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BACKGROUND: Returning to work after long-term sick leave can be challenging, particularly in small- and medium-sized enterprises (SMEs) where support may be limited. Recognizing the responsibilities and challenges of SME employers, a web-based intervention (hereafter the SME tool) has been developed. The SME tool aims to enhance the employer\'s intention and ability to support the sick-listed employee. Based on the Self-Determination Theory, it is hypothesized that this intention is enhanced by intervening in the employer\'s autonomy, competences, and relatedness targeted at, e.g., communication with sick-listed employee, involvement of other stakeholders, and practical support. This is achieved by means of providing templates, communication videos, and information on legislation. This article describes the design of an effect and process evaluation of the SME tool.
METHODS: A randomized controlled trial (RCT) with a 6-month follow-up will be conducted with a parallel-group design with two arms: an intervention group and a control group. Sick-listed employees (≤ 8 weeks) of SMEs (≤ 250 employees) at risk of long-term sick leave and their employers will be recruited and randomly allocated as a dyad (1:1). Employers randomized to the intervention group receive unlimited access to the SME tool, while those in the control group will receive care as usual. The primary outcome is the satisfaction of the employee with the return to work (RTW) support provided by their employer. Secondary outcomes include social support, work performance, and quality of work life at the employee level and self-efficacy in providing RTW support at the employer level. Outcomes will be assessed using questionnaires at baseline and 1, 3, and 6 months of follow-up. Process evaluation measures include, e.g., recruitment and use of and perceived usefulness of the SME tool. Additionally, semi-structured interviews with employers, employees, and occupational physicians will explore the interpretation of the RCT results and strategies for the national implementation of the SME tool.
CONCLUSIONS: The SME tool is hypothesized to be valuable in addition to usual care helping employers to effectively support the RTW of their long-term sick-listed employees, by improving the employers\' intention and ability to support.
BACKGROUND: ClinicalTrials.gov, NCT06330415. Registered on February 14, 2024.

Employee Assistance Programs (EAPs) have been shown to effectively reduce absenteeism, workplace injury rates, and health-related productivity impairments. However, established measures for determining its impact on employee-level productivity have rarely been used, nor have studies employed biological measures of well-being. Drawing on the allostatic load theory, we examine the effects of an EAP on biological measures (heart rate, heart rate variability), established measures of health-related productivity (Workability Index, Health and Work Performance Questionnaire, Workplace Limitations Questionnaire), and absenteeism 4 weeks and 6 months after clients started to receive counseling. We conducted a quasi-experimental study comparing an EAP (n = 73) with a matched control group (n = 134) using propensity score matching. We found that an EAP improves health-related productivity 4 weeks and 6 months after enrolling in counseling, above and beyond changes in the control group. Biological measures changed in the hypothesized directions, but differences between the groups did not reach significance. Absenteeism did not change in the EAP group 6 months after enrolling in counseling. In an exploratory analysis, we found that individuals requiring many sessions in the first 4 weeks showed worse productivity outcomes, demonstrating a negative dose-response relationship. Our study provides an example of how to include biological measures in EAP research. It adds to the scientific evidence of the usefulness of EAP services in restoring employee-level productivity. We calculate that the marginal productivity improvements per employee using the EAP are as much as $15,600 per annum. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

OBJECTIVE: Approximately 81% of traumatic brain injury cases are considered to be mild (mTBI), but few studies have reviewed mTBI caused by workplace violence (WPV). This study aimed to (1) determine the incidence of mTBI secondary to WPV in a statewide workers\' compensation system using International Classification of Disease codes and (2) analyse and compare factors associated with return-to-work outcomes between WPV mTBI cases versus other mechanisms.
METHODS: Using a retrospective cohort of claims data from the California Workers\' Compensation Information System during 2015-2019, cases with a return-to-work date were classified as WPV if the injury description contained keywords such as assault, gunpoint, harassed, intimidated, punch, threat, robbery, violent or verbal abuse.
RESULTS: Of the 14 089 mTBI claims analysed in this study, 11.2% were caused by WPV. When comparing WPV to non-WPV claims, the variables with statistically significant (p≤0.001) differences were age, income, industry and job class. There were no significant differences between groups for leave duration. In a linear mixed model, the variable of interest (WPV) was not associated with recovery duration after adjusting for other factors.
CONCLUSIONS: To our knowledge, this is the first study to examine WPV mTBI claims in the USA. The findings suggest that the public administration, education and healthcare and social services industries are at higher risk for WPV mTBI. WPV and job class were the only modifiable factors in the model and therefore should be the focus of additional research.

Work-related stress complaints are a growing societal problem. Occupational health professionals often play a key role in its prevention. However, studies providing an overview of preventive interventions and their effectiveness are lacking. Therefore, the aim of this systematic review was to summarise the evidence on the effectiveness of interventions delivered by occupational health professionals to prevent work-related stress complaints.A systematic search in PubMed, Embase, PsycInfo and Medline was performed in May 2023 based on PICO (population, intervention, control and outcomes) elements. Inclusion criteria were: peer-reviewed papers with a randomised controlled trial design, quasi-experimental design and pre-post evaluations with a control group; working populations not on sick leave; interventions delivered by occupational health professionals; and stress outcomes. Data were extracted using a predefined extraction form, risk of bias was assessed using the Cochrane risk of bias tool for randomised trials (RoB-2) and Risk of Bias in non-randomised Studies-of Interventions tool, and a narrative analysis was performed to summarise data.Nine studies were included in this review and encompassed a diverse range of populations, interventions and professionals involved, outcome measures, and effects observed. Five studies found either mixed effects on stress outcomes, short-term positive effects, or positive effects in a subgroup of participants demonstrating high adherence to the intervention.As the results show mixed findings, a high risk of bias, and a limited number of studies was available, more research is needed to the effectiveness of the interventions and the factors underlying this.

BACKGROUND: Psychotherapeutic consultation at work (PT-A) offers easily accessible, short-term support for employees experiencing psychological stress. The aim of the study was to evaluate aspects of the implementation regarding announcement, access, and use of the PT‑A.
METHODS: The study was conducted as part of a randomized controlled trial (RCT) called \"Early Intervention in the Workplace\". Forty-six company actors answered a questionnaire about how the companies announced the PT‑A to their employees, the barriers in the announcement of the PT‑A, and the beneficial factors of using the PT‑A. The access routes of the 550 participating employees were used from the baseline data of the RCT. Seven company actors were qualitatively interviewed about their expectations of the PT‑A and 22 participants of the RCT were interviewed about their experiences accessing and using the PT‑A.
RESULTS: The company actors hoped that the PT‑A would have an impact on all levels of prevention. Most companies announced the PT‑A centrally (e.g., flyers and intranet) as well as through individual recommendations (e.g., through the company\'s social counselling and occupational health professionals). Employees appreciated the opportunity to participate anonymously in the central announcement. Advantages of the supportive access were seen in the accessibility of employees without treatment experience, employees with high levels of suffering, and employees who have not yet recognized their own need for treatment.
CONCLUSIONS: The results suggest that it is useful to announce the PT‑A centrally to all employees but also to recommend it personally to affected employees. By using both methods, different PT‑A target groups can be reached and the advantages of anonymous participation are retained.
UNASSIGNED: EINLEITUNG: Die psychotherapeutische Sprechstunde am Arbeitsplatz (PT-A) bietet eine leicht zugängliche, kurzfristige Unterstützung für Beschäftigte mit psychischer Belastung. Ziel dieser Studie war es, die Implementierung der PT‑A in Hinblick auf ihre Bekanntmachung, den Zugang und die Nutzung zu untersuchen.
METHODS: Die Daten wurden im Rahmen der randomisiert kontrollierten Studie (RCT) „Frühe Intervention am Arbeitsplatz“ (friaa) erhoben. Quantitativ wurden 46 betriebliche Akteur:innen (BA) hinsichtlich verwendeter Bekanntmachungswege sowie förderlicher Faktoren der Nutzung der PT‑A befragt. Aus der Baseline-Erhebung der RCT wurden die Zugangswege der 550 teilnehmenden Beschäftigten verwendet. Qualitativ wurden 7 BA zur Erwartung an die PT‑A sowie 22 Beschäftigte der RCT zu den Erfahrungen des Zugangs und der Nutzung der PT‑A interviewt.
UNASSIGNED: Die BA erhoffen sich von der PT‑A Wirkungen auf allen Ebenen der Prävention. Die meisten Betriebe machten die PT‑A über zentrale betriebsinterne Wege (z. B. Flyer, Intranet) oder mithilfe von individuellen Gesprächen (z. B. Sozialberatung, Betriebsärzt:innen) bekannt. Die Beschäftigten wertschätzten bei der zentralen betriebsinternen Bekanntmachung die Möglichkeit zur anonymen Teilnahme. Vorteil des unterstützten Zugangs z. B. über Sozialberatung oder Betriebsärzt:innen war die Erreichbarkeit von Beschäftigten ohne Behandlungserfahrungen, aber mit hohem Leidensdruck.
CONCLUSIONS: Aufgrund der Ergebnisse wird empfohlen, die PT‑A sowohl zentral bei allen Beschäftigten zu bewerben als auch betroffene Beschäftigte in persönlichen Gesprächen direkt auf die PT‑A aufmerksam zu machen. Dadurch können verschiedene Zielgruppen erreicht werden und die Vorteile der anonymen Teilnahme bewahrt werden.

Given the enormous scale of the COVID-19 pandemic affecting the healthcare sector, limited human resource capacity, and efforts to prevent the spread of COVID-19, occupational health protection could not escape changes. The aim was to identify and compare the regulations regarding the provision of medical occupational check-ups (MOCs) during the pandemic in all European Union member states (EU MS). The study employed the Delphi method, involving experts from EU MS to assess MOC regulations between January 2020 and May 2021. Experts were queried regarding the existence and specifics of MOC regulations, particularly for entrance and periodic MOCs at hazardous and non-hazardous workplaces. Out of the 27 EU MS surveyed, 13 EU MS did not regulate MOCs, while 14 EU MS (51.6%) regulated the provision of MOCs. The regulations were changes in the way MOCs were provided, modifications (postponement in time, alternative provision, e.g. using telemedicine or online connection, or replacing the medical certificate of fitness to work based on the MOC with a declaration by the worker), or interruption without compensation, even for hazardous works. The regulations were in effect for different lengths of time and varied in some countries during the study period. The cumulative duration of MOC interruptions in all EU MS during the study period was 137 months (7.5% of the cumulative study period of 1836 months). Given the different approaches to the provision of MOCs in EU MS, it has proved appropriate to develop an optimal unified framework plan for future similar situations.

OCCUPATIONAL MEDICINE IN France : THE CURRENT SITUATION IN 2024. Occupational medicine has evolved since its creation in 1946. Occupational medicine services have become Occupational health services (OHS) and medical examination in nowadays only a part of their missions, which include helping the employers to perform risk assessment, patients to stay at work, and implementing health promotion in the workplaces in order to prevent disabilities. To fulfill those missions, OHS can rely on health specialists (occupational physicians and nurses) but also on a wide range of competencies, from toxicologists to ergonomists, and from psychologists to occupational hygiene specialists, all gathered in multidisciplinary teams, leaded by the occupational physician. Optimizing cooperation between general practitioners and occupational health physicians is still needed to improve the worker journey, to facilitate his ability to return to work and to ameliorate his long-term health follow-up according to his previous occupational exposures.
MÉDECINE DU TRAVAIL EN FRANCE, ÉTAT DES LIEUX EN 2024. La médecine du travail a peu à peu évolué, depuis sa création en 1946. Les services médicaux du travail sont devenus des services de prévention et de santé au travail, et le suivi de santé ne représente désormais qu’une partie de leur activité. L’aide à l’évaluation des risques, le maintien en emploi, les actions de promotion de la santé dans une perspective de prévention de la désinsertion professionnelle ont pris une place grandissante. Cela s’est accompagné d’une évolution des compétences au sein de ces services. Outre la compétence santé représentée par le binôme médecin-infirmier, des ergonomes, psychologues et toxicologues sont désormais présents ; ils interviennent en prévention des risques professionnels et constituent des équipes pluridisciplinaires, animées et coordonnées par le médecin du travail. Une meilleure collaboration entre médecin du travail et médecin traitant reste nécessaire pour améliorer le parcours du travailleur, son maintien en emploi et son suivi de santé au long cours en fonction de ses expositions professionnelles passées.

Many low- and middle-income countries (LMICs) grapple with shortages of health workers, a crucial component of robust health systems. The COVID-19 pandemic underscored the imperative for appropriate staffing of health systems and the occupational health (OH) threats to health workers. Issues related to accessibility, coverage, and utilization of OH services in public sector health facilities within LMICs were particularly accentuated during the pandemic. This paper draws on the observations and experiences of researchers engaged in an international collaboration to consider how the South African concept of Ubuntu provides a promising way to understand and address the challenges encountered in establishing and sustaining OH services in public sector health facilities. Throughout the COVID-19 pandemic, the collaborators actively participated in implementing and studying OH and infection prevention and control measures for health workers in South Africa and internationally as part of the World Health Organizations\' Collaborating Centres for Occupational Health. The study identified obstacles in establishing, providing, maintaining and sustaining such measures during the pandemic. These challenges were attributed to lack of leadership/stewardship, inadequate use of intelligence systems for decision-making, ineffective health and safety committees, inactive trade unions, and the strain on occupational health professionals who were incapacitated and overworked. These shortcomings are, in part, linked to the absence of the Ubuntu philosophy in implementation and sustenance of OH services in LMICs.