Presentation T O3

T O3 (Oral Presentation):
A return to work program for workers with occupational skin disease

Presented by: D Linn Holness


Holness DL1,2,3, Gomez P1,4, Kudla I1,2

  1. St Michael's Hospital, Toronto
  2. Dalla Lana School of Public Health, University of Toronto, Toronto
  3. Department of Medicine, University of Toronto
  4. Department of Occupational Therapy, University of Toronto



While there is substantial information on return to work (RTW) principles and programs, most of the work has focused on injury and musculoskeletal problems. There is minimal information available about RTW programs for workers with occupational skin disease (OSD). Reports from the German program, which includes in-patient and out-patient components, do not describe the RTW process specifically. The objective of this study is to describe the RTW program components and barriers and facilitators to RTW for workers with OSD in the RTW Program of the Occupational Disease Specialty Program at St Michael’s Hospital, Toronto, Canada.


The project was approved by the Research Ethics Board of St Michael’s Hospital. One hundred and ninety nine patients who had received RTW services for OSD between 2006 when the program started and the end of 2011 were identified and their charts were retrospectively abstracted. Information collected included: demographics, diagnosis, return to work interventions, barriers and facilitators for RTW and outcomes. Descriptive statistics were used for the analysis.


Of the 199 workers, sixty three percent had lost time from work, on average 128 days. Thirty two percent were from the manufacturing sector, 16% from automotive and 11% from healthcare. The RTW plans included specific direction for avoidance of particular exposures (86%), skin status monitoring with diary and pictures (71%), a specific prescription for personal protective equipment (57%), specified skin care products for use at work and home (55%) and either a RTW trial (35%) or graduated RTW (23%). Key barriers to RTW included ongoing skin problems (45%), continuing exposure in the workplace (37%), no permanent modified work available (31%) , employer not responsive to accommodations (14%), personal protective equipment not suitable or not available (13%) and difficulty with skin care management in the context of job tasks (13%). Facilitators to RTW included good communication between the workplace parties (61%), worker compliance with the treatment plan (53%) and the availability of modified work (44%).


Understanding the components of a RTW program and the barriers and facilitators to RTW may improve RTW for workers with OSD.

Schedule Details

Tuesday September 30
10:45 - 12:15 Morning Concurrent Sessions (T O1 - T O12 and Seminar 4)
Session: Healthcare providers’ interventions II
Room B