Article Text

Download PDFPDF
Update on the epidemiology of work-related traumatic brain injury: a systematic review and meta-analysis
  1. Danielle Toccalino1,
  2. Angela Colantonio2,3,
  3. Vincy Chan1,3
  1. 1 Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Ontario, Canada
  2. 2 Department of Occupational Science and Occupational Therapy; Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
  3. 3 KITE -Toronto Rehabilitation Institute, University Health Network, Toronto, Ontario, Canada
  1. Correspondence to Danielle Toccalino, Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, ON M5S 1A1, Canada; danielle.toccalino{at}


Background Traumatic brain injury (TBI) is a public health concern that can occur in a range of contexts. Work-related TBI (wrTBI) is particularly concerning. Despite overall work-related injury claims decreasing, the proportion of claims that are wrTBI have increased, suggesting prevention and support of wrTBI requires ongoing attention.

Objectives This review aimed to provide updated information on the burden and risk factors of wrTBI among the working adult population.

Methods Medline, Embase, PsycINFO, and Cumulative Index to Nursing and Allied Health Literature (CINAHL) were searched using a combination of TBI, work, and epidemiology text words and medical subject headings. Two reviewers independently assessed articles for inclusion. Meta-analyses were conducted to estimate prevalence and mortality of wrTBI and a narrative synthesis was conducted to provide additional context.

Results Pooled proportions meta-analyses estimate that 17.9% of TBIs were work-related and 6.3% of work-related injuries resulted in TBI, with 3.6% of wrTBI resulting in death. Populations of wrTBI were predominantly male (76.2%) and were 40.4 years of age, on average. The most commonly reported industries for wrTBI were education and training, healthcare and social assistance, construction, manufacturing, and transportation. Falls, being struck by an object or person, motor vehicle collisions, and assaults were the most commonly reported mechanisms of wrTBI.

Conclusions A better understanding of the epidemiology of wrTBI can inform prevention and management strategies. This review highlights existing gaps, including a notable lack of sex or gender stratified data, to direct future investigation.

PROSPERO registration number CRD42020169642.

  • epidemiology
  • health and safety
  • injury
  • meta-analysis
  • accidents

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.


  • Contributors DT and AC conceptualised the study as an update to a previous review conceptualised by AC and colleagues (Chang et al. 2015). DT updated the search strategy and conducted the search. DT and VC screened titles/abstracts and full-text articles for inclusion. DT extracted data from included articles and conducted quality appraisals of included studies; extracted data and quality appraisals were peer reviewed by VC. DT conducted meta-analyses and drafted the manuscript. VC and AC critically reviewed the manuscript, and all authors read and approved the final manuscript.

  • Funding The first author (DT) was supported through a research grant awarded to Christine Wickens and Robert Mann by the Workplace Safety and Insurance Board (Ontario) on which the second and last authors (AC and VC) were coinvestigators. This research was undertaken, in part, thanks to funding from the Canada Research Chairs Program.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.