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Richardson DB, Martin AT, McClure ES, Nocera M, Cantrell J, Ranapurwala SI, Marshall S. Forty-year trends in fatal occupational injuries in North Carolina. Am J Ind Med 2024; 67:87-98. [PMID: 37970734 DOI: 10.1002/ajim.23549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/25/2023] [Accepted: 11/01/2023] [Indexed: 11/17/2023]
Abstract
BACKGROUND We describe progress in the control of deaths on-the-job due to fatal occupational injury in North Carolina over the period 1978-2017. METHODS Forty years of information on fatal occupational injuries in North Carolina has been assembled from medical examiners' reports and death certificates, supplemented by newspaper and police reports. Cases were defined as unintentional fatal occupational injuries among adults. Annual estimates of the population at risk were derived from US Census data, and rates were quantified using Poisson regression methods. RESULTS There were 4434 eligible deaths. The unintentional fatal occupational injury rate at the beginning of the study period was more than threefold the rate at the end of the study. The fatal occupational injury rate among men declined from 9.6 per 100,000 worker-years in the period 1978-1982 to 3.1 per 100,000 worker-years in the period 2013-2017. The fatal occupational injury rate among women declined from 0.3 per 100,000 worker-years in the period 1978-1981 to 0.1 per 100,000 worker-years in the period 2013-2017. Declines in rates were observed for young adults as well as older workers and were observed across all major industry categories. Average annual declines in rates were greatest in those industries and occupations that had the highest fatal injury rates at the start of the study period. CONCLUSIONS The substantial decline in fatal injury rates underscores the importance of injury prevention and demonstrates the ability to make meaningful reductions in unintentional fatal injury.
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Affiliation(s)
- David B Richardson
- Department of Environmental and Occupational Health, Program in Public Health, University of California, Irvine, California, USA
| | - Amelia T Martin
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Elizabeth S McClure
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Maryalice Nocera
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - John Cantrell
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Shabbar I Ranapurwala
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Stephen Marshall
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Injury Prevention Research Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
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Lundstrom EW, Hendricks SA, Marsh SM, Groth CP, Smith GS, Bhandari R. Temporal trends in occupational injuries treated in US emergency departments, 2012-2019. Inj Epidemiol 2023; 10:13. [PMID: 36899403 PMCID: PMC9999541 DOI: 10.1186/s40621-023-00423-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019. METHODS Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019. RESULTS Occupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI = ± 10.5%), transportation incidents (- 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI = ± 8.9%). CONCLUSIONS This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.
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Affiliation(s)
- Eric W Lundstrom
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA.
| | - Scott A Hendricks
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Suzanne M Marsh
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Gordon S Smith
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Ruchi Bhandari
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
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Schofield KE, Ryan AD, Stroinski C. Risk factors for occupational injuries in schools among educators and support staff. JOURNAL OF SAFETY RESEARCH 2022; 80:67-77. [PMID: 35249629 DOI: 10.1016/j.jsr.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/25/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION School districts employ a large number of employees who work in educational (e.g., teachers) or other support roles, including educational assistants, custodians, food service, bus drivers, and community and recreation workers. District employees perform a wide array of job tasks and experience a wide spectrum of work-related risks and injuries. METHODS Workers' compensation data were coupled with Minnesota Department of Education district employee denominator data to evaluate risk factors for injury and severity. Variables included district location and type, employee job classification, age, and gender. Rates of injury and rate ratios were calculated to measure comparative injury risk using negative binomial regression and 95% confidence internals. Incidence and frequency of injury cause, nature, and body part we calculated. RESULTS Saint Paul and Minneapolis metropolitan area (versus non-metro) districts had higher risk (RR = 1.35, 95%CI = 1.18-1.54) of employee injuries. All job classifications in support roles had increased risk of injury claims versus educators, however food service (RR = 5.14, 95%CI = 4.61-5.74), custodial (RR = 3.85, 95%CI = 3.41-4.34), and transportation (RR = 4.15, 95%CI = 3.38-5.10) exhibited the highest comparative risk to educators; significant risk of lost-time injury was also present in these workers. Males and females had similar risk of injury for all claims, however males had elevated risk of lost-time injury (RR = 1.46, 95%CI = 1.26-1.69) versus females. All age groups >41-years-old exhibited increased risk of injury as compared to 31-40-year-olds. The magnitude of lost-time injury risk also increased with age. Falls and slips (29.1%), strains/sprains/ruptures (45.2%), and upper extremities (31.3%) most frequent cause, nature, and body part injured, respectively. CONCLUSIONS Characteristics of districts, schools, workers, and their jobs tasks and hazards vary. Many categories of support staff in schools have elevated risk of injury, including lost-time injury, as compared to educators. Practical Applications: Injury prevention in schools should be approached by targeting job classifications; high risk jobs can be prioritized for prevention.
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Affiliation(s)
- Katherine E Schofield
- Katherine E. Schofield, University of Minnesota Duluth, Department of Mechanical and Industrial Engineering, Voss Kovach Hall 105, 1305 Ordean Court, Duluth, MN 55812-3042, USA.
| | - Andrew D Ryan
- Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
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Reddan MC. Recommendations for the Development of Socioeconomically-Situated and Clinically-Relevant Neuroimaging Models of Pain. Front Neurol 2021; 12:700833. [PMID: 34557144 PMCID: PMC8453079 DOI: 10.3389/fneur.2021.700833] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2021] [Accepted: 08/06/2021] [Indexed: 11/13/2022] Open
Abstract
Pain is a complex, multidimensional experience that emerges from interactions among sensory, affective, and cognitive processes in the brain. Neuroimaging allows us to identify these component processes and model how they combine to instantiate the pain experience. However, the clinical impact of pain neuroimaging models has been limited by inadequate population sampling - young healthy college students are not representative of chronic pain patients. The biopsychosocial approach to pain management situates a person's pain within the diverse socioeconomic environments they live in. To increase the clinical relevance of pain neuroimaging models, a three-fold biopsychosocial approach to neuroimaging biomarker development is recommended. The first level calls for the development of diagnostic biomarkers via the standard population-based (nomothetic) approach with an emphasis on diverse sampling. The second level calls for the development of treatment-relevant models via a constrained person-based (idiographic) approach tailored to unique individuals. The third level calls for the development of prevention-relevant models via a novel society-based (social epidemiologic) approach that combines survey and neuroimaging data to predict chronic pain risk based on one's socioeconomic conditions. The recommendations in this article address how we can leverage pain's complexity in service of the patient and society by modeling not just individuals and populations, but also the socioeconomic structures that shape any individual's expectations of threat, safety, and resource availability.
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Affiliation(s)
- Marianne C. Reddan
- Department of Psychology, Stanford University, Stanford, CA, United States
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5
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Le AB, Wong SW, Lin HC, Smith TD. The association between union membership and perceptions of safety climate among US adult workers. SAFETY SCIENCE 2021; 133:105024. [PMID: 33052171 PMCID: PMC7544701 DOI: 10.1016/j.ssci.2020.105024] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2019] [Revised: 08/07/2020] [Accepted: 09/28/2020] [Indexed: 05/27/2023]
Abstract
OBJECTIVES An individual's perceptions of their workplace safety climate can influence their health and safety outcomes in the workplace. Even though union membership has been declining in the US, union members still comprise 10% of the working population and have higher-than-industry average non-fatal illness and injury rates. Due to limited research focused in this area, this study examined whether union membership was associated with worker perceptions of safety climate. METHODS This was a secondary data analysis study utilizing data from the Quality Work Life module from the General Social Survey centered on US workers aged 18 and above. Propensity-score matching was implemented to reduce potential selection bias between unionized and non-unionized workers. Linear regression explored the association between union membership and perceptions of safety climate, controlling for age, sex, education, industry, resource adequacy, supervisor support, co-worker support, and workload. RESULTS For perceived safety climate (on a 0-16 scale, the higher the more positive), those in union had a lower mean of perceived safety climate (12.44) compared to those not in a union (13.20). Based on the regression results, those who were in a union reported more negative perceptions of their workplace safety climate in a 12-month period (β = -0.61, p < .001). CONCLUSIONS By demonstrating a commitment to proactive injury prevention and bolstering the business's overall safety performance indicators, businesses who are open to collaborations with unions may see some long-term benefits (e.g. return on investment, increased job satisfaction) and enhance union workers' perceptions of safety climate.
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Affiliation(s)
- Aurora B Le
- Department of Environmental Health Sciences, University of Michigan, Ann Arbor, MI, USA
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Su-Wei Wong
- Department of Health Promotion and Behavioral Sciences, School of Public Health, The University of Texas Health Science Center, Houston, TX, USA
| | - Hsien-Chang Lin
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
| | - Todd D Smith
- Department of Applied Health Science, Indiana University School of Public Health, Bloomington, IN, USA
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Wels J. The role of labour unions in explaining workers' mental and physical health in Great Britain. A longitudinal approach. Soc Sci Med 2020; 247:112796. [PMID: 32007765 DOI: 10.1016/j.socscimed.2020.112796] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVES To assess whether there are mental and physical health benefits of being employed in a workplace where there is a union or staff association recognized by the management or being a member of such a union. METHODS Using four waves [W2 (2010-11), W4 (2012-13), W6 (2014-15), W8 (2016-18)] from Understanding Society (UKHLS), we use a propensity score matching method and apply a latent growth modeling on the original dataset and on the matched dataset to estimate the impact of change in union presence and union membership between wave 2 and wave 4 for the employed population on the change in mental health (Mental Component Summary - MCS) and physical health (Physical Component Summary - PCS), after controlling for socioeconomic characteristics, age and sector of activity. RESULTS Collective negotiation within the workplace plays a statistically significant role in supporting workers' mental and, to a greater degree, physical health. Being unionized does not add up significant physical health benefits but a slight positive effect on mental health is observed. CONCLUSION About 50 per cent of the employed population is not represented by a labour union at company level and this has negative effects on health. A major health policy issue is also about promoting collective negotiation at the workplace and more research is needed about the impact of implementing such type of negotiation. The study shows the benefits of using a longitudinal approach when analysing the impact of union presence and union membership on workers' health.
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Affiliation(s)
- Jacques Wels
- University of Cambridge, Department of Sociology, 16 Mill Lane, Cambridge, CB2 1SB, United Kingdom; Université libre de Bruxelles, Centre Metices, 44 Avenue Jeanne, Brussels, 1050, Belgium.
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Schofield K, Ryan AD, Dauner KN. Comparing disability and return to work outcomes between alternative and traditional workers' compensation programs. Am J Ind Med 2019; 62:755-765. [PMID: 31298426 DOI: 10.1002/ajim.23017] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Revised: 05/31/2019] [Accepted: 05/31/2019] [Indexed: 11/08/2022]
Abstract
BACKGROUND The Union Construction Workers' Compensation Program (UCWCP) was developed in 1996 as an alternative workers' compensation arrangement. The program includes use of a preapproved medical and rehabilitation network and alternative dispute resolution (ADR), and prioritizes a quick and safe return-to-work. The aim of this study is to determine if differences in recovery-related outcomes exist between UCWCP and the statutory workers' compensation system (SWCS). METHODS Claims data from 2003 to 2016 were classified as processed through UCWCP or SWCS. Outcomes included: temporary total disability (TTD), vocational rehabilitation (VR), claim duration and costs, and permanent partial disability (PPD). The relative risk of incurring TTD, VR, and PPD in UCWCP vs SWCS was calculated using log-binomial regression. Linear regression examined the relationship between programs and continuous outcomes including costs and duration. Estimates were adjusted for age, sex, wage, and severity. RESULTS The UCWCP processed 15.8% of claims; higher percentages of UCWCP claimants were older and earned higher wages. Results point to positive findings of decreased TTD incidence and cost, lower risk of TTD extending over time, higher likelihood of VR participation, and less attorney involvement and stipulation agreements associated with UCWCP membership. Differences were more apparent in workers who suffered permanent physical impairment. CONCLUSION Findings suggest that the defining programmatic elements of the UCWCP, including its medical provider and rehabilitation network and access to ADR, have been successful in their aims. Claims with increased severity exhibited more pronounced differences vs SWCS, potentially due, in part, to greater use of programmatic elements.
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Affiliation(s)
- Katherine Schofield
- Department of Mechanical and Industrial EngineeringUniversity of Minnesota Duluth Duluth Minnesota
| | - Andrew D. Ryan
- Department of Environmental Health SciencesUniversity of Minnesota Minneapolis Minnesota
| | - Kim N. Dauner
- Department of Economics and Health Care ManagementUniversity of Minnesota Duluth Duluth Minnesota
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Bird Y, Short JL, Toffel MW. Coupling Labor Codes of Conduct and Supplier Labor Practices: The Role of Internal Structural Conditions. ORGANIZATION SCIENCE 2019. [DOI: 10.1287/orsc.2018.1261] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Yanhua Bird
- Harvard Business School, Boston, Massachusetts 02163
| | - Jodi L. Short
- University of California, Hastings College of the Law, San Francisco, California 94102
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Altassan KA, Sakr CJ, Galusha D, Slade MD, Tessier-Sherman B, Cantley LF. Risk of Injury by Unionization: Survival Analysis of a Large Industrial Cohort. J Occup Environ Med 2018; 60:827-831. [PMID: 29727399 PMCID: PMC6131027 DOI: 10.1097/jom.0000000000001347] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To investigate the effect of union status on injury risk among a large industrial cohort. METHODS The cohort included hourly employees at 19 US plants between 2000 and 2007. Plants were classified by union status, and injuries were classified by severity. Cox-proportional hazard shared frailty model was used to determine time to first reportable injury. RESULTS A total of 26,462 workers were included: 18,955 (72%) unionized and 7507 (28%) non-unionized. Union workers incurred 3194 injuries (16.9%) compared with 618 injuries for non-union workers (8.2%). After adjusting for multiple covariates, union workers had a 51% higher risk of reportable injury. CONCLUSIONS Our results provide evidence for higher risk of reportable injuries in union workers; explanations for this increased risk remain unclear.
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Affiliation(s)
- Khaled Abdulrahman Altassan
- Department of Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut
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10
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Wels J. Are there health benefits of being unionized in late career? A longitudinal approach using HRS. Am J Ind Med 2018; 61:751-761. [PMID: 29956360 DOI: 10.1002/ajim.22877] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/07/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To assess whether unionization prevents deterioration in self-reported health and depressive symptoms in late career transitions. METHODS Data come from the Health and Retirement Study (N = 6475). The change in self-perceived health (SPH) and depressive symptoms (CESD) between wave 11 and wave 12 is explained using an interaction effect between change in professional status from wave 10 to wave 11 and unionization in wave 10. RESULTS The odds of being affected by a negative change in CESD when unionized are lower for unionized workers remaining in full-time job (OR:0.73, CI95%:0.58;0.89), unionized full-time workers moving to part-time work (OR:0.66, CI95%:0.46;0.93) and unionized full-time workers moving to part-retirement (OR:0.40, CI95%:0.34;0.47) compared to non-unionized workers. The same conclusion is made for the change in SPH but with odds ratios closer to 1. CONCLUSION The reasons for the associations found in this paper need to be explored in further research.
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Affiliation(s)
- Jacques Wels
- Department of Sociology, University of Cambridge, SSRMC, Cambridge, United Kingdom
- Université libre de Bruxelles, Centre Metices, Brussels, Belgium
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11
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Lee N, Sung H, Kim JH, Punnett L, Kim SS. Perceived discrimination and low back pain among 28,532 workers in South Korea: Effect modification by labor union status. Soc Sci Med 2017; 177:198-204. [DOI: 10.1016/j.socscimed.2017.01.057] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2016] [Revised: 12/27/2016] [Accepted: 01/26/2017] [Indexed: 11/28/2022]
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Feleus A, Miedema HS, Bierma-Zeinstra SMA, Hoekstra T, Koes BW, Burdorf A. Sick leave in workers with arm, neck and/or shoulder complaints; defining occurrence and discriminative trajectories over a 2-year time period. Occup Environ Med 2016; 74:114-122. [PMID: 27679674 DOI: 10.1136/oemed-2016-103624] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 08/01/2016] [Accepted: 08/20/2016] [Indexed: 11/03/2022]
Abstract
OBJECTIVES Impediments due to complaints of non-traumatic arm, neck and/or shoulder (CANS) during work often leads to consultation in primary care. This study examines the occurrence of sick leave among workers with new CANS, and evaluates sick leave trajectories and their characteristics. METHODS This prospective 2-year cohort study included workers with a new CANS presenting in general practice. Participants filled out postal questionnaires on sick leave at 6-monthly intervals. Latent class growth mixture modelling was used to identify distinct trajectories of sick leave. Multinomial regression analyses identified characteristics of the subgroups. RESULTS During follow-up, of the 533 participants 190 reported at least one episode of sick leave due to CANS. Three sick leave trajectories were distinguished: (1) 'low-risk' trajectory (n=366), with a constant low probability over time; (2) 'intermediate risk' trajectory, with a high probability at first consultation followed by a steep decrease in probability of sick leave (n=122); (3) 'high-risk' trajectory (n=45), with a constant high probability of sick leave. Compared to the 'low-risk' trajectory, the other trajectories were characterised by more functional limitations, less specific diagnoses, more work-related symptoms and low coworker support. Specific for the 'high-risk' subgroup were more recurrent symptoms, more musculoskeletal comorbidity, high score on somatisation and low score on job demands. CONCLUSIONS Three trajectories of sick leave were distinguished, graded from favourable to unfavourable. Several complaint-related and work-related factors and somatisation contributed modestly to identify an unfavourable trajectory of sick leave when presenting in primary care with CANS.
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Affiliation(s)
- A Feleus
- Research Center Innovations in Care, Rotterdam University, Rotterdam, The Netherlands
| | - H S Miedema
- Research Center Innovations in Care, Rotterdam University, Rotterdam, The Netherlands
| | - S M A Bierma-Zeinstra
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands.,Department of Orthopaedic Surgery, Erasmus MC, Rotterdam, The Netherlands
| | - T Hoekstra
- Department of Health Sciences, VU University, Amsterdam, The Netherlands.,Department of Epidemiology and Biostatistics, VU University Medical Center, the EMGO Institute for Health and Care Research, Amsterdam, The Netherlands
| | - B W Koes
- Department of General Practice, Erasmus MC, Rotterdam, The Netherlands
| | - A Burdorf
- Department of Public Health, Erasmus MC, Rotterdam, The Netherlands
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Bhandari R, Marsh SM, Reichard AA, Tonozzi TR. Characterizing emergency department patients who reported work-related injuries and illnesses. Am J Ind Med 2016; 59:610-20. [PMID: 27400440 DOI: 10.1002/ajim.22607] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/01/2016] [Indexed: 11/05/2022]
Abstract
BACKGROUND Per a Congressional directive and funding, this study describes worker and workplace characteristics of emergency department (ED) patients who reported their injury/illness to their employer. The study also responds to Congress's request to enumerate injured/ill self-employed workers and workers with chronic conditions. METHODS We conducted a follow-back study on injured/ill workers, including self-employed, identified from a national ED surveillance system from June 2012 through December 2013. RESULTS An estimated 3,357,000 (95%CI: 2,516,000-4,199,000) workers treated in EDs reported their injury/illness to their employer or were self-employed. Of those, 202,000 (95%CI: 133,000-272,000) had a chronic condition. Of all reporters, excluding self-employed, 77% indicated they received instructions as to whom to report. CONCLUSION The study did not identify underreporting issues and revealed that medical records data may not be appropriate for assessing underreporting. Additional research is needed to examine workplace characteristics that encourage injury and illness reporting. Am. J. Ind. Med. 59:610-620, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ruchi Bhandari
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch; Morgantown West Virginia
| | - Suzanne M. Marsh
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch; Morgantown West Virginia
| | - Audrey A. Reichard
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch; Morgantown West Virginia
| | - Theresa R. Tonozzi
- Centers for Disease Control and Prevention; National Institute for Occupational Safety and Health, Division of Safety Research, Surveillance and Field Investigations Branch; Morgantown West Virginia
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Walters D. One Step Forward, Two Steps Back: Worker Representation and Health and Safety in the United Kingdom. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2016; 36:87-111. [PMID: 16524166 DOI: 10.2190/9qp7-b16x-mxj1-dedj] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
There is now quite strong evidence for a set of preconditions that help determine the effectiveness of worker representation and consultation in improving health and safety outcomes. One of these preconditions is a regulatory framework that defines workers' rights to representation and employers' obligations to respond. Using the United Kingdom as its focus, this article explores developments at the national policy level. It shows how long-awaited legislative reforms to improve provisions for worker representation in health and safety have so far failed to materialize and, instead, government strategy has concentrated on promoting voluntary approaches. The author reviews the evidence of what makes worker representation in health and safety effective and suggests that, far from abandoning approaches to legislative reform, the U.K. agencies should be seeking to make improvements to the British provisions if they are to provide the necessary stimulus and support for worker representation in health and safety at work. Such improvements need to address long-standing weaknesses in existing provisions and their relevance to the changing world of work. The arguments presented here apply to the essential role of regulatory support for worker participation in all advanced market economies if it is to improve health and safety outcomes.
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Affiliation(s)
- David Walters
- Cardiff University School of Social Sciences, United Kingdom.
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15
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Protecting Construction Worker Health and Safety in Ontario, Canada: Identifying a Union Safety Effect. J Occup Environ Med 2015; 57:1337-42. [PMID: 26335767 DOI: 10.1097/jom.0000000000000562] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Do Ontario unionized construction firms have lower workers' compensation claims rates compared with nonunion firms? METHODS Building trade and construction trade association lists of union contractors were linked to Workplace Safety and Insurance Board claims data for 2006 to 2012. Data were pooled for 2006 to 2012, and negative binomial regressions conducted with adjustment to estimate a union safety effect. RESULTS The sample included 5797 unionized and 38,626 nonunion construction firms. Total claims rates were 13% higher (1.13, 1.09 to 1.18) in unionized firms because of higher allowed no-lost-time claim rates (1.28, 1.23 to 1.34), whereas the lost-time claims rate was 14% lower (0.86, 0.82 to 0.91). CONCLUSIONS Unionized construction firms compared with nonunion firms have higher no-lost-time and lower lost-time claims rates. Unionized firms may encourage occupational injury reporting and reduce risks through training and hazard identification and control strategies.
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Messing K. Pain and Prejudice: Does Collecting Information From the Standpoint of Exposed Workers Improve Scientific Examination of Work-Related Musculoskeletal Disorders? INTERNATIONAL JOURNAL OF HEALTH SERVICES 2015; 46:465-82. [PMID: 26272913 DOI: 10.1177/0020731415595337] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The meaning, feasibility, and importance of scientific objectivity have been debated among public health scientists. The debate is particularly relevant to occupational health, because of frequent opposition between employer and worker interests. This article suggests that the concept of standpoint (J. Eakin) may be more useful than that of objectivity in framing discussion of work-related musculoskeletal disorders. Studies done from a "worker" standpoint can, for example, investigate and characterize environmental risk factors for work-related musculoskeletal disorders, while studies from an "employer" standpoint may concentrate on identifying individual workers likely to report work-related musculoskeletal disorders or those for whom consequences of work-related musculoskeletal disorders are more severe. Within "worker" standpoints, a distinction between "high-prestige worker" and "lower-prestige worker" standpoints can be identified in the current scientific debate about the health costs and benefits of prolonged standing vs prolonged sitting at work. Contact with workers, particularly lower-prestige workers, is critical to developing and sustaining a worker-based standpoint among researchers in occupational health. This contact can be facilitated by formal collaborations between universities and unions or other community groups.
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Affiliation(s)
- Karen Messing
- CINBIOSE, Université du Québec à Montréal, Montréal, Quebec, Canada
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Ruser JW. Industry contributions to aggregate workplace injury and illness rate trends: 1992-2008. Am J Ind Med 2014; 57:1149-64. [PMID: 25223515 DOI: 10.1002/ajim.22355] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/07/2014] [Indexed: 11/05/2022]
Abstract
BACKGROUND Aggregate workplace injury and illness rates have generally declined over the past quarter century. Assessing which industries contributed to these declines is hampered by industry coding changes that broke time series data. MATERIALS AND METHODS Ratios were estimated to convert older incidence rate data to current industry codes and to create long industry time series from data of the BLS Survey of Occupational Injuries and Illnesses. These data were used to assess contributions to aggregate trends from within-industry incidence rate trends and across-industry hours shifts. RESULTS Hours shifts toward safer industries do not explain aggregate incidence rate declines. Rather declines resulted from within-industry declines. The top 20 contributors out of 307 industries account for 40 percent of the decline and include both goods-producing and service-providing industries. CONCLUSION These data help focus future research on industries responsible for rate declines and factors hypothesized as contributing to declines.
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Affiliation(s)
- John W. Ruser
- Office of Productivity and Technology; U.S. Bureau of Labor Statistics; Washington District of Columbia
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Stock S, Nicolakakis N, Raïq H, Messing K, Lippel K, Turcot A. Underreporting work absences for nontraumatic work-related musculoskeletal disorders to workers' compensation: results of a 2007-2008 survey of the Québec working population. Am J Public Health 2014; 104:e94-e101. [PMID: 24432882 PMCID: PMC3953776 DOI: 10.2105/ajph.2013.301562] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2013] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined underestimation of nontraumatic work-related musculoskeletal disorders (WMSDs) stemming from underreporting to workers' compensation (WC). METHODS In data from the 2007 to 2008 Québec Survey on Working and Employment Conditions and Occupational Health and Safety we estimated, among nonmanagement salaried employees (NMSEs) (1) the prevalence of WMSDs and resulting work absence, (2) the proportion with WMSD-associated work absence who filed a WC claim, and (3) among those who did not file a claim, the proportion who received no replacement income. We modeled factors associated with not filing with multivariate logistic regression. RESULTS Eighteen percent of NMSEs reported a WMSD, among whom 22.3% were absent from work. More than 80% of those absent did not file a WC claim, and 31.4% had no replacement income. Factors associated with not filing were higher personal income, higher seniority, shorter work absence, and not being unionized. CONCLUSIONS The high level of WMSD underreporting highlights the limits of WC data for surveillance and prevention. Without WC benefits, injured workers may have reduced job protection and access to rehabilitation.
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Affiliation(s)
- Susan Stock
- The authors are with the Scientific Group on Work-related Musculoskeletal Disorders, Québec Institute of Public Health, Montréal, Canada
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Qin J, Kurowski A, Gore R, Punnett L. The impact of workplace factors on filing of workers' compensation claims among nursing home workers. BMC Musculoskelet Disord 2014; 15:29. [PMID: 24476529 PMCID: PMC3912896 DOI: 10.1186/1471-2474-15-29] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2013] [Accepted: 11/06/2013] [Indexed: 11/10/2022] Open
Abstract
Background Injuries reported to workers’ compensation (WC) system are often used to estimate incidence of health outcomes and evaluate interventions in musculoskeletal epidemiology studies. However, WC claims represent a relatively small subset of all musculoskeletal disorders among employed individuals, and perhaps not a representative subset. This study determined the influence of workplace and individual factors on filing of workers’ compensation claims by nursing home employees with back pain. Methods Surveys were conducted in 18 skilled nursing facilities in four U.S. states. Self-administered questionnaires obtained information on demographic characteristics, working environment, and health behaviors/status. Employees who reported low back pain at least once in four questionnaire surveys were included. WC claims from the same facilities were obtained from the employer’s workers compensation insurer and matched by employee name. The dichotomous dependent variable was filing of back-related worker’s compensation claim. Association with predictors of interest, including pain severity, physical job demand, job strain, social support, schedule control, and safety climate, was assessed using multivariate regression modeling. Individual characteristics were tested as potential confounders. Results Pain severity level was significantly associated with filing low-back related claims (odds ratio (OR) = 1.49, 95% CI = 1.18 – 1.87). Higher physical demands at work (OR = 1.07, 95% CI = 1.01 – 1.14) also increased the likelihood of claim filing. Higher job strain (OR = 0.83, 95% CI = 0.73 – 0.94), social support at work (OR = 0.90, 95% CI = 0.82 – 0.99), and education (OR = 0.79, 95% CI = 0.71 – 0.89) decreased the likelihood of claim filing. Conclusions The results suggest that the WC system captured the most severe occupational injuries. Workplace factors had additional influence on workers’ decision to file claims, after adjusting for low back pain severity. Education was correlated with worker’s socioeconomic status; its influence on claim filing is difficult to interpret because of the possible mixed effects of working conditions, self-efficacy, and content knowledge.
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Affiliation(s)
| | | | | | - Laura Punnett
- Department of Work Environment, University of Massachusetts Lowell, One University Avenue, 01854 Lowell, MA, USA.
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Morse T, Bracker A, Warren N, Goyzueta J, Cook M. Characteristics of effective health and safety committees: survey results. Am J Ind Med 2013; 56:163-79. [PMID: 22886771 DOI: 10.1002/ajim.22096] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Although perhaps the most common worker-management structure, there has been surprisingly little research on describing and evaluating the characteristics of health and safety committees. METHODS A survey of 380 health and safety committee members from 176 manufacturing workplaces was supplemented with administrative data and compared with reported workers' compensation rates. Survey respondents also reported perceptions of overall safety, committee, effectiveness, committee activities, and "best practices." RESULTS Extensive descriptive data is presented, including a mean of 8.7 members per committee spending 1,167 hr per year on committee business for an estimate of $40,500 worth of time per committee. Higher speed to correct action items, a focus on ergonomics, and planning for safety training was associated with lower injury rates. The discrepancy between managers and hourly committee members in estimating overall safety was strongly positively associated with injury rates. CONCLUSIONS Communications and worker involvement may be important to address discrepancy issues. Prospective studies are needed to distinguish directionality of associations.
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Affiliation(s)
- Tim Morse
- Department of Community Medicine, Occupational and Environmental Health Center, University of Connecticut Health Center, Farmington, Connecticut 06030-6210, USA.
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21
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Asfaw A, Mark C, Pana-Cryan R. Profitability and occupational injuries in U.S. underground coal mines. ACCIDENT; ANALYSIS AND PREVENTION 2013; 50:778-86. [PMID: 22884379 PMCID: PMC4528673 DOI: 10.1016/j.aap.2012.07.002] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 06/08/2012] [Accepted: 07/01/2012] [Indexed: 05/13/2023]
Abstract
BACKGROUND Coal plays a crucial role in the U.S. economy yet underground coal mining continues to be one of the most dangerous occupations in the country. In addition, there are large variations in both profitability and the incidence of occupational injuries across mines. OBJECTIVE The objective of this study was to examine the association between profitability and the incidence rate of occupational injuries in U.S. underground coal mines between 1992 and 2008. DATA AND METHOD We used mine-specific data on annual hours worked, geographic location, and the number of occupational injuries suffered annually from the employment and accident/injury databases of the Mine Safety and Health Administration, and mine-specific data on annual revenue from coal sales, mine age, workforce union status, and mining method from the U.S. Energy Information Administration. A total of 5669 mine-year observations (number of mines×number of years) were included in our analysis. We used a negative binomial random effects model that was appropriate for analyzing panel (combined time-series and cross-sectional) injury data that were non-negative and discrete. The dependent variable, occupational injury, was measured in three different and non-mutually exclusive ways: all reported fatal and nonfatal injuries, reported nonfatal injuries with lost workdays, and the 'most serious' (i.e. sum of fatal and serious nonfatal) injuries reported. The total number of hours worked in each mine and year examined was used as an exposure variable. Profitability, the main explanatory variable, was approximated by revenue per hour worked. Our model included mine age, workforce union status, mining method, and geographic location as additional control variables. RESULTS After controlling for other variables, a 10% increase in real total revenue per hour worked was associated with 0.9%, 1.1%, and 1.6% decrease, respectively, in the incidence rates of all reported injuries, reported injuries with lost workdays, and the most serious injuries reported. CONCLUSION We found an inverse relationship between profitability and each of the three indicators of occupational injuries we used. These results might be partially due to factors that affect both profitability and safety, such as management or engineering practices, and partially due to lower investments in safety by less profitable mines, which could imply that some financially stressed mines might be so focused on survival that they forgo investing in safety.
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Affiliation(s)
- Abay Asfaw
- Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, Washington, DC, United States.
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22
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Souza NSS, Santana VS. [Socioeconomic position and duration of disability benefit due to work-related musculoskeletal disorders]. CAD SAUDE PUBLICA 2012; 28:324-34. [PMID: 22331158 DOI: 10.1590/s0102-311x2012000200011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2011] [Accepted: 09/15/2011] [Indexed: 11/22/2022] Open
Abstract
This study estimated the effect of socioeconomic position on the duration of disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs. A cohort study including 563 insured workers from the city of Salvador, Bahia, Brazil, registered in the General Social Security System and who received temporary disability benefits due to musculoskeletal disorders affecting the neck and/or upper limbs, was performed in 2008 using data from the National Social Security Institute. The results show that among union member workers with high psychosocial demands at work, those with low socioeconomic status are almost twice as likely to receive benefit for a shorter period of time compared to those with a higher socioeconomic position (RR = 1.89; 95%CI: 1.25-2.87). These results reveal an inequitable situation or unnecessary use of insurance for workers with a higher socioeconomic position. Future research aimed at elucidating the differences in the use of benefits are needed so that social insurance system managers may take the appropriate steps to resolve this issue.
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Spieler EA, Burton JF. The lack of correspondence between work-related disability and receipt of workers' compensation benefits. Am J Ind Med 2012; 55:487-505. [PMID: 22271439 DOI: 10.1002/ajim.21034] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/14/2011] [Indexed: 11/05/2022]
Abstract
BACKGROUND Previous studies suggest that many persons with disabilities caused by work do not receive workers' compensation benefits. METHODS Data from surveys of persons with disabilities were used to estimate the proportion of disability due to work-related injuries and diseases. Studies examining the proportion of workers with work-related disability who received workers' compensation benefits were reviewed. Legal and other factors explaining the lack of receipt of workers' compensation benefits were examined. RESULTS Many workers with disabilities caused by work do not receive workers' compensation benefits. The obstacles to compensation include increasingly restrictive rules for compensability in many state workers' compensation programs. CONCLUSIONS A substantial proportion of persons with work-related disabilities do not receive workers' compensation benefits. The solutions to this problem, such as providing healthcare to workers regardless of the source of injuries or diseases, are complicated and controversial, and will be difficult to implement.
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Affiliation(s)
- Emily A Spieler
- School of Law, Northeastern University, Boston, Massachusetts, USA
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24
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Lippel K. Preserving workers' dignity in workers' compensation systems: an international perspective. Am J Ind Med 2012; 55:519-36. [PMID: 22354856 DOI: 10.1002/ajim.22022] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/23/2012] [Indexed: 11/07/2022]
Abstract
BACKGROUND Workers' compensation systems are among the most generous disability insurance systems in North America, although they are also known to be potentially adversarial and may have iatrogenic effects on claimants. This article examines issues to be considered to ensure fair compensation provided in a way that respects the dignity of workers. METHODS An overview of the literature on characteristics and effects of workers' compensation systems is followed by an analysis based on classic legal methods, including those of comparative law, complemented with interview data to examine three models of disability compensation. RESULTS The first part of the article identifies cross cutting issues to be considered in the examination of the equity of compensation systems and the protection of the dignity of claimants. These include three underpinnings of workers' compensation: the links between a "no-fault" system and the adversarial process, the appropriate use of medical and scientific evidence in the determination of compensability and the application of appropriate measures for promoting return to work. The second part looks at accident compensation in New Zealand, where compensation is available regardless of the cause of the accident, and disability insurance in the Netherlands, where compensation is available regardless of the cause of the disability. It then describes a composite of characteristics favorable to equity drawn from the thirteen workers' compensation systems in Canada. CONCLUSION Systems that succeed in reducing opportunities for adversarial interactions and that provide substantive protection could better promote the dignity of claimants.
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Affiliation(s)
- Katherine Lippel
- Canada Research Chair in Occupational Health and Safety Law, University of Ottawa, Faculty of Law, Civil Law Section, Ontario, Canada.
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25
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Zhang W. The impact of public employment on health and health inequalities: evidence from China. INTERNATIONAL JOURNAL OF HEALTH SERVICES 2011; 41:647-78. [PMID: 22053527 DOI: 10.2190/hs.41.4.c] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Because the public and private sectors often operate with different goals, individuals employed by the two sectors may receive different levels of welfare. This can potentially lead to different health status. As such, employment sector offers an important perspective for understanding labor market outcomes. Using micro-level data from a recent Chinese household survey, this study empirically evaluated the impact of employment sector on health and within-sector health inequalities. It found that public sector employment generated better health outcomes than private sector employment, controlling for individual characteristics. The provision of more job security explained an important part of the association between public sector employment and better health. The study also found less health inequality by social class within the public sector. These findings suggest that policymakers should think critically about the "conventional wisdom" that private ownership is almost always superior, and should adjust their labor market policies accordingly.
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Affiliation(s)
- Wei Zhang
- Department of Health Policy and Management, Johns Hopkins University Bloomberg School of Public Health, Baltimore, USA.
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Luckhaupt SE, Calvert GM. Work-relatedness of selected chronic medical conditions and workers' compensation utilization: National health interview survey occupational health supplement data. Am J Ind Med 2010; 53:1252-63. [PMID: 20721967 DOI: 10.1002/ajim.20885] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
BACKGROUND An occupational health supplement (OHS) to the 1988 National Health Interview Survey (NHIS) bypassed many limitations of traditional occupational health surveillance systems, but the data collected about chronic work-related conditions have not yet been reported. METHODS We calculated the prevalence and proportion of cases related to work for the aggregation of 13 chronic conditions included in the NHIS-OHS, and for 11 conditions individually. For each of nine conditions, and for the aggregation of all conditions, we also calculated the prevalence of workers' compensation claims filed. RESULTS The overall prevalence of work-related chronic conditions was 7.5% (SE = 0.16). The work-related conditions with the highest prevalence were repeated trouble with the back/neck/spine (4.91%; SE = 0.13) and trouble hearing (1.14%; SE = 0.06). Overall, workers' compensation claims were filed for 39.0% (SE = 1.00) of work-related cases. CONCLUSIONS The burden of work-related illnesses in the US is substantial, and the workers' compensation system is underutilized.
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Affiliation(s)
- Sara E Luckhaupt
- Division of Surveillance, Hazard Evaluations, and Field Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, Ohio, USA.
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27
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Galizzi M, Miesmaa P, Punnett L, Slatin C. Injured Workers' Underreporting in the Health Care Industry: An Analysis Using Quantitative, Qualitative, and Observational Data. INDUSTRIAL RELATIONS 2010; 49:22-43. [PMID: 29725137 PMCID: PMC5929155 DOI: 10.1111/j.1468-232x.2009.00585.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Underreporting of occupational injuries was examined in four health care facilities using quantitative, qualitative, and observational data. Occupational Safety and Health Administration logs accounted for only one-third of the workers' compensation records; 45 percent of injured workers followed by survey had workers' compensation claims. Workers reported 63 percent of serious occupational injuries. Underreporting is explained by time pressure and workers' doubts about eligibility, reputation, income loss, and career prospects. Though aware of underreporting, managers subtly believe in workers' moral hazard behaviors.
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Affiliation(s)
- Monica Galizzi
- Department of Economics, University of Massachusetts Low-ell, FA 302 F, One University Avenue, Lowell, MA 01854; currently unaffiliated, formerly with Center for Health Promotion and Research, University of Massachusetts Lowell; Department of Work Environment, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854; Department of Community Health and Sustainability, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854
| | - Petra Miesmaa
- Department of Economics, University of Massachusetts Low-ell, FA 302 F, One University Avenue, Lowell, MA 01854; currently unaffiliated, formerly with Center for Health Promotion and Research, University of Massachusetts Lowell; Department of Work Environment, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854; Department of Community Health and Sustainability, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854
| | - Laura Punnett
- Department of Economics, University of Massachusetts Low-ell, FA 302 F, One University Avenue, Lowell, MA 01854; currently unaffiliated, formerly with Center for Health Promotion and Research, University of Massachusetts Lowell; Department of Work Environment, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854; Department of Community Health and Sustainability, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854
| | - Craig Slatin
- Department of Economics, University of Massachusetts Low-ell, FA 302 F, One University Avenue, Lowell, MA 01854; currently unaffiliated, formerly with Center for Health Promotion and Research, University of Massachusetts Lowell; Department of Work Environment, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854; Department of Community Health and Sustainability, University of Massachusetts Lowell, FA 302 F, One University Avenue, Lowell, MA 01854
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Morse TF, Deloreto A, St Louis T, Meyer JD. Are employment shifts into non-manufacturing industries partially responsible for the decline in occupational injury rates? Am J Ind Med 2009; 52:735-41. [PMID: 19722217 DOI: 10.1002/ajim.20742] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Bureau of Labor Statistics figures have shown declines in injury and illness rates over the past 25 years. It is unclear what factors are contributing to that decline. METHODS Connecticut injury and illness data was industry-adjusted to account for the shifts in employment by industry sector for the 25-year period from 1976 to 2000. Additional adjustment was made for manufacturing sub-sectors, since declines in manufacturing employment accounted for the largest proportion of the shift in injuries over that period. RESULTS Approximately 18% of the decline in injury and illness rates was associated with a shift in employment from more hazardous to less hazardous industries. Shifts in manufacturing sub-sectors accounted for an additional 5.7% of the decline. CONCLUSION A significant proportion of the decline in injury and illness rates appears to be due to demographic shifts in industry composition.
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Affiliation(s)
- Tim F Morse
- Occupational and Environmental Health Center, University of Connecticut Health Center, Farmington, Connecticut, USA.
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Stover B, Wickizer TM, Zimmerman F, Fulton-Kehoe D, Franklin G. Prognostic Factors of Long-Term Disability in a Workers?? Compensation System. J Occup Environ Med 2007; 49:31-40. [PMID: 17215711 DOI: 10.1097/01.jom.0000250491.37986.b6] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE We identified predictive factors of long-term disability in new workers' compensation claims to guide secondary prevention research and target interventions for high-risk claims. METHODS Workers with 4 or more days of work disability resulting from workplace injuries were followed for approximately 6 years in a population-based retrospective inception cohort study of 81,077 workers. RESULTS Predictors of long-term disability included delay between injury and first medical treatment, older age, construction industry, logging occupation, longer time from medical treatment to claim filing, back injury, smaller firm size, female gender, higher unemployment rate, and having dependents. We used logistic and quantile regression to investigate predictors of disability. These models produced consistent information regarding predictors. CONCLUSION These factors can be used to identify jobs or workers at increased risk for long-term disability that warrant prevention intervention.
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Affiliation(s)
- Bert Stover
- Department of Health Services, University of Washington, Seattle, Washington 98103-9058, USA.
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30
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Fan ZJ, Bonauto DK, Foley MP, Silverstein BA. Underreporting of work-related injury or illness to workers' compensation: individual and industry factors. J Occup Environ Med 2006; 48:914-22. [PMID: 16966958 DOI: 10.1097/01.jom.0000226253.54138.1e] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
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.
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Affiliation(s)
- Z Joyce Fan
- Safety & Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor & Industries, Olympia, Washington 98504-4330, USA.
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Huisstede BMA, Bierma-Zeinstra SMA, Koes BW, Verhaar JAN. Incidence and prevalence of upper-extremity musculoskeletal disorders. A systematic appraisal of the literature. BMC Musculoskelet Disord 2006; 7:7. [PMID: 16448572 PMCID: PMC1434740 DOI: 10.1186/1471-2474-7-7] [Citation(s) in RCA: 125] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2005] [Accepted: 01/31/2006] [Indexed: 11/10/2022] Open
Abstract
Background A systematic appraisal of the worldwide incidence and prevalence rates of UEDs available in scientific literature was executed to gauge the range of these estimates in various countries and to determine whether the rates are increasing in time. Methods Studies that recruited at least 500 people, collected data by using questionnaires, interviews and/or physical examinations, and reported incidence or prevalence rates of the whole upper-extremity including neck, were included. Results No studies were found with regard to the incidence of UEDs and 13 studies that reported prevalence rates of UEDs were included. The point prevalence ranged from 1.6–53%; the 12-months prevalence ranged from 2.3–41%. One study reported on the lifetime prevalence (29%). We did not find evidence of a clear increasing or decreasing pattern over time. The case definitions for UEDs used in the studies, differed enormously. Therefore, it was not possible to pool the data. Conclusion There are substantial differences in reported prevalence rates on UEDs. Main reason for this is the absence of a universally accepted way of labelling or defining UEDs. If we want to make progress in this field, the first requirement is to agree on unambiguous terminology and classification of EUDs.
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Affiliation(s)
- Bionka MA Huisstede
- Erasmus MC, Department of General Practice, Rotterdam, The Netherlands
- Erasmus MC, Department of Orthopaedic Surgery, Rotterdam, The Netherlands
| | | | - Bart W Koes
- Erasmus MC, Department of General Practice, Rotterdam, The Netherlands
| | - Jan AN Verhaar
- Erasmus MC, Department of Orthopaedic Surgery, Rotterdam, The Netherlands
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Morse T, Dillon C, Kenta-Bibi E, Weber J, Diva U, Warren N, Grey M. Trends in work-related musculoskeletal disorder reports by year, type, and industrial sector: a capture-recapture analysis. Am J Ind Med 2005; 48:40-9. [PMID: 15940716 DOI: 10.1002/ajim.20182] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Musculoskeletal disorders (MSD) are thought to be declining based on Bureau of Labor Statistics survey data, but there is also evidence of MSD under-reporting, raising the possibility of contrary trends. The magnitude of MSD under-reporting over time, and its industry distribution have not been adequately described. METHODS Capture-recapture analysis of 7 years of Connecticut MSD (1995-2001), utilizing Workers' Compensation and physician reporting data was performed. RESULTS Only 5.5%-7.9% of MSD cases appear to be reported to Workers Compensation annually. The capture-recapture estimated average annual rate for upper-extremity MSD was 133.1 per 10,000 employed persons, far above BLS rates. By industry, Manufacturing, State Government, and the Finance/Insurance/Real Estate sectors all had significantly higher MSD rates than Wholesale/Retail Trade. CONCLUSIONS Upper-extremity MSD appears to be significantly under-reported, and rates are not decreasing over time. Capture-recapture methods provide an improved surveillance method for monitoring temporal trends in injury rates.
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Affiliation(s)
- Tim Morse
- Division of Occupational & Environmental Medicine, University of Connecticut School of Medicine, Farmington, CT 06030-6210, USA.
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Morse T, Dillon C, Weber J, Warren N, Bruneau H, Fu R. Prevalence and reporting of occupational illness by company size: population trends and regulatory implications. Am J Ind Med 2004; 45:361-70. [PMID: 15029569 DOI: 10.1002/ajim.10354] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND Reports of occupational disease using the Bureau of Labor Statistics (BLS)/OSHA survey have shown increasing rates with larger establishment size. The literature is divided on whether this pattern is an artifact of under-reporting in smaller businesses or is the result of differences in underlying risk factors. METHODS A population-based survey [the Connecticut Upper-Extremity Surveillance Project (CUSP)] assessing prevalence of likely work related musculoskeletal disorders (MSD) in CT, coded by establishment size, is compared to CT MSD incidence rates based on the BLS/OSHA survey. RESULTS When analyses were controlled for age, gender, physical risks, and occupation, there was a marginally significant association between business size and the rate of MSD [odds ratio (OR) = 0.91, CI 0.82-1.01], but in the opposite direction of the BLS/OSHA rates, with larger businesses having somewhat lower rates of MSD. Reported risk factors varied in a similar direction, though with mid-sized companies having the highest physical risks. CONCLUSIONS The increased rates of occupational illness in larger businesses reported in the BLS/OSHA survey does not appear to be due to actual incidence or distribution of risk factors, but appears more likely to be due to under-reporting in smaller businesses. Estimates based on the assumption that the ORs based on size are actually similar to the CUSP population survey results suggest that MSD incidence is approximately 3.6-times the reported rates.
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Affiliation(s)
- Tim Morse
- Occupational and Environmental Medicine and Department of Community Medicine, University of Connecticut Health Center, Farmington, Connecticut 06030-6210, USA.
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