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Predictors of Time Loss After Back Injury in Nurses

Tate, Robert B. MSc*; Yassi, Annalee MD*†; Cooper, Juliette PhD‡§


Study Design. A 2-year prospective inception cohort study of back injury in nurses.

Objectives. To determine the extent to which characteristics of nurses, of the injury, and of the workplace predict occurrence and duration of time loss from work after back injury.

Summary of Background Data. During 2 years, 320 nurses incurred 416 back injuries at a large teaching hospital in Winnipeg, Canada. Nurses injured on preselected wards were targeted for early intervention, including provision of modified work, whereas nurses injured on other wards received the usual care.

Methods. Time loss attributable to the back injury during the 6 months after injury was analyzed. Three statistical models were used to examine occurrence of time loss (logistic regression), duration of time loss (Tobit regression), and duration of time loss once an injury incurring time loss had been documented (least-squares regression).

Results. In 218 of the 416 injuries, the injured nurse consented to interview. Whereas perceived disability was related to whether a time loss injury would ensue, self-reported pain was strongly related to the duration of time loss once an injury had become a time loss injury. Duration of time loss was reduced by participation in the return-to-work program. Mechanism of injury, specifically injury occurring while lifting patients, resulted in greater time loss.

Conclusions. Focusing on reducing the perception of disability at the time of injury is critical to preventing time loss, but once time loss has occurred, offer of modified work and attention to pain reduction are warranted. The findings add to the evidence that workplace-based intervention programs can be effective in reducing the morbidity resulting from back injury. [Key Words: low back injury, nurses, time loss]

From the *Department of Community Health Sciences, and the ‡Division of Occupational Therapy, University of Manitoba; and the †Departments of Occupational and Environmental Medicine and §Occupational Therapy, Health Science Center, Winnipeg, Manitoba, Canada.

Supported in part by the Workers’ Compensation Board of Manitoba and National Centres of Excellence-Health Evidence Application (NCE HEALNet) (funded by Medical Research Council and Social Science and Health Research Council [SSHERO]).

Acknowledgment date: April 2, 1998.

First revision date: August 14, 1998.

Acceptance date: November 9, 1998.

Address reprint requests to

Dr. Annalee Yassi

Director, Occupation and Environmental Unit

Department of Community Health Sciences

S112 750 Bannatyne Avenue

Winnipeg, MB Canada


Device status category: 1.

© 1999 by Lippincott Williams & Wilkins