The Association Between Pre-injury Occupation Type and Post-burn Employment Outcomes.

Abstract

Purpose: To explore the relationship between burn survivors' pre-injury occupation and the likelihood of successful return to employment in the post-rehab setting.

Methods: Participants in the Burn Model Systems database were designated as Labor or Non-labor employees based on their self-reported occupation pre-injury. The groups were compared across a variety of demographic and clinical variables using descriptive statistics. Logistic regression models were used to examine employment status at 12 months, and a Cox proportional hazards model was used to examine time to return to work. Sankey diagrams examined patterns in career change between the two groups.

Results: Burn survivors working in Labor occupations prior to injury differed from Non-labor counterparts across several sociodemographic and injury-related characteristics, including lower education levels, higher rates of employment-related injuries, and different insurance coverage patterns. In the a priori logistic regression model, Labor Group status was associated with lower odds of employment at 12 months (OR=0.44, 95% CI 0.22-0.90, p=0.024). However, this association was no longer statistically significant in a post hoc sensitivity analysis additionally adjusting for education and insurance status (OR=0.47, 95% CI 0.20-1.08, p=0.076). In the Cox proportional hazards model, participants in Labor occupations experienced a significantly slower return to work than those in Non-labor occupations (HR=0.51, 95% CI 0.31-0.82, p=0.005).

Conclusion: These findings underscore the importance of providing tailored support to burn survivors seeking to resume employment and demonstrate that the relationship between pre-injury occupation and workforce reintegration may differ depending on the employment outcome examined. While the association between Labor Group status and employment at 12 months was attenuated after accounting for education and insurance, Labor Group status remained significantly associated with a slower return to work. Pre-injury occupation, together with socioeconomic and structural factors, may therefore be important to consider when developing initiatives to support workforce reintegration following burn injury.