Barriers to employment among working-aged patients with major burn injury.

TitleBarriers to employment among working-aged patients with major burn injury.
Publication TypeJournal Article
Year of Publication2001
AuthorsFauerbach JA, Engrav LH, Kowalske KJ, Brych S, Bryant A, Lawrence J, Li G, Munster A, de Lateur B
JournalJ Burn Care Rehabil
Volume22
Issue1
Pagination26-34
Date Published2001 Jan-Feb
ISSN0273-8481
KeywordsAdolescent, Adult, Age Distribution, Burns, Disability Evaluation, Disabled Persons, Employment, Female, Humans, Injury Severity Score, Logistic Models, Longitudinal Studies, Male, Middle Aged, Multicenter Studies as Topic, Prevalence, Probability, Prospective Studies, Reference Values, Sex Distribution, Unemployment, United States
Abstract

The purpose of this study was to examine the prevalence of preexisting and burn-related impairments and to describe their association with preburn employment status. Data gathered during the acute hospitalization were analyzed on a consecutive series of burn patients aged 16 to 64 years (N = 770) enrolled in a prospective, longitudinal, multicenter study. Patients who were unemployed before the injury were more likely than those who were employed to report being alcohol-dependent (36 vs 18%), abusing other drugs (22 vs 10%), having received psychiatric treatment in the past year (21 vs 6%), and having preexisting physical disability (23 vs 3%); all were significant at P < .001). Of the unemployed patients who received toxicologic screening at admission, 49% tested positive for alcohol and 39% positive for other drugs, percentages that were significantly higher than 26 and 31%, respectively, for the employed. With adjustment for age, sex, race, and education, variables that were most predictive of preinjury unemployment status were preexisting physical disability (odds ratio, 51.0; 95% confidence interval, 7.7-336.9) and being alcohol-positive at admission (odds ratio, 2.8; 95% confidence interval, 1.2-6.8). Unemployed and employed patients also differed significantly in injury patterns and clinical outcomes, with inhalation injury and psychiatric distress being more prevalent among the unemployed and both hand burns and hand surgery among the employed. The greater prevalence of preexisting impairments among survivors who were unemployed before the injury helps explain why preburn employment status is such a powerful determinant of postburn work outcomes, and suggests the need to include psychosocial services in a program of comprehensive rehabilitation.

Alternate JournalJ Burn Care Rehabil
PubMed ID11227681