The long-term goal of this research is to identify organizational practices and policies (OPPs) the effectively support the injured worker's return to a productive work role. The research has two specific aims: to determine the relationship between OPPs and successfully RTW & reduced work disability and to examine the validity and reliability of workers reported OPPs. This research builds upon an on-going cohort study of 250 physician-reported CTS cases in Maine funded by the Arthritis Foundation (AF) that follows workers at baseline, 2, 6, and 12 months post surgery, collecting information on worker, job, and economic factors that predict work disability and return to work. Augmentation of individual-level health data with employer-level data on OPPs creates an opportunity to examine heretofore unanswered research questions. The investigators will interview 80 key organizational informants (representing 80 different employers) to collect employer-level data on 8 OPP (people-oriented culture, active safety leadership, safety diligence, safety training, standard ergonomics practices, disability case monitoring, proactive "return to work," labor-management health and safety committees) and use the employer-level data to predict individual-level return to work, lost work days, and work disability (CTS symptoms, paid and unpaid work functioning incidents). The investigators hypothesize that OPPs will be associated with fewer lost work days, a quicker "return to work," improved work, and unpaid work role functioning and less CTS symptoms. They will also compare employer with worker OPP reports. Additional hypotheses are that worker reports of OPP will significantly co-vary with employer reports of OPP; and workers of OPP will predict total lost work days, "return to work," improved paid and unpaid work functioning and less CTS symptoms. Because of the added cost of conducting an employer interview, demonstrating worker self-reports are valid and reliable and will provide new measurement tools heretofore unavailable in occupational health research. In addition, the investigators will collect workers' compensation data from employers and OSHA reportable data to replicate research conducted among Michigan employers. A second unique feature of the proposed research is the use of new measures of successful "return to work" that measure more than the fact of returning. In summary, this research will validate a critical new instrument (worker assessment of OPP), and by defining the association between OPP and health outcomes, open avenues for interventions to enhance the well-being of injured workers.

R01OH003523

1998-09-30

2002-09-29