Commuting Accidents and Sickness Absence Among Health and Social Care Workers in Spain: The Role of Age and Accident Characteristics

Background/Objectives: Commuting occupational accidents represent an important but comparatively understudied component of occupational risk among healthcare workers. This study aimed to characterise commuting accidents resulting in sickness absence among workers in the Spanish health and social care sector and to examine associations of age, sex, traffic involvement, commuting direction, and injured body part with sickness absence duration. Methods: This retrospective observational study used secondary administrative data from Spanish occupational accident reports registered through the Delt@ system. We analyzed 139,412 commuting occupational accidents resulting in sickness absence among health and social care workers during 2011–2023. Descriptive and bivariate analyses were complemented by zero-truncated negative binomial regression, with age modelled using a restricted cubic spline and adjustment for sex, traffic involvement, commuting direction, injury site, activity division, workplace province, occupation, source-file year, and employment-contract code. Descriptive and bivariate analyses were conducted using IBM SPSS Statistics version 29. Results: Mean recorded sickness absence duration was 44.15 days. Adjusted mean duration increased non-linearly with age, from 30.59 days at age 25 to 59.24 days at age 65. Traffic involvement and return journeys were associated with longer adjusted mean durations (mean ratios 1.271 and 1.102, respectively). Shoulder, arm and other upper-limb sites and wrist injuries had the largest injury-site contrasts. Sex was not associated with duration in the primary model, but a modest difference emerged after additional adjustment for injury type and severity. Conclusions: Older age, traffic involvement, return journeys, and injury site were associated with recorded sickness absence duration after expanded adjustment. The age association was non-linear, and the sex association depended on clinical adjustment. The findings support considering both accident occurrence and recorded absence burden in commuting prevention.