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

ABSTRACT

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.

KEYWORDS:

• Concussion
• mild TBI
• health and safety
• occupational brain injury
• reinjury
• sex difference
• workplace hazards

Abbreviations

CI, confidence interval; DSM-IV-TR, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition – Text Revision; PEO, Person, environment, occupation; TBI, traumatic brain injury; SD, standard deviation; WSIB, Workers Safety and Insurance Board

Disclosure statement

No potential conflict of interest was reported by the authors.

Additional information

Funding

The work was supported by the Canadian Institutes of Health Research [Canada Research Chair Program in Neurological Disorders and Brain Health (Tier 2) and Canada Research Chair in Traumatic Brain Injury and Underserved Populations (Tier 1)