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Characteristics and Prognostic Factors for Return to Work in Public Safety Personnel with Work-Related Posttraumatic Stress Injury Undergoing Rehabilitation

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Abstract

Purpose

Public safety personnel (PSP) are at risk of developing posttraumatic stress injury (PTSI) due to exposure to traumatic experiences and accidents. Rehabilitation programs are available, but their success varies. We studied: (1) characteristics of PSP undergoing PTSI rehabilitation in comparison to non-PSP workers; and (2) predictive value of various factors for return to work. Methods A population-based cohort study was conducted using data on injured workers undergoing PTSI rehabilitation. Of the 488 workers included, 131 were PSP. Outcome measures were: (1) return to pre-accident work at rehabilitation discharge; (2) days receiving wage replacement benefits in the year following rehabilitation. Results PSP were mainly employed (90.8%), male (59.5%), paramedics/ambulance workers (58.0%); a minority (43.5%) returned to pre-accident work after rehabilitation. Compared to non-PSP workers, PSP were more likely to initially be diagnosed with psychological injuries (94.7% versus 59.4%, p < 0.001) rather than musculoskeletal injuries. Return to pre-accident work was predicted by shorter injury duration, having a primary mental health diagnosis, working at time of admission, and not having symptoms requiring treatment in a complex rehabilitation program. PSPs were slower to experience full recovery in the year after rehabilitation. Factors predicting fewer benefit days included not having a secondary psychological injury, being employed, and working at time of admission. Conclusions Most PSP did not return to work in full after PTSI rehabilitation. Outcomes are likely to improve by starting treatment earlier and maintaining connections with the workplace.

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Acknowledgements

This work was supported by Alberta Health Services through the 2018 Post-Traumatic Stress Disorder (PTSD)/Operational Stress Injury (OSI) Research Grant program. The Workers’ Compensation Board Alberta provided the data for this research.

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Correspondence to Douglas P. Gross.

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Douglas P. Gross, Geoffrey S. Rachor, Shelby S. Yamamoto, Bruce D. Dick, Cary Brown, Ambikaipakan Senthilselvan, Sebastian Straube, Charl Els, Tanya Jackson, Suzette Brémault-Phillips, Don Voaklander, Jarett Stastny, Theodore Berry declare that they have no conflicts of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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This study was an analysis of an administrative dataset; therefore informed consent for the study was not obtained.

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Gross, D.P., Rachor, G.S., Yamamoto, S.S. et al. Characteristics and Prognostic Factors for Return to Work in Public Safety Personnel with Work-Related Posttraumatic Stress Injury Undergoing Rehabilitation. J Occup Rehabil 31, 768–784 (2021). https://doi.org/10.1007/s10926-021-09963-w

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