title: Occupational burnout and severe injuries: an eight-year prospective cohort study among Finnish forest industry workers.
abstract: OBJECTIVE
  Burnout is a psychological consequence of prolonged work stress. Studies have shown that it is related to physical and mental disorders. The safety outcomes of burnout have been studied to a lesser extent and only in the work context. This study explored the effect of burnout on future severe injuries regardless of their context.
  
  
  METHODS
  A total of 10,062 forest industry employees (77% men, 63% manual workers) without previous injuries participated in 1996 or 2000 in the "Still Working" study examining the work-related antecedents of health and mortality. Burnout was assessed using the Maslach Burnout Inventory-General Survey. Injuries leading to death or hospitalization were regarded as severe. We extracted such injuries from independent national registers. The relationship between burnout and new injuries was analyzed using Cox proportional regression. The analyses were adjusted for age, sex, marital status, and occupational status.
  
  
  RESULTS
  There were 788 new injuries over eight years. Injuries were more common among male and manual workers. After adjustments, each one-unit increase in the burnout score was related to a 9% increase in the risk of injury (95% confidence interval: 1.2-1.17). Experiencing symptoms at least monthly was related to a 1.18-fold adjusted injury risk (95% CI: 1.2-1.36). Of the subscales of burnout, exhaustion and cynicism but not lack of professional efficacy predicted injuries after adjustments.
  
  
  CONCLUSIONS
  In addition to mental and physical disorders, burnout predicts severe injuries. Developing work conditions and optimizing workload may enhance safety and decrease health expenses related to all injuries.
authors.affiliation: Development of Work and Work Organizations, Finnish Institute of Occupational Health.
authors.forename: Kirsi
authors.initials: K
authors.lastname: Ahola
authors.forename: Simo
authors.initials: S
authors.lastname: Salminen
authors.forename: Salla
authors.initials: S
authors.lastname: Toppinen-Tanner
authors.forename: Aki
authors.initials: A
authors.lastname: Koskinen
authors.forename: Aki
authors.initials: A
authors.lastname: Väänänen
mesh_terms: D000328:Adult; D002055:Burnout, Professional / Q000453:epidemiology* / Q000523:psychology; D015331:Cohort Studies; D015897:Comorbidity; D016001:Confidence Intervals; D005260:Female; D005387:Finland / Q000453:epidemiology; D016468:Forestry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology* / Q000523:psychology; D016272:Occupational Health; D060051:Occupational Injuries / Q000453:epidemiology* / Q000523:psychology; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D055815:Young Adult