Publications and resources


Research examining pathways to secondary psychological injury

Mental health and psychological injury have become a growing priority for Australian workplaces. Workers’ compensation claims for primary mental health conditions last significantly longer than claims for physical conditions and have increased significantly in recent years.

Concerns have also been raised about the impact of secondary psychological injury on worker recovery and return to work, claims costs and compensation scheme sustainability. However, while some of the features of secondary psychological injury are understood, there has been no commonly accepted working definition that allows consistent understanding of secondary psychological injury.

A new report produced by researchers from the Healthy Working Lives Research Group and funded by Safe Work Australia provides a critical step forward.

This research brings together evidence from literature reviews, industry stakeholder consultations, injured worker surveys, and workers’ compensation claims data to develop a nationally consistent working definition of secondary psychological injury.

Importantly, the report also identifies:

  • Key drivers of secondary psychological injury
  • When and how these injuries tend to develop
  • Practical recommendations for policy, practice, and future research

As mental health continues to shape the future of work and compensation systems, this report offers an evidence-based foundation to improve prevention, early identification, and system responses for injured workers.

Read the full report here.


Workforce Health in Australia

Report (PDF)

Pain and psychological distress are common in Australian workers.

This report shows that 39 percent of workers reported pain interfering with their work, and 40 per cent reported psychological distress in 2020-21.

The study also shows that 43 per cent of workers reported that their job was very demanding, and 12 per cent had a disability or long term condition affecting their work. Poor mental health led to 42 million days of lost work per annum in 2020 to 2022.


Design for Care

This research aims to understand and improve workplace mental health and well-being in Australia’s Healthcare and Social Assistance (H&SA) industry by developing evidence-based work design interventions to prevent psychological injury, which include but not limited to burnout and sustained work stress

At the heart of Design for Care is the prevention of psychological injury through good work design.


Driving Health

The Driving Health project aims to develop evidence-based strategies to improve the health of the Australian Truck Driver. Visit the Driving Health website to find out more.


COMPARE Project

The COMpensation Policy And Return to work Effectiveness (COMPARE) project was established to develop an evidence base that can support development and implementation of effective return to work policy in Australia. Find out more here.


Transitions Study


WorkCover Queensland Collaboration – Recovery Blueprint

About this project

Report (PDF)


The DSP Study

The DSP Study aims to build an evidence base on the health and experiences of people receiving the Disability Support Pension, and on the impact of government policy changes on access to Centrelink payments. Visit the Study website to find out more.

Report (PDF)


National Work Health and Safety Leading Indicator Survey

About this survey

Reports (PDF)

Below are some of our key publications that have demonstrably influenced policy or opinion in Australia and around the world. For more of our publications, visit the Monash University Research Portal profiles for Prof Alex Collie, Dr Shannon Gray, Dr Michael Di Donato and Dr Samineh Sanatkar.

2025

Early high-risk opioid prescribing and persistent opioid use in Australian workers with workers' compensation claims for back and neck musculoskeletal disorders or injuries: A retrospective cohort study.
Tefera YG, Gray S, Nielsen S, Di Donato M, Collie A.
CNS Drugs. 2025 May;39(5):499-512. doi: 10.1007/s40263-025-01169-5.

This study is the first to measure the extent of early high-risk prescribing patterns in Australia’s workers’ compensation system. Researchers analysed data from 30,590 workers with back and neck injuries.

Changes in Pregabalin Dispensing to Australians with Workers’ Compensation Claims for Low Back Pain Following the Listing of Pregabalin on the Pharmaceutical Benefits Scheme.
Di Donato MF, Abdel Shaheed C, Collie A, Maher CG, Mathieson S.
Journal of Occupational Rehabilitation. 2025 Feb 12. doi: 10.1007/s10926-025-10276-5. Epub ahead of print.

Adding pregabalin to the pharmaceutical benefits scheme in 2013 saw increases in the prevalence and number of dispenses and decreases in the costs of dispenses, to Victorians with workers' compensation time loss claims for low back pain.

Trends in opioid dispensing to injured workers following codeine scheduling changes in Australia: a retrospective cohort study.
Di Donato MF, Mathieson S, Ferreira GE, Xia T, Tefera YG, Abdel Shaheed C, Maher C, Collie A.
BMJ Open. 2025 Mar 12;15(3):e092651. doi: 10.1136/bmjopen-2024-092651.

Up-scheduling low-dose codeine in 2018 does not appear to have changed the supply to Australians with workers' compensation time loss claims for low back pain. Temporary increases in high-dose codeine, the mean dose of other opioids, and prevalence of other pain medicines appear to indicate a shift to alternative analgesics.

Effect of working hours and shift work on preterm birth among Australian women in paid work during pregnancy: Prospective cohort study.
Adane HA, Iles R, Boyle JA, Sheehan LR, Collie A.
Public Health. 2025 May;242:352-358. doi: 10.1016/j.puhe.2025.03.021.

In Australia, the rate of preterm births increased from 8.3 % in 2010 to 8.7 % in 2021, posing risks not only during pregnancy and the neonatal period but also for long-term offspring development.

2024

The burden of working time lost to compensable occupational injury and disease in Australia, 2012-17: a retrospective population-based study.
Collie A, Sheehan L.
Medical Journal of Australia. 2024 Jun 17;220(11):573-578. doi: 10.5694/mja2.52309.

To determine the national burden of working time lost to occupational injury and disease in Australia compensable by workers’ compensation schemes; to characterise the distribution of time lost by age, sex, and injury and disease type.

Effects of psychosocial work factors on preterm birth: systematic review and meta-analysis.
Adane HA, Iles R, Boyle JA, Gelaw A, Collie A.
Public Health. 2024 Mar;228:65-72. doi: 10.1016/j.puhe.2023.12.002.

Preterm birth is one of the global public health issues that result in high rates of infant mortality and long-term health complications. We sought to explore the association between psychosocial work factors and preterm birth.

Patterns of mental health service use in Australian workers with low back pain: A retrospective cohort study.
Gray SE, Di Donato M, Sheehan LR, Iles R, Collie A.
Journal of Occupational Rehabilitation. 2024 Feb 24. doi: 10.1007/s10926-024-10180-4.

We describe the volume, frequency and timing of psychologist, psychiatrist and social work services for people with low back pain claims, in four Australian workers' compensation jurisdictions: Victoria, Queensland, Western Australia and South Australia, between 2010 and 2015.

Patterns of physiotherapy attendance in compensated Australian workers with low back pain: a retrospective cohort study.
Di Donato M, Sheehan LR, Iles R, Gray S, Buchbinder R, Collie A.
Pain. 2024 Apr 2. doi: 10.1097/j.pain.0000000000003228.

Most people with workers' compensation claims for low back pain attend physiotherapy. Trajectory modelling indicates some attend numerous times over a long period.

How much physiotherapy, chiropractic, and osteopathy care do compensated Australian workers with low back pain receive? A retrospective cohort study.
Di Donato M, Gray S, Sheehan LR, Buchbinder R, Iles R, Collie A.
Journal of Occupational Rehabilitation. 2024 May 18. doi: 10.1007/s10926-024-10202-1.

To identify the prevalence and frequency of physiotherapy, chiropractic, and/or osteopathy care in Australians with workers’ compensation claims for low back pain (LBP).

2023

Factors associated with fatigued driving among Australian truck drivers: A cross-sectional study.
Ren X, Pritchard E, van Vreden C, Newnam S, Iles R, Xia T.
International Journal of Environmental Research and Public Health. 2023 Feb 3;20(3):2732. doi: 10.3390/ijerph20032732.

This cross-sectional study examines the role of demographic, occupational, lifestyle, and other health risk factors associated with fatigue among Australian truck drivers.

The prevalence of mental health service use in Australian workers with accepted workers' compensation claims for low back pain: A retrospective cohort study.
Gray SE, Di Donato M, Sheehan LR, Iles R, Collie A.
Journal of Occupational Rehabilitation. 2023 Sep;33(3):602-609. doi: 10.1007/s10926-023-10098-3.

This study determines the prevalence of funded mental health services for workers with compensated lower back pain.

Impact of work and coping factors on mental health: Australian truck drivers' perspective.
Pritchard E, van Vreden C, Xia T, Newnam S, Collie A, Lubman DI, de Almeida Neto A, Iles R.
BMC Public Health. 2023 Jun 6;23(1):1090. doi: 10.1186/s12889-023-15877-4.

The aim of this study was to explore the impact of work and coping factors on mental health of Australian truck drivers from their perspective.

Injured worker outcomes after compensation system overhaul: an interrupted time series study.
Lane TJ, Di Donato MF, Collie A.
Journal of Epidemiology & Community Health. 2023 Aug;77(8):515-520. doi: 10.1136/jech-2023-220387.

In 2015, South Australia replaced its workers’ compensation system with the aim of improving return to work rates. We examined whether this was achieved by focusing on the duration of time off work, as well as claim processing times and claim volumes to understand how this may have been achieved.

Maternal occupational risk factors and preterm birth: A systematic review and meta-analysis
Adane HA, Iles R, Boyle JA, Gelaw A, Collie A.
Public Health Reviews. 23 October 2023. doi: 10.3389/phrs.2023.1606085.

This systematic review and meta-analysis aimed to summarise the evidence on the relationship between physical occupational risks and preterm birth.

Exploring the health and economic burden among truck drivers in Australia: A health economic modelling study.
Peter Lee, Ting Xia, Ella Zomer, Caryn van Vreden, Elizabeth Pritchard, Sharon Newnam, Alex Collie, Ross Iles, Zanfina Ademi.
Journal of Occupational Rehabilitation. 2023 Jun;33(2):389-398. doi: 10.1007/s10926-022-10081-4. Epub 2022 Nov 10.

A Driving Health study on the health and economic consequences of poor truck driver health and the estimated work-related mortality burden among truck drivers over a 10-year period.

2022

The physical and mental health of Australian truck drivers: a national cross-sectional study.
Caryn van Vreden, Ting Xia, Alex Collie, Elizabeth Pritchard, Sharon Newnam, Dan I Lubman, Abilio de Almeida Neto, Ross Iles.
BMC Public Health. 2022 Mar 8;22(1):464. doi: 10.1186/s12889-022-12850-5.

The aims of this study were to characterise the physical and mental health of Australian truck drivers overall, and to identify any differences in factors influencing the health profile of long-haul compared to short-haul drivers.

Changes in work and health of Australians during the COVID-19 pandemic: a longitudinal cohort study.
Daniel Griffiths, Luke Sheehan, Caryn van Vreden, Dennis Petrie, Peter Whiteford, Malcolm R Sim, Alex Collie.
BMC Public Health. 2022 Mar 12;22(1):487. doi: 10.1186/s12889-022-12897-4.

A study on work and health during the COVID-19 pandemic and changes in mental and physical health following experiences of work loss and return to work.

The health impacts of a 4-month long community-wide COVID-19 lockdown: Findings from a prospective longitudinal study in the state of Victoria, Australia.
Daniel Griffiths, Luke Sheehan, Dennis Petrie, Caryn van Vreden, Peter Whiteford, Alex Collie.
PLoS One. 2022 Apr 7;17(4):e0266650. doi: 10.1371/journal.pone.0266650. eCollection 2022.

A study to determine health impacts during, and following, an extended community lockdown and COVID-19 outbreak in the Australian state of Victoria, compared with the rest of Australia.

Work-related injuries in the Australian education sector: A retrospective cohort study.
Fatimah M Al Afreed, Tyler J Lane, Shannon E Gray.
Injury. 2022 Dec;53(12):3962-3969. doi: 10.1016/j.injury.2022.09.046.

An Australian-first study of workplace injury amongst the nation’s teachers and teacher’s aides suggests educators are at higher risk of assault injuries than other workers, and that the risk is higher still among special educators and education aides. Educators were also at elevated risk of mental health conditions, particularly in secondary education and special education.

The relationship between work disability and subsequent suicide or self-harm: A scoping review
Alex Collie, Shannon E Gray.
PLOS Global Public Health. 2022 Dec 7;2(12): e0000922. doi: 10.1371/journal.pgph.0000922.

This study closely examined the relationship between a disabling work injury or illness, and later suicide or self-harm.

2021

Returning to the workplace during the COVID-19 pandemic: The concerns of Australian workers.
Daniel Griffiths, Luke Sheehan, Caryn van Vreden, Peter Whiteford, Alex Collie.
Journal of Occupational Rehabilitation. 2021 Dec;31(4):711-720. doi: 10.1007/s10926-021-09990-7.

Publication from our landmark COVID-19 Work and Health study that identifies the concerns Australian workers hold regarding workplace reopening after periods of lockdown.

Timing of health service use among truck drivers after a work-related injury or illness.
Ting Xia, Alex Collie, Sharon Newnam, Dan Lubman, Ross Iles.
Journal of Occupational Rehabilitation. 2021 Dec;31(4):744-753. doi: 10.1007/s10926-021-10001-y.

A publication from the Driving Health study that describes when truck drivers access health services, including services for mental health.

Changes in access to Australian disability support benefits during a period of social welfare reform.
Alex Collie, Luke Sheehan, Tyler Lane.
Journal of Social Policy. 2021, 1-23. doi: 10.1017/S0047279420000732.

This study describes how reforms to the Disability Support Pension eligibility and administrative processes led to a significant reduction in DSP grants and differentially affected people based on the nature of their medical condition or disability.

Prevalence, predictors and wage replacement duration associated with diagnostic imaging in Australian workers with accepted claims for low back pain: a retrospective cohort study.
Michael Di Donato, Ross Iles, Rachelle Buchbinder, Ting Xia, Alex Collie.
Journal of Occupational Rehabilitation. 2021 Apr 28. doi: 10.1007/s10926-021-09981-8.

This study identified the prevalence of diagnostic spinal imaging for compensated Australian workers with low back pain and its association with wage replacement duration.

2020

Development and pilot assessment of the PACE Tool: Helping case managers identify and respond to risk factors in workers’ compensation case management.
Ross Iles, Luke Sheehan, Karen Munk, Cameron Gosling.
Journal of Occupational Rehabilitation. 2020 Jun;30(2):167-182. doi: 10.1007/s10926-019-09858-x.

A comprehensive description of a tool to identify injured workers at risk of delayed return to work, including the results of applying the tool with more than 500 injured workers.

Impact of legislative reform on benefit access and disability duration in workers’ compensation: an interrupted time series study.
Alex Collie, Dianne Beck, Shannon Elise Gray, Tyler Jeremiah Lane.
Occupational and Environmental Medicine. 2020 Jan;77(1):32-39. doi: 10.1136/oemed-2019-106063.

Population based evaluation of a workers’ compensation policy change using sophisticated quasi-experimental analysis.

Psychological distress in workers’ compensation claimants: prevalence, predictors and mental health service use.
Alex Collie, Luke Sheehan, Tyler Lane, Ross Iles.
Journal of Occupational Rehabilitation. 2020 Jun;30(2):194-202. doi: 10.1007/s10926-019-09862-1.

Describes a high prevalence of psychological distress among workers with musculoskeletal disorder claims, and that most such workers in distress do not receive specialist mental health care.

The impact of income support systems on healthcare quality and functional capacity in workers with low back pain: a realist review.
Michael Di Donato, Ross Iles, Tyler Lane, Rachelle Buchbinder, Alex Collie.
Pain. 2020 Dec;161(12):2690-2709. doi: 10.1097/j.pain.0000000000001978.

This realist review revealed the impact of intersecting healthcare and social systems on healthcare quality and functional capacity in workers suffering low back pain.

The impact of income sources on financial stress in workers’ compensation claimants.
Luke Sheehan, Tyler Lane, Alex Collie.
Journal of Occupational Rehabilitation. 2020 Dec;30(4):679-688. doi: 10.1007/s10926-020-09883-1.

Using data from the National Return to Work Survey, this study shows that injured workers receiving workers’ compensation report greater financial stress than those back at work or those who were receiving the aged pension or superannuation.

2019

Individual recovery expectations and prognosis of outcomes in non-specific low back pain: prognostic factor review.
Jill Hayden, Maria Wilson, Richard Riley, Ross Iles, Tamar Pincus, Rachel Ogilvie.
Cochrane Database of Systematic Reviews. 2019 Nov 25;2019(11):CD011284. doi: 10.1002/14651858.CD011284.pub2.

This is a comprehensive review of the ability of recovery expectations to predict outcomes for people with low back pain, spanning 60 studies and more than 30,000 people with back pain.

Factors associated with employer support for injured workers during a workers’ compensation claim.
Luke Sheehan, Tyler Lane, Shannon Gray, Alex Collie.
Journal of Occupational Rehabilitation. 2019 Dec;29(4):718-727. doi: 10.1007/s10926-019-09834-5.

This study identified characteristics of injured workers who are more or less likely to feel supported by their employers and receive support in the form of a return to work plan.

Work disability in Australia: an overview of prevalence, expenditure, support systems and services.
Alex Collie, Michael Di Donato, Ross Iles.
Journal of Occupational Rehabilitation. 2019 Sep;29(3):526-539. doi: 10.1007/s10926-018-9816-4..

Landmark study that describes prevalence of work disability across Australia’s “system of systems” including workers compensation, social security, life insurance, sickness absence.

Patterns and predictors of return to work after major trauma: a prospective, population-based registry study.
Alex Collie, Pamela M Simpson, Peter A Cameron, Shanthi Ameratunga, Jennie Ponsford, Ronan A Lyons, Sandra Braaf, Andrew Nunn, James E Harrison, Belinda J Gabbe.
Annals of Surgery. 2019 May;269(5):972-978. doi: 10.1097/SLA.0000000000002666.

Identifies distinct patterns of return to work after major trauma, from analysis of population based longitudinal trauma registry data.

Evaluating the success of legislative amendments designed to reduce work disability.
Shannon Gray, Tyler Lane, Behrooz Hassani-Mahmooei, Alex Collie.
Policy Design and Practice. 2019; 3: 291-304, doi: 10.1080/25741292.2019.1610147.

Examined the effect of a major change to a workers’ compensation system, finding minimal evidence for intended effects and likely unintended consequences due to antagonistic components in the legislation.

We value media engagement as an important way to share our knowledge and findings directly with the community. The Healthy Working Lives Research Group is happy to provide expert comment to journalists and can be contacted via media@monash.edu.

Here are some of the highlights of our recent media activity:

Today Extra (Channel 9)

Interview with Professor Alex Collie about a study on early high-risk opioid prescribing and persistent opioid use in Australian workers with workers' compensation claims for back and neck musculoskeletal disorders or injuries

11 March 2025

ultra106five FM Hobart

Pain, psychological distress common in Australian workers – Professor Alex Collie interview on the Morning Lifestyle program

22 November 2024

ABC Radio Melbourne

Do you know what your rights are if you are injured at work? – The Conversation Hour

23 November 2023

ABC Radio Melbourne

How has being a shift worker impacted your life? – The Conversation Hour

1 November 2023

9 News

Shift work and long hours significantly increase risk of preterm birth: study

26 October 2023

7 News

New link between work patterns and premature births

26 October 2023

The Sydney Morning Herald

'Tip of the iceberg': The jobs most at risk of psychological injury

27 November 2022

ABC News

Monash University research finds poor truck driver health could cost Australia $2.5 billion

22 November 2022

9 News

Deadly perils for truckies exposed in driver health study

21 November 2022

9 News

Teachers most at risk of assault, research shows

7 November 2022

7 News

New research has revealed teachers are more likely to be assaulted on the job compared to the average Australian worker

3 November 2022

The Australian

Resilient Victorians recovered from lockdown within months

7 April 2022

PsychCentral

Tips to Cope with a Layoff – Dr Daniel Griffiths discusses his COVID study

3 April 2022

3AW Breakfast

The shocking state of Aussie truck drivers' health – Ross Iles discusses the Driving Health study findings

23 March 2022

The Australian

Truckies carrying too big a load

23 March 2022

The Conversation

Worksafe’s hotel quarantine breach penalties are a warning for other employers to keep workers safe from COVID

30 September 2021

The Sydney Morning Herald

Mental health is becoming our biggest lockdown concern

20 July 2021

The Age

Jerry drove trucks for 60 years, now it’s catching up with him

4 February 2021

7.30
(ABC TV)

Serious physical health crisis facing Australian truck drivers

4 February 2021

ABC News

Landmark research reveals 'horrific' mental health crisis facing Australian truck drivers

22 November 2020

The Australian

Top researchers recognised in The Australian's 2020 Research Magazine

23 September 2020

The Conversation

Counting the costs of illness and injury on Australian workers

1 May 2018

More media about the Driving Health study can be found here.

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2022 HEALTHY WORKING LIVES SEMINAR SERIES (PREVENTION THEME)

2022 HEALTHY WORKING LIVES SEMINAR SERIES (RECOVERY THEME)

2022 HEALTHY WORKING LIVES SEMINAR SERIES (SYSTEMS THEME)

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