New York court allows late claim for AIDS phobia

Beulah Crawford, a hospital dietary aide who suffered an occupational needlestick, may add a claim of "AIDS phobia" in a workers' compensation suit against her employer. The New York Supreme Court's Appellate Division ruled against the employer's contention that the 2-year statute of limitations in the Workers' Compensation Law should apply to psychiatric claims that result from occupational injuries. However, the original injury claim must be filed on time. Crawford previously had been awarded workers' compensation benefits because she lost use of her left hand. The ruling could be costly to employers, as psychological injuries are more difficult to verify with the passage of time.     

Surveillance and assessment of workplace assault injuries: analysis of Rhode Island workers' compensation claims 1998-2002

OBJECTIVE: To analyze workplace assault by rate, injury severity, and trends using Rhode Island workers' compensation claim data. METHOD: A total of 6402 workers' compensation assault claims from Rhode Island for the period of 1998 through 2002 was analyzed. Data from the U.S. Department of Labor was used to derive estimates of injury rates. RESULTS: An average rate of 27.7 assaults per 10,000 workers was found and varied only marginally across years. Females filed 75% of all assault claims, though injuries to males resulted in longer periods of indemnification. The total cost of workplace assaults was 7,025,997 dollars, averaging 1097 dollars per claim, and average indemnification duration was 16.8 days per claim. While the assault rate was relatively stable, a notable decline in both cost and indemnification periods over time was discovered. CONCLUSION: The assault rate found was among the highest reported to date, demonstrating that workplace violence remains a significant threat to employee safety. While a decline in incident severity was discovered over time, many outcomes were still serious. Preventive interventions to reduce incidents of workplace assaults among groups at the highest risk should be given highest priority.     

How many injured workers do not file claims for workers' compensation benefits?

BACKGROUND: Anecdotal evidence suggests that there are injured workers who do not file for workers' compensation (WC). Several recent studies support this, and we aim to quantify the extent of under-reporting. METHODS: A Canadian survey asked about work injuries in the previous year, and several questions established eligibility for WC and whether a claim had been filed. The proportion of eligible injuries with a claim was estimated. Logistic regression identified predictors of claim submission. RESULTS: Of 2,500 respondents, 143 had incurred an eligible injury, of whom 57 (40%, 95% CI 32-48%) had not filed a WC claim. Severity of injury was the strongest predictor of not claiming. CONCLUSIONS: Survey respondents reported a substantial degree of under-claiming of WC benefits, contrasting with public attention on fraudulent over-claiming. Policy makers should ensure that all relevant parties are aware of their obligations to report work injuries. This will create a more accurate picture of work safety.     

Occupational injuries among minors doing farm work in Washington State: 1986 to 1989.

BACKGROUND. There is growing evidence that many children are injured while engaged in agricultural work. However, little specific information on farm work-related injuries among minors is available, probably because employment or workers' compensation data for children are hard to obtain. METHODS. Workers' compensation data were used to evaluate occupational injuries among children in Washington State from 1986 through 1989. The frequency and severity of injuries among minors doing farm work were compared with the distributions of injuries among minors working in food service and all other occupations by year of injury, age of injury, and month and hour of injury. RESULTS. A total of 16,481 claims filed by children under age 18 were evaluated. Although farm workers accounted for only 7% of all claims, they made up 36% of claims filed by children under age 14, and 17% of claims filed by children aged 14 or 15. Injuries classified as serious accounted for 26% of farm worker claims compared with only 16% of all claims filed by children. CONCLUSIONS. Although injury rates could not be developed owing to the lack of denominator data, this study demonstrates that farm work is dangerous for young children.     

Natural rubber latex allergy workers' compensation claims: Washington State healthcare workers, 1991-1999

Occupational reaction to natural rubber latex experienced by healthcare employees was examined using data of all workers' compensation claims filed by state-insured healthcare employees in Washington State for the period 1991-1999 (n = 65,703). As latex reaction is not a condition for which there are specific identification codes, these claims were estimated by coupling source and nature of injury records that were consistent with reactions to latex. It was found that the claim rate was on average 2.66 per 10,000 state-insured healthcare workers annually. The most common condition experienced was dermal (84.3%), and most common body part affected was the hand (70.0%). Because few claims cited respiratory or conjunctivitis as reaction experienced, little evidence was discovered to support that glove powder acted as a widespread latex allergen transmitter in healthcare environments. Most cases did not require indemnity payment for lost work time (81.2%), suggesting most reactions were minor. The average cost per natural rubber latex claim was $2,759.10, compared to $3,178.18 for the average healthcare worker claim for all causes. Overall, the average cost per state-insured healthcare worker employed during this time was under $0.74 per year. Nursing aides/orderlies were the most frequent healthcare occupation filing a claim (33.2%). The majority of claimants were female (87.9%), and unmarried workers (52.0%) filed slightly more claims than married workers (48.0%). In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.34 percent of the total was potentially related to natural rubber latex, with other common healthcare workplace items cited more frequently as source of occupational injury.     

Underreporting of work-related injury or illness to workers' compensation: individual and industry factors

OBJECTIVE: We quantified the underreporting of work-related injury or illness to workers' compensation (WC). METHODS: Using data from 2612 wage-earning respondents who participated in the 2002 Washington State Behavioral Risk Factor Surveillance System, we assessed work-related injury or illness in the previous year and identified the factors associated with WC claim filing by logistic regression. RESULTS: The self-reported rate of work-related injury or illness of respondents was 13%. Among those who had a work-related injury or illness, 52% filed a WC claim. After adjustment for age, gender, and race, those who filed WC claims were more likely to be overweight and married. WC claim filing varies considerably across industry and occupation groups holding all other measured factors constant. CONCLUSIONS: Individual and industry/occupation factors are related to underreporting of work-related injury or illness to the WC system.     

Mental health of healthcare workers who experience needlestick and sharps injuries

Healthcare workers (HCWs) are exposed daily to the risk of injury by needlesticks and other medical instruments. However, the psychiatric impacts of such injuries have not been evaluated. The aim of this study was to evaluate the mental health status of HCWs with experiences of needlestick and sharps injuries. A cross-sectional written survey was performed. The psychological symptoms before injury and current status were measured using the Beck Depression Inventory (BDI), Hamilton Anxiety Scale (HAM-A) and Perceived Stress Scale (PSS). The proportions of HCWs with and without needlestick and sharps injuries were 71.1% (n=263) and 28.9% (n=107), respectively. HAM-A and BDI scores were significantly higher among HCWs with injury experiences (p<0.01). HCWs with injury experiences exhibited higher PSS and BDI scores after the injury and higher levels of anxiety and depression. Particular attention should be directed towards the psychological consequences of needlestick and sharps injuries in HCWs.     

Injury Rate Comparisons for Nonmechanized and Mechanized Logging Operations,Washington State, 2005-2014

ABSTRACT

Objectives: Current industry classification systems in the United States do not differentiate mechanized and nonmechanized logging operations. The objectives of this article are to quantify injury risk differences between mechanized and nonmechanized logging operations in Washington State and to evaluate for potential injury risk tradeoffs, such as decreasing traumatic injuries while increasing nontraumatic injuries that might occur when mechanized logging operations are substituted for nonmechanized logging operations.

Methods: Using Washington State workers’ compensation insurance risk classes to differentiate mechanized and nonmechanized logging operations, injury and illness claims data and employer reported hours were used to compare claim rates and to characterize injuries by type of logging operation.

Results: From 2005 to 2014, the accepted Washington State worker’s compensation claim rate for nonmechanized logging was 46.4 per 100 full-time equivalent employees compared to 6.7 per 100 full-time equivalent (FTE) for mechanized logging activities. The rate ratio for comparing nonmechanized to mechanized logging claims rates for all accepted claims was 6.9 (95% Confidence Interval 6.4–7.5). Claim rates for traumatic injury and nontraumatic injuries in nonmechanized logging exceeded comparable rates in mechanized logging activities, although the distribution of types of injury differed by type of logging operation. A greater percentage of accepted claims in nonmechanized logging were traumatic injuries than in mechanized logging (92.2% vs. 85.0%, respectively). In addition, nonmechanized logging had higher total claim and medical costs per FTE and had a higher proportion of claims with lost work time than mechanized logging.

Conclusion: Mechanized logging offers a considerable safety advantage over nonmechanized logging operations. Continued efforts to increase the mechanization of logging operations will result in decreased injury rates.     

Work-related injuries in drywall installation

Administrative data sources were used to describe the work-related injuries of drywall carpenters, to calculate rates of occurrence, and to explore high risk sub-groups. Health insurance eligibility files were used to identify a cohort of active union carpenters affiliated with a union local whose predominant work involved drywall installation in the state of Washington. These files contained the hours worked by each individual for each month between January 1989 and December 1995, providing person-hours at risk as a union carpenter. The Washington Department of Labor and Industries (L&I) provided records of workers' compensation claims filed by these individuals. Over seven years 1773 drywall carpenters filed 2567 workers' compensation claims representing an overall rate of 53.3 per 200,000 hours worked. These claims were filed by 1046 different individuals, or 59.0 percent of the cohort. Claims resulting in paid lost time from work were filed at a rate of 12.5 per 200,000 hours worked (n = 609) by 445 (25.1%) different individuals. The most common mechanisms of injury involved being struck (38.3%), overexertion (28.1%), and falls (13.2%). Struck by injuries most commonly involved cuts to the upper extremity. Overexertion injuries were most commonly described as sprains or strains involving the back. Sheetrock was associated with over 40 percent of these injuries. Falls most commonly involved injuries to the knee followed by the back and multiple injuries. Struck by injuries decreased steadily with increasing age and increasing time in the union. There was a steady increase in the rate of falls with increasing age. Overexertion injuries were responsible for the greatest proportion of costs for medical care, permanent impairment, and paid lost days. The high rates of overexertion injuries among these workers is consistent with known ergonomic stresses on drywall jobs. However, these workers are also at high risk of acute traumatic injuries.     

Work-related eye injuries among union carpenters

Union administrative records were combined with workers' compensation data to identify a cohort of 12,958 active union carpenters, their person-time at risk, and their documented work-related eye injuries between 1989 and 1995 in the state of Washington. The injuries were described using ANSI codes for injury nature, type (mechanism), and source or object associated with the event. Injuries which resulted in paid lost time from work were also described based on the ICD-9 codes attached to claims for their medical treatment. Overall rates of filing compensation claims for eye injuries as well as age, gender, and union local specific rates were calculated. To identify high risk subgroups and explore incident and recurrent events, the person-time and events were stratified by age, gender, time in the union, claim status, and predominant type of work of the union local with which each carpenter was affiliated for multivariate analyses with Poisson regression. Eye injuries were responsible for 12 percent (n = 1730) of workers' compensation claims during this time period, exceeded only by back and finger injuries. Thirty-one claims resulted in paid lost time from work and these cases accounted for one-third of all costs for medical care for eye injuries. At least 10 percent of all medical costs for eye injuries and 35.5 percent of medical costs for eye injuries which resulted in paid lost time were associated with injuries sustained while hammering--a very common carpenter exposure. Claims were filed at an estimated rate of 6.1 per 200,000 hours worked. Individuals with previous compensation claims for eye injuries had rates of injury 1.6 times higher than individuals without previous eye injuries. Rates decreased significantly with age and time in the union. Eye injuries among these union carpenters were very common, but the rate of injuries severe enough to require paid time off work was quite low. These findings raise questions about factors which might influence the failure to use appropriate protection including availability and acceptability of eye protection, use by peers, and perception of risk.     

Assessment of occupational eye injury risk and severity: an analysis of Rhode Island workers' compensation data 1998-2002

BACKGROUND: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions. METHODS: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations. RESULTS: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05). CONCLUSIONS: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees.     

Work-related pain and injury and barriers to workers' compensation among Las Vegas hotel room cleaners

OBJECTIVES: We examined the prevalence of work-related pain and injury and explored barriers to and experiences of reporting among workers. METHODS: We surveyed 941 unionized hotel room cleaners about work-related pain, injury, disability, and reporting. RESULTS: During the past 12 months, 75% of workers in our study experienced work-related pain, and 31% reported it to management; 20% filed claims for workers' compensation as a result of work-related injury, and 35% of their claims were denied. Barriers to reporting injury included "It would be too much trouble" (43%), "I was afraid" (26%), and "I didn't know how" (18%). An estimated 69% of medical costs were shifted from employers to workers. CONCLUSIONS: The reasons for underreporting and the extent of claim denial warrant further investigation. Implications for worker health and the precise quantification of shifting costs to workers also should be addressed.     

Prevalence and prevention of needlestick injuries among health care workers in a German university hospital

Objective Health care workers (HCWs) are exposed to bloodborne pathogens, especially hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency virus (HIV) through job-related risk factors like needlestick, stab, scratch, cut, or other bloody injuries. Needlestick injuries can be prevented by safer devices. Methods The purpose of this study was to investigate the frequency and causes of needlestick injuries in a German university hospital. Data were obtained by an anonymous, self-reporting questionnaire. We calculated the share of reported needlestick injuries, which could have been prevented by using safety devices. Results 31.4% (n = 226) of participant HCWs had sustained at least one needlestick injury in the last 12 months. A wide variation in the number of reported needlestick injuries was evident across disciplines, ranging from 46.9% (n = 91/194) among medical staff in surgery and 18.7% (n = 53/283) among HCWs in pediatrics. Of all occupational groups, physicians have the highest risk to experience needlestick injuries (55.1%—n = 129/234). Evaluating the kind of activity under which the needlestick injury occurred, on average 34% (n = 191/561) of all needlestick injuries could have been avoided by the use of safety devices. Taking all medical disciplines and procedures into consideration, safety devices are available for 35.1% (n = 197/561) of needlestick injuries sustained. However, there was a significant difference across various medical disciplines in the share of needlestick injuries which might have been avoidable: Pediatrics (83.7%), gynecology (83.7%), anesthesia (59.3%), dermatology (33.3%), and surgery (11.9%). In our study, only 13.2% (n = 74/561) of needlestick injuries could have been prevented by organizational measures. Conclusion There is a high rate of needlestick injuries in the daily routine of a hospital. The rate of such injuries depends on the medical discipline. Implementation of safety devices will lead to an improvement in medical staff’s health and safety.     

Work-related carpal tunnel syndrome in Washington State workers' compensation: temporal trends, clinical practices, and disability

BACKGROUND: Work-related carpal tunnel syndrome (CTS) is a leading cause of disability. There is a need for information about temporal trends, clinical practices, and treatment outcomes. METHODS: A population based, retrospective cohort study of Washington State workers' compensation claims for CTS was initiated focusing on claims filed during 1990-1994, followed through 2000 (n = 16,710). RESULTS: Half of the claims were filed for conditions other than CTS, but were eventually identified to be or include CTS. The first CTS diagnosis occurred more than 3 months after claim filing in 20% of claims. The longer that the CTS diagnosis occurred after claim filing, the more likely that CTS was accompanied by other problems, and disability tended to be longer. CONCLUSIONS: Making an accurate diagnosis of CTS and initiating appropriate actions earlier than might otherwise occur could reduce the disability and costs in a large fraction of claims that are ultimately determined to involve CTS.     

Determinants of escalating costs in low risk workers' compensation claims

OBJECTIVE: To identify and quantify attributes that lead to unanticipated cost escalation in workers' compensation claims. METHODS: We constructed four claim categories: low initial reserve/low cost, migrated catastrophic (low initial reserve/high cost), high initial reserve/low cost, and catastrophic (high initial reserve/high cost). To assess the attributes associated with the increased cost of migrated catastrophic claims, we analyzed 36,329 Louisiana workers' compensation claims in the four categories over a 5-year period. RESULTS: In the 729 claims initially thought to be low-cost claims (migrated catastrophic), the most significant predictors for cost escalation were attorney involvement and claim duration, followed by low back disorder, married/single/divorced status, male gender, small company size, high premium, reporting delays, and older age. These injuries accounted for 2% of all claims but 32.3% of the costs. Accelerated escalation of costs occurred late in the claim cycle (2 years). CONCLUSION: Certain attributes, particularly attorney involvement and claim duration, are associated with unanticipated cost escalation in a small number of claims that drastically affect overall losses. The results of this study suggest that these cases may be identified and addressed before rapid escalation occurs.     

Carpal tunnel syndrome and workers' compensation among an occupational clinic population in New York State

BACKGROUND: This study evaluated the experience in the New York State workers' compensation (WC) system of 135 patients with work-related carpal tunnel syndrome diagnosed at an academic occupational medicine clinic between 1991-1994. METHODS: Worker's Compensation Board (WCB) records were reviewed to ascertain: (1) the proportion of WC claims that were not initially accepted (i.e., that were challenged) by the WC insurer, (2) the proportion of challenged claims ultimately decided in the claimant's favor, (3) the length of the period between case filing and claim adjudication, and (4) risk factors for claim challenge. RESULTS: Seventy-nine percent of the claims were not initially accepted by the WC insurer (challenged/no response). Of the 81 challenged/no response cases adjudicated (ruled on) at the time of the study, 96.3% were accepted as work-related. Mean time from claim initiation to adjudication was 429 days (range 58-1,617). Mean time from physician request for any treatment and WCB authorization was 226 days (range 0-1,296). Mean time from physician request for surgery authorization and WCB authorization was 318 days (range 7-595). Claims filed by non-whites, low-wage workers, and union members were significantly more likely than others to be challenged. CONCLUSIONS: Patients with work-related carpal tunnel syndrome face frequent claim challenge by WC insurers in NY State, with attendant prolonged delays in adjudication and treatment authorization. Likelihood of claim rejection was strongly related to ethnicity and socio-economic status.     

Risk of needlestick injuries by injection pens

Injection pens are used by patients when auto-administering medication (insulin, interferon, apokinon etc.) by the subcutaneous route. The objective of this study was to evaluate the rate of injection pen use by healthcare workers (HCWs) and the associated risk of needlestick injuries to document and compare injury rates between injection pens and subcutaneous syringes. A one-year retrospective study was conducted in 24 sentinel French public hospitals. All needlestick injuries linked to subcutaneous injection procedures, which were voluntarily reported to occupational medicine departments by HCWs between October 1999 and September 2000, were documented using a standardized questionnaire. Additional data (total number of needlestick injuries reported, number of subcutaneous injection devices purchased) were collected over the same period. A total of 144 needlestick injuries associated with subcutaneous injection were reported. The needlestick injury rate for injection pens was six times the rate for disposable syringes. Needlestick injuries with injection pens accounted for 39% of needlestick injuries linked with subcutaneous injection. In all, 60% of needlestick injuries with injection pens were related to disassembly. Injection pens are associated with needlestick injuries six times more often than syringes. Nevertheless, injection pens have been shown to improve the quality of treatment for patients and may improve treatment observance. This study points to the need for safety-engineered injection pens.     

An epidemiological and risk analysis of Virginia workers' compensation burn claims 1999 to 2002: identifying and prioritizing preventive workplace interventions

OBJECTIVE: This study examines workers' compensation burn claims from Virginia to assess risk factors and costs associated with occupational burn injuries. METHODS: Virginia workers' compensation burn claims for the period of 1999 to 2002 were analyzed. Claim rates were determined by using the Bureau of Labor Statistics' Current Population Survey for the working population of Virginia. RESULTS: There were 5810 burn claims reported for the 4-year period examined, with the average burn rate estimated to be 4.3 per 10,000 workers. The total cost of claims was found to average $11,705,939 per year and $8059 per claim. There was over a sixfold increase for burn rates on weekends relative to weekdays. CONCLUSION: Burns are a common injury experienced by workers and are often severe. Assessing personnel issues affecting weekend employees may lead to valuable preventive interventions to reduce burn risk.