The aims of this study are to test the sensitivity over time of the Health Assessment Questionnaire (HAQ) to changes in function, fatigue, and pain by administering it prospectively to workers as a measure of the non-economic costs of work-related injury; and to determine the relationship between the HAQ scores, health care costs, and lost days from work as a measure of the economic impact of injuries. The primary hypothesis posed in this study is that the HAQ will demonstrate sensitivity to changes over time in function, fatigue, and pain, and will adequately capture the economic costs of injury. The investigators will test the utility of the HAQ as a measure of functional limitations, and collect information on pain, fatigue, iatrogenic effects, need for personal assistance, comorbid conditions, and treatment costs. The data source for the proposed project are municipal workers who are treated for injuries at an occupational health clinic. The group is diverse demographically and occupationally. Subjects (n = 100) will be recruited over a 12-month period. Only those cases who present with acute traumatic injuries or acute musculoskeletal condition will be eligible. The HAQ will be administered within 1-2 weeks of injury, and at 3 weeks, 4 weeks, 3 months, and 6 months post-injury. Sensitivity of the HAQ to changes over time will be analyzed using a one-way repeated measures analysis of variance. Descriptive statistics will provide a profile of symptoms and functional limitations. The correlation coefficient (r) will be used to describe the relationship between HAQ scores, health care costs, and lost days from work. Clinicians need patient-related measures that capture the patient impact of work-related injuries, and that help them develop appropriate return to work programs. This study will further test the HAQ's ability to measure functional limitations in injured workers, and expand knowledge by collecting information on the non-economic and economic costs of injuries borne by workers and their families.
