Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study

Abstract

ObjectivesDespite much focus on the health impact of road traffic injury (RTI) on life, there is a lack of knowledge of the dynamic process of return to work following RTI and its related factors. The aim of this study was to identify longitudinal patterns of sickness absence (SA) following RTI, to examine the patterns’ interplay with health-related quality of life (HRQoL) and to determine if there are differences, regarding the patterns and interplay, according to injury severity.DesignA register-based prospective cohort study.SettingAdministrative data on RTI in Sweden from the Swedish Traffic Accident Data Acquisition System (STRADA) and Swedish Social Insurance data.ParticipantsIndividuals suffering an RTI (total n=4761) were identified in STRADA between 1 January 2007 and 31 December 2009. A total of 903 of these met the inclusion criteria for the current study and were included.Primary and secondary outcome measuresThe primary outcome measure was SA following RTI. The secondary outcome measure was HRQoL.ResultsThree distinct patterns of SA were identified; ‘Stable’, ‘Quick decrease’ and ‘Gradual decrease’. The patterns differed in the number of initial SA days and the rate of reduction of SA days. After 3 years, all three patterns had almost the same level of SA. Higher injury severity and a higher number of SA days had a negative interplay with HRQoL. Participants who initially had a higher number of SA days were more likely to report a low HRQoL, indicating that people with a slower return to work are more vulnerable.ConclusionThe study highlights the heterogeneity of return to work after an RTI. People with a more severe injury and slower pace of return to work seem to be more vulnerable with regards to HRQoL loss following RTI.

Sequence analysis of sickness absence and disability pension in the year before and the three years following a bicycle crash; a nationwide longitudinal cohort study of 6353 injured individuals

“…The association between SA and hospitalisation was also observed in two previous old and relatively small studies [ 12 , 13 ]. Likewise, the association between age and SA and/or DP is consistent with previous studies reporting on this association [ 7 , 10 , 13 ].…”

“…In the present study we found that 66% had no or little SA and DP during the three follow-up years. This is in line with a Swedish study using group-based trajectory models, where 76% of the included 903 individuals who had a road traffic injury were found in a pattern with a low number of SA days during the three-year follow-up [ 10 ]. However, that study did not consider DP during the follow-up nor were different road user groups specified.…”

“…There is only limited scientific knowledge about SA and DP following a bicycle crash. Sickness absence has been shown to be a relatively common outcome after a road traffic injury [7][8][9][10][11]. However, there are only a few studies on bicyclists' injuries and their future risk of SA [9,[12][13][14][15], and only one study considering this with a long-term perspective, in this case, the duration of the SA spell starting in connection to the bicycle crash [14].…”

Sickness absence, disability pension and permanent medical impairment among 64 000 injured car occupants of working ages: A two-year prospective cohort study

“…In terms of net days SA/DP, a threshold of PMI ≥1% seems to capture a majority of the increase in SA and DP due to injury after a car crash, and could from that perspective be recommended as a target for policy and action to prevent such consequences. Regarding MAIS 3+, Rissanen et al has shown that road traffic injuries classified MAIS 3+ resulted in a higher number of SA days immediately after the crash which is then more quickly reduced, compared to less severe injuries 109 . This can be compared to the findings regarding WAD (an injury classified as AIS 1) in this thesis.…”

“…The risk of being injured in motor vehicle crashes has been found higher in general among those of older age in many studies 65,[124][125][126] . Older individuals have also been shown to have lower functioning and health after a crash 127 , and individuals with a slow decrease of gross SA days in the period after a crash are more often older than those with a quicker decrease 109 . Although, some specific injury types can have more severe consequences among younger age groups.…”