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Epidemiology
Research
Trajectories of sickness absence after road traffic injury: a Swedish register-based cohort study
  1. Ritva Rissanen1,
  2. Yajun Liang1,
  3. Jette Moeller1,
  4. Alicia Nevriana1,
  5. Hans-Yngve Berg1,2,
  6. Marie Hasselberg1
  1. 1 Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden
  2. 2 Swedish Transport Agency, Borlänge, Sweden
  1. Correspondence to Dr Ritva Rissanen; ritva.rissanen{at}ki.se

Abstract

Objectives Despite much focus on the health impact of road traffic injury (RTI) on life, there is a lack of knowledge of the dynamic process of return to work following RTI and its related factors. The aim of this study was to identify longitudinal patterns of sickness absence (SA) following RTI, to examine the patterns’ interplay with health-related quality of life (HRQoL) and to determine if there are differences, regarding the patterns and interplay, according to injury severity.

Design A register-based prospective cohort study.

Setting Administrative data on RTI in Sweden from the Swedish Traffic Accident Data Acquisition System (STRADA) and Swedish Social Insurance data.

Participants Individuals suffering an RTI (total n=4761) were identified in STRADA between 1 January 2007 and 31 December 2009. A total of 903 of these met the inclusion criteria for the current study and were included.

Primary and secondary outcome measures The primary outcome measure was SA following RTI. The secondary outcome measure was HRQoL.

Results Three distinct patterns of SA were identified; ‘Stable’, ‘Quick decrease’ and ‘Gradual decrease’. The patterns differed in the number of initial SA days and the rate of reduction of SA days. After 3 years, all three patterns had almost the same level of SA. Higher injury severity and a higher number of SA days had a negative interplay with HRQoL. Participants who initially had a higher number of SA days were more likely to report a low HRQoL, indicating that people with a slower return to work are more vulnerable.

Conclusion The study highlights the heterogeneity of return to work after an RTI. People with a more severe injury and slower pace of return to work seem to be more vulnerable with regards to HRQoL loss following RTI.

  • quality of life
  • register-based cohort
  • return to work
  • road traffic injury

This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/.

https://doi.org/10.1136/bmjopen-2019-031132

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    Footnotes

    • Contributors RR conceptualised the project and drafted the manuscript. H-YB collected the data. YL performed the statistical analyses. YL, JM, AN, H-YB and MH reviewed and edited the manuscript. All authors read and approved the final manuscript.

    • Funding This work was supported by Skyltfonden grant number TRV 2015/85015.

    • Competing interests None declared.

    • Patient consent for publication Not required.

    • Ethics approval The Regional Ethical Review Board in Stockholm (case number: 2016/182–31).

    • Provenance and peer review Not commissioned; externally peer reviewed.

    • Data availability statement Data files used in the study are securely held by the Swedish Transport Agency, the Swedish Social Insurance Agency, Statistics Sweden and cannot be shared by the authors, but are available via application (see www.transportstyrelsen.se; www.forsakringskassan.se; www.scb.se).