Multi–source surveillance for work‐related crushing injuries

Background

Work‐related crushing injuries are serious but preventable. For 2013 through 2015, the U.S. Bureau of Labor Statistics’ (BLS) Survey of Occupational Injuries and Illnesses (SOII) reported 1260 crushing injuries in Michigan. In 2013, Michigan initiated multi‐data source surveillance of work‐related crushing injuries.

Methods

Records from all 134 of Michigan's hospitals/emergency departments (EDs), the Workers Compensation Agency (WCA) and Michigan's Fatality Assessment Control and Evaluation (MIFACE) program were used to identify work‐related crushing injuries. Companies, where individuals were hospitalized or had an ED visit for a crushing injury, potentially had an OSHA enforcement inspection conducted.

Results

From 2013 through 2015, there were 3137 work‐related crushing injury incidents, including two fatalities. The Michigan OSHA program completed inspections at 77 worksites identified by the surveillance system.

Conclusion

The Michigan multisource surveillance system identified two and a half times more crushing injuries than BLS and was useful for initiating case‐based enforcement inspections.

     

Work‐related injuries in the Alaska logging industry, 1991‐2014

Background

Although loggers in Alaska are at high risk for occupational injury, no comprehensive review of such injuries has been performed since the mid‐1990s. We investigated work‐related injuries in the Alaska logging industry during 1991‐2014.

Methods

Using data from the Alaska Trauma Registry and the Alaska Occupational Injury Surveillance System, we described fatal and nonfatal injuries by factors including worker sex and age, timing and geographic location of injuries, and four injury characteristics. Annual injury rates and associated 5‐year simple moving averages were calculated.

Results

We identified an increase in the 5‐year simple moving averages of fatal injury rates beginning around 2005. While injury characteristics were largely consistent between the first 14 and most recent 10 years of the investigation, the size of logging companies declined significantly between these periods.

Conclusions

Factors associated with declines in the size of Alaska logging companies might have contributed to the observed increase in fatal injury rates.

     

Self‐reported musculoskeletal disorder pain: The role of job hazards and work‐life interaction

Background

Previous research identified an association between work‐family conflict and musculoskeletal pain. This study explores how the work‐life interface might affect pain experienced by residential aged care staff.

Methods

A cross‐sectional survey of 426 employees in residential aged care was analyzed to assess the impacts of workplace hazards, work‐family conflict, and work‐life balance on self‐reported musculoskeletal pain.

Results

Work‐family conflict acts as a mediator of the relationships between workplace hazards and the total number of body regions at which musculoskeletal pain was experienced. Work‐life balance only acts as a mediator for particular hazards and only if work‐family conflict is not taken into account.

Conclusions

Addressing work‐life interaction, and in particular work‐family conflict, warrants further investigation as a legitimate means through which musculoskeletal disorder risk can be reduced. Policies and practices to improve work‐life interaction and reduce work‐family conflict should be considered as integral components of musculoskeletal disorder risk management strategies.

     

Same‐level fall injuries in US workplaces by age group,gender, and industry

Background

As the workforce ages, occupational injuries from falls on the same level will increase. Some industries may be more affected than others.

Methods

We conducted a cross‐sectional study using data from the Bureau of Labor Statistics to estimate same‐level fall injury incidence rates by age group, gender, and industry for four sectors: 1) healthcare and social assistance; 2) manufacturing; 3) retail; and 4) transportation and warehousing. We calculated rate ratios and rate differences by age group and gender.

Results

Same‐level fall injury incidence rates increase with age in all four sectors. However, patterns of rate ratios and rate differences vary by age group, gender, and industry. Younger workers, men, and manufacturing workers generally have lower rates.

Conclusions

Variation in incidence rates suggests there are unrealized opportunities to prevent same‐level fall injuries. Interventions should be evaluated for their effectiveness at reducing injuries, avoiding gender‐ or age‐discrimination and improving work ability.

     

Agricultural injuries among farm and non‐farm children and adolescents in Alberta,Canada

Background

Understanding of the specific risk of agricultural injury sustained by different populations of children and adolescents is needed for effective safety intervention.

Objective

To compare the rates and patterns of agricultural injury incidence (fatal and non‐fatal injury) between farm and non‐farm children less than 18 years of age in Alberta, Canada.

Methods

A total of 115 378 children (five subgroups: two groups of farm children and three groups of non‐farm children) in Alberta were followed from 1999 to 2010 to examine injury incidence using the linkage of three administrative health databases. A recurrent event survival analysis using Cox proportional hazards regression was carried out.

Results

A total of 1 849 agricultural injury episodes (1 616 emergency department visits, 225 hospitalizations, and 8 deaths) were identified from 1999 to 2010. The age‐ and gender‐adjusted rate (per 100 000 person years) of agricultural injury was 672.3 for rural‐living farm children, 369.4 for urban‐living farm children, 180.2 for rural non‐First Nations (FN) children, 64.4 for rural FN children, and 23.7 for urban children in descending order.

Conclusion

Specific strategies for different children's populations to prevent agricultural injuries and to extend agricultural injury controls to non‐farming populations are needed.

     

The impact of weather,road surface,time‐of‐day,and light conditions on severity of bicycle‐motor vehicle crash injuries

Background

This study examined whether environmental variables including weather, road surface, time‐of‐day, and light conditions were associated with the severity of injuries resulting from bicycle‐motor vehicle crashes.

Methods

Using log‐binomial regressions, we analyzed 113 470 police reports collected between 2000 and 2014 in four U.S. states with environmental and injury severity information. “Severe” injuries included fatal and incapacitating injuries, and “non‐severe” included non‐incapacitating, possible or no‐injuries.

Results

Light condition was significantly associated with the injury severity to the bicyclist with more severe injuries at dawn (RR = 1.62 [95%CI 1.35‐1.94]) and during darkness (both lighted and unlighted roads: 1.32 [1.24‐1.40], respectively, 1.57 [1.41‐1.76]) as compared to daylight. In these conditions of low visibility, risk was further increased during early morning hours before 7 am (1.61 [1.22‐2.13]).

Conclusions

Crashes in low light conditions and during early morning hours are more likely to result in higher injury severity.

     

Dose‐response relationships between internally‐deposited uranium and select health outcomes in gaseous diffusion plant workers, 1948‐2011

Objective

To examine dose‐response relationships between internal uranium exposures and select outcomes among a cohort of uranium enrichment workers.

Methods

Cox regression was conducted to examine associations between selected health outcomes and cumulative internal uranium with consideration for external ionizing radiation, work‐related medical X‐rays and contaminant radionuclides technetium (⁹⁹Tc) and plutonium (²³⁹Pu) as potential confounders.

Results

Elevated and monotonically increasing mortality risks were observed for kidney cancer, chronic renal diseases, and multiple myeloma, and the association with internal uranium absorbed organ dose was statistically significant for multiple myeloma. Adjustment for potential confounders had minimal impact on the risk estimates.

Conclusion

Kidney cancer, chronic renal disease, and multiple myeloma mortality risks were elevated with increasing internal uranium absorbed organ dose. The findings add to evidence of an association between internal exposure to uranium and cancer. Future investigation includes a study of cancer incidence in this cohort.

     

Workplace violence injury in 106 US hospitals participating in the Occupational Health Safety Network (OHSN), 2012‐2015

Background

Workplace violence is a substantial occupational hazard for healthcare workers in the United States.

Methods

We analyzed workplace violence injury surveillance data submitted by hospitals participating in the Occupational Health Safety Network (OHSN) from 2012 to 2015.

Results

Data were frequently missing for several important variables. Nursing assistants (14.89, 95%CI 10.12‐21.91) and nurses (8.05, 95%CI 6.14‐10.55) had the highest crude workplace violence injury rates per 1000 full‐time equivalent (FTE) workers. Nursing assistants' (IRR 2.82, 95%CI 2.36‐3.36) and nurses' (IRR 1.70, 95%CI 1.45‐1.99) adjusted workplace violence injury rates were significantly higher than those of non‐patient care personnel. On average, the overall rate of workplace violence injury among OHSN‐participating hospitals increased by 23% annually during the study period.

Conclusion

Improved data collection is needed for OHSN to realize its full potential. Workplace violence is a serious, increasingly common problem in OHSN‐participating hospitals. Nursing assistants and nurses have the highest injury risk.

     

Adapting the T0‐T4 implementation science model to occupational health and safety in agriculture,forestry, and fishing: A scoping review

Background

Despite much research to develop life‐saving innovations for the agriculture, forestry, and fishing workforce, these populations continue to face the highest fatal and non‐fatal injury rates in the United States, as many of these solutions are not fully adopted.

Methods

A scoping review was conducted to provide an overview of research to practice efforts in this field. The language used to describe these initiatives, the utility of the NIH T0‐T4 model, and the progress along the research to practice continuum were examined.

Results

Fourteen eligible references demonstrated that progress in implementation science is lacking and that there is little consistency in how researchers apply the T0‐T4 model; thus, a new model is presented.

Conclusions

Researchers in this field face several challenges when moving from research to practice. While some challenges are addressed with the proposed model, additional resources and infrastructure to support such initiatives are necessary.

     

Workers’ compensation and the working poor

Background

The working poor are at highest risk of work‐related injuries and have limited access to occupational health care.

Objectives

To explore community health centers (CHCs) as a venue for accessing at risk workers; and to examine the experience, knowledge, and perceptions of workers’ compensation (WC) among the working poor.

Methods

Key informant interviews were conducted among patients in waiting rooms of rural and urban CHCs.

Result

Fifty‐one interviews of minority workers across sectors identified 23 prior work‐related injuries and mixed experiences with the WC system. Barriers to reporting and ways to overcome these barriers were elucidated.

Conclusions

Patients in CHCs work in jobs that put them at risk for work‐related injuries. CHCs are a good site for accessing at‐risk workers. Improving occupational healthcare and appropriate billing of WC insurance should be explored, as should best practices for employers to communicate WC laws to low wage workers.

     

Self‐employed individuals performing different types of work have different occupational safety and health problems

Introduction

We assessed the occupational safety and health (OSH) issues of self‐employed individuals in Korea.

Methods

The working conditions and OSH issues in three groups were analyzed using the Korean Working Conditions Survey of 2014.

Results

Among self‐employed individuals, “Physical work” was more common among males, whereas “Emotional work” was more common among females. Self‐employed individuals performing “Mental work” had more education, higher incomes, and the lowest exposure to physical/chemical and ergonomic hazards in the workplace. In contrast, those performing “Physical work” were older, had less education, lower incomes, greater exposure to physical/chemical and ergonomic hazards in the workplace, and more health problems. Individuals performing “Physical work” were most vulnerable to OSH problems.

Conclusion

The self‐employed are a heterogeneous group of individuals. We suggest development of specific strategies that focus on workers performing “Physical work” to improve the health and safety of self‐employed workers in Korea.

     

Evaluating an owner‐to‐worker training intervention in California nail salons using personal air monitoring

Background

Chemicals in nail products have been linked to numerous health concerns.

Methods

We recruited Vietnamese‐American nail salon owners and workers in California and randomized salons into an intervention or control group. Owners in the intervention group received training and then provided education to workers in their salons on best practices to reduce workplace chemical exposures. Methyl methacrylate (MMA), toluene, and total volatile organic compounds (TVOCs) were measured using personal air monitors worn by workers during the work‐shift.

Results

We enrolled 77 salons (37 intervention and 40 control) and 200 workers. There was no significant intervention effect between the two groups. However, MMA and TVOCs were higher for workers who used gel polish and acrylic nails as well as in busy salons.

Conclusions

Although the intervention did not show reductions in chemical levels, identifying worker tasks and salon characteristics that predict chemical levels can inform future interventions to reduce exposures.

     

The impact of a change in work posture from seated to stand‐up on work‐related musculoskeletal disorders among sewing‐machine operators

Background

Work‐related postural change could lead to improved musculoskeletal health.

Method(s)

In a quantitative, retrospective, longitudinal study, data of work‐related musculoskeletal disorders of 123 sewing‐machine operators were captured for 4.5 years, and analysed using Poisson regression.

Results

Stand‐up work posture (SUWP) reduced the incidence for spinal disorders (SD) to 0.29 fold the incidence for sitting work posture (SWP) (P < 0.001). Morbid obesity had significantly increased (P = 0.04) incidence of upper limb disorders (ULD), 3.35 times that of normal body mass index (BMI) (regardless of work posture). SUWP was associated with increased IRR (1.49) for lower limb disorders (LLD). LLDs were associated with obesity (overweight (IRR = 2.58; P = 0.08), obese (IRR = 2.45; P = 0.09), and morbidly obese (IRR = 6.24; P = 0.001)).

Conclusions

The protective benefit of the SUWP was statistically significant for SD incidence. Owing to high mean BMI, SUWP had a negative impact on the incidence of LLDs for the first 2 months.

     

Work‐related mortality in the US fishing industry during 2000‐2014: New findings based on improved workforce exposure estimates

Background

Commercial fishing is a global industry that has been frequently classified as high‐risk. The use of detailed surveillance data is critical in identifying hazards.

Methods

The purpose of this study was to provide updated statistics for the entire US fishing industry during 2010‐2014, generate fleet‐specific fatality rates using a revised calculation of full‐time equivalent estimates, and examine changes in the patterns of fatalities and in risk over a 15‐year period (2000‐2014).

Results

During 2010‐2014, 188 commercial fishing fatalities occurred in the United States. Vessel disasters and falls overboard remain leading contributors to commercial fishing deaths. The Atlantic scallop fleet stands out for achieving substantial declines in the risk of fatalities over the 15‐year study period. However, fatality rates ranged from 21 to 147 deaths per 100 000 FTEs, many times higher than the rate for all US workers.

Conclusions

Although the number of fatalities among commercial fishermen in the United States has generally declined since 2000, commercial fishing continues to have one of the highest occupational fatality rates in the United States. The sustainable seafood movement could assist in improving the health and safety of fishing industry workers if worker well‐being was integrated into the definition of sustainable seafood.

     

The role of compensation in explaining harmful effects of overtime work on self‐reported heart disease: Preliminary evidence from a Germany prospective cohort study

Background

Research evidence suggests harmful effects of overtime work on risk of heart disease. However, whether withdrawing compensation for overtime work (time‐off or money) provides a relevant explanation of this association has not been explored.

Methods

Using cohort data, we included 6345 employees from Germany (3079 men and 3266 women), and applied Poisson regression analysis to examine the prospective association of overtime work without compensation with risk of self‐reported incident heart disease over 2 years.

Results

Uncompensated overtime work was associated with an elevated risk of heart disease after adjustment for relevant variables (RR = 1.85, 95%CI: 1.05‐3.25), compared to no overtime work. Stratified analyses indicated particularly strong effects among women and among employees with low socioeconomic position.

Conclusions

In line with the stress‐theoretical model of effort‐reward imbalance at work, these findings document an important role of compensation on heart disease in the frame of overtime work.

     

Prevalence of hearing loss among noise‐exposed workers within the agriculture,forestry, fishing,and hunting sector, 2003‐2012

Background

The purpose of this study was to estimate the prevalence of hearing loss among noise‐exposed US workers within the Agriculture, Forestry, Fishing, and Hunting (AFFH) sector.

Methods

Audiograms for 1.4 million workers (17 299 within AFFH) from 2003 to 2012 were examined. Prevalence, and the adjusted risk for hearing loss as compared with the reference industry (Couriers and Messengers), were estimated.

Results

The overall AFFH sector prevalence was 15% compared to 19% for all industries combined, but many of the AFFH sub‐sectors exceeded the overall prevalence. Forestry sub‐sector prevalences were highest with Forest Nurseries and Gathering of Forest Products at 36% and Timber Tract Operations at 22%. The Aquaculture sub‐sector had the highest adjusted risk of all AFFH sub‐sectors (PR = 1.70; CI = 1.42‐2.04).

Conclusions

High risk industries within the AFFH sector need continued hearing conservation efforts. Barriers to hearing loss prevention and early detection of hearing loss need to be recognized and addressed.

     

Employer knowledge of federal requirements for recording work‐related injuries and illnesses: Implications for occupational injury surveillance data

Background

Accuracy of the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII) data is dependent on employer compliance with workplace injury and illness recordkeeping requirements. Characterization of employer recordkeeping can inform efforts to improve the data.

Methods

We interviewed representative samples of SOII respondents from four states to identify common recordkeeping errors and to assess employer characteristics associated with limited knowledge of the recordkeeping requirements and non compliant practices.

Results

Less than half of the establishments required to maintain OSHA injury and illness records reported doing so. Few establishments knew to omit cases limited to diagnostic services (22%) and to count unscheduled weekend days as missed work (27%). No single state or establishment characteristic was consistently associated with better or worse record‐keeping.

Conclusion

Many employers possess a limited understanding of workplace injury recordkeeping requirements, potentially leading them to over‐report minor incidents, and under‐report missed work cases.

     

Early labor force exit subsequent to permanently impairing occupational injury or illness among workers 50‐64 years of age

Background

Severity of workplace injury tends to increase with age. Whether older workers who experience a workplace injury or illness exit the labor force sooner than comparable peers is not established.

Methods

A case‐cohort study design and complementary log‐log model were used to identify factors associated with average time to early substantial labor force exit among workers’ compensation claimants 50‐64 years of age with permanent impairment from an occupational injury or illness. Analysis was based on Ontario's workers’ compensation claimant data from 1998 to 2006 linked with Canadian tax files.

Results

Workers with permanent impairment left the labor force earlier, on average, than peers without claims. Early retirement was associated with older age in the injury/illness year, greater impairment, lower pre‐claim income, physically demanding jobs, and soft‐tissue injuries.

Conclusions

Policies aiming to extend older adults’ working lives should account for the potentially disparate impacts on older workers of occupational injury and illness.

     

The psychological distress and care needs of mesothelioma patients and asbestos‐exposed subjects: A systematic review of published studies

Background

The purpose of this study is to present the results of a systematic review of published research that focuses on psychological aspects of malignant mesothelioma patients and asbestos‐exposed people.

Methods

Our research includes primary studies published between 1980 and 2016, using information from the Cochrane Library, the Psychology Behavioral Sciences Collection, PsychINFO, PubMed, PubGet, PubPsych, and Scopus, in compliance with PRISMA guidelines.

Results

We identified 12 papers that investigated the psychological distress and care needs of mesothelioma patients, and nine papers for asbestos‐exposed subjects.

Conclusions

This paper highlights the paucity of studies on the psychological distress and care needs of mesothelioma patients and asbestos‐exposed subjects. It confirms that malignant mesothelioma is associated with the physical, emotional, and social functioning of patients, while also suggesting that the risk of developing asbestos‐related diseases among asbestos‐exposed subjects is associated with high levels of psychological distress, despair, and mental health difficulties.

     

Cancer mortality update with an exposure response analysis among styrene‐exposed workers in the reinforced plastics boatbuilding industry

Background

There is sparse and inconsistent evidence of an association between styrene exposure and cancer.

Methods

This study examines mortality patterns in a previously studied cohort of 5201 workers employed in two Washington boat‐building facilities, extending follow‐up 5 years. Standardized mortality ratios (SMR) were calculated using state rates as referent. Cox regression calculated rate ratios (RR) per year employed in styrene‐exposed exposed jobs.

Results

No excess deaths from lymphohematopoietic cancers (LHCs) were observed (SMR: 0.99, 95%CI: 0.74‐1.30) when compared to the referent population; however, the relative risk increased with duration of employment in internal analyses. Conversely, lung cancer mortality was significantly elevated (SMR: 1.24, 95%CI: 1.08‐1.41), but there was no evidence of a dose‐response relationship.

Conclusion

We found evidence that occupational exposure to styrene was associated with increased LHC risk, while no such association was observed for lung cancer.