Study: Can Mild Traumatic Brain Injury Affect Employment Status?

People who suffer mild traumatic brain injuries (mTBI) incur the risk of losing their jobs due to persistent post-concussive symptoms, and this is especially true for people in their 30’s, according to a study published in BMJ Open.

In a longitudinal nationwide register-based cohort study with five years of follow-up, the researchers assessed 19,732 Danish hospital patients between the ages of 18 and 60 years old diagnosed with mTBI. For almost every patient, one control was matched based on age, gender, and location (n=18,640). Because more patients with mTBI were married and had more somatic and psychiatric comorbidities, it was not possible to discern a matching control for each patient. The study’s primary outcomes were defined as the time spent not attending ordinary work combined with premorbid risk factors including comorbidities, cohabitational status, education, ethnicity, and age.

Concussion Influences Labor Status

Following analysis, the results showed that while single status patients’ jobs were more affected in the short-term with mTBI (OR 1.38, 95% CI 1.30 to 1.46), patients with mTBI with a partner were slightly more long-term affected (OR 1.64, 95% CI 1.48 to 1.81). The authors noted a that a “clear inverse educational gradient was observed, where both in the short-run and long-run (OR 1.51, 95% CI 1.31 to 1.74) (OR 2.15, 95% CI 1.78 to 2.59) higher educated patients with mTBI were most affected on their ability to work.”

Moreover, non-Danish patients experienced long-term effects on employment status (OR 1.98, 95% CI 1.52 to 2.57), which showed similar effect among women (OR 1.62, 95% CI 1.48 to 1.77). A short-term gradient related to age was observed in this study and was most pronounced among the oldest-age group (50–60 years) (OR 1.54, 95% CI 1.37 to 1.73). However, patients with mTBI between 30 and 39 years were more long-term affected on employment status (OR 1.93, 95% CI 1.68 to 1.23). Patients with mTBI with comorbidities were both short-term and long-term affected (OR 1.81, 95% CI 1.38 to 2.37). Conversely, patients with mTBI without psychiatric comorbidities were more affected on employment status at 5 years postinjury (OR 1.56, 95% CI 1.46 to 1.65).

“This study found that absence of psychiatric diagnoses predicted not attending ordinary work, and that the odds did not increase from 6 months to 5 years,” the study authors wrote.

“For patients with psychiatric diseases, mTBI did not affect labor market attachment. This was unexpected, since psychiatric diseases often affect labor market attachment. These results were also in contrast to increasing odds in patients with physiological comorbidities, which we also demonstrated in this study. However, it also needs to be remembered that this study evaluated the presence of psychiatric disease not as a predictor of worsened outcome, but as a factor that may increase the effect of mTBI on labor market attachment.”