This study investigates the barriers to return to work after burn injury. The electronic records of burn survivors treated at a Regional Burn Center outpatient clinic from 2001 to 2007 were retrospectively reviewed. Inclusion criteria included employment at the time of burn injury and age 18 years or older. Documentation of barriers to return to work were reviewed and classified into eight categories. Logistic regression analysis was used to determine predictors of return to work at more than 1 year. Ordered logistic regression analysis was performed to determine barrier predictors of employment. The authors identified 197 patients for inclusion in the study. The age was 37 +/- 0.8 (mean +/- SEM) and total body surface area burned was 16 +/- 1.3%. Two thirds (n = 132) of subjects returned to work by 1 year. The most common barriers included pain (n = 79), neurologic problems (n = 69), impaired mobility (n = 58), and psychiatric issues (n = 51). Pain was the most frequent barrier to return to work at all time intervals. Significant predictors of return to work at more than 12 months included length of hospital stay, inpatient rehabilitation, electric etiology, and burn at work (P < .05). Impaired mobility was a statistically significant (P < .05) barrier and other medical issues showed a trend toward statistical significance (P = .054) in predicting return to work at more than 12 months. There are many barriers that impede return to work in the burn population, including pain, neurologic problems, impaired mobility, and psychiatric issues. Early identification of those at risk for prolonged unemployment should prompt expeditious referral to comprehensive rehabilitation services that include work hardening and vocational training programs.

This study compares employment rates and barriers to return to work in subjects burned at work with those burned outside of work. Further, this study examines the influence of electrical etiology on return to work outcomes. The electronic records of burn survivors treated at a Regional Burn Center outpatient clinic from 2001 to 2007 were retrospectively reviewed. Inclusion criteria included employment at the time of burn injury and age of 18 years or older. Demographic and medical data were collected. Documentation of barriers to return to work was reviewed and classified into eight categories. Return to employment was grouped into four time intervals: 0 to 3, 3 to 6, 6 to 12, and greater than 12 months after injury. Logistic regression analysis was used to determine predictors of unemployment at greater than 1 year for subjects burned at work, outside of work, and those burned at work without electric injury. The authors identified 197 patients for inclusion in the study. Their age was 37 ± 0.8 years (mean ± SEM), and TBSA burned was 16 ± 1%. Fifty percent of subjects were burned at work. Electric etiology was seen only in those burned at work (n = 24). Forty-four percent (n = 43) of subjects injured at work remained unemployed at 1 year compared with 22% (n = 22) of subjects injured outside of work. The most frequent employment barriers included pain (72%), neurologic problems (62%), and psychiatric problems (53%) for those burned at work; and pain (63%), neurologic problems (59%), and impaired mobility (54%) for those burned outside of work. Significant predictors of unemployment at greater than 12 months included burn at work, pain, impaired mobility, other medical problems, and inpatient rehabilitation (P < .05). When the electrical injury subjects are removed from the analysis, significant predictors of unemployment at 12 months include burn at work, pain, inpatient rehabilitation, and length of stay (P < .05). Burn survivors experience multiple complex barriers in returning to work. Burn at work is a significant predictor of unemployment at 1 year even after controlling for electric etiology. Further study is required to better understand the influence of work setting on employment outcomes.