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Mild traumatic brain injury caused by workplace violence in a US workers' compensation system
Kerri Wizner1, W Shane Journeay2,3,4, Daniel Jolivet5
1MDGuidelines, Lincolnshire, Illinois, USA kerri.wizner@MDGuidelines.com.
Objectives:
Approximately 81% of traumatic brain injury cases are considered to be mild (mTBI), but few studies have reviewed mTBI caused by workplace violence (WPV). This study aimed to (1) determine the incidence of mTBI secondary to WPV in a statewide workers' compensation system using International Classification of Disease codes and (2) analyse and compare factors associated with return-to-work outcomes between WPV mTBI cases versus other mechanisms.
Methods:
Using a retrospective cohort of claims data from the California Workers' Compensation Information System during 2015-2019, cases with a return-to-work date were classified as WPV if the injury description contained keywords such as assault, gunpoint, harassed, intimidated, punch, threat, robbery, violent or verbal abuse.
Results:
Of the 14 089 mTBI claims analysed in this study, 11.2% were caused by WPV. When comparing WPV to non-WPV claims, the variables with statistically significant (p≤0.001) differences were age, income, industry and job class. There were no significant differences between groups for leave duration. In a linear mixed model, the variable of interest (WPV) was not associated with recovery duration after adjusting for other factors.
Conclusion:
To our knowledge, this is the first study to examine WPV mTBI claims in the USA. The findings suggest that the public administration, education and healthcare and social services industries are at higher risk for WPV mTBI. WPV and job class were the only modifiable factors in the model and therefore should be the focus of additional research.
Insights
Workplace violence (WPV) caused 11.2% of mild traumatic brain injuries (mTBI) in California. Public administration, education, and healthcare sectors face higher WPV mTBI risks, highlighting areas for targeted prevention strategies.
Area of Science:
- Occupational health
- Neurology
- Public health
Background:
- Mild traumatic brain injury (mTBI) is common, but mTBI resulting from workplace violence (WPV) is understudied.
- Understanding the incidence and outcomes of WPV-related mTBI is crucial for targeted interventions.
Purpose of the Study:
- To determine the incidence of mTBI due to WPV within a state workers' compensation system.
- To compare return-to-work outcomes between mTBI cases caused by WPV and other mechanisms.
Main Methods:
- Retrospective cohort analysis of California Workers' Compensation Information System data (2015-2019).
- mTBI cases were identified and classified as WPV-related based on injury description keywords.
- Return-to-work outcomes were analyzed, comparing WPV mTBI with non-WPV mTBI.
Main Results:
- 11.2% of 14,089 analyzed mTBI claims were attributed to WPV.
- Significant differences between WPV and non-WPV groups were observed in age, income, industry, and job class (p≤0.001).
- No significant differences in leave duration were found; WPV was not associated with recovery duration after adjusting for covariates.
Conclusions:
- This is the first study to examine WPV-related mTBI claims in the USA.
- Public administration, education, and healthcare/social services industries show higher risk for WPV-related mTBI.
- WPV and job class are identified as modifiable factors warranting further research for prevention and intervention.
