Non-recreational burn injuries are associated with worse pain interference and social integration: a Burn Model...

While established predictors such as pre-injury employment influence return-to-work (RTW) outcomes, the specific impact of where and how a burn occurred remains less clear. This study investigates the impact of burn injury circumstance on RTW and psychosocial outcomes in adult burn survivors to identify populations that would benefit from tailored support measures.

Data were collected from adult burn survivors in a longitudinal database from 2015 to 2024. Participants were categorized by injury circumstance: work-related (WR), recreational (Rec), and non-work and non-recreational related (NWR). Only participants who were employed before the injury were included. Primary outcomes were employment status and patient-reported outcomes in pain, anxiety, depression, fatigue, physical function, and social reintegration at 12 months.

Among 2117 participants, 735 (34.7%) were in the WR cohort, 1148 (54.2%) in the NWR cohort, and 234 (11.1%) in the Rec cohort. After adjusting for confounders, there was no difference in employment rates at 12 months when comparing Rec to WR (OR= 0.91, p = 0.62) or NWR (OR= 1.02, p = 0.73) groups. Compared to Rec injuries, WR injuries were associated with increased pain interference (p = 0.02), and both WR and NWR cohorts had more difficulty with social reintegration (WR: p = 0.03; NWR: p = 0.02).

Burn injury circumstance has an association with pain and social reintegration, independent of injury severity. Predicting successful RTW remains challenging, as outcomes are often dependent on other contextual factors as well, such as the patient's financial need or the availability of vocational resources.