Special issue on work-related injuries and illnesses and the role of occupational therapy: implications of a systematic literature review for practice, research, education, and policy.

A ccording to the U.S. Bureau of Labor Statistics (2009), musculoskeletal disorders (MSDs) accounted for 29% of the injuries and illnesses requiring a median of 10 days away from work in 2008, a percentage that has not varied greatly since 2005. In 2008, MSDs required a median of 10 days away from work. Injuries to the back accounted for 20.4% (or one-fifth) of all work-related injuries and illnesses, requiring a median of 7 days away from work per incident. Injuries to the upper extremities accounted for .23% of all workplace injuries, with carpal tunnel syndrome in particular accounting for an average of 28 days away from work per incident, more than most other MSDs. Decreased productivity resulting from injury and workers’ compensation claims and costs result in lost revenue for many companies. In 2007, the National Academy of Social Insurance reported that cash benefits to injured workers and medical payments for their health care were $55.4 billion, with total costs to employers of $85 billion (Sengupta, Reno, & Burton, 2009). This special issue emerged in response to trends in workers’ compensation reforms in the United States, which initially occurred in California in 2003 and 2004. Note that workers’ compensation systems are administered by each state and receive no direct federal financing or administration, unlike other U.S. social insurance programs (Sengupta et al., 2009). California, however, is a big state, and large shifts in its workers’ compensation benefits and employers’ costs will naturally affect the course of national trends. Major reforms in California in 2003 and 2004 attempted to limit spending by introducing evidence-based treatment guidelines, which represented the first time a workers’ compensation law identified specific clinical guidelines to inform benefits coverage. In 2004, the Division of Workers’ Compensation in California chose the American College of Occupational and Environmental Medicine’s (2004) Practice Guidelines (2nd ed.) as the gold standard for guiding clinical decision making, requiring that physicians “choose treatments scientifically proven to cure or relieve workrelated injuries and illnesses” (California Division ofWorkers’ Compensation, 2010, para. 1). Unfortunately, these evidencebased guidelines did not include occupational therapy services. In response to these trends, the American Occupational Therapy Association’s (AOTA’s) Representative Assembly passed a proposal in 2005 to develop evidence-based occupational therapy guidelines for clinical conditions related to workers’ compensation. This issue of the American Journal of Occupational Therapy includes the summaries from a systematic evidence-based literature review examining the effectiveness of occupational therapy interventions for individuals with work-related injuries. The reviews were based on four focused questions derived from specific areas of practice: low back; elbow; forearm, wrist, and hand; and shoulder. The reviews include studies from the occupational therapy Jeff Snodgrass, PhD, MPH, OTR/L, CWCE