# Differences in perceived return-to-work barriers between manual and nonmanual workers

## TL;DR

Manual workers with chronic conditions face more psychological and workplace system barriers when returning to work compared to nonmanual workers.

## Contribution

Quantitatively demonstrates that manual workers report higher psychological and workplace system barriers during return-to-work processes.

## Key findings

- Manual workers were significantly more likely to report psychological and workplace system barriers.
- Work ability was the most frequently reported barrier in both manual and nonmanual workers.
- Job-specific accommodations and psychological readiness assessments are needed for manual workers.

## Abstract

Return-to-work (RTW) support has become a growing priority in occupational health. Manual workers—who constitute over half of the global labor force—may face greater RTW barriers due to the physically demanding nature of their jobs. However, few studies have quantitatively compared the perceived RTW barriers between manual and nonmanual workers. This study aimed to compare perceived RTW barriers between manual and nonmanual workers with chronic conditions to inform the development of tailored support strategies.

We analyzed 219 employed adults, either actively working or on certified leave, who attended consultations at one particular hospital between September 2019 and June 2020 to obtain support for balancing work and medical treatment. Perceived RTW barriers were assessed with a validated 10-category yes/no structured checklist (personal: work ability/psychological/health literacy; workplace: structure/system/support; intersectoral/social). Logistic regression was performed to compare barriers between manual and nonmanual workers.

Manual workers were significantly more likely to report barriers related to psychological impacts (odds ratio [OR] = 2.34) and workplace systems (OR = 2.88). Although work ability did not differ significantly by job type, it was the most frequently reported RTW barrier in both groups.

Manual workers’ RTW challenges are characterized by psychological and organizational barriers. RTW programs should assess psychological readiness before resumption of duties and provide managerial training to address anxiety and loss of confidence, while implementing job-specific accommodations such as phased tasks, ergonomic adjustments, and light duties in coordination with health care providers.

Key points

What is already known on this topic

Workers with chronic conditions often face multiple barriers when returning to work (RTW). Among them, engagement in physically demanding work—that is, being a manual worker—has been identified as a factor that makes RTW more difficult. However, few studies have quantitatively examined how engagement in manual labor influences the perception of RTW barriers.

What this study adds

This study demonstrates that manual workers are significantly more likely than nonmanual workers to report RTW barriers related to psychological impacts and workplace systems. Although work ability was the most frequently reported barrier across both groups, it did not differ significantly by job type.

How this study might affect research, practice, or policy

This study emphasizes the need for occupation-specific RTW systems that address psychological and organizational barriers among manual workers. In practice, assessing psychological readiness before resumption of duties and training supervisors to support workers with anxiety or loss of confidence are essential. Coordinated efforts between health care providers and employers can facilitate effective, job-specific accommodations and promote sustainable RTW in physically demanding sectors.