Long-term mortality risk in individuals with permanent work-related impairment

Heather K. Scott-Marshall, Emile Tompa, Ying Wang, Qing Liao


OBJECTIVES: Recent estimates indicate that at least one in five activity-limiting injuries occurs at work. Of individuals who suffer these injuries approximately 10% experience some degree of functional impairment. We were interested in investigating long-term mortality risk in individuals with permanent impairment from work injury and to examine whether work disability is a significant explanatory factor.

METHODS: We used a retrospective matched cohort methodology to examine differences in mortality rates between individuals with permanent impairment from a work injury and a group of non-injured controls over a 19-year period. We used a sample of impaired workers to investigate the impact of work disability on mortality risk using percentage of earnings recovery after injury as the key proxy measure. All analyses were stratified by sex.

RESULTS: Permanent impairment from a work injury was predictive of premature mortality in both male and female claimants, though the risk was slightly higher among women. Work disability was a key explanatory factor in the rate of death among impaired workers, the effects being more pronounced in men. We also found that higher impairment level was associated with mortality in men but not in women.

CONCLUSION: The study demonstrates the impact of permanent work-related impairment on longevity and identifies work disability as an important determinant of mortality risk. Given the disconnect between impairment ratings derived from standard diagnostic tools and labour-market activity after accident, more research is needed on the specific factors that contribute to work disability, particularly those related to psycho-social health and well-being.


Work injury; work disability; mortality; longitudinal methods

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DOI: http://dx.doi.org/10.17269/cjph.105.4535