Introduction Mental health conditions are a major contributor to productivity loss and are common after injury. This study quantifies postinjury productivity loss and its association with preinjury and postinjury mental health, injury, demographic, health, social and other factors.
Methods Multicentre, longitudinal study recruiting hospitalised employed individuals aged 16–69 years with unintentional injuries, followed up at 1, 2, 4 and 12 months. Participants completed questionnaires on injury, demographic factors, health (including mental health), social factors, other factors and on-the-job productivity upon return to work (RTW). ORs were estimated for above median productivity loss using random effects logistic regression.
Results 217 adults had made an RTW at 2, 4 or 12 months after injury: 29% at 2 months, 66% at 4 months and 83% at 12 months. Productivity loss reduced over time: 3.3% of working time at 2 months, 1.7% at 4 months, 1% at 12 months. Significantly higher productivity loss was associated with preinjury psychiatric conditions (OR 21.40, 95% CI 3.50 to 130.78) and post-traumatic stress avoidance symptoms at 1 month (OR for 1-unit increase in score 1.15, 95% CI 1.07 to 1.22). Significantly lower productivity loss was associated with male gender (OR 0.32, 95% CI 0.14 to 0.74), upper and lower limb injuries (vs other body regions, OR 0.15, 95% CI 0.03 to 0.81) and sports injuries (vs home, OR 0.18, 95% CI 0.04 to 0.78). Preinjury psychiatric conditions and gender remained significant in analysis of multiply imputed data.
Conclusions Unintentional injury results in substantial productivity loss. Females, those with preinjury psychiatric conditions and those with post-traumatic stress avoidance symptoms experience greater productivity loss and may require additional support to enable successful RTW.
- mental health
- functional outcome
Data availability statement
No data are available. Permission was not obtained to share the data.
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Contributors DK, CC, RM, SJ and BK contributed to the conception or the design of the work. BK, DK, PD, KB, JB and JS contributed to the acquisition of data. DK, CC, PD and BK contributed to the analysis and interpretation of data. BK, DK, PD and JW drafted the manuscript. All authors provided final approval for the manuscript.
Funding This study was funded by the National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care (CLAHRC) for Nottinghamshire, Derbyshire and Lincolnshire. RM is currently funded by the NIHR CLAHRC East Midlands and the Nottingham NIHR Biomedical Research Centre.
Disclaimer The views expressed are those of the authors and not necessarily of the National Health Service, NIHR or the Department of Health.
Competing interests None declared.
Patient and public involvement statement A Patient and Public Involvement member was involved in the design and conduct of this research.
Provenance and peer review Not commissioned; externally peer reviewed.
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