title: Work Limitations 4 Years After Mild Traumatic Brain Injury: A Cohort Study.
abstract: To explore employment status, work limitations, and productivity loss after mild traumatic brain injury (TBI).
  
  
  
  Inception cohort study over 4 years.
  
  
  
  General community.
  
  
  
  Adults (N=245; >16y at the time of injury) who experienced a mild TBI and who were employed prior to their injury.
  
  
  
  Not applicable.
  
  
  
  Details of the injury, demographic information, and preinjury employment status were collected from medical records and self-report. Symptoms and mood were assessed 1 month postinjury using the Rivermead Post-Concussion Symptom Questionnaire and the Hospital Anxiety and Depression Scale. Postinjury employment status and work productivity were assessed 4 years postinjury using the Work Limitations Questionnaire.
  
  
  
  Four years after mild TBI, 17.3% of participants had exited the workforce (other than for reasons of retirement or to study) or had reduced their working hours compared with preinjury. A further 15.5% reported experiencing limitations at work because of their injury. Average work productivity loss was 3.6%. The symptom of taking longer to think 1 month postinjury significantly predicted work productivity loss 4 years later (β=.47, t=3.79, P≤.001).
  
  
  
  Although changes in employment status and difficulties at work are likely over time, the results indicate increased unemployment rates, work limitations, and productivity loss in the longer term after a mild TBI. Identification of cognitive difficulties 1 month after TBI in working aged adults and subsequent interventions to address these difficulties are required to facilitate work productivity.
authors.affiliation: National Institute for Stroke and Applied Neuroscience, School of Public Health & Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand. Electronic address: alice.theadom@aut.ac.nz.
authors.forename: Alice
authors.initials: A
authors.lastname: Theadom
authors.affiliation: School of Psychology, University of Auckland, Auckland, New Zealand.
authors.forename: Suzanne
authors.initials: S
authors.lastname: Barker-Collo
authors.affiliation: National Institute for Stroke and Applied Neuroscience, School of Public Health & Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Kelly
authors.initials: K
authors.lastname: Jones
authors.affiliation: Waikato Occupational Services, Hamilton, New Zealand.
authors.forename: Michael
authors.initials: M
authors.lastname: Kahan
authors.affiliation: Department of Biostatistics and Epidemiology, School of Public Health and Psychosocial Studies, Auckland University of Technology, Auckland.
authors.forename: Braden
authors.initials: B
authors.lastname: Te Ao
authors.affiliation: Health Research Council of New Zealand, Auckland, New Zealand.
authors.forename: Kathryn
authors.initials: K
authors.lastname: McPherson
authors.affiliation: School of Psychology, University of Waikato, Hamilton, New Zealand.
authors.forename: Nicola
authors.initials: N
authors.lastname: Starkey
authors.affiliation: National Institute for Stroke and Applied Neuroscience, School of Public Health & Psychosocial Studies, Auckland University of Technology, Auckland, New Zealand.
authors.forename: Valery
authors.initials: V
authors.lastname: Feigin
mesh_terms: D000328:Adult; D001924:Brain Concussion / Q000534:rehabilitation*; D015331:Cohort Studies; D004526:Efficiency; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009520:New Zealand; D062707:Return to Work / Q000706:statistics & numerical data*; D012959:Socioeconomic Factors; D013997:Time Factors; D015599:Trauma Severity Indices; D014938:Work Capacity Evaluation
keywords: Brain concussion; Brain injuries, traumatic; Employment; Longitudinal studies; Rehabilitation; Work