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© 2020 - IOS Press and the authors. All rights reserved. BACKGROUND: Musculoskeletal symptoms (MSSs) remain the most frequently reported type of injuries sustained during fire-ground operations in firefighters. However, there is a paucity of reports concerning the prevalence estimates of MSSs among female firefighters and different fire services across Canada. OBJECTIVES: To assess the point prevalence of self-reported MSSs, stratified by age and sex in a cohort of active duty firefighters from across Canada, and to determine whether age, sex or length of service can be used to predict the likelihood of the number of MSSs sustained. METHODS: We recruited 390 firefighters (272 males, 118 females). To identify the prevalence of self-reported rates of MSSs, firefighters were asked to complete a standardized 11-item questionnaire that asked, 'Please indicate whether you have experienced pain in any body region within the last week', with response options that included 'Yes', 'No', and 'Head', 'Neck', 'Shoulder', 'Arm/Elbow/Hand', 'Back', 'Stomach/Abdomen', 'Upper Thigh', 'Knee', 'Lower Leg', 'Foot', 'Other, please specify'. RESULTS: Among the 390 full-time firefighters, 212 (54%) indicated to have experienced some type of MSSs within the last week. The most prevalent region-specific MSSs included, 123 (32%) in the back region, 92 (24%) in the shoulder region, 74 (19%) in the neck region and 70 (18%) in the knee region. In addition, women indicated a 1.6 times greater likelihood of sustaining ≥2 MSSs when controlling for individual differences in age and years of service. CONCLUSIONS: The point prevalence of MSSs in a cohort of full-time firefighters was 54% (55% males; 53% females). Women experienced a 1.4-1.6 times greater likelihood of sustaining MSSs when controlling for individual differences in age and years of service.

Background Systemic sclerosis (SSc) is an auto-immune connective tissue disease characterized by fibrosis of skin, blood vessels, and internal organs that results in significant disability. Objective To identify the work barriers faced by people with systemic sclerosis (SSc) in maintaining employment. Methods Thirty-six people with SSc who were working more than 8 hours per week completed the Work Experience Survey, which contains lists of potential work barriers, including the ability to travel to and from work; get around at work; perform essential job functions, including physical, cognitive, and task-related activities; work with others; and manage work conditions. Results Thirty-three participants completed and returned the questionnaires, most of whom were female, and working full time and in professional careers. Principal disease symptoms included fatigue, Raynaud's phenomenon, esophageal involvement, and leg or hand/wrist pain. All participants reported some barriers with a mean of 18 barriers per participant. At least three quarters of participants cited outside temperature (82%), cold temperatures inside the workplace (76%), and household work (76%), as barriers. The next most common barriers were using both hands (64%), arranging and taking part in social activities (64%), being able to provide self-care (61%) and working 8 hours (58%). Conclusion Participants reported a wide range of barriers, from cold temperatures, to physical job, fatigue related, and non-workplace demands, in maintaining the worker role. The barriers reflect the disease symptoms they reported. Identifying workplace barriers facilitates the creation of job accommodations or adaptations that will allow people with SSc to continue working.

BACKGROUND: Studies indicate that long-term sickness absence reduces the ability to return to work (RTW). Multidisciplinary medical assessments (MMA) have been used as a method to receive a more versatile assessment of long-term sickness absentees (LTSA) and thereby a better basis for adequate medical and vocational rehabilitation, and an increasing ability to maintain or regain work capacity. OBJECTIVE: The objective of this study was to investigate the associations between the prognoses of LTSAs’ future work capacity made at a MMA and the assessments of their work incapacity made by the Social Insurance Offices (SIO) two years later. PARTICIPANTS: 385 LTSAs referred to an MMA by SIOs in the Stockholm area in Sweden between 2001 and 2006. METHODS: Data was collected at the MMA on demographic factors, health, diagnoses, and future work capacity. Information on SIO decisions on sickness benefits and disability pension and what measures the SIO had taken was extracted from the case filesat the SIOs. Descriptive statisticsand multiple regression analyses were used to assess the associations between the prognosis and decisions on benefits, controlling for individual factors. RESULTS: Of those predicted to be able to maintain or regain work capacity, 68% received full-time benefits two years later. Work capacity was negatively affected by high age, full time sickness absence at MMA and number of physical symptoms at MMA. The prognosis at the MMA was not significantly related to work capacity when socio-demographic and health factors were controlled for. However, this was partly due to the fact that the MMA also included recommendations for vocational rehabilitation and that this factor had an effect on assessed work incapacity after two years. CONCLUSION: The prognosis of future work capacity evaluated at a multidisciplinary medical assessment correlated with actual work capacity two years later. However, a range of other factors were decisive for the result. The study shows that the link between the prognosis and recommendations for vocational rehabilitation should be followed by the SIOs responsible for enhancing RTW among individuals on long-term sick leave.

Objective Investigate the effect of the symptom magnification syndrome (SMS) behavior pattern on industrial rehabilitation on return to work and maintenance at work. Participants A sample of 99 clients with active workers' compensation claims was studied; 25 identified as having SMS. Methods A protocol-driven functional capacity evaluation (FCE) was administered and the presence of SMS was determined from a standard protocol that considered 13 factors. Results Upon conclusion of intervention, 80 of the 99 clients were classified as ready to return to full-time usual and customary employment. The readiness for full-time return to work among those who did not have SMS (84%) was not statistically different from those with the syndrome (72%). Six months after discharge, follow-up work status data were obtained for 63 clients. Among those that did not display SMS, 76% continued to work full time, while 39% of those initially identified as SMS were working, a statistically significant difference. Conclusions SMS had no significant bearing on work readiness, but appears to impact maintenance of employment. The value of return to work on a modified basis may need to be reconsidered, because none of the clients who had been discharged ready for modified work were employed at the six-month follow-up.

Background: The experiences and barriers associated with the return to paid employment following healing from recurrent suicide attempts related to mental illness have not been addressed in the literature to date. Method: This paper is a collaborative case study between graduates (experts by experience) and facilitators of a psychoso- cial/psychoeducational group for people with recurrent suicide attempts. The journeys taken by the experts by experience are explored through thematic narrative analysis. Findings/Results: Issues of stigma, disclosure, accommodations, maintaining wellness and coming to re-define a sense of self were consistent themes found throughout all narratives. Conclusions: The paper identified key areas of challenge and celebration, suggesting the need for enhanced support from health care providers, workplace managers, supervisors and colleagues for successful transitions into the workplace.