OBJECTIVE: To identify barriers to return to work after burn injury as identified by the patient.

DESIGN: A cohort study with telephone interview up to 1 year.

SETTING: Hospital-based burn centers at 3 national sites.

PARTICIPANTS: Hospitalized patients (N=154) meeting the American Burn Association criteria for major burn injury, employed at least 20 hours a week at the time of injury, and with access to a telephone after discharge.

INTERVENTION: Patients were contacted via telephone every 2 weeks up to 4 months, then monthly up to 1 year after discharge.

MAIN OUTCOME MEASURES: A return to work survey was used to identify barriers that prevented patients from returning to work. A graphic rating scale determined the impact of each barrier.

RESULTS: By 1 year, 79.7% of patients returned to work. Physical and wound issues were barriers early after discharge. Although physical abilities continued to be a significant barrier up to 1 year, working conditions (temperature, humidity, safety) and psychosocial factors (nightmares, flashbacks, appearance concerns) became important issues in those with long-term disability.

CONCLUSIONS: The majority of patients return to work after a burn injury. Although physical and work conditions are important barriers, psychosocial issues need to be evaluated and treated to optimize return to work.