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Occupational Medicine Advance Access originally published online on December 18, 2007
Occupational Medicine 2008 58(2):88-93; doi:10.1093/occmed/kqm138
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© The Author 2007. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Return-to-work policies in Finnish occupational health services

Sirkku Kivistö1, Jos H. Verbeek2, Maria Hirvonen3 and Helena Varonen4

1 Work and Mental Health Team, Finnish Institute of Occupational Health, Topeliuksenkatu 41aA, FIN-00250 Helsinki, Finland
2 Cochrane Occupational Health Field, Knowledge Transfer Team, Finnish Institute of Occupational Health, PO Box 93, 70701 Kuopio, Finland
3 Statistics Team, Finnish Institute of Occupational Health, PO Box 93, 70701 Kuopio, Finland
4 Finnish Institute of Occupational Health, Topeliuksenkatu 41aA, FIN-00250 Helsinki, Finland

Aim To describe return-to-work services for employees on sick leave offered by Finnish occupational health services (OHS).

Methods Finnish OHS are surveyed every 3 years. Respondents are asked if they offer services to facilitate return to work (RTW), and if so, to describe them. The description was qualitatively analysed using the Atlas-ti programme to find the themes that best describe the services. We also studied characteristics of OHS predicting a return-to-work policy.

Results Of the total sample of 969 occupational health units, 95% responded to the survey. Forty-one per cent reported offering services for facilitating RTW after sick leave. The service usually consisted of occupational physician examination of employees on sick leave for ~6 weeks. This was followed by a joint discussion between employee, physician and supervisor, which could result in work accommodation or a work trial period. There was a substantial variation, with only 10% mentioning a joint meeting and 13% mentioning a work trial period or work accommodation. Return-to-work policies were more frequently found in the OHS that served only a few employers, provided more group activities and collaborated more with employers and research institutes.

Conclusion Less than half of Finnish OHS offer return-to-work services of which the contents show wide variation that is not in line with current scientific evidence. A guideline project for return-to-work practices is needed to fill the gap. More research is needed to best define monitoring and screening practices for workers on sick leave.

Keywords      Disability evaluation; occupational health nurse; occupational physician; sick leave; vocational rehabilitation

Correspondence to: Jos H. Verbeek, Knowledge Transfer Team, Finnish Institute of Occupational Health, PO Box 93, Kuopio 70701, Finland. Tel: +358-304747289; fax: +358-304747221; e-mail: jos.verbeek{at}ttl.fi


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