Getting back to work is the best medicine, study finds

THE biggest health risk posed by workplace injuries is not the injury itself, or returning to work too quickly, but not returning to work quickly enough, a new report reveals.

Yet across Australia the proportion of injured workers who never return to the workplace has risen consistently over the past five years.

A report by the Australasian Faculty of Occupational and Environmental Medicine presented in Adelaide yesterday shows that the longer someone is off work, the worse their health becomes.

The tendency towards a sedentary lifestyle after a workplace injury, and the loss of identity and social status produced by long-term worklessness, massively increases the risk of cardiovascular disease, lung cancer and suicide.

The risks associated with not working were higher than working in the most dangerous construction or forestry occupations and were equivalent to smoking multiple packets of cigarettes daily, contributing to elevated mortality rates.

''Not working for long periods of time is one of the greatest known risks to public health,'' the co-author of the report, Dr Robin Chase, said. ''It reduces life expectancy to a greater extent than cardiovascular disease. For example, suicide among young men out of work for more than six months increases 40-fold. It increases six-fold among the population more generally.'' Conversely, workers who return to work soon after suffering an injury have far better health.

But messages about the benefits of returning to work appear not to be getting through to employers, doctors, or the workforce more generally.

The return-to-work rate among injured workers has fallen from 80 per cent in 2005-06 to 72 per cent in 2008-09.

The authors of the report found that many people with mild to moderate musculoskeletal problems, such as back pain, were being wrongly certified unfit fit for work for long periods. This was despite the fact that most of these health conditions could be accommodated in a willing workplace with the right support.

''When doctors give people a script for medication they'll weigh the side effects against the benefits,'' the other co-author of the report, Dr Mary Wyatt, said.

''But we don't do that when time off work is proscribed. After all, people take holidays all the time right? But there are side effects and they are quite profound. We need a community approach - it's the guys down the pub who need to say: 'What do we need to do to help you get back to work mate?' and the doctor working hard with workers to figure out a solution.''

Associate Professor Baigent, a clinical adviser to beyondblue, said the organisation often found that rates of mental illness and drug and alcohol addiction were higher among the unemployed.

''There's no doubt that working plays an important role in people's mental health - not only does it pay the bills, but gives us social contact,'' Dr Baigent said.

''When you've got someone who has to take time off, it can precipitate depression … there are higher rates of depression for the unemployed.''