Return to work of transgender people: A systematic review through the blender of occupational health

Background and objectives Return to work (RTW) or work resumption after a work absence due to psychosocial or medical reasons benefits the well-being of a person, including transgender people, and is nowadays a major research domain. The objective is to examine, through an occupational lens, the literature reporting objective RTW outcomes and experiences in transgender people to (a) synthesize what is known about return to work (full-time, part-time, or self-employed) and (b) describe which gaps persist. Methods & sample Several databases and the gray literature were explored systematically. Studies between November 1, 2006 and March 1, 2021 revealing RTW quantitative and qualitative data of adult transgender people were eligible. This review was registered on PROSPERO (CRD42019128395) on April 30, 2019. Results Among the 14,592 articles initially identified, 97 fulfilled the inclusion criteria which resulted in 20 being analyzed. Objective RTW outcomes, such as number of RTW attempts, time to RTW or number of sick days, were lacking; thus, other relevant work outcomes were reported. Compared to the general population, lower employment rates and more economic distress were observed, with trans women in particular saying that their work situation had deteriorated. Research on positive RTW experiences was highlighted by the importance of disclosure, the support from especially managers and coworkers who acted as mediators, personal coping, and a transition plan along with work accommodations. Negative work experiences, such as demotion, lay-offs, and discrimination were often prominent together with a lack of knowledge of trans issues among all stakeholders, including occupational health professionals. Conclusion & recommendations Few studies have explored employment characteristics and experiences of transgender people (TP). RTW is a dynamic process along with transition in itself, which should be tailored through supportive policies, education, a transition plan and work accommodations with the help of external experts. Future studies should include more occupational information and report RTW outcomes to enhance our knowledge about the guidance of TP and to make way for interventional studies.

Employer perspectives on their supportive role in promoting sustainable RTW of disabled workers

Background Employers play an important supportive role in facilitating sustainable Return to Work (RTW) of workers with disabilities. Little is understood about how employers deal with their supportive role, what kind of support they offer and which facilitators of employer support are important to successful RTW. Methods A semi-structured interview study was conducted among 27 employer representatives (e.g. supervisors, HR managers, case managers) of companies in the Netherlands who had experience in retaining at least one disabled workers within their company. Participants were included through purposive sampling on sector and company size. Data was analyzed by means of thematic analysis. Results We identified three different types of employer support: 1. instrumental support (offering work accommodations), 2. emotional support (encouragement, empathy, understanding) and 3. informational support (providing information, setting boundaries). Facilitators of employer support were categorized into three main themes: 1. good collaboration, with subthemes (in)formal contact, trustful relationships, mutual responsibilities and (in)formal networks, 2. employer characteristics, including supportive organizational culture, leadership skills and flexibility, and 3. employee characteristics including flexibility and resilience. Conclusions Different types of employer support are considered as important in the RTW process of disabled workers. Besides offering work accommodations, also emotional and informational support are necessary. In addition, good collaboration and flexibility of both employer and employee may be viewed as facilitators for optimizing supervisor and employee interaction during the RTW process. Key messages Instrumental, emotional and informational support by the employer are important in the RTW process of disabled workers. Facilitating factors include collaboration, flexibility and leadership.

The Role of the Employer in Supporting Work Participation of Workers with Disabilities: A Systematic Literature Review Using an Interdisciplinary Approach

Purpose There is growing awareness that the employer plays an important role in preventing early labor market exit of workers with poor health. This systematic review aims to explore the employer characteristics associated with work participation of workers with disabilities. An interdisciplinary approach was used to capture relevant characteristics at all organizational levels. Methods To identify relevant longitudinal observational studies, a systematic literature search was conducted in PubMed, Web of Science, PsycINFO and EconLit. Three key concepts were central to the search: (a) employer characteristics, (b) work participation, including continued employment, return to work and long-term work disability, and (c) chronic diseases. Results The search strategy resulted in 4456 articles. In total 50 articles met the inclusion criteria. We found 14 determinants clustered in four domains: work accommodations, social support, organizational culture and company characteristics. On supervisor level, strong evidence was found for an association between work accommodations and continued employment and return to work. Moderate evidence was found for an association between social support and return to work. On higher organizational level, weak evidence was found for an association between organizational culture and return to work. Inconsistent evidence was found for an association between company characteristics and the three work outcomes. Conclusions Our review indicates the importance of different employer efforts for work participation of workers with disabilities. Workplace programs aimed at facilitating work accommodations and supervisor support can contribute to the prevention of early labor market exit of workers with poor health. Further research is needed on the influence of organizational culture and company characteristics on work participation.

Work accommodations and sustainable working: The role of social partners and industrial relations in the employment of disabled and older people in Estonia, Hungary and Poland

The under-utilization of the labour of disabled and older people is a problem across the European Union (EU) but is most pronounced in Central and Eastern European (CEE) member states, where labour shortages are greatest. This presents a puzzle that is explored with reference to a project with social partners from Estonia, Hungary and Poland, the objective of which was to stimulate debate and actions around the role of industrial relations actors in facilitating work accommodations for disabled and older people. After establishing the extent of the demographic labour crisis in these countries, the policy tools being employed to address it are scrutinized and found wanting. A variety of factors are identified as having contributed to debate in this area: historical legacy, social policy path-dependency, social partner identity and agency, a ‘dead letter’ approach to EU policies, and the limited role of civil society organizations. We examine the potential of the concept of sustainable work, more commonly found in Northern Europe, to influence alternative approaches to the employment of disabled and older people in countries where state, labour and employment relations differ.

Work Experiences, Accommodations, and Information in the Context of Fibromyalgia: A Literature Review and Conceptual Synthesis

This paper explores the challenges that individuals with fibromyalgia may experience in navigating the workplace. Fibromyalgia is a syndrome characterized by chronic widespread pain, stiffness, sleep disruption, and other symptoms, without a well-defined underlying disease. At work, patients can struggle with various problems, including fluctuating symptoms, exhaustion, skepticism, questions about whether to disclose, and finding ways to adjust work situations. Individuals often lack information concerning how to manage their health, as well as different aspects of their lives, including work. Work accommodations such as extended health benefits, modified schedules, and work-at-home arrangements could help. However, individuals may need to learn how to advocate for themselves, which can include finding information on legal rights and accommodation options. Differences in information awareness and seeking skills can lead to inequities in the management of chronic health conditions in the workplace. We explore extant literature in three parts. First, we review research on the experience of work among individuals with fibromyalgia, and to a lesser extent, other conditions and disabilities. Then, we consider work accommodations, and third, we conclude with a conceptual synthesis. In our analysis, we first identify a need for clearer conceptualization of the role of information to facilitate workplace self-advocacy. Then, we identify gaps in the literature concerning information and information behavior related to work accommodations. Last, we emphasize the need for involvement of stakeholders over time. This paper may be of interest to researchers, health care providers, library and information science professionals, and health policy researchers striving to achieve health equity.

The influence of collective employment relations on work accommodation: case studies in Estonia, Hungary and Poland

Work accommodations are generally understood to refer to individual solutions for older and disabled employees that have been tailored to their specific situation within a workplace. This article, however, argues that there is potential for collective employment relations to motivate and enable social partners to develop a role in implementing reasonable accommodations and supporting older and disabled employees in the labour market. Focusing on industrial relations and work accommodation systems in Estonia, Poland and Hungary, the potential role that social partners could play in creating more inclusive workplaces is explored. This is done by reference to the findings from an action research project that brought together social partners to discuss ways in which practices in providing work accommodations could help better to integrate underutilised sources of labour in these three countries. The industrial relations regimes in the three countries have potentially enabling characteristics that could facilitate work accommodations. Current knowledge of the work accommodation process and the integration of this issue into the collective employment relations agenda, however, needs further improvement.