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Abstract Introduction Many disability prevention strategies are focused on acute injuries and brief illness episodes, but there will be growing challenges for employers to manage circumstances of recurrent, chronic, or fluctuating symptoms in an aging workforce. The goal of this article is to summarize existing peer-review research in this area, compare this with employer discourse in the grey literature, and recommend future research priorities.
The collaboration included a topical review of the scientific and industry literature, group discussion to identify key areas and challenges, drafting of initial documents, and feedback from peer researchers and a special panel of experts with employer experience. Results Cancer and mental illness were chosen as examples of chronic or recurring conditions that might challenge conventional workplace return-to-work practices.
Workplace problems identified in the literature included fatigue, emotional exhaustion, poor supervisor and co-worker support, stigma, discrimination, and difficulties finding appropriate accommodations. Workplace intervention research is generally lacking, but there is preliminary support for improving workplace self-management strategies, collaborative problem-solving, and providing checklists and other tools for job accommodation, ideas echoed in the literature directed toward employers.
Research might be improved by following workers from an earlier stage of developing workplace concerns. Conclusions Future research of work disability should focus on earlier identification of at-risk workers with chronic conditions, the use of more innovative and flexible accommodation strategies matched to specific functional losses, stronger integration of the workplace into on-going rehabilitation efforts, and a better understanding of stigma and other social factors at work.
Keywords: Chronic health conditions, Employer practices, Cancer, Mental health Introduction One profound demographic shift facing many industrialized nations is the increasing longevity and average age of the population.
As the population ages, the available workforce is also aging. By , at least quarter of the workforce in many countries is expected to be age 55 and older [ 1 ].
At the same time, chronic health conditions are becoming increasingly important as a cause of work disability across the globe, affecting not only aging workers, but also youth in transition, and mid-career workers.
These shifts in the age and fitness of workers are likely to influence employer practices to manage and prevent disability. Research of employer practices and their impact on health and disability may be improved by adopting a life-course perspective on employee health and disability.
This perspective creates an opportunity to examine how the impact of workplace factors and workplace responses to work disability might differ depending on the age and career stage of a worker, and where particular workplace WDP approaches may be more important.
Although some work disability problems observed in aging workers are primarily related to health, other factors—such as competing retirement options, career status, likelihood of accommodations and mobility in the workforce—are specific to age group and career stage, and can interact with health [ 3 ].
Economic, social and demographic changes have led to an increased need to include more older workers in the workforce, and to find ways to better enable workers with health conditions to maintain employment [ 4 ]. This direction is supported by new legislation that seeks to support the rights and ability to work of persons with potentially disabling conditions, as exemplified by the UN Convention of the Rights of Persons with Disabilities CRPD , stating that workers with disabilities have an equal opportunity to employment [ 5 ].
The rights of disabled people set out in the CRPD presently are recognized by more than one hundred and fifty nations who ratified the treaty [ 5 ]. These developments all suggest the need for more information on how workplace factors and related interventions can better support the employment of persons with various health conditions, across the life-course.
There are fundamental principles and effective strategies for work disability prevention WDP that appear to be common across health conditions and work situations, and are consistent with the goals of the CRPD. However, most research on workplace issues and WDP has focused on musculoskeletal disorders and work injuries, there is less evidence for generalization of these principles across other types of health conditions [ 7 ].
Our objective was to identify relevant scientific research and current employer practices for managing chronic health conditions and related work disability in the workplace, as a basis for recommendations for improving future research of employer disability prevention strategies.
Methods and general proceedings of the conference are described in the introductory article to this special issue [ 8 ].
The authors of this article represented a sub-group tasked with understanding the state of the science with respect to employer practices for managing the increasing prevalence of chronic health conditions and workplace efforts to prevent this source of disability through job accommodation and support, through a life-course view of employment and disability. We contrast key conceptual and theoretical frameworks, review the applicable scientific literature, assess its impact for employer decision-making, and compare recommendations with that of the employer-directed grey literature.
These observations and recommendations are useful for areas that have not been thoroughly investigated. We recommend future research priorities, based on important scientific gaps. Two chronic health conditions with divergent prevalence across the life span—mental disorders [ 9 ] and cancer [ 10 ]—were chosen as exemplars to illustrate key principles that may apply across a range of conditions. Although there are significant differences by country, retirement ages are gradually increasing in most established economies.
In older workers, chronological age may be inconsistent with career stage and status. Some older workers may be nearing retirement, and others are already in post-retirement careers, and thus may have very different work disability considerations. Nonetheless, extraordinary activities have been found to bring various shifting levels of adequacy in lessening LBP Understanding the cause of a back pain is essential with a specific end goal to expel it from the patient's life and not to duplicate the development amid treatment Nonetheless, when the reason for the back pain is obscure, endorsing focused on treatment can demonstrate predicaments, which then leads to general exercise being frequently suggested At most times, intercession programs have received a mono-disciplinary way to deal with restoring NSCLBP 15 , 21 , There was no restriction on the inclusion of a follow up in the included studies.
CLBP can be a debilitating effect on patients' lives, bringing possibilities of them being handicapped and diminishing their capability to complete exercises from a day to day living An acute back pain is a pain that remains in parts for under a month and a half 39 , 40 and sub-intense back pain is back pain for about a month and a half and 3 months.
Being physically dynamic, through exercises of day to day living, it has been highlighted as imperatively helpful to the recuperation of intense and NSCLBP Subsequently, patients with intense LBP ought not to begin an activity program for restoration The differences amongst PA and exercise is that activity is arranged and organized which includes disturbing homogeneous by concentric, unconventional and isometric strong action and includes monotonous developments Muscle fortifying activities could conceivably cause additional harm that is so intense to the back pain and because of the extra strain on the tendons and muscles in the back, which will later cause a swell Money matters: A meta-analytic review of the effects of financial incentives on recovery after closed head injury.
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