job Retention and Rehabilitation Pilot of the Department for Work and Pensions. METHODS: A literature review identified risks for long-term incapacity and job loss as multifactorial. Potential predictors for return to work were then assembled into a set of questions and tested by a prospective study in general practice surgeries and a retrospective study of occupational health records of local authority employees referred for sickness absence management, using univariate and multivariate logistic regression analysis. RESULTS: Univariate logistic regression analysis of the retrospective study produced odds ratios with 95% confidence intervals for each question (where P

Burying the evidence: how Great Britain is prolonging the occupational cancer epidemic.

The U.K. authorities are failing to acknowledge or deal effectively with an epidemic of work-related cancers. The government's Health and Safety Executive (HSE) underestimates the exposed population, the risks faced as a result of those exposures, and the potential for prevention. The HSE fails to acknowledge the social inequality in occupational cancer risk, which is concentrated in manual workers and lower employment grades, or the greater likelihood these groups will experience multiple exposures to work-related carcinogens. It continues to neglect the largely uninvestigated and unprioritized risk to women and currently has neither a requirement nor a strategy for reducing the numbers and volumes of cancer-causing substances, processes, and environments at work. The result is that the U.K. faces at least 20,000 and possibly in excess of 40,000 new cases of work-related cancer every year, leading to thousands of deaths and an annual cost to the economy of between pounds 29.5bn and pounds 59bn. This paper outlines flaws in the HSE's approach and makes recommendations to address effectively the U.K.'s occupational cancer crisis.

Predictors of delayed return to work or job loss with respiratory ill-health: a systematic review.

INTRODUCTION: Every year approximately 17,000 people in the UK are off work through sickness for six or more weeks. Only fifty percent of those off for six months return to work. METHODS: A systematic review was conducted to identify potential risk factors for non-return to work within six to 26 weeks or job loss in adult workers with respiratory ill-health. Twelve databases, citation and author lists and cited references were searched. All abstracts and papers were double read and quality assessed. Main outcome measures were return to work and employment status. RESULTS: Five studies of variable methodological quality were identified, all focussing on asthma, occupationally induced or not, with two single studies also covering chronic obstructive pulmonary disease or rhinitis. In the single study of a general working population, blue collar workers having either asthma or chronic obstructive pulmonary disease, were from two to six times less likely to return to work quickly compared with office workers. Overall, unemployment was high with becoming unemployed three times higher in those with all forms of asthma compared with rhinitis. Also, in those with occupational asthma, job loss was more likely if working in smaller companies and being less well educated. CONCLUSIONS: Evidence on predictors for non-return to work or job loss with respiratory ill-health in a general working population is limited. Yet without an understanding of these, interventions to reduce the further step to long term disability cannot be designed and implemented.

The perceptions of occupational health in primary care.

AIM: A random sample of general practitioners (GPs), practice nurses (PNs) and practice managers (PMs) in Sheffield and Manchester was recruited into a study to evaluate the perceptions of occupational health (OH) in primary care. METHODS: Qualitative data were collected using focus groups with three groups of primary care sector professionals. Quantitative data were collected nationally from 295 GPs using a postal questionnaire. RESULTS: GPs and PNs had minimal OH training, and 60% of GPs reported constraints in addressing OH matters with patients. The lack of referral routes (63 and 67%, respectively) was also seen as a barrier. OH was regarded as a speciality, and primary care professionals preferred to refer patients with OH problems to specialist centres because they perceived barriers to their dealing with the issues. A total of 74% of GPs surveyed thought that speedier access to secondary care would help them to address OH problems. CONCLUSIONS: This study has identified some of the problems associated with delivering OH through primary care. It also demonstrated a need for greater emphasis on OH education in medical and nurse training, and a need for better advice for GPs, PNs and PMs regarding support services for OH.