{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,22]],"date-time":"2026-10-22T00:28:30Z","timestamp":1792628910208,"version":"4.5.0"},"reference-count":21,"publisher":"BMJ","issue":"10","license":[{"start":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T00:00:00Z","timestamp":1603238400000},"content-version":"unspecified","delay-in-days":20,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100011897","name":"Rockwool Fonden","doi-asserted-by":"publisher","award":["NA (PF)"],"award-info":[{"award-number":["NA (PF)"]}],"id":[{"id":"10.13039\/501100011897","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006636","name":"Forskningsr\u00e5det om H\u00e4lsa, Arbetsliv och V\u00e4lf\u00e4rd","doi-asserted-by":"publisher","award":["Grant no. 2016-07099 (PF)"],"award-info":[{"award-number":["Grant no. 2016-07099 (PF)"]}],"id":[{"id":"10.13039\/501100006636","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2020,9,15]]},"published-print":{"date-parts":[[2020,10]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Concussions are the most frequent traumatic brain injuries. Yet, the socioeconomic impact of concussions remains unclear. Socioeconomic effects of concussions on working-age adults were studied on a population scale.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This population-based, event time study uses administrative data as well as hospital and emergency room records for the population of Denmark.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>We study all Danish patients, aged 20\u201359 years, who were treated at a public hospital or at an emergency room between 2003 and 2017 after suffering a concussion without other intracranial or extracranial injuries (n=55 424 unique individuals). None of the patients had a prior diagnosis of intracranial or extracranial injuries within the past 10 years leading up to the incident.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>As primary endpoint, we investigate the mean effect of concussion on annual salaried income within a 5-year period after trauma. In an exploratory analysis, we study whether the potential impact of concussion on annual salaried income is driven by patient age, education or economic cycle.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Concussion was associated with an average change in annual salary income of \u2212\u20ac1223 (95% CI: \u2212\u20ac1540 to \u2212905, p&lt;0.001) corresponding to a salary change of \u22124.2% (95% CI: \u22125.2% to \u22123.1 %). People between 30 and 39 years and those without high school degrees suffered the largest salary decreases. Affected individuals leaving the workforce drove the main part of the decrease. Absolute annual effect sizes were countercyclical to the unemployment rate.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Concussions have a large and long-lasting impact on salary and employment of working-age adults on a nationwide scale.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2020-038161","type":"journal-article","created":{"date-parts":[[2020,10,21]],"date-time":"2020-10-21T17:21:51Z","timestamp":1603300911000},"page":"e038161","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":22,"title":["Effect of concussion on salary and employment: a population-based event time study using a quasi-experimental design"],"prefix":"10.1136","volume":"10","author":[{"given":"Peter","family":"Fallesen","sequence":"first","affiliation":[{"name":"Swedish Institute for Social Research, Stockholm University, Stockholm, Sweden"},{"name":"ROCKWOOL Foundation, Copenhagen, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7243-8333","authenticated-orcid":false,"given":"Benito","family":"Campos","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany"},{"name":"Department of Health Tech, Technical University of Denmark, Lyngby, Denmark"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,10,21]]},"reference":[{"key":"2025121511142996000_10.10.e038161.1","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/16501960410023732","article-title":"Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre Task force on mild traumatic brain injury","author":"Cassidy","year":"2004","journal-title":"J Rehabil Med"},{"key":"2025121511142996000_10.10.e038161.2","unstructured":"Pinner M , Jensen R , Birket-Smith M , et al . Konsensusrapport Om commotio cerebri (hjernerystelse). Videnscenter for Hjerneskade 2003."},{"key":"2025121511142996000_10.10.e038161.3","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp-2011-300767"},{"key":"2025121511142996000_10.10.e038161.4","doi-asserted-by":"publisher","DOI":"10.1097\/00001199-200511000-00009"},{"key":"2025121511142996000_10.10.e038161.5","doi-asserted-by":"publisher","DOI":"10.1097\/HTR.0b013e31825ad658"},{"key":"2025121511142996000_10.10.e038161.6","doi-asserted-by":"crossref","first-page":"1674","DOI":"10.1080\/02699052.2017.1332783","article-title":"Quality of return to work in patients with mild traumatic brain injury: a prospective investigation of associations among post-concussion symptoms, neuropsychological functions, working status and stability","volume":"31","author":"Chu","year":"2017","journal-title":"Brain Inj"},{"key":"2025121511142996000_10.10.e038161.7","doi-asserted-by":"crossref","first-page":"1560","DOI":"10.1016\/j.apmr.2017.01.010","article-title":"Work limitations 4 years after mild traumatic brain injury: a cohort study","volume":"98","author":"Theadom","year":"2017","journal-title":"Arch Phys Med Rehabil"},{"key":"2025121511142996000_10.10.e038161.8","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0191655","article-title":"Population-Based cohort study of the impacts of mild traumatic brain injury in adults four years post-injury","volume":"13","author":"Theadom","year":"2018","journal-title":"PLoS One"},{"key":"2025121511142996000_10.10.e038161.9","doi-asserted-by":"publisher","DOI":"10.1016\/j.apmr.2013.10.010"},{"key":"2025121511142996000_10.10.e038161.10","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2018-026104"},{"key":"2025121511142996000_10.10.e038161.11","unstructured":"Ogilvie D , Adams J , Bauman A , et al . Using natural experimental studies to guide public health action: turning the evidence-based medicine paradigm on its head. J Epidemiol Community Health."},{"key":"2025121511142996000_10.10.e038161.12","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1257\/aer.20161038","article-title":"The economic consequences of hospital admissions","volume":"108","author":"Dobkin","year":"2018","journal-title":"Am Econ Rev"},{"key":"2025121511142996000_10.10.e038161.13","doi-asserted-by":"crossref","unstructured":"Fadlon I , Nielsen TH . Household responses to severe health shocks and the design of social insurance. Cambridge, MA, 2015.","DOI":"10.3386\/w21352"},{"key":"2025121511142996000_10.10.e038161.14","doi-asserted-by":"publisher","DOI":"10.2147\/CLEP.S91125"},{"key":"2025121511142996000_10.10.e038161.15","unstructured":"Statistics Denmark . Documentation of statistics: Income Statistics - Statistics Denmark, 2015. Available: https:\/\/www.dst.dk\/en\/Statistik\/dokumentation\/documentationofstatistics\/income-statistics [Accessed 20 Aug 2018]."},{"key":"2025121511142996000_10.10.e038161.16","first-page":"625621","article-title":"Working with mild traumatic brain injury: voices from the field","volume":"2012","author":"Buck","year":"2012","journal-title":"Rehabil Res Pract"},{"key":"2025121511142996000_10.10.e038161.17","doi-asserted-by":"crossref","first-page":"733","DOI":"10.3109\/09638288.2015.1061608","article-title":"Prognostic factors of return to work after traumatic or non-traumatic acquired brain injury","volume":"38","author":"Donker-Cools","year":"2016","journal-title":"Disabil Rehabil"},{"key":"2025121511142996000_10.10.e038161.18","doi-asserted-by":"publisher","DOI":"10.1017\/S174413310700401X"},{"key":"2025121511142996000_10.10.e038161.19","doi-asserted-by":"crossref","first-page":"681","DOI":"10.1089\/neu.2017.5169","article-title":"Correlation of concussion symptom profile with head impact biomechanics: a case for individual-specific injury tolerance","volume":"35","author":"Rowson","year":"2018","journal-title":"J Neurotrauma"},{"key":"2025121511142996000_10.10.e038161.20","doi-asserted-by":"publisher","DOI":"10.1080\/02699050601111419"},{"key":"2025121511142996000_10.10.e038161.21","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1080\/16501960410023732","article-title":"Incidence, risk factors and prevention of mild traumatic brain injury: results of the who collaborating centre Task force on mild traumatic brain injury","volume":"36","author":"Cassidy","year":"2004","journal-title":"J Rehabil Med"}],"container-title":["BMJ Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bmjopen-2020-038161","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,15]],"date-time":"2025-12-15T19:14:39Z","timestamp":1765826079000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmjopen.bmj.com\/lookup\/doi\/10.1136\/bmjopen-2020-038161"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,10]]},"references-count":21,"journal-issue":{"issue":"10","published-online":{"date-parts":[[2020,10,21]]},"published-print":{"date-parts":[[2020,10]]}},"alternative-id":["10.1136\/bmjopen-2020-038161"],"URL":"https:\/\/doi.org\/10.1136\/bmjopen-2020-038161","relation":{},"ISSN":["2044-6055","2044-6055"],"issn-type":[{"value":"2044-6055","type":"print"},{"value":"2044-6055","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,10]]}}}