Upper Extremity Injured Workers Stratified by Current Work Status: An Examination of Health Characteristics, Work Limitations and Work Instability

D Pichora, H Grant


Background: Upper extremity injured workers are an under-studied population. A descriptive comparison of workers with shoulder, elbow and hand injuries reporting to a Canadian Workplace Safety and Insurance Board (WSIB) clinic was undertaken.

Objective: To determine if differences existed between injury groups stratified by current work status.

Methods: All WSIB claimants reporting to our upper extremity clinic between 2003 and 2008 were approached to participate in this descriptive study. 314 working and 146 non-working WSIB claimants completed the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH); Short Form health survey (SF36); Worker’s Limitations Questionnaire and the Work Instability Scale. Various parametric and non-parametric analyses were used to assess significant differences between groups on demographic, work and health related variables.

Results: Hand, followed by the shoulder and elbow were the most common site of injury. Most non-workers listed their current injury as the reason for being off work, and attempted to return to work once since their injury occurrence. Non-workers and a subset of workers at high risk for work loss showed significantly worse mental functioning. Workers identified physical demands as the most frequent injury-related on the job limitation. 60% of current workers were listed as low risk for work loss on the Work Instability Scale.

Conclusions: Poorer mental functioning, being female and sustaining a shoulder injury were risk factors for work instability. Our cohort of injured non-workers were unable to return to work due to their current injury, reinforcing the need to advocate for modified duties, shorter hours and a work environment where stress and injury recurrence is reduced. Future studies examining pre-injury depression as a risk factor for prolonged work absences are warranted.


Upper extremity; Forearm injuries; Sick leave; Musculoskeletal diseases; Return to work; Work instability

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 pISSN: 2008-6520
 eISSN: 2008-6814

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