Increased all-cause mortality following occupational injury: a comparison of two states. Issue 12 (17th October 2022)

• Record Type: Journal Article
• Authors: Boden, Leslie I; Asfaw, Abay; Busey, Andrew; Tripodis, Yorghos; O'Leary, Paul K; Applebaum, Katie M; Stokes, Andrew C; Fox, Matthew P
• Is Part Of: Occupational and environmental medicine. Volume 79:Issue 12(2022)
• Page Start: 816
• Page End: 823
• Publication Date: 2022-10-17
• Subjects: mortality -- occupational health -- public health -- epidemiology; Medicine, Industrial -- Periodicals; Environmental health -- Periodicals; 616.980305
• DOI: 10.1136/oemed-2022-108481
• Languages: English
• ISSNs: 1351-0711

Abstract

Abstract : Objectives: To measure the impact of lost-time occupational injuries on all-cause mortality in Washington State and, using the same data elements and study design, to determine whether the estimated impact was similar to previous estimates for New Mexico. Methods: We linked injuries in the Washington workers' compensation system with Social Security Administration data on earnings and mortality. We estimated Cox survival models of mortality for women and men with lost-time compared with medical-only injuries, adjusting for age, pre-injury earnings and industry. We used quantitative bias analysis to account for confounding by pre-injury smoking and obesity. Results: The estimated mortality HR was 1.24 for women (95% CI 1.21 to 1.28) and 1.22 for men (95% CI 1.20 to 1.24). After adjusting for unmeasured pre-injury smoking and obesity, the estimated HR for women was 1.10, 95% simulation interval (SI) 1.00 to 1.21; for men, it was 1.15, 95% SI 1.04 to 1.27. Conclusions: All-cause mortality for Washington workers with lost-time injuries was higher than for those with medical-only injuries. Estimated HRs for Washington were consistent with those previously estimated for New Mexico, a less populous state with lower median wages and a different workers' compensation insurance mechanism. This suggests that the relationship between workplace injury and long-term mortality may be generalisable to other US states. These findings support greater efforts to enhance safety and to investigate factors that improve postinjury employment opportunities and long-term health. This association should be examined in additional locations, with different study conditions, or using additional data on pre-injury risk factors.