Sex differences in work-related traumatic brain injury: a concurrent mixed methods study employing the person-environment-occupation model

BackgroundWork-related traumatic brain injury (wrTBI) is considered a critical injury that can be prevented. Few studies have integrated clinical data and workers' injury narratives to inform sex-specific wrTBI prevention.ObjectiveTo examine sex differences in pre-injury factors and provide recommendations for primary prevention of wrTBI.MethodsConcurrent mixed methods study. The Person-Environment-Occupation (PEO) model served as a theoretical framework for qualitative and quantitative data analyses.ResultsThe sample consisted of 93 workers (51% female, 67% aged over 40) with wrTBI sustained as a result of being struck by/against an object (SBA, 46%), falls (30%), motor vehicle accident (13%), and assault (11%). Qualitative analysis of injury events revealed distinct patterns between male and female workers in the nature and physical/social load of occupational activities performed at the time of injury. Quantitative analysis enriched interpretation of observed sex differences across PEO factors. New insights emerged by stratifying SBA injury cases, revealing sex differences in Environment- and Occupation-related factors unique to workers struck by an object.ImplicationsSex- and cause-specific analysis of injury events is essential for surveillance and prevention of wrTBI. Addressing fitness for duty, supervisor-worker relationships, and industry-specific hazards in prevention strategies is essential to ensure workplace safety.