A study at an academic medical center found that employees who experienced a work-related injury within their six months of employment were more than twice as likely to have three or more lost-time injuries for the duration of their tenure.

Findings from the study, Do Work-Related Lost-Time Injuries Sustained Early in Employment Predict Multiple Lost-Time Injuries Throughout Employment? published in the October 2019 edition of the Journal of Occupational and Environmental Medicine, are based on 5,906 injuries followed from 1994 to 2017, or 1,046,218 person years.

Researchers found that the odds ratio of having three or more lost-time injuries was 2.12 for employees having their first lost-time injury within the first six months of employment versus those injured after that, controlling for demographics and employment duration. For each increasing year before the first lost-time injury, the probability of having three or more lost-time injuries decreased by 13 percent.

The authors concluded that employment duration before the first lost-time injury may be used to predict future lost-time injuries without detailed information of underlying risk factors.

What’s the Significance?

WorkCare’s Executive Chairman and Chief Medical Officer Peter P. Greaney, M.D., says a number of factors can contribute to the occurrence of an injury early in a person’s employment. For example, there may be a poor match between the employee and essential job functions, insufficient training or misalignment between the employee’s personal characteristics and the company’s culture.

According to Dr. Greaney, a board-certified occupational physician, a training or cultural issue is usually the byproduct of a systemic employer approach that rarely gets fixed, in turn increasing the likelihood of an initial injury and a recurrence. Once a person becomes injured, he or she learns how the system works and identifies perceived benefits derived from that condition – such as monetary, days away from work, job accommodation, medications (possibly including opioids), and attention (positive or negative) from supervisors and managers, friends and family. The bottom line is that some needs are met.

As life crises emerge, the employee reverts to behavior that was positively reinforced from earlier experiences. An injury event does not have to be contrived. It may be all subconscious and driven by pain mechanisms.

Related Research

Related research supports the use of preventive interventions, including training, to address correlations between early employment and injury risks. Here are three examples:

• 1. Among 58,271 workers who experienced 10,260 injuries, those with job tenure of less than six months showed higher relative injury risk compared to employees with job tenure of more than two years. Relative injury risk was 41 percent higher among workers under age 30 and 22 percent higher among people over 40. Authors’ conclusion: “If institutions don’t adopt appropriate prevention policies, injury risk is likely to increase, especially among young people.”
• 2. A 10-year study of the association between job tenure and lost-time claim rates found significantly higher rates among workers with shorter job tenure. Authors’ conclusion: Elevated risk among new workers suggests the need to improve training, reduce exposures, promote permanent employment, and monitor work injury trends and risk factors.
• A 2014-15 study of Tennessee construction workers found 44.5 percent of reported injuries were sustained by workers with tenure of one year or less. The three most common types of injuries (strain, laceration and contusion) accounted for 62 percent of the top ten types of injuries. Authors’ conclusion: The importance of new employee “on-boarding” orientation cannot be over emphasized. Contents should include injury incidence data and training for temporary workers.

A WorkCare Solution

WorkCare’s Incident Intervention® program supports immediate reporting of non-emergency work-related injuries and early telehealth intervention by occupational physicians and nurses, optimally within the “golden hour” following onset. About 75 percent of the time employees elect to follow self-care guidance at the first-aid level and are able to safely go back to work in a full or temporarily modified capacity. Those who choose to visit a clinic or are referred to a local provider by a WorkCare clinician are positioned to receive the right care, at the right time, in the right setting. Only a small percentage of incidents result in lost work time.

In all cases, a positive initial injury care experience helps improve outcomes and reduce the likelihood of injury recurrence.