Is gradual return-to-work effective and cost-beneficial for BC’s workers with musculoskeletal disorders?


A nurse bandaging a kneeWorldwide, musculoskeletal disorders, such as sprains, fractures and dislocations, are a major cause of sickness absence, work disability, reduced productivity, and early retirement. Musculoskeletal disorders are the most prevalent of all chronic conditions in Canada, and account for almost $15 billion in disability costs.

In British Columbia (BC), more than 65% of all lost-time workers’ compensation claims in 2013, and almost 80% of all work disability days between 2009 and 2013 were due to work-related musculoskeletal disorders. The burden of disease by musculoskeletal disorders will likely increase in high-income countries, given the predicted population growth and aging. Retaining a healthy aging workforce is crucial, and identifying effective and cost-effective interventions, and population-based policies for the management of work disability related to musculoskeletal disorders are priorities for the Canadian government.

Data access has been approved for this study to determine whether gradual return-to-work is effective and cost-beneficial for people with a work-acquired musculoskeletal disorder in BC. The study is being carried out by Postdoctoral Fellow, Dr Esther Maas, under the supervision of Professor Chris McLeod, at the Partnership for Work, Health and Safety in the University of British Columbia’s School of Population and Public Health.

“Despite the general agreement that it is beneficial to return to work, the uptake of gradual return-to-work for injured workers in BC is low, and the effects of this key intervention have not been evaluated. Recourses for occupational health are scarce, and providing evidence of the effectiveness and cost-benefits is critical for the uptake and implementation of GRTW by workers’ compensation boards/employers/industries as a workforce health/population health strategy.” says Dr Maas.

“Analyzing return-to-work as a dynamic trajectory using longitudinal data and advanced statistics to fully understand the benefits of gradual return-to-work as a policy instrument is important, albeit new in the field of occupational health,” continues Dr Maas. “In this study, longitudinal return-to-work data will be used to precisely delineate each return-to-work state using calendar start and end dates, in which return-to-work trajectories can be captured for a population-based cohort of workers with a work-related musculoskeletal disorder.”

PopData will be linking data sets from the BC Ministry of Health, BC Vital Statistics Agency and WorkSafeBC for the project, which is funded by the Canadian Institutes for Health Research.