Presentation T O37

T O37 (Oral Presentation):
Is early return to work a threat to future health? A two-year follow-up of sick listed .

Presented by: Kerstin Ekberg

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Ekberg K1,2, Wåhlin C3,4, Persson J5, Bernfort L5, Öberg B6

  1. National Centre for Work and Rehabilitation, Dept. of Medicine and Health, Linköping University
  2. Helix Vinn Excellence Centre, Linköping University
  3. Intervention and Implementation Research Unit, Inst. of Environmental Medicine, KI
  4. Dept of Occupational and Environmental Medicine, County Council of Östergötland
  5. Division of Health Care Analysis, Dept. of Medicine and Health, Linköping University
  6. Division of Physiotherapy, Dept. of Medicine and Health, Linköping University, Sweden



Evidence is lacking regarding effects of early and late RTW on sustainable health and work ability and future presenteeism. The study aimed to prospectively investigate long-term health effects among sick listed in common mental (CMD) or musculoskeletal (MSD) disorders with early RTW (within three months) or later RTW (3 -12 months).


Cases were granted sick leave due to CMD or MSD at primary and occupational health care centers and were recruited in their second to third week of sick leave during 2008-2009. Sick leave records were followed for one year after inclusion. A baseline questionnaire comprising demographics, health, work ability, individual resources and work conditions was sent to 1348 participants, 935 responded (69%). After exclusion of unemployed 863 (92%) remained, 425 (49%) responded a two year follow-up questionnaire. Analyses of differences between early and late returners with sustainable RTW (working for at least 4 weeks) were analyzed with pairwise comparisons of means (t-test), proportions (chi-square) and analysis of variance of change.


Independent of diagnosis had early returners at baseline more favorable scores than late returners in all health measures and in work ability . A higher proportion of early returners were blue collar workers. In the MSD subcohort late returners improved more after two years in health, function and work ability, but early returners´ health and work ability were still at better levels (EQ-VAS, p=.01), pain (p=.004), functional ability (p=.001), work ability (p=.001). In the CMD subcohort the differences at baseline in health, function and work ability had diminished after two years. A higher proportion of early returners had more favorable scores in perceived justice at work (p=.03).


Early RTW does not seem to have adverse effects on health. There are notable differences between sick listed with MSD and CMD as late RTW in the MSD subcohort was associated with long term reduced health and work ability, while the initial differences at baseline between early and late returners in the CMD subcohort essentially had disappeared after two years. The results support the need for early assessment of relevant rehabilitation interventions for in particular sick listed in MSD.

Schedule Details

Tuesday September 30
15:45 - 17:30 Afternoon Concurrent Sessions (T O25 - T O38 and Seminar 6)
Session: Social Interventions for work disability
Room A