Prognostic factors for chronic disability from acute low-back pain in occupational health care by van der Weide WE, Verbeek JHAM, Sallé HJA, van Objectives This study attempted to determine the prognostic indicators of low-back pain in an occupational health setting. Methods The identification of prognostic factors of (i) functional disability after 3 months' follow-up, (ii) functional disability after 12 months' follow-up, and (iii) time to return to work among 120 workers who reported to an occupational health unit and were off work with low-back pain for at least 10 days. Crude and adjusted odds ratios and hazard ratios with 95% confidence intervals were estimated for the 3 outcome measures.Results Factors related to a longer time to return to work were radiating pain, high functional disability at the beginning of the study, problems in relations with colleagues, and high work tempo and work quantity. High functional disability at the beginning of the study and a high avoidance coping style predicted functional disability at 3 months. Functional disability at 12 months was more accurately predicted by work-related and psychosocial factors. C O~C~U S~O~S Especially radiating pain and functional disability predict a long duration of low-back pain in occupational health practice. Occupational physicians should also note work-related and psychosocial characteristics.Key terms functional disability, health care workers, prognosis, return to work.Musculoskeletal disorders, especially low-back pain, are common reasons for absence from work (1). Especially for patients with chronic low-back pain, sickness absence is a major consequence of their health problems. A recent population-based prevalence study reported work absenteeism in the last 12 months for 32% of chronic patients (2). Approximately 22% of all disability pensions in The Netherlands are due to musculoskeletal disorders. About half of this musculoskeletal category consists of patients who are disabled because of low-back pain (3).Diagnoses for sickness benefits show similar figures for back pain (4).To intervene more efficiently occupational physicians should be able to identify patients with a high risk of chronic disability. However, in spite of the magnitude of the problem, little is known about the course of and prognostic factors for low-back pain among sick employees. Most studies about this topic concern patients in general practice or patients in a rehabilitation center, and the results will differ from those involving workers on sick leave with low-back pain who visit their occupational physicians (5,6). Patients with chronic low-back pain in primary care usually have little sickness absence, and patients from a rehabilitation center form a selection of more problematic cases (7).In 5 prospective studies on the prognosis of acute low-back pain in an occupational health setting, only pain intensity and radicular signs were positively related to duration of sick leave or work status at follow-up in more than 1 study (8)(9)(10)(11)(12). Three fac...

No abstract

No abstract

In a cross-sectional study involving 131 flower bulb farmers (mean age = 43 y) and 67 well-matched controls, peripheral and autonomic nerve functions were examined. The study group had been exposed during a period of 20 y (standard deviation = 7) and applied a similar pesticide package. Lifetime cumulative exposure was estimated based on exposure levels for specific application methods and duration of exposure. Exposure-related decreased conduction velocities were found in the motor fibers of the median (-1.1 m/s) and peroneal (fast fibers: -1.2 m/s, slow fibers: -1.3 m/s) nerves, and in the sensory fibers of the median (-1.4 m/s) and sural (-0.9 m/s) nerves. In addition, the refractory period was determined and found to be increased in the sural and peroneal nerves. With regard to the autonomic nerve function, a decrease was found in resting sinus arrhythmia (-10%).