Fatal occupational injuries among self-employed workers in North Carolina

BACKGROUND: Research suggests that rates of occupational injury and death may be higher among self-employed workers than in the wage and salaried population. This analysis was conducted to describe the demographic and occupational characteristics, as well as injuries, activities, and occupations of self-employed workers who are fatally injured on the job. METHODS: Characteristics of workers by type of employment were compared using data from the North Carolina Office of the Chief Medical Examiner, 1978-1994. Age-, activity-, and industry-specific fatality rates in self-employed workers (N=395) were contrasted to those privately employed (N=1,654). RESULTS: Highest fatal injury rates among the self-employed occurred in agriculture, retail, and transportation industries. Homicide deaths occurred more frequently among self-employed workers; deaths resulting from unintentional injuries occurred more frequently among non-self-employed workers. CONCLUSIONS: Elevated occupational fatality death rates among self-employed workers, especially in retail and transportation industries, provide justification for addressing work-related conditions of self-employed workers in North Carolina.     

Dermatoses among poultry slaughterhouse workers

A survey on the incidence of occupational dermatoses among poultry slaughterhouse workers, who, in order to do their work more efficiently, protected their hands only with cotton gloves, revealed that many workers had dermatoses of the hands. Their symptoms included maceration, erosio interdigitalis, paronychia, trichophytia unguium, and eczema, presumably caused by the constant wetness of their hands during work. Candida albicans was detected in the ungual lesions of some patients. A second survey including a skin examination was performed at a plant where preventive measures such as better working gloves and improved sanitary conditions had been implemented because of the high incidence of skin disorders. The results of this survey showed marked improvement in the reduction of the incidence of dermatoses.     

Fatal occupational injuries among electric power company workers

Surveillance data suggest high rates of electrocutions and fatal falls among workers in electric utility companies, who may be exposed to electric current, heights, flammable agents, and frequent motor vehicle travel. To characterize the occurrence of fatal injuries among electric utility workers, we studied workers in five electric power companies in the United States. A cohort of 127,129 men hired between 1950 and 1986 was followed through 1988. Injuries at work were identified through manual review of death certificates. The occurrence of occupational injuries was analyzed with directly adjusted rates and Poisson regression. The overall rate of fatal occupational injuries was 13.20 per 100,000 person‐years (n = 192), with 76% due to electric current, homicide, and falls from heights. Deaths were concentrated in a few groups with elevated injury rates, notably linemen (rate ratio (RR) 3.33), electricians (RR 2.79), and painters (RR 3.27). Occupations requiring daily work on elevations or frequent, direct contact with energized electrical equipment experienced markedly higher rates of fatal injury from falls and electrocutions with rate ratios of 21.8 (95% confidence interval (CI) 11.4–41.5) and 16.7 (95% CI 6.6–42.6), respectively, independent of worker age and seniority. Although fatal injury rates in this industry have declined in recent decades, significant numbers of deaths still occur. Based on the premise that all injuries are preventable, a need for continued vigilance and efforts at prevention is indicated. Am. J. Ind. Med. 35:302–309, 1999. © 1999 Wiley‐Liss, Inc.     

Nonfatal occupational injuries and illnesses among older workers --- United States, 2009

Older workers (defined as those aged ≥ 55 years) represented 19% of the U.S. workforce in 2009* and are the nation's fastest growing segment of the working population (1). To identify occupational safety issues affecting older workers, an analysis of data from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII) was conducted by CDC, BLS, and several state partners. This report summarizes the results of that analysis, which indicated that, based on employer reports, an estimated 210,830 nonfatal occupational injuries and illnesses among older workers in 2009 resulted in lost workdays. Although older workers had similar or lower rates for all injuries and illnesses combined compared with younger workers, the length of absence from work increased steadily with age and was highest for older workers (medians of 11 and 12 days for workers aged 55-64 years and ≥ 65 years, respectively). Older workers had higher rates of falls on the same level, fractures, and hip injuries compared with younger workers and workers of all ages. Public health and research agencies should conduct research to better understand the overall burden of occupational injuries and illnesses on older workers, aging-associated risks, and effective prevention strategies. Employers and others should take steps to address specific risks for older workers such as falls (e.g., by ensuring floor surfaces are clean, dry, well-lit, and free from tripping hazardS.)     

Self-reported symptoms of neurotoxicity and agricultural injuries among Ohio cash-grain farmers

BACKGROUND: In 1993, the Ohio Farm Family Health and Hazard Surveillance Program (OFFHHSP) was initiated to assess the health status of cash-grain farmers and their families. The objective of this study was to examine the postulated relationship between symptoms of neurotoxicity and risk of agriculture-related injury among Ohio cash-grain farmers. METHODS: A reanalysis of the data from a previously published case-control study of cash-grain farmers [Crawford et al. (1998) Am J Ind Med 34:588-599] was performed. The Principal Operator (PO) of each farm was asked to complete a self-administered questionnaire which included items about injuries experienced during the past year. A section of the questionnaire contained a 24-item instrument ("Q24") that queried symptoms of neurotoxicity experienced during the previous 12 months. Design-based multiple logistic regression analyses were conducted to evaluate associations between neuropsychological subsets ("domains") of the 24-item instrument and injury risk among the white male POs (who accounted for >99% of all POs). RESULTS: Significantly elevated odds ratios (ORs) were found in 8 of 11 domains. POs answering in the affirmative to the single item "Have you been bothered by lack of coordination or loss of balance?" were 3.12 times more likely to have reported an injury than POs responding negatively (95% CI 1.68-5.81). CONCLUSIONS: Farmers with higher scores on several Q24 domains, and for particular questionnaire items, appear to be at increased risk of agricultural injury.     

Epidemiologic study of occupational injuries among foreign and native workers in Taiwan

This study was designed to compare the risk of occupational injuries in foreign workers compared to native workers in Taiwan. The cohort of foreign workers under study was constructed by records of legally registered workers migrated from foreign countries to Taiwan from July 1, 1991 to December 31, 1993. The native Taiwanese workers for comparison were labor-insured workers working in the same industries as foreign workers in 1992. The number of occupational injuries in the first year of employment were obtained by matching the cohort of foreign workers with the labor insurance payment records by name, birth date and passport number. The 1-year incidence rate of occupational injuries in the first year of employment was calculated and a standardized morbidity ratio (SMR) was used for comparison with adjustment for age distribution and to accommodate the small sample size of foreign workers. The risk to occupational injuries among total (SMR = 0.86) and male (SMR = 0.58) foreign workers was not higher: indeed, it was even lower, than that among native workers in Taiwan. However, the risk to female migrant workers, especially in the construction industry, was significantly higher than that of female Taiwanese workers (SMR = 1.60). Stratified by industry, the incidence was high in the fabricated metal products manufacturing industry and in machinery and equipment manufacturing industry for male foreign workers, while a high incidence for the female foreign workers occurred in construction industry and rubber products manufacturing industry. The risk of occupational injuries was greater for foreign workers who had been in Taiwan for only a short time. Most fo the injuries occurred within the first 6 months of employment. Eighty-four out of the 394 occupational injuries among foreign workers resulted in disabilities. None of the accidents was fatal, but most of the disabilities were severe. The most common disabling injuries were cut or crushed fingers. The finding of a similar distribution of occupational injuries among foreign and native workers indicates that control measures are needed to reduce occupational injuries for all foreign and native workers in Taiwan. Am. J. Ind. Med. 31:623–630, 1997. © 1997 Wiley-Liss, Inc.     

Death certificate-based occupational mortality surveillance in the United States

Surveillance of cause-specific mortality patterns by occupation and industry through the use of death certificate records is a simple and relatively inexpensive approach to the generation of leads as to potential occupational disease problems. Researchers from the National Institute for Occupational Safety and Health (NIOSH) have been working with the National Center for Health Statistics, other federal agencies, and state health departments on a number of programs to foster the development of standardized, routine coding of occupation and industry entries on death certificates by state health departments. Thirty-one states and the District of Columbia are now doing such coding. These data are being analyzed currently by investigators at NIOSH and at individual state health departments for the purpose of hypothesis generation on occupation-disease relationships. The proportionate mortality ratio method is the predominant method being used, as appropriate denominator data are not generally available. This type of surveillance is particularly useful for the study of occupation and industry groups for which it is difficult to assemble cohorts, such as groups that are predominantly non-union and in small workplaces. Limitations of this surveillance include its inappropriateness for monitoring those occupational diseases which are not often fatal, and the limited scope and accuracy of death certificate information.     

Barriers to documenting occupational injuries among personal assistance services workers

BACKGROUND: Personal Assistance Services (PAS) workers provide essential support to disabled and elderly individuals living at home rather than institutions. Occupational injury risks are known, but limitations in occupational injury surveillance prevent assessing injury prevalence. Changing employment arrangements adopted by publicly funded programs may complicate the classification of PAS workers. METHODS: We surveyed state workers' compensation agencies and Financial Management Services organizations used by state Medicaid programs. RESULTS: Changing employment arrangements pose further barriers to classifying and documenting injury, and accessing workers' compensation coverage. Workers' Compensation coverage varies according to employment arrangements of the PAS workers. Financial Management Services organizations vary in their roles for reporting injury. Most frequent activities were providing written information about injury reporting, and reporting injuries to appropriate agencies or insurance companies. CONCLUSIONS: Current limitations undercount the prevalence and consequences of PAS-related occupational injuries among agency workers and largely ignore independent providers. Policy and research recommendations are presented.     

Occupational injuries among adolescents in Washington State, 1988–1991

Background To characterize work-related injuries and illnesses in minors. Methods We analyzed Washington State workers' compensation claims from 1988 through 1991. Results There were 17,800 claims among adolescents from age 11 through 17 years accepted in the 4-year period, including three occupational fatalities, 22 amputations, and 464 fractures; 89% of all injuries occurred among the 16- and 17-year-olds. Claims were most frequent in restaurants, food stores, service industry, other retail and wholesale trade, and agriculture. Washington State census data were used for the denominator in calculating injury rates for adolescents and adults. The crude injury rate for 16- and 17-year-olds employed at the time of the census was similar to that seen among adults (9.0 vs.10.4 per 100 workers), despite that minors work fewer hours per year. The rate among boys was almost twice that seen among girls (11.7 vs. 6.4 per 100 workers). Highest rates, per 100 workers, were in public administration (27.0), construction (21.1), agriculture (11.4), and restaurants (11.0). Using census data for those working anytime over the course of the year and adjusted for the number of hours worked, the injury rate for 16- and 17-year-olds was 19.4/100 full-time equivalents compared with 10.6 of 100 full-time equivalents for adults. Most injuries were lacerations, sprains and strains, contusions, and burns. Conclusions Public health policy and injury prevention strategies for working adolescents should be developed and implemented. Am. J. Ind. Med. 34:121–132, 1998. © 1998 Wiley-Liss, Inc.