Partnership for Work, Health and Safety, School of Population and Public Health, University of British Columbia, Vancouver, British Columbia, Canada.
PLoS One. 2018 Apr 3;13(4):e0193618. doi: 10.1371/journal.pone.0193618. eCollection 2018.
Multiple jobholders (MJHs) have a higher risk of injury compared to single jobholders (SJHs), but it is unknown if return-to-work (RTW) after a work injury is affected by multiple jobholding. This study examined the association between multiple versus single jobholding and time to RTW for workers with a work-related musculoskeletal disorder (MSD).
We used administrative workers' compensation data to identify injured workers with an accepted MSD lost-time claim between 2010-2014 in British Columbia, Canada (n = 125,639 SJHs and 9,029 MJHs). The outcome was days until RTW during twelve months after the first day of time-loss. The MJH and SJH cohorts were balanced using coarsened exact matching that yielded a final matched cohort of 8,389 MJHs and 8,389 SJHs. The outcome was estimated with Cox regression, using piecewise models, and the hazard ratios were stratified by type of MSD, a serious injury indicator, gender, weekly workdays preceding MSD, and wage categories.
MJHs were less likely to RTW compared to SJHs within the first six months after the first time-loss day, with greater and longer lasting effects for males, workers with a serious injury, and a higher wage. No difference between MJHs and SJHs was found for workers who had a six- or seven-day work week preceding MSD, for workers with dislocations, and for workers who were still off work after six months.
Overall, MJHs with a workweek of maximum five days are disadvantaged compared to SJHs in terms of RTW following a work-related MSD within the first six months after the first time-loss day. This difference might be caused by more precarious job contracts for MJHs that challenges RTW because of lack of support for modified work, higher workload, and reduced likelihood that MJHs file a workers' compensation claim. Despite adjusting for type of MSD, severity of injury and occupation, the differences persisted for the vast majority of the study sample.
与单职业者（SJHs）相比，多职业者（MJHs）受伤的风险更高，但尚不清楚工作相关肌肉骨骼障碍（MSD）后重返工作岗位（RTW）是否受到多职业的影响。本研究调查了多职业与单职业与接受 MSD 丧失工作能力索赔的工人 RTW 之间的关联。
我们使用行政工人赔偿数据来确定 2010-2014 年期间不列颠哥伦比亚省（加拿大）因工作相关 MSD 丧失工作能力索赔的受伤工人（n = 125,639 名 SJHs 和 9,029 名 MJHs）。结果是首次无薪缺勤之日后 12 个月内 RTW 的天数。通过粗化精确匹配平衡 MJH 和 SJH 队列，得出最终匹配队列，其中包括 8,389 名 MJHs 和 8,389 名 SJHs。使用分段模型的 Cox 回归估计结果，并按 MSD 类型、严重伤害指标、性别、MSD 前一周的工作天数和工资类别对危险比进行分层。
与 SJHs 相比，MJHs 在首次无薪缺勤日后的前六个月内 RTW 的可能性较低，并且对于男性、有严重伤害的工人以及较高工资的工人，这种影响更大且持续时间更长。在 MSD 前一周有六天或七天工作周的工人、脱位工人以及六个月后仍未工作的工人中，MJHs 与 SJHs 之间没有差异。
总体而言，每周工作时间不超过五天的 MJHs 在首次无薪缺勤日后的前六个月内与 SJHs 相比，在与工作相关的 MSD 后 RTW 方面处于不利地位。这种差异可能是由于 MJHs 的工作合同更不稳定，缺乏对工作调整的支持、工作量更高以及 MJHs 提出工人赔偿索赔的可能性降低，从而阻碍了 RTW。尽管调整了 MSD 类型、受伤严重程度和职业，但在研究样本的绝大多数中，这种差异仍然存在。
