The burden of musculoskeletal disorders on society is substantial, requiring effective management especially in an occupational context. Occupational health guidelines recommend addressing potentially detrimental psychosocial factors in the management of workers sick-listed with musculoskeletal disorders, yet the specific influence on absence from occupational and clinical psychosocial risk factors (termed 'blue' and 'yellow' flags) remains under-explored.
A four-year study was carried out in two phases: (1) a workforce survey of a large multi-site company in the UK, (2) a controlled trial of an occupational guidelines-based intervention protocol for workers with musculoskeletal disorders, focusing on obstacles to recovery/return-to-work.
The results confirmed a general association between the psychosocial work environment and musculoskeletal disorders. Prospectively, psychosocial risk factors predicted the likelihood of future absence, but not its duration; routine psychosocial screening to predict return-to-work time may have limited value. Implementation of an early proactive occupational health protocol (psychosocial intervention and a supportive network with all players onside) was a successful strategy for reducing absence due to musculoskeletal disorders, for both return-to-work time and future workloss. The effect was observed at both the site level and the individual level. Organisational obstacles (black flags) were identified, which compromised the experimental intervention. It remains to be determined which, if any, specific components of the intervention package might be most effective.
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