The impact of major occupational injuries on professional reintegration. A Portuguese medico-legal contribution |
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| Institution: | 1. CINTESIS, Faculty of Medicine, University of Porto, Alameda Prof. Hernâni Monteiro, 4200-319, Porto, Portugal;2. CRPG – Centro Reabilitação Profissional de Gaia, Av. João Paulo II, 961, 4410-406, Arcozelo, Vila Nova de Gaia, Portugal;3. Porto Healthcare Unity - Accidents, Fidelidade - Insurance Company, Rua Direita de Campinas 324, 4100-207, Porto, Portugal;4. IINFACTS - Institute of Research and Advanced Training in Health Sciences and Technologies, Department of Sciences, University Institute of Health Sciences (IUCS), CESPU, CRL, Rua do Paço 5, Penafiel, Gandra, Portugal;1. Division of cardiovaskular epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Box 210, SE-17177 Stockholm, Sweden;2. Scandinavian College of Naprapathic Manual Medicine, Kräftriket 23A, SE-11419 Stockholm, Sweden;3. Division of Public Health Epidemiology, Department of Public Health Sciences, Karolinska Institutet, Norrbacka, SE-171 76 Stockholm, Sweden;4. Alberta Centre for Injury Control and Research, School of Public Health, University of Alberta, 4075 RTF, 8308 114 St, Edmonton, AB T6G 2E1, Canada;5. Occupational and Industrial Orthopaedic Center (OIOC), NYU Hospital for Joint Diseases, New York University Langone Medical Center, 63 Downing St, New York, NY 10014, USA;1. Department of Surgery, North Carolina Jaycee Burn Center, School of Medicine, University of North Carolina at Chapel Hill, 4008 Burnett Womack Building, CB 7228, Chapel Hill, NC, USA;2. Department of Surgery, North Carolina Jaycee Burn Center, University of North Carolina at Chapel Hill, 4004 Burnett Womack Building, 101 Manning Drive, Chapel Hill, NC 27599, USA;1. The Forensic Panel, United States;2. Iowa State University, United States;1. Division of Forensic Dentistry, Faculdade Sao Leopoldo Mandic, Brazil;2. Post-Graduate Program in Dentistry, School of Dentistry, Federal University of Uberlândia, Brazil;3. School of Dentistry, Federal University of Uberlândia, Brazil;4. Crime Scene Investigation, General Institute of Forensics, Santa Catarina, Brazil;5. Division of Preventive and Community Dentistry, School of Dentistry, Federal University of Uberlândia, Brazil;6. Department of Therapeutic Stomatology, Sechenov University, Russia;1. Faculty of Medicine, University of Jordan, Head of Forensic Division, Jordan University Hospital, Amman, Jordan;2. King Fahd Military Medical Complex, P.O.Box No. 946, Dhahran, 31932, Saudi Arabia;3. An-Najah National University, Nablus, Palestine;4. Analytical Toxicology, University of Jordan, Jordan |
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| Abstract: | Occupational injuries represent an enormous economic impact for victims, respective families, involved institutions and all the community due to professional outcomes. Thus, it is of the utmost importance that medico-legal personal injury assessment and the posterior follow-up of these victims, may allow their concrete damage repair, considering the victims' needs fulfilment and professional reintegration, whenever possible. The main objective of this study is to reflect on the role that legal medicine can play in promoting the professional reintegration of victims of major occupational accidents through the analysis of occupational injuries cases considering the medico-legal examinations performed. A retrospective study was conducted using medico-legal major occupational injuries cases (Partial Permanent Disability ≥40%). Data were collected from two medico-legal assessment moments: (a) personal injury assessment homologated by a labour court 4.8 years on average after occupational injury; (b) medico-legal follow-up for needs and/or Partial Permanent Disability adjustments performed 18.9 years on average after occupational injury. The final sample includes 103 cases. The results showed that in major occupational accidents, permanent long-term outcomes were principally associated with neurological (62.1%) and orthopaedic (52.4%) sequelae. Permanent professional damage parameters assigned by the labour court included Partial Permanent Disability (23.3%), Permanent Absolute Disability for Regular Work (41.7%) and Permanent Absolute Disability for Any Work (35%). Three-dimensional methodology is helpful in predicting Partial Permanent Disability and Permanent Absolute Disability for Any Work. However, three-dimensional methodology did not reveal correlations with Permanent Absolute Disability for Regular Work, and currently 65% of the victims who were considered able to work by the labour court are not professionally active. Thus, these major cases deserve a more detailed medico-legal approach based on concrete information about the professional reality of each victim, especially cases with an eventual Permanent Absolute Disability for Regular Work. Medico-legal Injury Assessment must be based on concrete aspects of the victim's professional reality and not only on permanent disability tables. This calls for an articulation between all institutions working with the victim of occupational injuries and legal medicine to promote recovery and the necessary measures to assure professional rehabilitation. |
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| Keywords: | Occupational injury Professional outcomes Professional reintegration Injury assessment Legal medicine |
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