Abstract
OBJECTIVES: Recent estimates indicate that at least one in five activity-limiting injuries occurs at work. Of individuals who suffer these injuries approximately 10% experience some degree of functional impairment. We were interested in investigating long-term mortality risk in individuals with permanent impairment from work injury and to examine whether work disability is a significant explanatory factor.
METHODS: We used a retrospective matched cohort methodology to examine differences in mortality rates between individuals with permanent impairment from a work injury and a group of non-injured controls over a 19-year period. We used a sample of impaired workers to investigate the impact of work disability on mortality risk using percentage of earnings recovery after injury as the key proxy measure. All analyses were stratified by sex.
RESULTS: Permanent impairment from a work injury was predictive of premature mortality in both male and female claimants, though the risk was slightly higher among women. Work disability was a key explanatory factor in the rate of death among impaired workers, the effects being more pronounced in men. We also found that higher impairment level was associated with mortality in men but not in women.
CONCLUSION: The study demonstrates the impact of permanent work-related impairment on longevity and identifies work disability as an important determinant of mortality risk. Given the disconnect between impairment ratings derived from standard diagnostic tools and labour-market activity after accident, more research is needed on the specific factors that contribute to work disability, particularly those related to psycho-social health and well-being.
Keywords: Work injury, work disability, mortality, longitudinal methods
Résumé
OBJECTIFS : Selon des estimations récentes, au moins un traumatisme sur cinq limitant les activités se produit au travail. Environ 10 % des personnes qui subissent ces traumatismes éprouvent une certaine incapacité fonctionnelle. Nous avons voulu étudier les risques de mortalité à long terme chez les personnes atteintes d’une incapacité permanente à la suite d’un accident du travail et déterminer si l’incapacité professionnelle en est un facteur explicatif important.
MÉTHODE : À l’aide d’un modèle d’étude de cohorte rétrospective appariée, nous avons examiné sur une période de 19 ans les différences dans les taux de mortalité de sujets atteints d’une incapacité permanente à la suite d’un accident du travail et d’un groupe témoin n’ayant pas subi de traumatisme. Nous avons utilisé un échantillon de travailleurs ayant une incapacité pour étudier l’impact de l’incapacité professionnelle sur le risque de mortalité en utilisant le pourcentage de récupération des gains après le traumatisme comme variable substitutive clé. Toutes nos analyses ont été stratifiées selon le sexe.
RÉSULTATS : Une incapacité permanente à la suite d’un accident du travail était une variable prédictive de mortalité prématurée tant chez les hommes que chez les femmes ayant présenté une demande d’indemnisation, bien que le risque ait été légèrement supérieur chez les femmes. L’incapacité professionnelle était un facteur explicatif clé du taux de décès des travailleurs ayant une incapacité, les effets étant plus prononcés chez les hommes. Nous avons aussi constaté qu’un niveau d’incapacité supérieur était associé à la mortalité chez les hommes, mais non chez les femmes.
CONCLUSION : Cette étude montre l’impact d’une incapacité professionnelle permanente sur la longévité et identifie l’incapacité professionnelle comme étant un important déterminant du risque de mortalité. Étant donné le décalage entre les taux d’incapacité dérivés des outils de diagnostic standard et l’activité sur le marché du travail après un accident, il faudrait pousser la recherche sur les facteurs précis qui contribuent à l’incapacité professionnelle, surtout ceux qui sont liés à la santé et au bien-être sur le plan psychosocial.
Motsclés: accidents du travail, incapacité professionnelle, mortalité; méthodes longitudinales
Footnotes
Conflict of Interest: None to declare.
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