Introduction: A systematic review was conducted to review the effectiveness of workplace-based return-to-work (RTW) interventions. Method: Seven databases were searched, in English and French, between January 1990 and December 2003 for peer-reviewed studies of RTW interventions provided at the workplace to workers with work disability associated with musculoskeletal or other pain-related conditions. Methodological quality appraisal and data extraction were conducted by pairs of reviewers. Results: Of a total of 4124 papers identified by the search, 10 studies were of sufficient quality to be included in the review. There was strong evidence that work disability duration is significantly reduced by work accommodation offers and contact between healthcare provider and workplace; and moderate evidence that it is reduced by interventions which include early contact with worker by workplace, ergonomic work site visits, and presence of a RTW coordinator. For these five intervention components, there was moderate evidence that they reduce costs associated with work disability duration. Evidence for sustainability of these effects was insufficient or limited. Evidence regarding the impact of supernumerary replacements was insufficient. Evidence levels regarding the impact of the intervention components on quality-of-life was insufficient or mixed. Conclusions: Our systematic review provides the evidence base supporting that workplace-based RTW interventions can reduce work disability duration and associated costs, however the evidence regarding their impact on quality-of-life outcomes was much weaker.
This is a preview of subscription content, log in to check access.
Buy single article
Instant access to the full article PDF.
Tax calculation will be finalised during checkout.
Subscribe to journal
Immediate online access to all issues from 2019. Subscription will auto renew annually.
Tax calculation will be finalised during checkout.
MacEachen E, Clarke J, Franche RL, Irvin E. Working paper #299. A systematic review of qualitative studies on return to work. Toronto: Institute for Work & Health, 2005.
Franche R-L, Cullen K, Clarke J, MacEachen E, Frank J, Sinclair S, and the IWH Workplace-based return-to-work intervention literature review group. Workplace-based return-to-work interventions: A systematic review of the quantitative and qualitative literature. Report. Toronto, Canada: Institute for Work & Health, 2004.
Cullen K, Franche RL, Clarke J, Irvin E. Working Paper #296. The role of organizational factors in workplace-based return-to-work interventions: A systematic review. Toronto: Institute for Work & Health, 2005.
Drummond M, O'Brien G. What does economic evaluation mean? In: Stoddart GL and Torrance GW, eds. Basic types of economic evaluation. In, methods for the economic evaluation of health care programmes. Oxford: Oxford University Press, 1997, pp. 8–11.
Workplace Safety and Insurance Board of Ontario. Statistical Supplement to the 2003 Annual Report. Toronto: Workplace Safety and Insurance Board of Ontario, 2004.
Guzman J, Esmail R, Karjalainen K, Malmivaara A, Irvin E, Bombardier C. Multidisciplinary rehabilitation for chronic low back pain: Systematic review. BMJ 2001; 322: 1511–1516.
Karjalainen K, Malmivaara A, Van Tulder M, Roine R, Jauhiainen M, Hurri H, Koes B. Multidisciplinary biopsychosocial rehabilitation for subacute low back pain in working-age adults: A systematic review within the framework of the Cochrane Collaboration Back Review Group. Spine 2001; 26(3): 262–269.
Koes BW, Van Tulder MW, Van Der Windt DAWM, Bouter LM. The efficacy of back schools: A review of randomized clinical trials. J Clin Epidemiol 1994; 47: 851–862.
Scheer SJ, Radack KL, O'Brien DR, Jr. Randomized controlled trials in industrial low back pain relating to return to work. Part 1. Acute interventions. Arch Phys Med Rehab 1995; 76: 966–973.
Scheer SJ, Watanabe TK, Radack KL. Randomized controlled trials in industrial low back pain. Part 3. Subacute/chronic pain interventions. Arch Phys Med Rehab 1997; 78: 414–423.
Van Tulder MW, Esmail R, Bombardier C, Koes BW. Back schools for non-specific low back pain. Cochrane Library 1999: 1–15.
Schonstein E, Kenny DT, Keating J, Koes BW. Work conditioning, work hardening and functional restoration for workers with back and neck pain. Cochrane Library 2003: 1–39.
Briss P, Zaza S, Pappaioanou M, Fielding J, Wright-De Aguiro S, Truman BI, Hopkins DP, Mullen PD, Thompson RS, Woolf SH, Carande-Kulis VG, Anderson L, Hinman, AR, McQueen D, The Task Force on Community Preventive Medicine, Harris JR. Developing an evidence-based guide to community preventive services—Methods. Am J Prev Med 2003; 18(1S): 35–43.
Carroll LJ, Cassidy JD, Peloso PM, Garritty C, Giles-Smith L. Systematic search and review procedures: Results of the WHO collaborating centre task force on mild traumatic brain injury. J Rehab Med 2004; Suppl. 43: 11–14.
Côté P, Cassidy JD, Carroll L, Frank JW, Bombardier C. A systematic review of the prognosis of acute whiplash and a new conceptual framework to synthesize the literature. Spine 2001; 26: E445–E458.
Oxman AD, Guyatt GH. Validation of an index of the quality of review articles. J Clin Epidemiol 1991; 44: 1271–1278.
Smith B. Chronic pain expert advisory panel. Report of the Chronic Pain Expert Advisory Panel. Toronto: Workplace Safety and Insurance Board, 2000.
Tompa E, Trevithick S, McLeod C. Working Paper #213. A systematic review of the prevention incentives of insurance and regulatory mechanisms for occupational health and safety. Toronto: Institute for Work & Health, 2004.
Zaza S, Wright-De Aguero LK, Briss PA, Truman BI, Hopkins DP, Hennessy MH. Data collection instrument and procedure for systematic reviews in the Guide to Community Preventive Services. Task Force on Community Preventive Services. Am J Prev Med 2000; 18: 44–74.
Hogg-Johnson S, Cole D. Early prognostic factors for duration on benefits among workers with compensated occupational soft tissue injuries. Occup Environ Med 2003; 60: 244–253.
Brooker A-S, Cole DC, Hogg-Johnson S, Smith J, Frank JW. Modified work: Prevalence and characteristics in a sample of workers with soft-tissue injuries. J Occup Environ Med 2001; 43: 276–284.
Slavin RE. Best-evidence synthesis: An alternative to meta-analytic and traditional reviews. Educ Res 1986; Nov.: 5–11.
Slavin RE. Best evidence synthesis: An intelligent alternative to meta-analysis. J Clin Epidemiol 1995; 48: 9–18.
Scheel IB, Birger HK, Herrin J, Carling C, Oxman AD. Blind faith? The effects of promoting active sick leave for back pain patients: A cluster-randomized controlled trial. Spine 2002; 27: 2734–2740.
Scheel IB, Hagen KB, Oxman AD. Active sick leave for patients with back pain: All the players onside, but still no action. Spine 2002; 27: 654–659.
Scheel IB, Hagen KB, Herrin J, Oxman AD. A call for action: A randomized controlled trial of two strategies to implement active sick leave for patients with low back pain. Spine 2002; 27: 561–566.
Amick BC III, Habeck RV, Hunt A, Fossel AH, Chapin A, Keller RB, Katz JN. Measuring the impact of organizational behaviors on work disability prevention and management. J Occup Rehab 2000; 10(1): 21–38.
Arnetz BB, Sjogren B, Rydehn B, Meisel R. Early workplace intervention for employees with musculoskeletal-related absenteeism: A prospective controlled intervention study. J Occup Environ Med 2003; 45: 499–506.
Karjalainen K, Malmivaara A, Pohjolainen T, Hurri H, Mutanen P, Rissanen P, Pahkajarvi H, Levon H, Karpoff H, Roine R. Mini-intervention for subacute low back pain: A randomized controlled trial. Spine 2003; 28(6): 533–540.
Loisel P, Abenhaim L, Durand P, Esdaile JM, Suissa S, Gosselin L, Simard R, Turcotte J, Lemaire J. A population-based, randomized clinical trial on back pain management. Spine 1997; 22(24): 2911–2918.
Loisel P, Durand P, Abenhaim L, Gosselin L, Simard R, Turcotte J, Esdaile JM. Management of occupational back pain: the Sherbrooke model. Results of a pilot and feasibility study. Occup Environ Med 1994; 51: 597–602.
Loisel P, Gosselin L, Durand P, Lemaire J, Poitras S, Abenhaim L. Implementation of a participatory ergonomics program in the rehabilitation of workers suffering from subacute back pain. Appl Ergo 2001; 32: 53–60.
Loisel P, Lemaire J, Poitras S, Durand M-J, Champagne F, Stock S, Diallo B, Tremblay C. Cost-benefit and cost-effectiveness analysis of a disability prevention model for back pain management: A six year follow up study. Occup Environ Med 2002; 59: 807–815.
Loisel P, Durand M-J, Diallo B, Vachon B, Charpentier N, Labelle J. From evidence to community practice in work rehabilitation: The Quebec experience. Clin J Pain 2003; 19: 105–113.
Bernacki EJ, Guidera JA, Schaefer JA, Tsai SP. A facilitated early return to work program at a large urban medical center. J Occup Environ Med 2000; 42: 1172–1177.
Bernacki EJ, Tsai SP. Managed care for workers' compensation: Three years of experience in an ‘employee choice’ state. J Occup Environ Med 1996; 38: 1091–1097.
Green-McKenzie J, Parkerson J, Bernacki E. Comparison of workers' compensation costs for two cohorts of injured workers before and after the introduction of managed care. J Occup Environ Med 1998; 40: 568–572.
Bernacki EJ, Guidera JA, Schaefer JA, Lavin RA, Tsai SP. An ergonomics program designed to reduce the incidence of upper extremity work related musculoskeletal disorders. J Occup Environ Med 1999; 41: 1032–1041.
Bernacki EJ, Tsai SP. Ten years' experience using an integrated workers' compensation management system to control workers' compensation costs. J Occup Environ Med 2003; 45: 508–516.
Crook J, Moldofsky H, Shannon H. Determinants of disability after a work related musculoskeletal injury. J Rheumatol 1998; 25: 1570–1577.
Habeck RV, Hunt HA, VanTol B. Workplace factors associated with preventing and managing work disability. Rehab Counsel Bull 1998; 42: 98–143.
Hunt HA, Habeck RV. The Michigan disability prevention study. Kalamazoo, Michigan: WE Upjohn Institute for Employment Research, 1993.
Verbeek JH, Van der Weide WE, Van Dijk FJ. Early occupational health management of patients with back pain: A randomized controlled trial. Spine 2002; 27: 1844–1851.
Yassi A, Tate R, Cooper JE, Snow C, Vallentyne S, Khokhar JB. Early intervention for back-injured nurses at a large Canadian tertiary care hospital: An evaluation of the effectiveness and cost benefits of a two-year pilot project. Occup Med 1995; 45: 209–214.
Yassi A, Khokhar J, Tate R. The epidemiology of back injuries in nurses at a large Canadian tertiary care hospital: Implications for prevention. Occup Med 1995; 45: 215–221.
Cooper JE, Tate R, Yassi A. Work hardening in an early return to work program for nurses with back injury. Work 1997; 8:149–156.
Cooper JE, Tate RB, Yassi A. Components of initial and residual disability after back injury in nurses. Spine 1998; 23: 2118–2122.
Yassi A. Utilizing data systems to develop and monitor occupational health programs in a large Canadian hospital. Methods Inform Med 1998; 37: 125–129.
Tate RB, Yassi A, Cooper J. Predictors of time loss after back injury in nurses. Spine 1999; 24: 1930–1936.
Karjalainen K, Malmivaara A, Mutanen P, Roine R, Hurri H, Pohjolainen T. Mini-intervention for subacute low back pain: Two-year follow-up and modifiers of effectiveness. Spine 2004; 29: 1069–1076.
Davis PM, Badii M, Yassi A. Preventing disability from occupational musculoskeletal injuries in an urban, acute and tertiary care hospital: Results from a prevention and early active return-to-work safely program. J Occup Environ Med 2004; 46: 1253–1262.
Dasinger LK, Krause N, Deegan LJ, Brand RJ, Rudolph L. Duration of work disability after low back injury: A comparison of administrative and self-reported outcomes. Am J Ind Med 1999; 35: 619–631.
Kingery PM, Ellsworth CG, Corbett BS, Bowden RB, Brizzolara JA. High-cost analysis: A closer look at the case for worksite-site health promotion. J Occup Med 2004; 36:1341–1347.
National Institute of Disability Management and Research (NIDMAR). Code of Practice for Disability Management. Describing effective benchmarks for the creation of workplace-based disability management programs. National Institute of Disability Management and Research, 2000.
Krause N, Dasinger LK, Neuhauser F. Modified work and return to work: A review of the literature. J Occup Rehab 1998; 8: 113–139.
Pransky G. Mini-intervention for subacute low back pain: A randomized controlled trial: Point of view. Spine 2003; 28: 540–541.
Govinda Raj A. Prognostic modeling of upper-extremity soft tissue disorders (dissertation). University of Toronto, 2003.
Koehoorn M, Cole D, Hertzman C, Lee H. Health care use associated with work-related musculoskeletal disorders among hospital workers. J Occup Rehab (in press).
Pransky G, Benjamin K, Hill-Fotouhi C, Fletcher KE, Himmelstein J, Katz JN. Work-related outcomes in occupational low back pain: A multidimensional analysis. Spine 2002; 27: 864–870.
Hinkle L, Wolff HG. The nature of man's adaptation to his total environment and the relation of this to illness. Arch Int Med 1957; 99: 442–460.
Peterson MA, Reville RT, Stern RK. Compensating permanent workplace injuries: A study of the California system. Santa Monica: Rand Institute for Civil Justice, 1998.
Dasinger LK, Krause N, Thompson PJ, Brand RJ, Rudolph L. Doctor proactive communication, return to work recommendation, and duration of disability after a workers' compensation low back injury. J Occup Environ Med 2001; 43: 515–525.
Goldenhar LM, Schulte PA. Methodological issues for intervention research in occupational health and safety. Am J Ind Med 1996; 29: 289–294.
Goldenhar LM, LaMontagne AD, Katz T, Heaney C, Landsbergis P. The intervention research process in occupational safety and health: An overview from the National Occupational Research Agenda Intervention Effectiveness Research team. J Occup Environ Med 2001; 43: 616–622.
Zwerling C, Daltroy LH, Fine LJ, Johnston JJ, Melius J, Silverstein BA. Design and conduct of occupational injury intervention studies: A review of evaluation strategies. Am J Ind Med 1997; 32: 164–179.
Donald Cole, Jeremy Dacombe, Jaime Guzman, Sheilah Hogg-Johnson, Ellen MacEachen, Victoria Pennick, Anusha Raj, Rhoda Reardon, Dwayne Van Eerd.
About this article
Cite this article
Franche, RL., Cullen, K., Clarke, J. et al. Workplace-Based Return-to-Work Interventions: A Systematic Review of the Quantitative Literature. J Occup Rehabil 15, 607–631 (2005). https://doi.org/10.1007/s10926-005-8038-8
- return to work
- disability management
- compensation costs