Occupational health intervention programmes in reducing sickness absence among employees at risk
Author(s): Simo Taimela, A. Malmivaara, S. Justen, E. Läärä, H. Sintonen, J. Tiekso, & T. Aro Country: Finland
Is the intervention sector specific?	No
Is the intervention usable with different enterprise sizes?	Yes
Is the intervention equally applicable to both genders?	Yes
Is the intervention based on theory?	Yes
Can the intervention approach be adapted/ tailored?	Yes
Does the intervention promote CSR and how?	The intervention was not explicitly linked to responsible business practices although it does promote employee well-being
Does the intervention promote social dialogue and how?	Social dialogue was not a key component of this intervention
Overview (including risk assessment and law – legal requirements etc.): The overall objective of the intervention was to identify ‘high’ risk employees of sickness absence; and for those employees identified to provide early treatment and rehabilitation. This was accomplished by conducting a health survey within the organisation. This form of health survey has been used in a large variety of sectors (both public and private), and has been used in predominantly large and medium-sized organisations.
Implementation: The health survey was administered throughout the organisation. Based on the results of the survey, ‘high risk’ employees were identified. Individuals were classified as ‘high risk’ if they reported one or several listed impairments (musculoskeletal pain, high levels of depression, fatigue, and/or sleep disturbance or problems). Following the health survey identified ‘high risk’ participants were provided with personal feedback on questionnaire results and were invited to a consultation with occupational health services. The consultation was conducted by the occupational nurse, lasting 90 minutes; an occupational physician joined the consultation if and when required. The overall objective of the consultation was to develop an action plan in collaboration with the medical team; and if-and-when needed appropriate referral to a further consultation by a specialist or psychologist was provided. The occupational nurses created a file on each participant throughout the intervention process: regarding attendance and compliance, referrals to further evaluation or interventions, health advice received, and considerations of occupational health services if not further action was required.
Practical applications: This was a pragmatic trail of interventions that work within the pre-existing structure of an organisation within a human resource framework.
Innovative aspects: This pragmatic approach to reducing sickness absence provides corporations with the tools to identify risks and risk groups within their given organisation. Expert consultation is provided on how to improve the occupational wellbeing of employees within either the existing framework of occupational health services or within human resource management.
Evaluation (including process issues, outcomes and sustainability): To assess the effectiveness of the intervention, individuals classified within the ‘at-risk’ group were randomly assigned to either the intervention group (consultation with occupational health services) or to a ‘treatment as usual’ condition. ‘Treatment as usual’ consisted of an optional consultation with the organisations’ occupational nurse or physician on request. The primary outcome measure used to assess the intervention effectiveness was sickness absence collected through organisational records following one year. Additionally, an economic evaluation of the intervention was conducted, using sickness absence as its primary outcome.
Benefits (including cost effectiveness): The results of the evaluation of the intervention, demonstrated that the occupational health intervention was effective in controlling sickness absence within employees classified as ‘high risk’. The observed difference between sickness absence between the intervention condition and usual care was 11 days. The results of the cost-effectiveness evaluation demonstrated a saving of 43 euro per sickness absence day avoided with available direct total cost data, and 17 euro with missing total cost data imputed.
References: Taimela, S., Malmivaara, A., Justen, S., Läärä, E., Sintonen, H., Tiekso, J., & Aro, T. (2007). The effectiveness of two occupational health intervention programs in reducing sickness absence among employees at risk. Two randomised controlled trails. Occupational Environmental Medicine, published on 6 August. Taimela, S., Justen, S., Aronen, P., Sintonen, H., Läärä, E., Malmivaara, A., Tiekso, J., & Aro, T. (2007). An occupational health intervention program for workers at high risk for sickness absence. Cost-effectiveness analysis based on a randomised controlled trail. Occupational Environmental Medicine, published online Oct. 12, 2007
Comments: The implementation of this intervention requires the availability of occupational health experts at the organisational level and as such might not be readily applicable to SMEs.