Traumatic Brain Injury in the Workplace

Epidemiology of Work-Related Traumatic Brain Injury and COVID-19 Pandemic Lockdown Consequences: Experience in a Reference Center in Chile

INTRODUCTION

Work-related traumatic brain injury is a frequent cause of chronic morbidity, mortality, and high treatment costs. Its causes are highly environmentally determined and were affected by COVID-19 pandemic lockdowns.

OBJECTIVE

We aimed to describe traumatic brain injury (TBI) epidemiology in working population and evaluate its modifications during the COVID-19 pandemic.

METHODS

We performed a 2-year retrospective epidemiological analysis of TBI patients hospitalized in a tertiary work-related hospital before and during the COVID-19 pandemic.

RESULTS

In the prepandemic period, TBI patients were predominantly men, with a bimodal age distribution. Crash accidents were the leading work-related traumatic brain injury cause. During COVID-19 pandemic lockdowns, there was a positive correlation between street traffic and TBI rate, presenting increased motor crash accidents as a cause of TBI.

CONCLUSIONS

These results are relevant for planning and focalization of resources for TBI prevention.

Utility of Person-Environment-Occupation model in exploring sex-specific causes of work-related traumatic brain injury: a retrospective chart review

BACKGROUND

Work-related traumatic brain injury (wr-TBI) is on the rise. The pre-injury period, a significant consideration for preventive initiatives, is largely unexplored.

OBJECTIVES

To identify Person-Environment-Occupation (PEO) variables associated with wr-TBI to inform sex-specific primary prevention.

METHODS

Retrospective chart review data were analyses. Two-tailed t-test and chi-squared tests were used to study sex differences. Multivariate logistic regression models of wr-TBI were fit with a priori defined PEO variables.

RESULTS

The sample comprised 330 consecutive workers with wr-TBI (40.8 ± 11.1 years old, 71% male). Sex differences were observed across PEO variables. In multivariable logistic regression analyses the odds of sustaining a wr-TBI from a fall increased with the presence of a mood disorder and participation in non-labourer occupations (odds ratio (OR) 2.89 (95% CI 1.06-7.89) and OR 2.89 (95% CI 1.06-7.89), respectively) and decreased being a male (OR 0.31 (95% CI 0.17-0.54)). The odds of sustaining a wr-TBI from being striken by an object was greater in workers with prior head injury (OR 2.8 (95% CI 1.24-6.45)). None of the variables studied were associated with wr-TBI sustained from being striken against an object.

CONCLUSIONS

Workers' health status pre-injury is associated with external causes of wr-TBI. Sex differences across PEO categories warrant further study.

Incidence of Traumatic Brain Injury by Severity Among Work-Related Injured Workers From 2010 to 2019: An Analysis of Workers' Compensation Insurance Data in Korea

OBJECTIVE

This study aimed to investigate the status of work-related traumatic brain injury (wrTBI) in Korea between 2010 and 2019.

METHODS

This study used Korea Workers' Compensation Insurance data, and the sample comprised workers who claimed compensation for wrTBI from 2010 to 2019. The annual incidence of wrTBI was calculated as the rate per 100,000 workers. Time trends over the 10-year period were assessed using Poisson regression.

RESULTS

The mean incidence of wrTBI was 28.4/100,000. Regarding the incidence rate of wrTBI by severity, mild TBI and moderate-to-severe TBI were 12.9/100,000 and 15.5/100,000, respectively. The incidence of mild TBI among workers was higher in 2010, but moderate-to-severe TBI was higher after 2011.

CONCLUSIONS

Our findings highlight the need for providing information on mild TBI to workers as part of occupational safety and health education.

Application of polyethylene air-bubble cushions to improve the shock absorption performance of Type I construction helmets for repeated impacts

BACKGROUND

The use of helmets was considered to be one of the important prevention strategies employed on construction sites. The shock absorption performance of a construction (or industrial) helmet is its most important performance parameter. Industrial helmets will experience cumulative structural damage when being impacted repeatedly with impact magnitudes greater than its endurance limit.

OBJECTIVE

The current study is to test if the shock absorption performance of Type I construction helmets subjected to repeated impacts can be improved by applying polyethylene air-bubble cushions to the helmet suspension system.

METHODS

Drop impact tests were performed using a commercial drop tower test machine following the ANSI Z89.1 Type I drop impact protocol. Typical off-the-shelf Type I construction helmets were evaluated in the study. A 5 mm thick air-bubble cushioning liner was placed between the headform and the helmet to be tested. Helmets were impacted ten times at different drop heights from 0.61 to 1.73 m. The effects of the air-bubble cushioning liner on the helmets' shock absorption performance were evaluated by comparing the peak transmitted forces collected from the original off-the-shelf helmet samples to the helmets equipped with air-bubble cushioning liners.

RESULTS

Our results showed that a typical Type I construction helmet can be subjected to repeated impacts with a magnitude less than 22 J (corresponding to a drop height 0.61 m) without compromising its shock absorption performance. In comparison, the same construction helmet, when equipped with an air-bubble cushioning liner, can be subjected to repeated impacts of a magnitude of 54 J (corresponding to a drop height 1.52 m) without compromising its shock absorption performance.

CONCLUSIONS

The results indicate that the helmet's shock absorbing endurance limit has been increased by 145% with addition of an air-bubble cushioning liner.

Update on the epidemiology of work-related traumatic brain injury: a systematic review and meta-analysis

BACKGROUND

Traumatic brain injury (TBI) is a public health concern that can occur in a range of contexts. Work-related TBI (wrTBI) is particularly concerning. Despite overall work-related injury claims decreasing, the proportion of claims that are wrTBI have increased, suggesting prevention and support of wrTBI requires ongoing attention.

OBJECTIVES

This review aimed to provide updated information on the burden and risk factors of wrTBI among the working adult population.

METHODS

Medline, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using a combination of TBI, work, and epidemiology text words and medical subject headings. Two reviewers independently assessed articles for inclusion. Meta-analyses were conducted to estimate prevalence and mortality of wrTBI and a narrative synthesis was conducted to provide additional context.

RESULTS

Pooled proportions meta-analyses estimate that 17.9% of TBIs were work-related and 6.3% of work-related injuries resulted in TBI, with 3.6% of wrTBI resulting in death. Populations of wrTBI were predominantly male (76.2%) and were 40.4 years of age, on average. The most commonly reported industries for wrTBI were education and training, healthcare and social assistance, construction, manufacturing, and transportation. Falls, being struck by an object or person, motor vehicle collisions, and assaults were the most commonly reported mechanisms of wrTBI.

CONCLUSIONS

A better understanding of the epidemiology of wrTBI can inform prevention and management strategies. This review highlights existing gaps, including a notable lack of sex or gender stratified data, to direct future investigation.

PROSPERO REGISTRATION NUMBER

CRD42020169642.

Evaluation of the shock absorption performance of construction helmets under repeated top impacts

It is accepted in industries that an industrial helmet should be disposed of when it is subjected to a significant impact. There is no scientific evidence that supports this well-accepted belief. The current study was intended to evaluate the shock absorption performance of industrial helmets under repeated impacts. Common industrial or construction helmets are categorized as Type I according to ANSI Z89.1 and they are designed to mainly protect top impacts. A representative basic Type I construction helmet model was selected in the study. Helmets were repeatedly impacted ten times using a commercial drop tower tester with an impactor (mass 3.6 kg) at different drop heights from 0.30 to 2.03 m. A total of 80 impact trials were performed in the study. The relationships of the transmitted force with the drop height and with impact number were analyzed. A new parameter - the endurance limit - was proposed to evaluate the shock absorption performance of a helmet. The helmets were observed to experience cumulative structural damage with increasing impact number, resulting in a degrading shock absorption performance, when being impacted repeatedly with magnitudes greater than the endurance limit. Repeated impacts with magnitudes smaller than the endurance limit did not cause measurable cumulative structural damage to the helmets in our study.

Effects of mixed reality head-mounted glasses during 90 minutes of mental and manual tasks on cognitive and physiological functions

Background

We evaluated the effects of a mixed reality (MR) head-mounted deviceon some cognitiveand physiological functions during 90 min tasks in an attempt to determine their safety for workers.

Methods

A total of 12 volunteers performed 90-min intellectual and manual tasks with and without MR glasses. Balance, Stroop, and memory tests were conducted before, during and after these tasks. Heart rate and electromyographic activity of some muscles were recorded. A survey was used to determine subjective fatigue, pain, or discomfort.

Results

Balance, heart rate, rate of perceived exertion, memory, and attention were unaffected by wearing MR glasses. Electromyographic activity increased with MR glasses for deltoid, biceps brachii, and soleus muscles. Few subjects reported discomfort, pain, or visual fatigue with MR glasses. Some participants reported they lost the notion of time and reality.

Discussion

Accordingly, we concluded that the MR glasses under investigation (Hololens) can be used safely. An appropriate setup and familiarization are needed to optimize use.