Traumatic brain injury (TBI) can occur through various mechanisms, including violence and car crashes, but the mechanism of TBI I am focusing upon today is through a work-related injury. As a wife and mother, I know that I want my husband to return from work at the end of each shift in relatively the same condition as when he left for his shift, albeit a little more grubby! You can understand my alarm, then, as I read an article by Chang, Ruseckaite, Collie and Colantonio which explores the epidemiology of 4186 husbands, wives, mothers, fathers, sisters, brothers, sons, daughters, aunts, uncles, grandparents and grandchildren who did not come home from work in the same state as they went to work.

The Authors examined the TBI workers’ compensation claims during the period 2004-2011 in the Australian state of Victoria, identifying clear gender differences in the experience of TBI. To illustrate, male employees were considerably more likely to sustain a TBI (nearly 64% of claims were male), which may reflect the difference in occupations apparent across the claims (males worked predominantly as tradesmen/technicians, machinery operators/drivers, and labourers; females as professionals/scientific/technical services and community/personal service workers).

TBIs were incurred most commonly by being struck by/against an object (53%), falls (24%), assaults/violence (13%) and car crash (7%), with struck by/against accounting for a greater proportion of female TBI, and assaults/violence and car crashes accounting for a greater proportion of male TBI. Interestingly, most falls for males were found to occur from a height, whilst females were more likely to fall from the same level. Notwithstanding this, the proportion of falls increased for both genders with increasing age. For TBI victims who claimed lost-work-time,  the TBI resulted in an average of 219 days of work disability, at a claim cost of $96,343 on average. Males were more likely to be hospitalised, and for longer, with commensurate greater TBR-associated costs.

What does this mean for intervention? While a gradual downward trend in TMR was observed throughout the measurement period, particularly for males, as a wife with a husband who operates a very large machine and is at risk of a TBI during every work shift, I want to be sure that everything is being done to keep him – and other workers – safe. This means safe policies and practices in government regulations, workplace conditions, company management, and by him and his offsiders. It means regular equipment maintenance, including equipment repair, and the provision of personal protective equipment in addition to fully-functioning guards on the machine and rails on the catwalk. It means reasonable work expectations and management of customer demands, particularly as his company operates 24-hours a day to meet the demands of a 24-hour society. It means support at work, including through risk management and rehabilitation in case of injury. It means responsibility for safety at all levels, from government, to managers, to those on the coalface. It means a culture of safety, not a culture of shifting the blame if something does go wrong and someone is injured. It means learning from the past -for the present and the future – including learning from epidemiological studies such as Chang et al.

Let’s keep our workers safe, and for reasons beyond the negative impact upon the employer’s hip pocket.