Utility of Person–Environment–Occupation Model in Exploring Sex-Specific Causes of Work-Related Traumatic Brain Injury: a Retrospective Chart Review

ABSTRACT Background Work-related traumatic brain injury (wr-TBI) is on the rise. The pre-injury period, a significant consideration for preventive initiatives, is largely unexplored. Objectives To identify Person–Environment–Occupation (PEO) variables associated with wr-TBI to inform sex-specific primary prevention. Methods Retrospective chart review data were analyses. Two-tailed t-test and chi-squared tests were used to study sex differences. Multivariate logistic regression models of wr-TBI were fit with a priori defined PEO variables. Results The sample comprised 330 consecutive workers with wr-TBI (40.8 ± 11.1 years old, 71% male). Sex differences were observed across PEO variables. In multivariable logistic regression analyses the odds of sustaining a wr-TBI from a fall increased with the presence of a mood disorder and participation in non-labourer occupations (odds ratio (OR) 2.89 (95% CI 1.06–7.89) and OR 2.89 (95% CI 1.06–7.89), respectively) and decreased being a male (OR 0.31 (95% CI 0.17–0.54)). The odds of sustaining a wr-TBI from being striken by an object was greater in workers with prior head injury (OR 2.8 (95% CI 1.24–6.45)). None of the variables studied were associated with wr-TBI sustained from being striken against an object. Conclusions Workers’ health status pre-injury is associated with external causes of wr-TBI. Sex differences across PEO categories warrant further study.