Canadian Journal of Public Health

, Volume 105, Issue 5, pp e330–e335 | Cite as

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

  • Heather K. Scott-MarshallEmail author
  • Emile Tompa
  • Ying Wang
  • Qing Liao
Quantitative Research


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 


OBJECTIFS : Selon des estimations récentes, au moins un traumatisme sur cinq limitant les activités se produit au travail. Environ 10 % des personnes qui subissent ces traumatismes éprouvent une certaine incapacité fonctionnelle. Nous avons voulu étudier les risques de mortalité à long terme chez les personnes atteintes d’une incapacité permanente à la suite d’un accident du travail et déterminer si l’incapacité professionnelle en est un facteur explicatif important.

MÉTHODE : À l’aide d’un modèle d’étude de cohorte rétrospective appariée, nous avons examiné sur une période de 19 ans les différences dans les taux de mortalité de sujets atteints d’une incapacité permanente à la suite d’un accident du travail et d’un groupe témoin n’ayant pas subi de traumatisme. Nous avons utilisé un échantillon de travailleurs ayant une incapacité pour étudier l’impact de l’incapacité professionnelle sur le risque de mortalité en utilisant le pourcentage de récupération des gains après le traumatisme comme variable substitutive clé. Toutes nos analyses ont été stratifiées selon le sexe.

RÉSULTATS : Une incapacité permanente à la suite d’un accident du travail était une variable prédictive de mortalité prématurée tant chez les hommes que chez les femmes ayant présenté une demande d’indemnisation, bien que le risque ait été légèrement supérieur chez les femmes. L’incapacité professionnelle était un facteur explicatif clé du taux de décès des travailleurs ayant une incapacité, les effets étant plus prononcés chez les hommes. Nous avons aussi constaté qu’un niveau d’incapacité supérieur était associé à la mortalité chez les hommes, mais non chez les femmes.

CONCLUSION : Cette étude montre l’impact d’une incapacité professionnelle permanente sur la longévité et identifie l’incapacité professionnelle comme étant un important déterminant du risque de mortalité. Étant donné le décalage entre les taux d’incapacité dérivés des outils de diagnostic standard et l’activité sur le marché du travail après un accident, il faudrait pousser la recherche sur les facteurs précis qui contribuent à l’incapacité professionnelle, surtout ceux qui sont liés à la santé et au bien-être sur le plan psychosocial.


accidents du travail incapacité professionnelle mortalité; méthodes longitudinales 


  1. 1.
    Wilkins K, Mackenzie SG. Work injuries. Health Reports 2007;18(3):25–42.PubMedGoogle Scholar
  2. 2.
    Billette J-M, Janz T. Injuries in Canada: Insights from the Canadian Community Health Survey. Health at a Glance 2011 June:1–16. Statistics Canada Catalogue no. 82-624-X.Google Scholar
  3. 3.
    Association of Workers’ Compensation Boards of Canada. Key Statistical Measures. Mississauga, ON, 2012.Google Scholar
  4. 4.
    WorkSafeBC. WorkSafeBC Statistics 2011. Richmond, BC, 2011.Google Scholar
  5. 5.
    Workplace Safety and Insurance Board. High Impact Claims Fact Sheet. Ottawa, ON: Workplace Safety and Insurance Board, 2011.Google Scholar
  6. 6.
    Wall CL, Ogloff JRP, Morrissey SA. Psychological consequences of work injury: Personality, trauma and pschological distress symptoms of noninjured workers and injured workers returning to or remaining at work. Int J Disability Management Res 2008;2(2):37–46.CrossRefGoogle Scholar
  7. 7.
    Stice BD, Dik BJ. Depression among injured workers receiving vocational rehabilitation: Contributions of work values, pain and stress. J Occup Rehab 2009;19:354–63.CrossRefGoogle Scholar
  8. 8.
    Ballantyne P, Tompa E, Endicott M, Mantis S. Injured Worker Health Survey Panel–Phase I. Health trajectories and health care utilization among injured workers: A longitudinal survey. Research Action Alliance on the Consequences of Work Injury, 2010.Google Scholar
  9. 9.
    Tompa E, Mustard C, Sinclair S, Fang M, Scott-Marshall H. Post-accident earnings and benefits adequacy and equity. In: Final Report for the National Institute for Occupational Safety and Health. Toronto, ON: Institute for Work & Health, 2009.Google Scholar
  10. 10.
    Konstantinidis A, Talving P, Kobayashi L, Barmparas G, Plurad D, Lam L, et al. Work-related injuries: Injury characteristics, survival and age effect. Am Surgeon 2011;77(6):702–707.PubMedGoogle Scholar
  11. 11.
    Steenland K, Burnett C, Lalich N, Ward E, Hurrell J. Dying for work: The magnitude of US mortality from selected causes of death associated with occupation. Am J Indust Med 2003;43:461–82.CrossRefGoogle Scholar
  12. 12.
    Tiesman HM, Konda S, Bell JL. The epidemiology of fatal occupational traumatic brain injury in the U.S. Am J Prev Med 2011;41(1):61–67.CrossRefGoogle Scholar
  13. 13.
    Cameron CM, Kliewer EV, Purdie DM, McClure RJ. Long-term mortality following injury in working age adults: A systematic review. Int J Inj Contr Saf Promot 2007;14(1):11–18.CrossRefGoogle Scholar
  14. 14.
    Lin S-H, Lee H-Y, Chang Y-Y, Jang Y, Chen PC, Wang J-D. Increased mortality risk for workers with a compensated, permanent occupational disability of the upper or lower extremities: A 21-year follow-up study. Am J Epidemiol 2010;171(8):917–23.CrossRefGoogle Scholar
  15. 15.
    Ho JJ, Hwang JS, Wang JD. Life expectancy estimations and the determinants of survival after 15 years of follow-up for 81,249 workers with permanent occupational disabilities. Scand J Work Environ Health 2006;32(2):91–98.CrossRefGoogle Scholar
  16. 16.
    Rosenbaum PR, Rubin DB. Constructing a control group using multivariate matched sampling methods that incorporate the propensity score. Am Statistician 1985;39:33–38.Google Scholar
  17. 17.
    Stuart EA. Matching methods for causal inference: A review and a look forward. Stat Sci 2010;25(1):1–21.CrossRefGoogle Scholar
  18. 18.
    Cox DR. Regression models and life tables. J R Stat Soc Series 1972:B:187–220.Google Scholar
  19. 19.
    Scott-Marshall H, Tompa E, Liao Q, Fang M. Marital formation in individuals with work-related permanent impairment. Disabil Health J 2013;6(1):43–51.CrossRefGoogle Scholar
  20. 20.
    Kim M-H, Kim C, Park J-K, Kawachi I. Is precarious employment damaging to self-rated health? Results of propensity score matching methods using longitudinal data in South Korea. Soc Sci Med 2008;67:1982–94.CrossRefGoogle Scholar
  21. 21.
    Sinclair S, Burton J. Development of a schedule for compensation of non-economic loss: Quality-of-life values vs. clinical impairment ratings. In: Thomason T, Chaykowski RP [Eds], Research in Canadian Workers’ Compensation. Kingston, ON: IRC Press, 1995.Google Scholar
  22. 22.
    Peterson MA, Reville RT, Stern RK, Barth PS. Compensating permanent workplace injuries: A study of the California system. Santa Monica, CA: RAND, 1998.Google Scholar

Copyright information

© The Canadian Public Health Association 2014

Authors and Affiliations

  • Heather K. Scott-Marshall
    • 1
    • 2
    Email author
  • Emile Tompa
    • 1
    • 2
    • 3
  • Ying Wang
    • 1
  • Qing Liao
    • 1
  1. 1.Institute for Work & HealthTorontoCanada
  2. 2.Dalla Lana School of Public HealthUniversity of TorontoTorontoCanada
  3. 3.Department of EconomicsMcMaster UniversityHamiltonCanada

Personalised recommendations