"Work-related traumatic brain injuries (wrTBIs) in the construction industry have been studied in North America but, to the best of our knowledge, not in Europe. This study analyzed sets of public data on head injuries occurring in the construction industry from the workers' compensation systems in Sweden and Germany, 2014 – 2018.
The ratio of wrTBI varied from 11% to 61% of all head injuries, with higher ratios for more severe injuries. The average yearly incidence (per 100,000 FTE) of wrTBI resulting in more than four days absence from work was nine in Sweden and 117 in Germany, as compared to 22–212 in North American studies. A limitation of studies based on workers' compensation claims is that they underestimate the true burden of wrTBI.
The most frequent events leading to wrTBI were falls, followed by loss of control, failure of material agents, and body movements without stress. Falls from a height caused 35% of all wrTBI with more than 14 days off work in Sweden and 57% of all new injury pensions granted in Germany. In North American studies, 52–78% of the wrTBI were caused by falls. This highlights the relevance of fall safety measures to reduce wrTBI in the construction industry, such as avoiding work at heights, use of safety nets, education, and etcetera. The energy absorption of safety helmets mainly protects the head excluding face of which 49–62% were wrTBI, indicating that helmet testing standards should evaluate protection against TBI as well as skull fractures."

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