Determinants of sickness absence duration after an occupational back injury in the Belgian population

Background
This study aimed at assessing factors associated to the duration of sickness absence after a back injury in the Belgian working population, with a special emphasis on cultural factors.
Methods
The data were retrieved from the Belgian Fund for Work Accidents database over a three-year period (2001-2003). The population source involved all Belgian workers under a job contract in the private sector registered as compensated cases for an accident that occurred at the workplace (n=558276). From that database, all back injury cases involving a complete data set and registered during the first 6 months of each year (n= 11262) were selected and eight factors (gender, age, seniority in the current job, job category, accident regional location, enterprise size, sector of activity and accident circumstances) were analyzed in relation to the outcome variable, sick leave duration recorded as ordered time intervals between 0 day and 183-366 days.
Results
Sick leave duration was strongly associated in a multivariate model to age (>= 40 years: OR=2.18), blue collar job (1.55), work in building industry (1.32) and enterprise size (>100 : 0.85), and to a less extent to seniority (>10y: 0.88), and circumstance of accident (falls: 1.26). Injuries occurring in the French-speaking part of the country were associated to a longer sick leave (1.07; p=0.034).
Conclusions
This study shows that besides well-known risk factors, subtle cultural language-linked factors and/or regional differences in economic climate may significantly influence the length of disability period after a back injury.