Anxiety and Adult ADHD Symptoms Among Occupational Injury Cases Presenting to the Emergency Department: A Cross-Sectional Study

Abstract

Background: Work-related injuries have economic and psychosocial consequences. Emerging evidence suggests neurocognitive and affective factors, including attention deficit hyperactivity disorder (ADHD) symptoms and anxiety, may contribute to occupational injury risk; however, data integrating these factors in emergency department (ED) settings remain limited. This study aimed to compare ADHD and anxiety symptom burden between adults with occupational injuries and age- and sex-matched non-injured controls and to evaluate symptom associations with occupational injury. Methods: Adults presenting to a tertiary ED in Türkiye with occupational injuries and age- and sex-matched non-injured controls were assessed using the Adult ADHD Self-Report Scale (ASRS) and Beck Anxiety Inventory (BAI). Sociodemographic, occupational, hazard, injury, and clinical variables were recorded. Logistic regression evaluated factors independently associated with occupational injury, and correlations with sleep duration were analyzed. Findings: A total of 609 participants were included (292 injured; 317 controls). Injured workers showed higher ASRS and BAI scores than controls ( p < .05). ASRS and BAI scores demonstrated gradients across occupational hazard class, trauma mechanism, and clinical outcomes, including hospitalization and impairment. Prior injury history was more frequent among injured workers. In multivariable analysis, occupational hazard class, ASRS scores, and BAI scores remained independently associated with occupational injury. Sleep duration showed moderate negative correlations with ASRS and BAI scores. Conclusions/Application to Practice: Adult ADHD and anxiety symptoms were associated with occupational injury in ED presentations. Screening for neurocognitive and affective vulnerabilities, together with fatigue and sleep management strategies, may enhance occupational injury prevention efforts. Further longitudinal studies are warranted.

The authors' abstract, as published at the source. Workplace Health & Safety, 2026 · DOI ↗