A Population-Based Study on Return to Work After Traumatic Injuries

Document Type : Original Article

Authors

1 Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran

2 Department of Neurosurgery, Trauma Research Center, Kashan University of Medical Sciences, Kashan, Iran

3 Department of Clinical Psychology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran

10.4103/iahs.iahs_97_20

Abstract

Background: 
Trauma is one of the main causes of morbidity and mortality in developing countries. Most of the people who have trauma are young and in the activity period of living. Trauma is the main cause of disability in the young population. Trauma also affects return to work (RTW). RTW is a specific criterion for trauma evaluation. This study aims to investigate the RTW period after traumatic injuries.
Methods: 
In this cross-sectional study used household survey data collected during a 2018–2019 study on over 15 years in Kashan. We conducted univariate and multivariate analyses to evaluate associations of RTW during 1 year after trauma. Relation between RTW and risk factors was investigated at three levels: preinjury (demographic) factors, injury-related factors, and postinjury factors.
Results: 
In this study, the incidence of trauma in 1000 estimated 70.61 (62.60–78.70) in 1 year. Nearly 77.73% were male. The most mechanism of trauma (51%) was related to traffic accidents. Nearly 9.1% of people with trauma had returned to their daily activities 1–6 days and 7.3% RTW after 7–14 days and 11.2% RTW after 60 days.
Conclusion: 
Findings of this study indicated that time of RTW was related to three levels of factor: preinjury factors, injury-related factors, and postinjury factors. These factors need to be evaluated in larger-scale, long-term studies with more homogeneous samples in terms of the type and the severity of traumas.

Keywords


1.     Naghavi M, Abolhassani F, Pourmalek F, Lakeh M, Jafari N, Vaseghi S, et al. The burden of disease and injury in Iran 2003. Popul Health Metr 2009;7:9.
2.     Azami‑Aghdash S, Sadeghi‑Bazargani H, Shabaninejad H, Abolghasem Gorji H. Injury epidemiology in Iran: A systematic review. J Inj Violence Res 2017;9:27‑40.
3.     Gosselin RA, Spiegel DA, Coughlin R, Zirkle LG. Injuries: The neglected burden in developing countries. Bull World Health Organ 2009;87:246a.
4.     Saadat S, Hafezi‑Nejad N, Ekhtiari YS, Rahimi‑Movaghar A, Motevalian A, Amin‑Esmaeili M, et al. Incidence of fall‑related injuries in Iran: A population‑based nationwide study. Injury 2016;47:1404‑9.
5.     Abedzadeh‑Kalahroudi M, Razi E, Sehat M, Asadi‑Lari M. Return to work after trauma:Asurvival analysis. Chin J Traumatol 2017;20:67‑74.
6.     Smith GS, Wellman HM, Sorock GS, Warner M, Courtney TK, Pransky GS, et al. Injuries at work in the US adult population: Contributions to the total injury burden. Am J Public Health 2005;95:1213‑9.
7.     Rahmani F, Sepehri Majd P, Ebrahimi Bakhtavar H, Rahmani F. Evaluating the accuracy of emergency nurses in correct triage using emergency severity index triage in Sina hospital of Tabriz:
A cross‑sectional analysis. J Emerg Pract Trauma 2018;4:9‑13.
8.     Dembe AE. The social consequences of occupational injuries and illnesses. Am J Ind Med 2001;40:403‑17.
9.     Du CL, Lai CF, Wang JD. Delayed return‑to‑work in workers after non‑severe occupational upper extremity fracture in Taiwan. J Formos Med Assoc 2007;106:887‑93.
10.     Lehmann U, Pape HC, Seekamp A, Gobiet W, Zech S, Winny M, et al. Long term results after multiple injuries including severe head injury. Eur J Surg 1999;165:1116‑20.
11.     Vles WJ, Steyerberg EW, Essink‑Bot ML, van Beeck EF, Meeuwis JD, Leenen LP. Prevalence and determinants of disabilities and return to work after major trauma. J Trauma 2005;58:126‑35.
12.     Holtslag HR, Post MW, van der Werken C, Lindeman E. Return to work after major trauma. Clin Rehabil 2007;21:373‑83.
13.     Kendrick D, Vinogradova Y, Coupland C, Christie N, Lyons RA, Towner EL, et al. Getting back to work after injury: The UK Burden of Injury multicentre longitudinal study. BMC Public Health 2012;12:584.
14.     Kendrick D, Dhiman P, Kellezi B, Coupland C, Whitehead J, Beckett K, et al. Psychological morbidity and return to work after injury: Multicentre cohort study. Br J Gen Pract 2017;67:e555‑64.
15.     Salmi LR, Cassidy JD, Holm L, Cancelliere C, Côté P, Borg J. Introduction to the Findings of the International Collaboration on Mild Traumatic Brain Injury Prognosis: What is a Prognostic Study? Arch Phys Med Rehabil 2014;95 Suppl 3:S95‑100.
16.     Vikane E, Hellstrøm T, Røe C, Bautz‑Holter E, Assmus J, Skouen JS. Predictors for return to work in subjects with mild traumatic brain injury. Behav Neurol 2016;2016:8026414.
17.     Cancelliere C, Kristman VL, Cassidy JD, Hincapié CA, Côté P, Boyle E, et al. Systematic review of return to work after mild traumatic brain injury: Results of the international collaboration on mild traumatic brain injury prognosis. Arch Phys Med Rehabil 2014;95 Suppl 3:S201‑9.
18.     Ownsworth T, McKenna K. Investigation of factors related to employment outcome following traumatic brain injury: A critical review and conceptual model. Disabil Rehabil 2004;26:765‑83.
19.     Nightingale EJ, Soo CA, Tate RL. A systematic review of early prognostic factors for return to work after traumatic brain injury. Brain Impairment 2007;8:101‑42.
20.     Fakharian E, Sehat Z, Sehat M. Traumatic spine injury in Kashan, Iran. J Emerg Pract Trauma 2019;5:65‑70.
21.     Karimi H, Soleyman‑Jahi S, Hafezi‑Nejad N, Rahimi‑Movaghar A, Amin‑Esmaeili M, Sharifi V, et al. Direct and indirect costs of nonfatal road traffic injuries in Iran: A population‑based study. Traff Inj Prev 2017;18:393‑7.
22.     Reihani H, Pirazghandi H, Bolvardi E, Ebrahimi M, Pishbin E, Ahmadi K, et al. Assessment of mechanism, type and severity of injuryin multiple trauma patients: A cross sectional study of a trauma center in Iran. Chin J Traumatol 2017;20:75‑80.
23.     Sehat Z, Fakharian E, Sehat M, OmidiA. Disability and post‑trauma stress in the population over 15 years old in Kashan, Iran: A population‑based study. Chin J Traumatol.Dec 2020;23:351-5.
24.     Shafiei S, Yazdani S, Jadidfard M‑P, Zafarmand AH. Measurement components of socioeconomic status in health‑related studies in Iran. BMC Res Notes 2019;12:70.
25.     MansouriA, Emamian MH, Zeraati H, Hashemi H, FotouhiA. Economic inequality in presenting vision in Shahroud, Iran: Two decomposition methods. Int J Health Policy Manag 2018;7:59‑69.
26.     Willmott SA, Boardman JA, Henshaw CA, Jones PW. Understanding general health questionnaire (GHQ‑28) score and its threshold. Soc Psychiatry Psychiatr Epidemiol 2004;39:613‑7.
27.     Mahmoudi O, Amini MR. The reliability and validity of the post‑traumatic stress disorder checklist (PCL) in the Earthquake‑stricken population of Kermanshah, Iran. Int J Health Life Sci 2020;6:e101860.
28.     Azami‑Aghdash S, Gorji HA, Sadeghi‑Bazargani H, Shabaninejad H. Epidemiology of road traffic injuries in Iran: Based on the data from disaster management information system (DMIS) of the iranian red crescent. Iran Red Crescent Med J 2017;19:e38743.
29.     Hafezi‑Nejad N, Rahimi‑MovagharA, MotevalianA,Amin‑Esmaeili M, Sharifi V, Hajebi A, et al. A nationwide population‑based study on incidence and cost of non‑fatal injuries in Iran. Injury Prevent 2014;20:e9.
30.     Murgatroyd DF, Harris IA, Tran Y, Cameron ID. Predictors of return to work following motor vehicle related orthopaedic trauma. BMC Musculoskelet Disord 2016;17:171.
31.     Soroush D, Deloei MT, Reihani H, Vakili V, Gharaee AM, Tafakori A, et al. Characteristics of road traffic injuries in the second largest city of Iran. J Emerg Pract Trauma 2015;1:48‑51.
32.     Alemany R, Ayuso M, Guillén M. Impact of road traffic injuries on disability rates and long‑term care costs in Spain. Accid Anal Prev 2013;60:95‑102.
33.     Clay FJ, Newstead SV, Watson WL, McClure RJ. Determinants of return to work following non life threatening acute orthopaedic trauma: A prospective cohort study. J Rehabil Med 2010;42:162‑9.
34.     Lilley R, Davie G, Ameratunga S, Derrett S. Factors predicting work status 3 months after injury: Results from the prospective outcomes of injury study. BMJ Open 2012;2:e000400.
35.     O’Donnell ML, Varker T, Holmes AC, Ellen S, Wade D, Creamer M, et al. Disability after injury: The cumulative burden of physical and mental health. J Clin Psychiatry 2013;74:e137‑43.
36.     Cubbin C, LeClere FB, Smith GS. Socioeconomic status and injury mortality: Individual and neighbourhood determinants. J Epidemiol Community Health 2000;54:517‑24.
37.     Meerding WJ, Looman CW, Essink‑Bot ML, Toet H, Mulder S, van Beeck EF. Distribution and determinants of health and work status in a comprehensive population of injury patients. J Trauma 2004;56:150‑61.
38.     Zheng QL, Tian Q, Hao C, Gu J, Lucas‑Carrasco R, Tao JT, et al. The role of quality of care and attitude towards disability in the relationship between severity of disability and quality of life: Findings from a cross‑sectional survey among people with physical disability in China. Health Quality Life Outcomes 2014;12:25.
39.     Cubbin C, Smith GS. Socioeconomic inequalities in injury: Critical issues in design and analysis. Annu Rev Public Health 2002;23:349‑75.
40.     Soberg HL, Finset A, Bautz‑Holter E, Sandvik L, Roise O. Return to work after severe multiple injuries a multidimensional approach on status 1 and 2 years post‑injury. J Trauma 2007;62:471‑81.