Work-related traumatic brain injury: A brief report on workers perspective on job and health and safety training, supervision, and injury preventability

Testing the shock protection performance of Type I construction helmets using impactors of different masses

BACKGROUND

Wearing protective helmets is an important prevention strategy to reduce work-related traumatic brain injuries. The existing standardized testing systems are used for quality control and do not provide a quantitative measure of the helmet performance.

OBJECTIVE

To analyze the failure characterizations of Type I industrial helmets and develop a generalized approach to quantify the shock absorption performance of Type I industrial helmets based on the existing standardized setups.

METHODS

A representative basic Type I construction helmet model was selected for the study. Top impact tests were performed on the helmets at different drop heights using two different impactor masses (3.6 and 5.0 kg).

RESULTS

When the helmets were impacted with potential impact energies smaller than the critical potential impact energy values, there was a consistent relationship between the peak impact force and the potential impact energy. When the helmets were impacted under potential impact energies greater than the critical potential impact energy values, the peak impact forces increased steeply with increasing potential impact energy.

CONCLUSION

A concept of safety margin for construction helmets based on potential impact energy was introduced to quantify the helmets' shock absorption performance. The proposed method will help helmet manufacturers improve their product quality.

Treatment and Management of Work-Related Mild Traumatic Brain Injury in Physical Medicine and Rehabilitation

ABSTRACT

The purpose of this narrative review was to assess work-related mild traumatic brain injury treatment approaches and outcomes. Literature indicates that incidence of work-related mild traumatic brain injury is high. Ability to return to work after injury is variable, with differences identified across industry sector, mechanisms of injury, sex, and timely treatment and referral. Additional challenges exist in the context of secondary gains (e.g., financial) and the potential for symptom exaggeration. Emerging evidence from studies outside the United States demonstrate the benefits of proactive assessment and treatment at the time of injury. These benefits can be further augmented by early referral to multidisciplinary treatment teams led by physical medicine and rehabilitation physicians. Opportunities for ongoing research and development of strategies to improve treatment, management, and more timely return to work for patients with occupational mild traumatic brain injury are discussed. It is concluded that challenges persist in treatment and management of patients with work-related mild traumatic brain injury as they present unique challenges not seen in those with nonwork-related mild traumatic brain injuries. The unique position of physical medicine and rehabilitation and the skills of physiatrists render them poised to lead multidisciplinary treatment teams for these patients and contribute to the development of a new guideline for return to work, with an emphasis on functional recovery.

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.

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.

Sleep before and after work-related concussion: Sex differences in effects and functional outcomes

BACKGROUND

Recent studies have started disentangling components of disturbed sleep as part of the post-concussive syndrome, but little is known about the workers with an injury' perspectives on post-injury sleep changes or what causes these changes.

OBJECTIVES

To determine the effects of work-related concussion/mild traumatic brain injury (wr-mTBI) on perceptions of refreshing sleep in workers with an injury and to identify the relevant factors responsible for sleep changes.

METHODS

We studied post-concussive changes in sleep in 66 adults (50% male workers, 42% aged 30-50 years, median post-injury days: 155) who had sustained wr-mTBI and experienced functional limitations long after the injury. We collected sociodemographic, occupational and health status data and identified variables related to post-concussive changes in refreshing sleep.

RESULTS

Forty-seven workers with wr-mTBI (79% of male workers, 64% of female workers) perceived their sleep as being refreshing before injury and unrefreshing afterwards (χ2 = 67.70 for change, χ2 = 27.6 for female and χ2 = 41.1 for male workers, p < 0.0001). Post-concussive losses in refreshing sleep were associated with socio demographic, occupational, and health status data variables. Sex stratification revealed differences between male and female workers.

CONCLUSIONS

Workers with wr-mTBI experience clinically meaningful changes in refreshing sleep that are associated with modifiable variables. The observed differences in functional outcomes between male and female workers warrant further study.

Critical methodological considerations in recruiting and engaging non-native English speaking workers with a head injury: a Canadian perspective

OBJECTIVE

Non-native English speaking workers with a mild work-related traumatic brain and/or head injury are a vulnerable and underrepresented population in research studies. The researchers present their experiences with recruiting and performing qualitative interviews with non-native English speaking individuals with a work-related mild traumatic brain injury, and provide recommendations on how to better include this vulnerable population in future research studies. This paper presents considerations regarding ethics, recruitment challenges, interview preparation and debriefing, sex & gender and language and cultural issues must be made when working with this vulnerable population.

RESULTS

The researchers discuss critical issues and provide recommendations in recruiting and engaging with non-native English language workers including ethics, recruitment challenges, interview preparation and debriefing, sex & gender and language, and cultural considerations that must be made when working with this population. The study recommendations advise investigators to spend more time to learn about the non-native English participants in the mild wrTBI context, to be familiar with the vulnerabilities and specific circumstances that these workers experience. By increasing their awareness of the challenging facing this vulnerable population, the intention is to provide better care and treatment options through evidence-based research and practice.