A study of the effects of isokinetic pre-employment physical capability screening in the reduction of musculoskeletal disorders in a labor intensive work environment. The value of preplacement medical examinations for nonhazardous light duty work. Preplacement assessments. Impact on injury outcomes. The effects of prework functional screening on lowering an employer's injury rate, medical costs, and lost work days. A comparison between two systems for pre-employment medical assessment in the Royal Netherlands Army by a randomized, controlled study. The effect of individual job coaching and use of health threat in a job-specific occupational health education program on prevention of work-related musculoskeletal back injury. A controlled trial of an educational pamphlet to prevent disability after occupational low back injury. Preassignment examination for personnel on Iwo Jima. Histamine provocation test: an effective pre-employment selection method for aluminium workers.
This study investigated the effects of pre-employment physical ability screening using isokinetic dynamometry in injury development, specific to musculoskeletal disorders (MSDs) of the knees, shoulders and back among workers in physically demanding jobs.
                New hires (n=503) from a large US employer's 105 industrial yards were screened to match the physical demands of their prospective jobs and tracked for up to 33 months. Results were compared to a control group of 1423 workers.
                There were significant reductions in the frequency and severity of musculoskeletal disorder injuries in the screened employee population. Non-screened applicants were 2.38 times more likely to experience a MSD-related overexertion injury specific to the knees, shoulders and back than screened hires (OR=2.3759; p=0.0001), and incurred 4.33 times higher cost of claims (p=0.0003). Covariates of age, pay type, race and job classification were markedly different between screened and unscreened hires. Among the screened cohort, only the more physically demanding job classifications were significant with field material handlers 7.1 times more likely to experience a non-MSD than less physically demanding workers (OR=7.1036; p=0.0063).
                Objective isokinetic pre-employment screening may significantly reduce injuries in physically demanding jobs. Employees having been effectively matched to the physical demands of their jobs may be at significantly lesser risk of injury and disability from both musculoskeletal and non-musculoskeletal disorders. A prospective study on 6,125 job applicants for light duty telephone company work is presented, which indicates that a preplacement medical evaluation is not predictive of risks relating to work attendance or job performance in nonhazardous assignments. Results show that between groups of employees, who were medically classified at the time of hire into categories with or without employment risk factors, there was no significant difference relative to sickness, accident or other absence, or to work performance during the first twelve months after hire. A work force loss of 25% is seen during the first year after hire without significant difference between groups for either numbers of employees lost or reason for loss. A cost-benefit analysis based on this study is presented, which demonstrates that the preplacement medical evaluation for light duty assignments is not cost effective. In addition, further unnecessary costs are incurred when job applicants are medically evaluated but not hired, which is shown to occur here for 27.5% of healthy applicants. Evaluation of the impact of preplacement assessments is important given the resources companies and occupational health nurses allocate to screening and the ambiguity of the literature about the effectiveness of such assessments. This study examined the effects of preplacement assessments on employee injuries. All individuals screened by an occupational health clinic in the upper Midwest and given work restrictions during a 3 year period were identified as cases (n = 67). Cases were matched with controls without work restrictions (n = 264) on the basis of employer, gender, and job. Age was controlled for statistically. Chi-square analysis, used to test differences in percent distribution of injuries between cases and controls, found no statistically significant differences in musculoskeletal injuries between the groups. Work restrictions recommended as a result of preplacement assessments appear to protect vulnerable workers. The data in this study were gathered retrospectively after the progress of program development in terms of employee outcomes within an organization. This design characterizes a retrospective longitudinal study.
                To determine whether prework functional screens are effective in lowering the incidence of work-related back sprains or strains, related medical costs, and lost work days within an organization.
                Musculoskeletal injuries are considered the leading cause of disability for people during their working years. Back injuries are the most common reason for workers' decreased work capacity and reduced leisure time. The increased rate of injury and escalating workers' compensation costs are are a major force motivating companies to implement a tool that can be effective in lowering back sprain or strain injuries and containing their workers' compensation costs. The U.S. Department of Health and Human Services reports a major objective of increasing the number of companies offering back injury prevention programs by the year 2000.
                The study follows the effects realized when a medical center institutes close case management, early return to work policies, and prework functional screens in three stages over the course of 10.5 years.
                The severity of back sprains or strains, related medical costs, and lost work days were significantly lower with the use of prework functional screens on all new employees hired into physically laborious jobs.
                This study offers employers a proven effective tool that can be used to help lower the severity of on-the-job back sprains or strains, resulting medical costs, and lost work days in their organization. In 1998, the basic medical requirements for the Royal Netherlands Army were introduced as a standard for the assessment of the medical suitability of military personnel, consisting of 43 dichotomized points of judgment. This system replaced the old physical capacity, upper limbs, locomotion, hearing, eyesight, and emotional and mental state system, based on the detection of diseases and infirmities. We compared the two different examination systems for their ability to identify suitable recruits. For the latter purpose, we used the two operational measures of availability and health care costs. We performed a randomized, controlled study in which 352 soldiers were monitored for 2 years after being declared fit by one of the pre-employment medical assessment systems in question and having passed their general military training. We found that the pre-employment medical assessment system was the dominant factor for predicting the number of days fit-for-duty, as well as for the health care costs incurred. Those declared fit by the new system showed a statistically significant higher mean number of days fit-for-duty (648 compared with 612) and incurred significantly lower mean health care costs (6396 compared with 746 Euro). In this study, we were not able to uncover the mechanism by which the "basic medical requirements" examination system led to an improvement in outcome. For the present, this mechanism is interpreted because of differences between the two systems. To examine the effect of individual job coaching and use of health threat in a job-specific occupational health education program in preventing work-related musculoskeletal back injuries during manual materials handling in construction laborers.
                Two hundred five laborers were recruited by 3-stage cluster sampling process and randomly assigned to receive different education programs on manual materials handling. Control group was given a conventional program, whereas experimental group received a job-specific program.
                A statistically significant group difference was found in the knowledge and practical skills on manual materials handling after training (P < 0.0001). Furthermore, the results from 1-year cumulative incidence revealed a significantly lesser number of first-time reports of work-related musculoskeletal back injuries in the experimental group.
                These results indicate that job-specific education is an effective preventive strategy for work-related musculoskeletal back injury. Randomized controlled trial.
                To test the ability of an educational pamphlet to improve recovery in terms of pain, work status, and health care utilization after occupational low back injury.
                Low back pain and disability persist as occupational health problems of epidemic proportions. Because interventions based on biomechanical models have had limited impact, recent educational approaches to preventing back problems have stressed psychosocial recovery issues.
                A pamphlet was developed by compiling activity resumption, self-care, and attitudinal advice from recent publications. The pamphlet was sent at random to half of all consenting workers reporting back pain within 11 days of occupational injury between 7/96 and 6/97. Three and 6 months later, back pain, work status, health care use, and pamphlet impact outcomes were assessed through structured telephone interviews.
                Of the 726 eligible workers, 486 consented to participate. Consenters and nonconsenters and intervention and control groups were similar in initial demographic variables. The pamphlet had no statistically significant impact at the 0.05 significance level on pain severity or reduction, health care visits, or work absence. Of the 229 pamphlet recipients, 129 thought it had provided useful information, but only 25 thought it had helped them return to work more quickly.
                In this trial, a pamphlet stressing psychosocial recovery issues did not prevent or reduce postinjury pain, health care use, or work absence. The Japan Maritime Self-Defense Force (JMSDF) requires all personnel assigned to Iwo Jima to undergo a preassignment medical examination. The efficacy and benefit of this mandatory examination has not been evaluated objectively in depth. Our purpose was to review the health status of JMSDF personnel assigned to Iwo Jima and to evaluate the correlation of the preassignment medical examination to their current health status for the study period. We divided the participants into two groups. Group Y was composed of JMSDF personnel receiving a preassignment medical examination, and group N was composed of those personnel who did not receive the examination. After the annual health examination, health status was evaluated using objective criteria. We found little statistically significant difference among group Y and group N participants. However, proportionally more patients currently receiving care for or diagnosed with hypertension, hyperuricemia, or severe obesity were identified as being members of group N than group Y. We have demonstrated that the preassignment medical examination may contribute to predicting the health status of potential Iwo Jima personnel and may contribute to controlling the cost of care associated with these specific diagnoses by limiting the assignment of at-risk personnel. A descriptive study was made at a primary aluminium smelter to find evidence of the efficiency of the Histamine Provocation Test as part of a pre-employment examination. 174 cases of potroom asthma were divided into two groups. 157 cases were employed in the years 1970-1981. The second group consisted of 17 men who were employed after the introduction of the HPT in 1982. The urinary fluoride levels showed a lowering in exposure to fluorides during the last five years. Medical data collected at the pre-employment examination was compared between the two groups. There were significantly more smokers in the first group of 157 men. Bronchitis or asthma during childhood was mentioned by many men in the second group. It is concluded that the HPT played an important role in the attempt to reduce the incidence of potroom asthma, followed by greater attention to working conditions.
There is very low quality evidence that pre-employment examinations that are specific to certain jobs or health problems could reduce occupational disease, injury, or sickness absence. This supports the current policy to restrict pre-employment examinations to job-specific examinations. More studies are needed that take into account the harms of rejecting job applicants.