Abstract:
OBJECTIVES:The fit note, introduced in England, Wales and Scotland in 2010, was designed to change radically the sickness certification process from advising individuals on their inability to work to advising them on what they could do if work could be adapted. Our review aimed to evaluate the following: (1) Is the 'maybe fit' for work option being selected for patients? (2) Are work solutions being recommended? (3) Has the fit note increased return to work? (4) Has the fit note reduced the length of sickness absence? We considered the way in which outcomes vary according to patient demographics including type of health problem. METHODS:Studies were identified by a systematic search. We included all studies of any design conducted in the UK with working age adults, aged 16 or over, from 1 April 2010 to 1 Nov 2017. Risk of bias was assessed using a modified Newcastle-Ottawa Scale. RESULTS:Thirteen papers representing seven studies met inclusion criteria. In the largest study, 'maybe fit' for work was recommended in 6.5% of fit notes delivered by general practitioners (GP; n=361 801) between April 2016 and March 2017. 'Maybe fit' recommendations were made in 8.5%-10% of fit notes received by primary care patients in employment, and in 10%-32% of patients seen by GPs trained in the Diploma in Occupational Medicine. 'Maybe fit' was recommended more for women, those with higher socioeconomic status, and for physical, as opposed to psychiatric disorders. The majority of fit notes with the 'maybe fit' option selected included work solutions. There was inconclusive evidence to suggest that the introduction of the fit note has reduced sickness absence among patients in employment. CONCLUSIONS:Fit notes represent a major shift in public policy. Our review suggests that they have been incompletely researched and not implemented as intended.
journal_name
Occup Environ Medjournal_title
Occupational and environmental medicineauthors
Dorrington S,Roberts E,Mykletun A,Hatch S,Madan I,Hotopf Mdoi
10.1136/oemed-2017-104730subject
Has Abstractpub_date
2018-07-01 00:00:00pages
530-539issue
7eissn
1351-0711issn
1470-7926pii
oemed-2017-104730journal_volume
75pub_type
杂志文章abstract:OBJECTIVE:To study the effect on the incidence of cancer of exposure to chemicals handled in the leather tanning industry. MATERIALS AND METHODS:A case-control study was performed within a cohort of 2487 workers employed for at least six months during the period 1900-89 in three Swedish leather tanneries. 68 cancer ca...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.53.7.463
更新日期:1996-07-01 00:00:00
abstract::: This systematic review and meta-analysis aimed to examine whether working beyond the standard working hours was associated with a greater risk of depressive disorder among workers included in published prospective studies. This manuscript was prepared according to the PRISMA guideline checklist. A database search wa...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1136/oemed-2016-103845
更新日期:2016-12-01 00:00:00
abstract:OBJECTIVES:To assess sensitivity and specificity of a questionnaire designed to detect neurotoxic symptoms in workers exposed to solvents and in patients with a psycho-organic syndrome. METHODS:The Swedish Q16 is a self administered questionnaire for neurotoxic symptoms. The modified German version consists of 18 ques...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.58.1.19
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Controversy still exists about the breast carcinogenic properties in humans of environmental xenoestrogens (organochlorines), justifying new investigations. AIMS:To compare the blood levels of total dichlorodiphenyltrichloroethane (DDT) and hexachlorobenzene (HCB) in samples collected at the time of breast ...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.60.5.348
更新日期:2003-05-01 00:00:00
abstract::Internationally, the debate on aims for occupational health policy is expanding its horizons. Included among the issues are not only concerns about safety for workers, but also for their progeny. Equality among the sexes is also assuming a prominent position. In several countries, existing and proposed legislation alr...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,评审
doi:10.1136/oem.52.5.294
更新日期:1995-05-01 00:00:00
abstract:OBJECTIVES:To determine cell differential counts and the number of asbestos bodies (ABs) in bronchoalveolar lavage (BAL) fluid obtained from patients with asbestosis, and to correlate the results with their survival. METHODS:The BAL cell differential counts and ABs from 91 patients with asbestosis were determined. The...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oemed-2018-105606
更新日期:2019-10-01 00:00:00
abstract:OBJECTIVES:To estimate the risk of lymphoma among farmers in Spain. METHODS:This is a multicentre case control study conducted in Spain. Cases were subjects diagnosed with lymphoma according to the World Health Organization (WHO) classification in four hospitals between 1998-2002. Hospital controls were frequency matc...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,多中心研究
doi:10.1136/oem.2005.024026
更新日期:2006-10-01 00:00:00
abstract::The International Agency for Research on Cancer has classified occupational exposure as a painter as 'carcinogenic to humans', largely based on increased risks of bladder and lung cancer. A meta-analysis, including more than 2900 incident cases or deaths from bladder cancer among painters reported in 41 cohort (n=2), ...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,评审
doi:10.1136/oem.2009.051565
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVES:Chronic exposure to high levels of noise may be associated with increased risk of cardiovascular disease. We therefore undertook a quantitative retrospective exposure assessment using predictive statistical modelling to estimate historical exposures to noise among a cohort of 27,499 sawmill workers as part o...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,多中心研究
doi:10.1136/oem.2008.040881
更新日期:2009-06-01 00:00:00
abstract::A 32 year old male research physician accidentally received a minor wound from a needle which had been previously used on rabbit tissue. Within 15 minutes serious anaphylactic reactions started and he was taken to hospital where his condition stabilised within five hours. Serum immunoglobulin E antibodies to rabbit ep...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.53.8.573
更新日期:1996-08-01 00:00:00
abstract::Worldwide, millions of office workers use a computer. Reports of adverse health effects due to computer use have received considerable media attention. This systematic review summarises the evidence for a relationship between the duration of work time spent using the computer and the incidence of hand-arm and neck-sho...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章,评审
doi:10.1136/oem.2006.026468
更新日期:2007-04-01 00:00:00
abstract:BACKGROUND:Conclusions that can be drawn from earlier studies on noise and children's blood pressure are limited due to inconsistent results, methodological problems, and the focus on school noise exposure. OBJECTIVES:To investigate the effects of aircraft and road traffic noise exposure on children's blood pressure a...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2006.026831
更新日期:2006-09-01 00:00:00
abstract:AIMS:To determine the risk of all cause mortality, cause specific mortality, and incident cancer in meatworkers. METHODS:In a retrospective cohort study, a list of members of a meatworkers union in Australia was matched with the national death and cancer registries. Standardised mortality ratios (SMR) and standardised...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.60.9.e4
更新日期:2003-09-01 00:00:00
abstract:AIMS:To assess the impact of newly introduced point-of-sale glass bottle recycling on indoor air quality and employee health. METHODS:Airborne exposures and both chronic and acute respiratory and somatic symptoms were surveyed among 226 employees at 36 randomly selected liquor stores with bottle recycling and in-house...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2003.009753
更新日期:2004-07-01 00:00:00
abstract::Although the neurological and cardiovascular effects of Freons have been extensively described, the respiratory effects have been less well documented. We report four cases of occupational asthma following accidental exposure to bromochlorodifluoromethane (Halon 1211) due to release of the contents of a fire extinguis...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2003.009837
更新日期:2004-08-01 00:00:00
abstract:OBJECTIVES:Poisson regression is now widely used in epidemiology, but researchers do not always evaluate the potential for bias in this method when the data are overdispersed. This study used simulated data to evaluate sources of overdispersion in public health surveillance data and compare alternative statistical mode...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2008.042887
更新日期:2009-11-01 00:00:00
abstract:OBJECTIVES:Self-reported exposure to vapours, gas, dust or fumes (VGDF) has been widely used as an occupational exposure metric in epidemiological studies of chronic lung diseases. Our objective was to characterise the performance of VGDF for repeatability, systematic misclassification, and sensitivity and specificity ...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2008.040022
更新日期:2009-03-01 00:00:00
abstract:OBJECTIVES:This paper describes findings from the study of chronic bronchitis (CB) incidence after occupational exposure to ionising radiation among workers employed at Russian Mayak Production Association (PA) during 1948 and 1982 and followed up until 2008 based on 'Mayak Worker Dosimetry System 2008'. METHODS:Analy...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oemed-2015-103283
更新日期:2017-02-01 00:00:00
abstract:AIMS:To investigate the use of a worker based methodology to assess the physical stresses of lifting tasks on effort expended, and to associate this loading with musculoskeletal outcomes (MO). METHODS:A cross sectional study was conducted on 217 male manual handling workers from the Hong Kong area. The effects of four...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.60.10.730
更新日期:2003-10-01 00:00:00
abstract:OBJECTIVES:To examine the relationship between protease exposure and respiratory disease in a cohort of detergent enzyme manufacturers. METHODS:Case-referent analysis of a cohort of employees working in a European detergent factory between 1989 and 2002. Cases with new lower or upper respiratory disease were ascertain...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2008.043851
更新日期:2009-11-01 00:00:00
abstract:BACKGROUND:It has been speculated on theoretical grounds that biomarkers are superior surrogates for chemical exposures to air samples in epidemiology studies. METHODS AND RESULTS:Biomarkers were classified according to their position in the exposure-disease continuum-that is, parent compound, reactive intermediate, s...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2004.013102
更新日期:2005-11-01 00:00:00
abstract:BACKGROUND:Assessment of exposure assessment to metal working fluids (MWF) has almost exclusively focused on inhalation exposure. AIMS:To assess levels of, and factors affecting, dermal and inhalation exposure to semi-synthetic MWF, and to identify suitable dermal exposure grouping schemes among metal workers for an e...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2004.015396
更新日期:2005-09-01 00:00:00
abstract:OBJECTIVES:For regulatory risk assessment under REACH a tiered approach is proposed in which the first tier models should provide a conservative exposure estimate that can discriminate between scenarios which are of concern and those which are not. The Stoffenmanager is mentioned as a first tier approach in the REACH g...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2008.045500
更新日期:2010-02-01 00:00:00
abstract:AIMS:To test whether (1) physically demanding work is less frequent for older than younger employees, and whether (2) the association of physically demanding work with decline of physical functioning is stronger for older employees than their younger counterparts. The gender differences in these associations were exami...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2004.014035
更新日期:2005-02-01 00:00:00
abstract:BACKGROUND:Although crystalline silica exposure is associated with silicosis, lung cancer, pulmonary tuberculosis, and chronic obstructive pulmonary disease (COPD), there is less support for an association with autoimmune disease, and renal disease. METHODS:Using data from the US National Occupational Mortality Survei...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.60.2.122
更新日期:2003-02-01 00:00:00
abstract:OBJECTIVES:To evaluate the effects of chronic exposure to lead on the peripheral nervous system in lead workers. METHODS:Nerve conduction velocity and electromyographic studies were performed on 31 lead workers of a battery recycling factory and 31 sex and age matched controls. 25 cases with mild distal extensor weakn...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.52.6.415
更新日期:1995-06-01 00:00:00
abstract:OBJECTIVE:Violence from care recipients and family members, including both verbal and physical abuse, is a serious occupational hazard for healthcare and social assistance workers. Most workplace violence studies in this sector focus on hospitals and other institutional settings. This study examined verbal abuse in a l...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oemed-2018-105604
更新日期:2019-07-01 00:00:00
abstract::Complex and dynamic physiologic processes underlie the exposure-response relations that occupational and environmental epidemiologists study. Simple summary measures of exposure such as the average, cumulative exposure, or duration of exposure, can be applied suitably in exposure-response analyses in many instances. H...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oem.2006.030031
更新日期:2007-07-01 00:00:00
abstract:BACKGROUND:Commercial airline crew is one of the occupational groups with the highest exposures to ionising radiation. Crew members are also exposed to other physical risk factors and subject to potential disruption of circadian rhythms. METHODS:This study analyses mortality in a pooled cohort of 93 771 crew members f...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oemed-2013-101395
更新日期:2014-05-01 00:00:00
abstract:OBJECTIVES:There is an ongoing debate regarding environmental health risks of exposures to dust and microbial agents from livestock farming in the Netherlands. The aims of the study were (1) to investigate associations between indicators of air pollution from livestock farms and asthma, allergic rhinitis and chronic ob...
journal_title:Occupational and environmental medicine
pub_type: 杂志文章
doi:10.1136/oemed-2013-101485
更新日期:2014-02-01 00:00:00