ORCID Profile
0000-0002-8029-6838
Current Organisation
Monash University
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Epidemiology | Social Policy | Policy and Administration
Social Structure and Health | Disability and Functional Capacity | Public Services Policy Advice and Analysis |
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.INJURY.2017.09.019
Abstract: Workers in first responder (FR) occupations are at heightened risk for workplace injury given their exposure to physical sychological hazards. This study sought to (1) characterise the occupational risk of injury (2) determine factors associated with injury and (3) characterise the burden of injury-related disability in police, ambulance officers, fire/emergency workers, compared with other occupations. A retrospective cohort of 2,439,624 claims occurring between July 2003 and June 2012 was extracted from the Australian National Dataset for Compensation-Based Statistics. Cases aged 16-75 years working 1-100 pre-injury hours per week were included. Regression models estimated risk of making a workers' compensation (WC) claim by age, gender, occupation and injury type. Injury burden was calculated using count and time loss, and statistically compared between groups. The risk of making a WC claim among FR occupations was more than 3 times higher than other occupations. Risk of claiming was highest among female FRs and those aged 35-44 years. Ambulance officers had the greatest risk of upper-body MSK injuries and fire and emergency workers the greatest risk of lower-body MSK injuries. The risk of mental health conditions was elevated for all FR occupations but highest among police officers. The total burden of injury (expressed as working weeks lost per 1000 workers) differed significantly between groups and was highest amongst police. First responders record significantly higher rates of occupational injury claims than other occupations. Using a national population based dataset, this study demonstrates that not only are first responders exposed to significantly higher rates of occupational injury than all other occupations combined, but they experience differential injury patterns depending on their occupation. This suggests that among FR occupations injury prevention efforts should reflect these differences and be targeted to occupation-specific patterns of injury.
Publisher: BMJ
Date: 27-03-2020
DOI: 10.1136/OEMED-2019-106325
Abstract: To determine whether step-downs, which cut the rate of compensation paid to injured workers after they have been on benefits for several months, are effective as a return to work incentive. We aggregated administrative claims data from seven Australian workers’ compensation systems to calculate weekly scheme exit rates, a proxy for return to work. Jurisdictions were further sub ided into four injury subgroups: fractures, musculoskeletal, mental health and other trauma. The effect of step-downs on scheme exit was tested using a regression discontinuity design. Results were pooled into meta-analyses to calculate combined effects and the proportion of variance attributable to heterogeneity. The combined effect of step-downs was a 0.86 percentage point (95% CI −1.45 to −0.27) reduction in the exit rate, with significant heterogeneity between jurisdictions ( I 2 =68%, p=0.003). Neither timing nor magnitude of step-downs was a significant moderator of effects. Within injury subgroups, only fractures had a significant combined effect (−0.84, 95% CI −1.61 to −0.07). Sensitivity analysis indicated potential effects within mental health and musculoskeletal conditions as well. The results suggest some workers’ compensation recipients anticipate step-downs and exit the system early to avoid the reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative. Postprint link: ontent/10.1101/19012286
Publisher: Elsevier BV
Date: 12-2014
Publisher: Cold Spring Harbor Laboratory
Date: 19-11-2019
DOI: 10.1101/19012286
Abstract: To determine whether step-downs, which cut the rate of compensation paid to injured workers after they have been on benefits for several months, are effective as a return to work incentive. We aggregated administrative claims data from seven Australian workers’ compensation systems to calculate weekly scheme exit rates, a proxy for return to work. Jurisdictions were further sub ided into four injury subgroups: fractures, musculoskeletal, mental health, and other trauma. The effect of step-downs on scheme exit was tested using a regression discontinuity design. Results were pooled into meta-analyses to calculate combined effects and the proportion of variance attributable to heterogeneity. The combined effect of step-downs was a 0.86 percentage point (95% CI -1.45 to -0.27) reduction in the exit rate, with significant heterogeneity between jurisdictions ( I 2 = 68%, p = .003). Neither timing nor magnitude of step-downs was a significant moderator of effects. Within injury subgroups, only fractures had a significant combined effect (-0.84, 95% CI -1.61 to -0.07). Sensitivity analysis indicated potential effects within mental health and musculoskeletal conditions as well. The results suggest some workers’ compensation recipients anticipate step-downs and exit the system early to avoid the reduction in income. However, the effects were small and suggest step-downs have marginal practical significance. We conclude that step-downs are generally ineffective as a return to work policy initiative. 1. A number of workers’ compensation systems around the world reduce payments to injured workers after they have been in the system for several months. In Australia, where each state, territory, and Commonwealth system employs step-downs, the stated policy objective is to increase the rate of return to work through financial incentives. However, there is little empirical evidence to either support or reject this claim. 2. The rate at which claimants exited workers’ compensation systems increased ahead of step-downs taking effect, suggesting an anticipatory effect. However, the effect was relatively small, changing the exit rate by less than a percentage point overall, with substantial heterogeneity between systems. 3. While statistically significant, the findings suggest that step-downs provide workers’ compensation claimants little incentive to return to work. Policymakers may need to reconsider step-downs as a component of scheme design, or justify them according to their original purpose, which was to save costs.
Publisher: Cold Spring Harbor Laboratory
Date: 27-02-2020
DOI: 10.1101/2020.02.24.20027540
Abstract: To describe incidence, duration, and patterns of working time loss claims in compensated Australian workers with low back pain (LBP), and compare this with other musculoskeletal conditions. The National Dataset for Compensation-based Statistics (NDS) was used for this study. Any accepted workers’ compensation time loss claims for LBP, limb fracture or limb soft tissue disease occurring between July 2010 and June 2015 were included. Demographic information, occupation, and total cumulative time loss data were extracted. Counts, rates per 10,000 covered workers, the relative risk and median duration of time loss were calculated. Multivariate Cox and quantile regression models were used to determine factors affecting time loss duration and patterns. There were 56,102 LBP claims, 42,957 limb fracture claims, and 18,249 limb soft tissue disease claims. The relative risk of a claim for LBP was significantly greater than limb fractures after adjustment for all covariates (RR 1.30, 95%CI 1.29 – 1.32, p 0.001). LBP claims had longer median time loss (9.39 weeks) than limb fracture claims (9.21 weeks). Quantile regression demonstrated that LBP claims were more likely than limb fracture claims to resolve within seven weeks, and to persist for periods beyond seven weeks. There were differential patterns of time loss in LBP claims and limb fracture claims. The interaction between conditions, and policies and practices may contribute to these patterns. The findings should reiterate to workers’ compensation stakeholders the importance of returning a worker to work as soon as practicable, to avoid future delays or challenges. LBP is a prevalent musculoskeletal symptom the leading contributor to the burden of disability for people of working age. Musculoskeletal conditions like LBP comprise the largest proportion of compensated conditions in Australia. The incidence of claims for work-related LBP is higher than other work-related musculoskeletal conditions. Median time loss associated with a claim for LBP is similar to time loss for a claim for a limb fracture but less than for limb soft tissue disease claims. The likelihood of time loss duration is greater for workers with claims LBP than claims for limb fracture in the short term (seven weeks), but lower than limb fracture claims after this time. Workers’ compensation stakeholders including clinicians, insurers, and workers’ compensation authorities should carefully consider the importance of returning a worker to work as soon as practicable to avoid future challenges, particularly for a condition as burdensome as LBP.
Publisher: Elsevier BV
Date: 12-2014
Publisher: Springer Science and Business Media LLC
Date: 12-07-2016
Publisher: Elsevier BV
Date: 12-2014
Publisher: Elsevier BV
Date: 02-2010
Publisher: Cold Spring Harbor Laboratory
Date: 24-07-2020
DOI: 10.1101/2020.07.23.20160416
Abstract: Time off work after workplace injury varies by compensation system. While often attributed to features of the compensation system, unaccounted regional factors may drive much of the effect. In this study, we compare disability durations by state and territory of residence within a single national workers’ compensation system. Large differences would indicate that factors other than compensation system settings are responsible for system effects observed in previous studies. We applied crude and adjusted Cox proportional hazards models to compare disability durations by state and territory of residence. Confounders included factors known to influence disability duration. Durations were left-censored at two weeks and right-censored at 104 weeks. We analysed N = 38,686 claims. In both crude and adjusted models, three of the seven states and territories significantly differed from the reference group, New South Wales. However, two of the three were different between crude and adjusted models. Regional effects were relatively small compared to other factors including insurer type, age, and type of injury. Regional factors influence disability duration, which persist with adjustment for demographic, work, insurer type, and injury confounders. However, the effects are inconsistently significant and fairly small, especially when compared to the effect of confounders and system effects found in previous studies. Regional factors likely only account for a small share of the difference in disability duration between compensation systems.
Publisher: Elsevier BV
Date: 12-2014
Publisher: Elsevier BV
Date: 09-0012
Publisher: Elsevier BV
Date: 12-2014
Publisher: Public Library of Science (PLoS)
Date: 07-12-2022
DOI: 10.1371/JOURNAL.PGPH.0000922
Abstract: Work disability occurs when an injury or illness limits the ability of a worker to participate in employment. While evidence suggests that people with work disability are at increased risk of suicide and intentional self-harm, this relationship has not been the subject of systematic review. This scoping review aims to assess and summarise the research literature regarding the relationship between work disability and subsequent suicide or intentional self-harm. Review protocol was published on the Open Science Foundation and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews. Peer-reviewed studies published in English from 1st January 2000 were included if they reported suicide or self-harm outcomes in people aged 15 years or older with work disability. Studies were identified via systematic search of Medline, Scopus and Pubmed databases, via recommendation from topic experts, and citation searching of included articles. A narrative synthesis was undertaken. Literature search yielded 859 records of which 47 eligible studies were included, nine set in workers’ compensation, 20 in sickness absence, 13 in disability pension systems, and five from mixed cohorts. Of 44 quantitative studies, 41 reported a positive relationship between work disability and suicidal behaviour. The relationship is observed consistently across nations, work disability income support systems and health conditions. Several factors elevate risk of suicidal behaviour, including presence of mental health conditions and longer work disability duration. There were few studies in some nations and no suicide prevention interventions. The risk of suicide and self-harm is elevated in people experiencing work disability. Further observational research is required to fill evidence gaps. This review suggests the need for governments, employers and those involved in the care of people with work disability to focus on identification and monitoring of those at greatest risk of suicidal behaviour, and suicide prevention.
Publisher: BMJ
Date: 02-12-2019
DOI: 10.1136/OEMED-2019-106063
Abstract: To determine the impact of legislative changes to the New South Wales (NSW) workers’ compensation scheme on injured workers access to benefits, insurer claim processing and work disability duration. Population-based interrupted time series study of workers’ compensation claims made in NSW 2 years before and after legislative amendment in June 2012. Outcomes included incidence of accepted claims per 100 000 workers, the median and 75th percentile insurer decision time in days, and the median and 75th percentile of work disability duration in weeks. Effects were assessed relative to a comparator of seven other Australian workers’ compensation jurisdictions. n=1 069 231 accepted workers’ compensation claims were analysed. Claiming in NSW fell 15.3% following legislative reform, equivalent to 46.6 fewer claims per 100 000 covered workers per month. This effect was greater in time loss claims (17.3%) than medical-only claims (10.3%). Across models, there were consistent trend increases in insurer decision time. Median work disability duration increased following the legislative reform. The observed reduction in access to benefits was consistent with the policy objective of improving the financial sustainability of the compensation scheme. However, this was accompanied by changes in other markers of performance that were unintended, and are suggestive of adverse health consequences of the reform. This study demonstrates the need for care in reform of workers’ compensation scheme policy.
Publisher: Elsevier BV
Date: 12-2022
DOI: 10.1016/J.INJURY.2022.09.046
Abstract: Educators are exposed to several work-related hazards. Evidence suggests musculoskeletal pain, psychological distress, and student-inflicted violence-related injuries are common. However, there is little evidence on the burden of workplace injury among Australian educators. To compare incidence of injury claims and duration of compensated time off work between educators and non-educators, and associated factors. Retrospective cohort study of 1,559,676 Australian workers' compensation claims, including 84,915 educator claims, lodged between July 2009 to June 2015, from the National Dataset for Compensation-based Statistics. Cases were included if aged 18+ years and working in the education sector less than 100 h per week. Negative binomial regression models estimated the relative risk of making a compensation claim and survival analyses calculated disability duration within educators by sex, age, injury type and mechanism, socioeconomic area, remoteness, and jurisdiction. Compared to non-educators, educators had lower rates of injury claims and shorter disability durations. However, educators had a higher rate of claims for mental health conditions and assault, with the highest risk being among those in special education and education aides. Among educators, injury claim rates were highest among special educators, education aides, and secondary educators. Though surveys indicate Australians in the education sector have higher incidences of work-related injuries, this study found lower incidence of injury claims and shorter disability durations than others. Educators' injury-reporting and absenteeism behaviors may be constrained by ethical, social, and administrative attitudes. Educators had higher rates of claims for mental health and assault-related injury, particularly special educators, and education aides, which suggests a need for targeted prevention efforts.
Publisher: Informa UK Limited
Date: 06-05-2019
Publisher: Inderscience Publishers
Date: 2018
Publisher: Informa UK Limited
Date: 14-11-2015
DOI: 10.1080/02701367.2014.975177
Abstract: The purpose of this study was to provide an epidemiological profile of injuries sustained by participants in fitness activities in Victoria, Australia, based on hospital admissions and emergency department (ED) presentations and to identify the most common types, causes, and sites of these injuries. Hospital-treated fitness activity-related injury cases were identified from International Classification of Disease activity codes (for admissions) and from text narratives of injury events (for ED presentations) from 2003 to 2010, inclusive. Cases were categorized as being associated with aerobics/group exercise (n = 252), resistance/weight training (n = 830) or "other equipment" (motorized and general gym equipment n = 1,156). Participation information was taken from the Exercise, Recreation and Sport Survey. Overall, 2,238 cases were identified and 11.6% of all patients with ED presentations were subsequently hospitalized. Those participants with aerobics cases were generally female (76.6%) and aged 25 to 34 years old (35.3%), with injuries to the lower limbs (59.1%) and due to falls (57.9%). Resistance-training injuries increased significantly during the 8-year period (by 215.7% 95% CI [133.5, 326.9]) and generally occurred in male participants (78.0%), in people aged 15 to 24 years old (36.4%), and with injuries to the upper limbs (45.1%) caused by being hit, struck, or crushed by weights or fellow exercisers (71.4%). The "other equipment" cases were equally distributed by gender they occurred most commonly in people aged 15 to 24 years old (27.8%), with injuries to the lower limbs (41.5%) and due to falls (57.6%). Across all categories, dislocations, sprains, and strains were the most common injury types. Fitness activity-related injury prevention strategies should be targeted at different subgroups according to the type of fitness activity being undertaken.
Publisher: Elsevier BV
Date: 07-2019
DOI: 10.1016/J.INJURY.2019.05.032
Abstract: Road traffic crash (RTC) burden is typically reported using hospitalisations or fatalities, yet alternative measures such as work absence provide further insight into RTC impacts. This study aimed to quantify work absence due to compensable RTCs in Victoria, and to determine the characteristics associated with prolonged work absence. In Victoria, Australia, two systems provide income support whilst unable to work, among other benefits, to those injured during RTCs either at work (workers' compensation: WC) or elsewhere (RTC compensation). Administrative data of accepted claims between July 1 2003 and June 30, 2013 were included from working age people (15-65 years) if at least one day of income support was paid. Total time (in weeks) on income support, and hence absent from work, was calculated for each person and for each predictor (age group, sex, compensation system, length of hospital stay, injury type and road user type). Cox regression was used to determine the likelihood of prolonged work absence by predictor, presented as hazard ratios (HR) with 95% confidence intervals. For 36,640 injured people, 1,121,863 weeks were compensated (median 10 weeks). Median work absence was shortest among those involved in a train/tram crash (2.9 weeks, HR:0.57[0.51-0.64]) and those with contusions/abrasions (3.7 weeks, HR:0.66[0.64,0.69]). Median work absence was longest among those with spinal cord injury (115.9 weeks, HR:1.56[1.26,1.92]) or severe acquired brain injury (129.6 weeks, HR:1.60[1.44,1.77]). Work absence likelihood increased with length of hospital stay. Median work absence was similar between compensation systems (WC: 10.1 weeks, RTC: 10.0 weeks) yet likelihood of greater work absence was higher in the RTC compensation system (HR:1.12[1.08,1.17]). Work absence is both a measureable and important metric for assessing the impact of RTC injury in those working at the time of injury. Work absence was at least ten weeks for more than half of all injured persons, reinforcing need for road safety, injury prevention, and return to work services. Furthermore, this study identified those most at risk of prolonged work absence, providing the opportunity to target specific in iduals to develop strategies to reduce work absence, such as occupation-specific rehabilitation or graduated return to work.
Publisher: Springer Science and Business Media LLC
Date: 14-04-2015
Publisher: Springer Science and Business Media LLC
Date: 04-02-2019
DOI: 10.1007/S10926-019-09828-3
Abstract: Purpose General Practitioners (GPs) play an important role in personal injury compensation systems yet system processes have been perceived as burdensome. Objectives were to (1) determine attitudes of Australian GPs on health benefits of return to work (RTW) after injury/illness and (2) identify associations between GP characteristics and agreement with issues surrounding treating compensable patients. Methods Cross-sectional postal survey of 423 Australian GPs to determine agreement with issues associated with compensable patients (including patient advocacy, conflicting opinions between GPs and compensation systems, fitness-for-work certification, and refusal to treat). Results The vast majority of GPs agreed there was a health benefit to early RTW. GPs with 16-20 years' experience had significantly higher odds of agreeing that the certificate of work capacity is the primary method of communication between RTW stakeholders (OR 2.36 [1.13-4.92]) than those with greater experience. 49% of GPs agreed they should be able to refuse to treat compensable patients. Female GPs had significantly lower odds (OR 0.60 [0.40-0.90]) of agreeing with right to refuse than male GPs, as did those from remote or regional practices (OR 0.43 [0.20-0.94] OR 0.60 [0.39-0.92]) than GPs from urban practices. Conclusions Reducing administrative barriers identified by Australian GPs and improving communication with compensation systems will likely have a positive impact on their refusal to treat compensable patients.
Publisher: Informa UK Limited
Date: 09-05-2017
Publisher: BMJ
Date: 11-03-2014
Publisher: BMJ
Date: 11-03-2014
Publisher: Elsevier BV
Date: 05-2019
Publisher: BMJ
Date: 11-03-2014
Start Date: 07-2022
End Date: 06-2028
Amount: $375,288.00
Funder: Australian Research Council
View Funded Activity