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Work restrictions and Unfitness to work: Prevalence and risk factors a cross-sectional study on 70 000 occupational
Luther Dogbla1,2, Cédric Gouvenelle2,3, Anne-Sophie Escobar2
1Université Clermont Auvergne, CNRS, LaPSCo, Physiological and Psychosocial Stress, CHU Clermont-Ferrand, Occupational Medicine, Clermont-Ferrand, France.
Background:
Few studies have assessed work restrictions and unfitness to work simultaneously, particularly on large populations, and evidence on their main influencing factors remains limited.
Objective:
To assess prevalence and risk factors of work restrictions and unfitness to work.
Method:
We included all visits conducted in occupational health departments of the Cher, over two consecutive years. Visits had to have a conclusion: fitness to work, temporary work restrictions, permanent work restrictions, and unfitness to work. Mixed multinomial models with individual random effects were used.
Results:
Among the 71,848 occupational health visits, 62,436 had a conclusion. Most (90.6%, 95 CI 90.4 to 90.8%) were fit to work, 3.2% (3.1 to 3.3%) had temporary restrictions, 4.9% (4.7 to 5.1%) had permanent restrictions, and 1.3% (1.2 to 1.4%) were unfit to work. The risk of temporary restrictions was multiplied by 1.69 (1.16 to 2.48) in workers over 55 vs < 25 years old; by 1.74 (1.42 to 2.14) in workers with disabilities; by 1.30 (1.07 to 1.58) for workers with 10-20 vs < 5 years of seniority; and by 1.57 (1.22 to 2.01) in companies with 50-199 vs < 10 workers. The risk of permanent restrictions was multiplied by 2.24 (1.68 to 2.97) in workers over 55 yo; by 1.86 (1.57 to 2.21) in workers with disabilities; by 1.47 (1.05 to 2.06) for qualified workers; by 1.24 (1.05 to 1.46) for workers with 10-20 years of seniority; and by 1.30 (1.07 to 1.58) for workers in companies with 50-199 employees. The risk of unfitness to work decreased with increasing seniority in the company, while a significant interaction between sex and sector of activity was observed for temporary restrictions.
Conclusion:
Nearly one worker out of ten were unfit to work or had restrictions. The main risk factors for both unfit to work and restrictions were older age, women, and return-to-work visits; whereas lower seniority and smaller companies were risk factors for unfit to work, and longer seniority and bigger companies were risk factors for restrictions.
