Clinical, social, and situational determinants of prolonged recovery after commuting.

BACKGROUND: Prolonged recovery from work following commuting accidents entails substantial personal, social, and economic costs; however, the social and health determinants of delayed recovery remain comparatively underexplored. Identifying factors associated with extended recovery is essential for informing prevention strategies and strengthening return-to-work policies. METHODS: Administrative records from Mutual de Seguridad (Chile) were analyzed using a balanced sample of 10,940 commuting accidents (50% with recoveries of ≥ 90 days and 50% with recoveries of < 90 days). Prolonged recovery was defined as an absence of 90 days or more. A probit model was estimated, and average marginal effects (AMEs) were computed. The dataset was randomly divided into training (70%) and validation (30%) samples to assess model stability. RESULTS: The validation model confirmed the robustness of the estimated effects. A greater probability of prolonged recovery was observed among male workers (10%), individuals aged 45 years or older (12%), individuals with multiple diagnoses (20%), and cases classified as severe (59%). Situational factors were also relevant: Commuting accidents occurring between 18:00 and 24:00 h (6%) and during the Friday-Sunday period (5%) were associated with an increased likelihood of extended absence. In contrast, injuries classified as traumatic were associated with a lower probability of prolonged recovery (-43%). CONCLUSION: The findings underscore the importance of considering not only individual and clinical characteristics but also situational factors when designing prevention and return-to-work strategies for commuting-related injuries. Preventive policies should prioritize older workers, men, and late-day and late-week (Friday-Sunday) commuting contexts while recognizing that accident frequency does not necessarily coincide with the recovery burden. A commuting-specific perspective may strengthen occupational risk management and contribute to reducing prolonged work absence.