Trajectory and predictors of return-to-work outcomes for people after a road traffic injury: A prospective cohort study

Identifying factors influencing work after road traffic injuries (RTI) is important for developing early and appropriate interventions. Purpose : This study aimed to quantify vocational outcomes up to 12 months after RTIs; to explore Return to work (RTW) trajectories over this period; and to identify predictors of RTW status and disability days at baseline, 6, and 12 months post-RTI. Methods : Individuals aged 18 to 64 years with mild to serious RTI presenting to two Australian public hospital emergency departments were recruited. Exclusions were severe injury and not being in paid employment pre-injury. Assessment occurred at baseline, six months, and 12 months post-RTI. Results : Sixty-three participants completed the baseline survey. By 12 months, 88% had returned to work, mostly with work modifications, while 13% experienced at least one RTW failure. Mean disability days were 48 (SD= 93). Predictors of RTW at baseline were lower injury severity, less pain/disability, and younger age (R²=0.65, p<0.05); at 6 months, being a casual/part-time employee (R ² = 0.2, p<0.05) and at 12 months, higher pre-injury income (R ² = 0.25, p<0.05). Predictors of more disability days at baseline included being male, hospital admission, greater injury severity, greater disability, lodging a compensation claim, and higher distress from intrusion (R ² = 0.53, p<0.05); at 6 months, older age and lower RTW self-efficacy (R ² = 0.18, p<0.05); and at 12 months, older age, lower level of education, greater injury severity, and casual/part-time pre-injury employment (R ² = 0.29, p<0.05). Conclusions : RTW after RTI is a dynamic, staged process. Early outcomes are primarily health-related, whereas 6–12-month outcomes are shaped by psychosocial factors. Sustained RTW often requires work modifications, underscoring the need for coordinated, systems-based rehabilitation strategies.