Effects of residential location and work-commuting on long-term work disability

Little is known about the independent effect of workers' residential location and work-commuting on their long-term disability due to work-related injuries. We examined 149,110 incident claims while adjusting for multiple risk factors in a large, population-based sample of Washington State workers' compensation State Fund claims during 2002-2008.

Claimants' residential addresses were geocoded with census tract and aggregated into four category classification of the Rural Urban Commuting Area Codes (RUCAs) which takes into account for tract-level work-commuting. We used logistic regressions to assess the association between RUCAs and whether or not a person was off work for more than 180 days due to injury; Quantile regressions to predict various percentiles of cumulative lost workdays by RUCAs.

Compared to those who live in the Urban Core, workers in other areas experienced longer average paid time loss days due to work-related injury. The association between residential location and long-term disability was significant, odds ratio (OR) 1.19 (95 % confidence interval (CI) 1.11-1.27) for residents of Small Town and Isolated Rural and OR 1.17 (95 % CI 1.12-1.22) for those of Sub Urban, and persisted after controlling for injury nature, socio-demographic, employment-related, and claim administrative characteristics. The impact of residential location and work-commuting elevated as the duration of disability increased.

This study shows that residential location and work-commuting has a significant and time-varying impact on duration of work disability. Workers living in Sub Urban and Small Town and Isolated Rural areas represent a particularly vulnerable group with respect to risk of long-term work disability.