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Medicina y Seguridad del Trabajo

On-line version ISSN 1989-7790Print version ISSN 0465-546X


VICENTE PARDO, José Manuel  and  LOPEZ-GUILLEN GARCIA, Araceli. Supervening ability after prolonged work incapacity due to cancer. Med. segur. trab. [online]. 2019, vol.65, n.255, pp.112-138.  Epub Mar 30, 2020. ISSN 1989-7790.

Thanks to the diagnostic and therapeutic advances, the number of cancer survivors able to work is increasing. Nevertheless, the return to work of the worker who has suffered cancer takes place after a long term work incapacity and after having undergone an aggressive treatment causing the return to be made in sudden circumstances. These are understood as the condition of the worker who after a disability period in which he lost capabilities, he received the medical discharge (not disability, medical discharge of the loss), returning to the job in a new health situation (capacities) and facing the worker and the work new risks for his health and new risks at work. A study of more than 365 days sick leave due to cancer was made as well as a six-months-follow-up of the relapses after the returning to work. Proposals are made to ensure a healthy and effective return.

Material and method:

In order to search not only the articles about the return to work after cancer but also the barriers that may arise and the proposals in order to facilitate an effective return, the following bibliographic databases up to May 2019 were revised: SciELO, PUBMED. A study of cancer processes that kept prolonged sick leave within a 365-day period was carried out, analyzing how many of them did eventually end in medical discharge, how many of these processes had relapsed in the following six months and why had it taken place, and how many of the relapses ended in permanent disability.


In the study carried out on workers with cancer sick leaves that reached or exceeded 365 days, it has been verified that 81% of its cases have been incorporated to work with dysfunctions configuring such sudden circumstances. These dysfunctions are precisely the cause of 75% of the disability relapses in the following six months, causing a failed attempt to return to work. Asthenia / fatigue, psychological disorders (including anxiety, low mood, depressive symptoms, cognitive impairment type attention deficit, concentration or memory), dysesthesias / paresthesias, and arthralgias are the most predominant and most impacting dysfunctions. Supervised aptitude modifies its previous functional capacity undergoing new risks for his health and his work. The following issues should be taken into account: A compulsory adaptation period to facilitate the labor recovery with no risk factors and in a healthy and continuous way; to address the partial discharge in this initial stage reducing the workloads, as well as a psychological support for those cancer workers in order to face the return to work; to support policies in the company protecting and supporting the reincorporation as well as to establish fiscal measures that incentive them; to improve the disability assessment criteria / ability to work, as well as the knowledge of work by using occupational worksheets; to take as well into consideration those preventive returning-to-work decisions; to consider the improvement of the communication between the agents involved in the health care, managers of disability and of the world of work; to prepare a strategic plan for the comprehensive protection of the cancer survivor; to draw up an Occupational Disability Map in Spain in order to carry out the analysis of work incapacity and its economic, social and health impact, as well as to evaluate the management policies.

Keywords : cancer survivor; return to work; labor reinsertion; laboral incapacity; supervening aptitude; sick leave; prolonged sick leave due to cancer; Work after cancer; occupational health.

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