Traumatic Brain Injuries May Result in Long-Term Work Disability for Up To Five Years: Study

Researchers found that long-term disability risks were increased for workers regardless of the severity of the TBI.

New data highlights the long-term risks associated with traumatic brain injuries among workers, suggesting that individuals who sustain a head injury face an increased risk of needing extended time off from work, which can last for many years.

According to findings published in the journal Neurology on February 11, people who suffer traumatic brain injuries (TBIs) are more likely to need disability, regardless of how severe the injury, with even minor blows to the head increasing these risks for up to five years.

Traumatic brain injuries occur when a person suffers a blow or jolt to the head, ranging from mild concussions to severe, life-altering trauma. Even so-called “mild” TBIs can disrupt normal brain function, affecting memory, concentration and emotional processing long after the initial injury.

In the weeks and months that follow, many patients report lingering symptoms such as dizziness, insomnia, depression, brain fog and delayed reaction times. Growing research also suggests the long-term consequences of TBI’s may extend well beyond these immediate effects.

Previous studies have linked TBIs to a heightened risk of depression and other mood disorders. Harvard researchers have reported that individuals with a history of traumatic brain injury may face a significantly increased risk of developing cancerous brain tumors later in life. A separate Canadian study found that adults over age 65 who suffered a TBI had a 70% higher risk of developing dementia compared to those without a head injury.

For the new study, researchers from Uppsala University in Sweden reviewed national medical records for more than 98,000 individuals between the ages of 21 and 60 who were diagnosed with a traumatic brain injury between 2005 and 2016. The findings were then compared to a control group of more than 981,000 individuals without a TBI.

Led by Dr. Andrea Klang, the research team analyzed how different severities of traumatic brain injury affected a person’s likelihood of transitioning to work disability, examining outcomes across three categories of injury:

• TBI A – Individuals who required specialized outpatient care or were hospitalized for two days or less
• TBI B – Individuals hospitalized for three days or more
• TBI C – Individuals hospitalized for three days or more or who required neurosurgery

Work disability was defined as any absence from employment lasting longer than 14 days.

Within the first 30 days after injury, disability risk increased with severity. Individuals with TBI A faced a 6% increased risk of work disability, compared to 29% for TBI B and 43% for TBI C, while those without a TBI had just a 0.5% increased risk.

The elevated risk persisted over time. Five years after the injury, disability rates remained 7% higher among TBI A patients, 11% higher among TBI B patients and 13% higher among TBI C patients, compared to a 4% increased risk among individuals who did not suffer a TBI.

Older workers were particularly vulnerable, with TBI A associated with a 23% greater likelihood of transitioning to disability, TBI B with a 34% greater likelihood and TBI C with a 59% greater likelihood. Women were also at higher risk, nearly 60% more likely to experience work disability after TBI A and 35% more likely after TBI B, while psychiatric patients faced a 34% greater risk following TBI A and a 28% greater risk following TBI B.

“TBI was associated with persistently elevated transition probabilities to work disability across all severity groups, with early peaks in TBI B and C and a delayed increase in TBI A, influenced by sociodemographic and medical factors.”

— Dr. Andrea Klang, Five-Year Follow-Up of Work Disability After Traumatic Brain Injury

Regardless of the severity of the injury, researchers determined that sustaining a TBI was linked to a greater risk of suffering work disability. They suggested rehabilitation efforts after TBI must be approached on an individualized basis.

Traumatic brain injuries are the leading cause of long-term disability among working-age people, with doctors considering a return to work to be a key marker of recovery. However, Klang points out that most research only looks at fixed points for disability, not at long-term transitions that can happen on and off in the many years following injury.

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