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Laskaris Z, Markowitz SB. Why presumptions are important in occupational health: The example of COVID-19 infection as an occupational disease. Am J Ind Med 2024; 67:3-9. [PMID: 37837415 DOI: 10.1002/ajim.23544] [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: 07/05/2023] [Revised: 09/29/2023] [Accepted: 10/03/2023] [Indexed: 10/16/2023]
Abstract
Workers who become ill or injured on the job while undertaking extraordinary risks on behalf of the public are, at times, granted facilitated access to workers' compensation (WC) benefits through the application of presumptions in the compensation process. Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, a broad range of occupational groups faced an elevated risk of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) exposure at work to perform vital services to maintain our food supply, sustain needed transportation, provide health care, assure energy supply and others. Some states or jurisdictions in the United States recognized both the risk and the service of these workers by enacting COVID-19 presumption laws to streamline selected essential workers' eligibility for WC benefits. Other states did not. Results of these contrasting public approaches permit an examination of the impact of presumptions in compensation by examining the frequency and outcomes of COVID-19 claims in "COVID-19 presumption" and "nonpresumption" states. Despite state-level variations in economic response to the pandemic, industry mix, and presumption eligibility criteria, the use of COVID-19 presumptions appears to have substantially increased claim filing rates and improved access to benefits. Lastly, the additional costs of COVID-19 claims to employers and insurers were lower than initially predicted. In response to future airborne infectious disease outbreaks, workers' compensation presumption laws should be universally implemented to permit a broad range of high-risk workers to work on the public's behalf without fear of losing wages and incurring medical expenses associated with a work-related viral exposure.
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Affiliation(s)
- Zoey Laskaris
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, USA
| | - Steven B Markowitz
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, Queens, New York, USA
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Sears JM, Wickizer TM, Franklin GM, Fulton-Kehoe D, Hannon PA, Harris JR, Graves JM, McGovern PM. Development and maturation of the occupational health services research field in the United States over the past 25 years: Challenges and opportunities for the future. Am J Ind Med 2023; 66:996-1008. [PMID: 37635638 DOI: 10.1002/ajim.23532] [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: 05/09/2023] [Revised: 08/09/2023] [Accepted: 08/14/2023] [Indexed: 08/29/2023]
Abstract
Work is an important social determinant of health; unfortunately, work-related injuries remain prevalent, can have devastating impact on worker health, and can impose heavy economic burdens on workers and society. Occupational health services research (OHSR) underpins occupational health services policy and practice, focusing on health determinants, health services, healthcare delivery, and health systems affecting workers. The field of OHSR has undergone tremendous expansion in both definition and scope over the past 25 years. In this commentary, focusing on the US, we document the historical development and evolution of OHSR as a research field, describe current doctoral-level OHSR training, and discuss challenges and opportunities for the OHSR field. We also propose an updated definition for the OHSR field: Research and evaluation related to the determinants of worker health and well-being; to occupational injury and illness prevention and surveillance; to healthcare, health programs, and health policy affecting workers; and to the organization, access, quality, outcomes, and costs of occupational health services and related health systems. Researchers trained in OHSR are essential contributors to improvements in healthcare, health systems, and policy and programs to improve worker health and productivity, as well as equity and justice in job and employment conditions. We look forward to the continued growth of OHSR as a field and to the expansion of OHSR academic training opportunities.
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Affiliation(s)
- Jeanne M Sears
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Harborview Injury Prevention and Research Center, Seattle, Washington, USA
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Thomas M Wickizer
- Division of Health Services Management and Policy, The Ohio State University, Columbus, Ohio, USA
| | - Gary M Franklin
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
- Department of Neurology, University of Washington, Seattle, Washington, USA
- Washington State Department of Labor and Industries, Tumwater, Washington, USA
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, Washington, USA
| | - Peggy A Hannon
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Health Promotion Research Center, University of Washington, Seattle, Washington, USA
| | - Jeffrey R Harris
- Department of Health Systems and Population Health, University of Washington, Seattle, Washington, USA
- Health Promotion Research Center, University of Washington, Seattle, Washington, USA
| | - Janessa M Graves
- College of Nursing, Washington State University, Spokane, Washington, USA
| | - Patricia M McGovern
- Division of Environmental Health Sciences, University of Minnesota, Minneapolis, Minnesota, USA
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Kyung M, Lee SJ, Dancu C, Hong O. Underreporting of workers' injuries or illnesses and contributing factors: a systematic review. BMC Public Health 2023; 23:558. [PMID: 36959647 PMCID: PMC10037763 DOI: 10.1186/s12889-023-15487-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 03/21/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Accurate identification of work-related health problems is important to understand workplace safety issues and develop appropriate interventions. Although workers' reporting of work-related injuries or illnesses is the very first step of the reporting process, many workers may encounter challenges in reporting them to their management or workers' compensation (WC) programs. This systematic review aimed to identify the level of workers' underreporting of work-related injuries and illnesses and the contributing factors and reasons for underreporting among US workers. METHODS This study searched PubMed (Medline), PsycINFO (ProQuest), CINAHL (EBSCOhost), EMBASE (Embase.com), and Social Science Citation Index (Web of Science) using search terms related to underreporting of work-related injury or illness. RESULTS Twenty studies (17 quantitative and three mixed methods studies) were identified. The studies investigated reporting to management (n = 12), WC programs (n = 6), multiple organizations (n = 1), and not specified (n = 1). The timeframe used to measure reporting prevalence varied from three months to entire careers of workers, with the most common timeframe of 12 months. This review indicated that 20-91% of workers did not report their injuries or illnesses to management or WC programs. From quantitative studies, contributing factors for injury or illness underreporting were categorized as follows: injury type and severity, sociodemographic factors (e.g., age, gender, education, and race/ethnicity), general health and functioning, worker's knowledge on reporting, job and employment characteristics (e.g., work hour, job tenure, work shift, type of occupation, and physical demand), psychosocial work environment (e.g., supervisor support, coworker support, and safety climate), and health care provider factors. From the review of qualitative studies, the reasons for underreporting included the following: fear or concern, cumbersome time and effort in the reporting process, lack of knowledge regarding reporting, perceptions of injuries as not severe or part of the job, and distrust of reporting consequences. CONCLUSIONS The review findings indicated that low wage earners, racial/ethnic minority workers, and workers who perceive a poor psychosocial work environment encounter more barriers to reporting a work-related injury or illness. This review also identified variations in the measurement of work-related injury reporting across studies and a lack of standardized measurement. TRIAL REGISTRATION The review was registered in the PROSPERO, an international database of prospectively registered systematic reviews in health and social care (CRD42021284685).
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Affiliation(s)
- MinJung Kyung
- Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, Suite #N-505, San Francisco, CA, 94143, USA.
| | - Soo-Jeong Lee
- Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, Suite #N-505, San Francisco, CA, 94143, USA
| | - Caroline Dancu
- Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, Suite #N-505, San Francisco, CA, 94143, USA
| | - OiSaeng Hong
- Department of Community Health Systems, School of Nursing, University of California San Francisco, 2 Koret Way, Suite #N-505, San Francisco, CA, 94143, USA
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Lane TJ. Collider Bias in Administrative Workers' Compensation Claims Data: A Challenge for Cross-Jurisdictional Research. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:161-169. [PMID: 34097183 DOI: 10.1007/s10926-021-09988-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 05/28/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE Workers' compensation claims consist of occupational injuries severe enough to meet a compensability threshold. Theoretically, systems with higher thresholds should have fewer claims but greater average severity. For research that relies on claims data, particularly cross-jurisdictional comparisons of compensation systems, this results in collider bias that can lead to spurious associations confounding analyses. In this study, I use real and simulated claims data to demonstrate collider bias and problems with methods used to account for it. METHODS Using Australian claims data, I used a linear regression to test the association between claim rate and mean disability durations across Statistical Areas. Analyses were repeated with nesting by state/territory to account for variations in compensability thresholds across compensation systems. Both analyses are repeated on left-censored data. Simulated claims data are analysed with Cox survival analyses to illustrate how left-censoring can reverse effects. RESULTS The claim rate within a Statistical Area was inversely associated with disability duration. However, this reversed when Statistical Areas were nested by state/territory. Left-censoring resulted in an attenuation of the unnested association to non-significance, while the nested association remained significantly positive. Cox regressions with simulated claims data demonstrated how left-censoring can reverse effects. CONCLUSIONS Collider bias can seriously confound work disability research, particularly cross-jurisdictional comparisons. Work disability researchers must grapple with this challenge by using appropriate study designs and analytical approaches, and considering how it affects the interpretation of results.
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Affiliation(s)
- Tyler J Lane
- School of Public Health and Preventive Medicine, Monash University, 553 St Kilda Road, Melbourne, VIC, 3181, Australia.
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Hudon A, MacEachen E, Lippel K. Framing the Care of Injured Workers: An Empirical Four-Jurisdictional Comparison of Workers' Compensation Boards' Healthcare Policies. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:170-189. [PMID: 35038105 DOI: 10.1007/s10926-021-10021-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/15/2021] [Indexed: 06/14/2023]
Abstract
PURPOSE The objective of this study was to explore how workers' compensation policies related to healthcare provision for workers with musculoskeletal injuries can affect the delivery and trajectories of care for injured workers. The principal research question was: What are the different ways in which workers' compensation (WC) policies inform and transform the practices of healthcare providers (HCPs) caring for injured workers? METHODS We conducted a cross-jurisdictional policy analysis. We conducted qualitative interviews with 42 key informants from a variety of perspectives in the provinces of Ontario and Quebec in Canada, the state of Victoria in Australia and the state of Washington in the United States. The main methodological approach was Framework Analysis. RESULTS We identified two main themes: (1) Shaping HCPs' clinical practices and behaviors with injured workers. In this theme, we illustrate how clinical practice guidelines and non-economic and economic incentives were used by WCs to drive HCP's behaviours with workers; (2) Controlling workers' trajectories of care. This theme presents how WC policies achieve control of the workers' trajectory of care via different policy mechanisms, namely the standardization of care pathways and the power and autonomy vested in HCPs. CONCLUSIONS This policy analysis shed light on the different ways in which WC policies shape HCP's day-to-day practices and workers' trajectories. A better understanding and a nuanced portrait of these policies' impacts can help support reflections on future policy changes and inform policy development in other jurisdictions.
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Affiliation(s)
- Anne Hudon
- School of Rehabilitation, Faculty of Medicine, Université de Montreal, Pavillon du Parc, Office 402-5, C.P. 6128, Succ. Centre-ville, Montréal, QC, H3C 3J7, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, QC, Canada.
- Centre de Recherche en Éthique (CRÉ), Montréal, QC, Canada.
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Katherine Lippel
- Faculty of Law, Civil Law Section, University of Ottawa, Ottawa, ON, Canada
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Analyzing decline in quality of life by examining employment status changes of occupationally injured workers post medical care. Ann Occup Environ Med 2022; 34:e17. [PMID: 36093268 PMCID: PMC9436793 DOI: 10.35371/aoem.2022.34.e17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 05/14/2022] [Accepted: 05/24/2022] [Indexed: 11/20/2022] Open
Abstract
Background This study aimed to investigate the decline in quality of life (QOL) by examining changes in the employment status of workers who had completed medical treatment after an industrial accident. Methods This study utilized the Panel Study of Worker’s Compensation Insurance cohort (published in October 2020) containing a sample survey of 3,294 occupationally injured workers who completed medical care in 2017. We divided this population into four groups according to changes in working status. A multivariate logistic regression model was utilized for evaluating QOL decline by adjusting for the basic characteristics and working environment at the time of accident. Subgroup analysis evaluated whether QOL decline differed according to disability grade and industry group. Results The QOL decline in the “maintained employment,” “employed to unemployed,” “remained unemployed,” and “unemployed to employed” groups were 15.3%, 28.1%, 20.2%, and 11.9%, respectively. The “maintained employment” group provided a reference. As a result of adjusting for the socioeconomic status and working environment, the odds ratios (ORs) of QOL decline for the “employed to unemployed” group and the “remained unemployed” group were 2.13 (95% confidence interval [CI], 1.51–3.01) and 1.47 (95% CI, 1.13–1.90), respectively. The “unemployed to employed” group had a non-significant OR of 0.76 (95% CI, 0.54–1.07). Conclusions This study revealed that continuous unemployment or unstable employment negatively affected industrially injured workers’ QOL. Policy researchers and relevant ministries should further develop and improve “return to work” programs that could maintain decent employment avenues within the workers’ compensation system.
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Sears JM, Edmonds AT, MacEachen E, Fulton-Kehoe D. Appraisal of Washington State workers' compensation-based return-to-work programs and suggested system improvements: A survey of workers with permanent impairments. Am J Ind Med 2021; 64:924-940. [PMID: 34462931 PMCID: PMC8500921 DOI: 10.1002/ajim.23289] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 08/09/2021] [Accepted: 08/19/2021] [Indexed: 11/09/2022]
Abstract
BACKGROUND Following a work-related permanent impairment, injured workers commonly face barriers to safe and successful return to work (RTW). Examining workers' experiences with the workers' compensation (WC) system could highlight opportunities to improve RTW outcomes. Objectives included summarizing workers': (1) appraisal of several WC-based RTW programs, and (2) suggestions for vocational rehabilitation and WC system improvements to promote safe and sustained RTW. METHODS In telephone interviews, 582 Washington State workers with work-related permanent impairments were asked whether participation in specified WC-based RTW programs helped them RTW and/or stay at work. Suggestions for program and system improvements were solicited using open-ended questions; qualitative content analysis methods were used to inductively code responses. RESULTS Most respondents reported positive impacts from RTW program participation; for example, 62.5% of vocational rehabilitation participants reported it helped them RTW, and 51.7% reported it helped them stay at work. Among 582 respondents, 28.0% reported that no change was needed to the WC system, while 57.6% provided suggestions or critiques. Reduce delays/simplify process/improve efficiency was the most frequent WC system theme-mentioned by 34.9%. Among 120 vocational rehabilitation participants, 35.8% reported that no change was needed to vocational rehabilitation, while 46.7% (N = 56) provided suggestions or critiques. More worker choice/input into the vocational retraining plan was the most frequent vocational rehabilitation theme-mentioned by 33.9%. CONCLUSIONS This study's findings suggest that there is substantial room for improvement in workers' experience with the WC system. In addition, injured workers' feedback may reflect opportunities to reduce administrative burden and to improve worker health and RTW outcomes.
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Affiliation(s)
- Jeanne M. Sears
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
- Harborview Injury Prevention and Research Center, Seattle, WA, USA
- Institute for Work and Health, Toronto, Ontario, Canada
| | - Amy T. Edmonds
- Department of Health Systems and Population Health, University of Washington, Seattle, WA, USA
| | - Ellen MacEachen
- School of Public Health Sciences, University of Waterloo, Ontario, Canada
| | - Deborah Fulton-Kehoe
- Department of Environmental and Occupational Health Sciences, University of Washington, Seattle, WA, USA
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8
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Alexander BM, Wurzelbacher SJ, Zeiler RJ, Naber SJ. Lessons learned from Ohio workers' compensation claims to mitigate hazards in the landscaping services industry. Am J Ind Med 2021; 64:699-713. [PMID: 34076900 DOI: 10.1002/ajim.23261] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 04/13/2021] [Accepted: 05/13/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND The landscaping services industry is one of the more dangerous in the United States, with higher rates of both fatal and nonfatal injuries than the all-industry average. This study uses claims from the Ohio Bureau of Workers' Compensation (OHBWC) database to identify high rates of occupational injuries and illnesses in this industry in Ohio. The causes of those illnesses and injuries are highlighted to identify common factors. METHODS The OHBWC database includes injured-worker industry identification, occupation, business size, demographics, diagnoses, and free-text descriptions of injury circumstances. We identified landscaping service industry claims from 2001 to 2017, and describe annual claim counts and rates. RESULTS Over the 17-year period, 18,037 claims were accepted, with "Struck by object or equipment" and "Overexertion involving outside sources" being the most common events or exposures. Sprains and fractures were the most prevalent of the more serious lost-time (LT) injuries. Free-text descriptions of claims indicate that arborist work and loading/unloading of work vehicles and trailers are particularly hazardous. Younger and shorter-tenured workers were injured most frequently, although the average workers' age was higher for LT claims. The total cost of claims to the OHBWC from the landscaping services industry for 2001-2017 was over $226,000,000. Almost $214,000,000, or 94.4%, was for LT injuries and illnesses, even though LT claims comprise only 18% of total claims. CONCLUSIONS Targeted improvements in landscaper safety could come from controlling events leading to LT claims. Engineering controls and improved training are strongly recommended to reduce falls, overexertion, and struck-by injuries.
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Affiliation(s)
- Barbara M. Alexander
- Division of Field Studies and Engineering National Institute for Occupational Safety and Health Cincinnati Ohio USA
| | - Steven J. Wurzelbacher
- Division of Field Studies and Engineering National Institute for Occupational Safety and Health Cincinnati Ohio USA
| | - Rachel J. Zeiler
- Division of Field Studies and Engineering National Institute for Occupational Safety and Health Cincinnati Ohio USA
| | - Steven J. Naber
- Division of Safety and Hygiene Ohio Bureau of Workers' Compensation Columbus Ohio USA
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Bush AM, Bunn TL, Liford M. Identification of work-related injury emergency department visits using International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) codes. Inj Prev 2021; 27:i3-i8. [PMID: 33674326 PMCID: PMC7948185 DOI: 10.1136/injuryprev-2019-043507] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 11/19/2020] [Accepted: 11/27/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Emergency department (ED) visit discharge data are a less explored population-based data source used to identify work-related injuries. When using discharge data, work-relatedness is often determined by the expected payer of workers' compensation (WC). In October 2015, healthcare discharge data coding systems transitioned to the International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM). ICD-10-CM's structure offers potential new work-related codes to enhance work-related injury surveillance. This study identified work-related ED visits using relevant ICD-10-CM work-related injury codes. Cases identified using this method were compared with those identified using the WC expected payer approach. METHODS State ED visit discharge data (2016-2019) were analysed using the CDC's discharge data surveillance definition. Injuries were identified using a diagnosis code or an external cause-of-injury code in any field. Injuries were assessed by mechanism and expected payer. Literature searches and manual review of ICD-10-CM codes were conducted to identify possible work-related injury codes. Descriptive statistics were performed and assessed by expected payer. RESULTS WC was billed for 87 361 injury ED visits from 2016 to 2019. Falls were the most frequent injury mechanism. The 246 ICD-10-CM work-related codes identified 36% more work-related ED injury visits than using WC as the expected payer alone. CONCLUSION This study identified potential ICD-10-CM codes to expand occupational injury surveillance using discharge data beyond the traditional WC expected payer approach. Further studies are needed to validate the work-related injury codes and support the development of a work-related injury surveillance case definition.
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Affiliation(s)
- Ashley M Bush
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA
| | - Terry L Bunn
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA
| | - Madison Liford
- Kentucky Injury Prevention and Research Center, University of Kentucky, Lexington, Kentucky, USA
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Adu-Gyamfi AB. Counting the costs: occupational injuries and illnesses among auto-artisans. Int J Inj Contr Saf Promot 2020; 28:29-38. [PMID: 33064047 DOI: 10.1080/17457300.2020.1835989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although assessing the cost of workplace injuries and illnesses as part of occupational health and safety management is important in ensuring workplace safety, the issue is generally neglected among informal auto-artisans in Ghana. This paper examines the costs of occupational injuries and illnesses in terms of productivity, financial and social aspects of selected auto-artisans who service or fabricate auto parts in Suame 'Magazine' in Kumasi, Ghana. Employing a descriptive cross-sectional design, data were collected from 957 auto-artisans selected through a multistage cluster sampling method. The study found that the most frequent occupational illnesses and injuries experienced by the auto-artisans are those related to sharp objects (83.9%), inhalation of dust particles (45.8%), objects falling from height (35.6%) and burns (21.8%). These injuries and illnesses have led to loss of productivity and income which affects family members with no variations between the various categories of auto-artisans (p = 0.976). It is concluded that occupational injuries and illnesses among informal auto-artisans presents enormous financial and emotional costs to survivors and their families. It is recommended that government should lead a policy dialogue on safety in the country's informal sector, while supporting artisans to establish insurance schemes to support them in times of injuries and illnesses.
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Rosebush CE, Zaidman B, Schofield KE, Erickson DJ, Ramirez M, Tschida B, McGovern PM. Occupational differences in workers' compensation indemnity claims among direct care workers in Minnesota nursing homes, 2005-2016. Am J Ind Med 2020; 63:517-526. [PMID: 32166773 DOI: 10.1002/ajim.23102] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 02/26/2020] [Accepted: 02/27/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Nursing assistants have one of the highest injury rates in the U.S., but few population-based studies assess differential injury risk by occupation in nursing homes. This statewide study assessed differences in musculoskeletal disorders (MSDs) and patient handling injuries among direct care workers in Minnesota nursing homes. METHODS Indemnity claims from the Minnesota workers' compensation database were matched to time at risk from the Minnesota Nursing Home Report Card to estimate 2005 to 2016 injury and illness claim rates for certified nursing assistants (CNAs), licensed practical nurses (LPNs), and registered nurses (RNs). Associations between occupation and claim characteristics were assessed using multivariable regression modeling. RESULTS Indemnity claim rates were 3.68, 1.38, and 0.69 per 100 full-time equivalent workers for CNAs, LPNs, and RNs, respectively. Patient handling injuries comprised 62% of claims. Compared to RNs, CNAs had higher odds of an indemnity claim resulting from an MSD (odds ratio [OR] = 1.67; 95% confidence interval [CI], 1.31-2.14) or patient handling injury (OR = 1.89; 95% CI, 1.47-2.45) as opposed to another type of injury or illness. CNAs had lower odds of receiving temporary and permanent partial disability benefits and higher odds of receiving a stipulation settlement. CONCLUSIONS CNAs in Minnesota nursing homes are at heightened risk for lost time MSDs and patient handling injuries. Claims filed by CNAs are more frequently settled outside the regular workers' compensation benefit structure, an indication that the workers' compensation system is not providing adequate and timely benefits to these workers.
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Affiliation(s)
- Christina E. Rosebush
- Division of Environmental Health SciencesSchool of Public Health, University of Minnesota Twin Cities Minneapolis‐Saint Paul Minnesota
| | - Brian Zaidman
- Minnesota Department of Labor and IndustryResearch and Statistics Saint Paul Minnesota
| | - Katherine E. Schofield
- Department of Mechanical and Industrial EngineeringSwenson College of Science and Engineering, University of Minnesota Duluth Duluth Minnesota
| | - Darin J. Erickson
- Division of Epidemiology and Community HealthSchool of Public Health, University of Minnesota Twin Cities Minneapolis‐Saint Paul Minnesota
| | - Marizen Ramirez
- Division of Environmental Health SciencesSchool of Public Health, University of Minnesota Twin Cities Minneapolis‐Saint Paul Minnesota
| | - Breca Tschida
- Minnesota Department of Labor and IndustryWorkplace Safety Consultation Saint Paul Minnesota
| | - Patricia M. McGovern
- Division of Environmental Health SciencesSchool of Public Health, University of Minnesota Twin Cities Minneapolis‐Saint Paul Minnesota
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12
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Punnett L. On the Relationship of Musculoskeletal Disorder Compensation Claims to Ergonomic Factors in Manufacturing. Ann Work Expo Health 2020; 64:111-113. [DOI: 10.1093/annweh/wxaa004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Laura Punnett
- Department of Biomedical Engineering, University of Massachusetts Lowell, Lowell, MA, USA
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13
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Cheng W, Chung P, Cheng Y. Transfer of the health care burden of occupational injuries and diseases from labor insurance to national health insurance in Taiwan. Am J Ind Med 2019; 62:496-502. [PMID: 31046145 DOI: 10.1002/ajim.22979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Revised: 03/18/2019] [Accepted: 03/19/2019] [Indexed: 11/11/2022]
Abstract
BACKGROUND Occupational injury and diseases result in substantial national health care burden. However, medical costs are often transferred to injured workers or the health insurance system. This study aims to examine the health care service utilization patterns of injured workers under the National Health Insurance (NHI) program in Taiwan and the barriers to medical benefit claims from labor insurance workers' compensation. METHODS The total amount spent on medical benefits and national health expenditure from 1980 to 2014 was obtained. Workers who have experienced occupational injuries or diseases were identified in four waves of national surveys, and the types of medical care use were compared. In-depth interviews were conducted with 52 workers who had experienced occupational injuries and diseases. RESULTS Since the implementation of the NHI program in 1995, medical benefits from workers' compensation have dropped substantially. In total, 75% of the workers who experienced occupational injuries or diseases had their medical costs covered through NHI. The time and effort costs caused by barriers against claiming medical benefits from workers' compensation decreased the incentive for workers from certain socioeconomic groups to make workers' compensation claims. CONCLUSION Medical costs attributable to occupational injuries or diseases were mainly paid through NHI instead of through labor insurance. The economic burden was partially shifted from employers to workers, taxpayers, and the government.
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Affiliation(s)
- Wan‐Ju Cheng
- Department of PsychiatryChina Medical University HospitalTaichung Taiwan
- Department of Public HealthChina Medical UniversityTaichung Taiwan
| | - Pei‐Hua Chung
- Department of Public HealthInstitute of Health Policy and Management, National Taiwan UniversityTaipei Taiwan
| | - Yawen Cheng
- Department of Public HealthInstitute of Health Policy and Management, National Taiwan UniversityTaipei Taiwan
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Sears JM, Edmonds AT, Coe NB. Coverage Gaps and Cost-Shifting for Work-Related Injury and Illness: Who Bears the Financial Burden? Med Care Res Rev 2019; 77:223-235. [PMID: 31018756 DOI: 10.1177/1077558719845726] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The heavy economic burden of work-related injury/illness falls not only on employers and workers' compensation systems, but increasingly on health care systems, health and disability insurance, social safety net programs, and workers and their families. We present a flow diagram illustrating mechanisms responsible for the financial burden of occupational injury/illness borne by social safety net programs and by workers and their families, due to cost-shifting and gaps in workers' compensation coverage. This flow diagram depicts various pathways leading to coverage gaps that may shift the burden of occupational injury/illness-related health care and disability costs ultimately to workers, particularly the most socioeconomically vulnerable. We describe existing research and important research gaps linked to specific pathways in the flow diagram. This flow diagram was developed to facilitate more detailed and comprehensive research into the financial burden imposed by work-related injury/illness, in order to focus policy efforts where improvement is most needed.
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Affiliation(s)
- Jeanne M Sears
- University of Washington, Seattle, WA, USA.,Harborview Injury Prevention and Research Center, Seattle, WA, USA.,Institute for Work and Health, Toronto, Ontario, Canada
| | | | - Norma B Coe
- University of Washington, Seattle, WA, USA.,University of Pennsylvania, Philadelphia, PA, USA.,National Bureau of Economic Research, Cambridge, MA, USA
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15
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Syron LN, Lucas DL, Bovbjerg VE, Kincl LD. Injury and illness among onshore workers in Alaska's seafood processing industry: Analysis of workers' compensation claims, 2014-2015. Am J Ind Med 2019; 62:253-264. [PMID: 30688374 PMCID: PMC6417873 DOI: 10.1002/ajim.22953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2019] [Indexed: 11/05/2022]
Abstract
BACKGROUND Alaska's onshore seafood processing industry is economically vital and hazardous. METHODS Accepted Alaska workers' compensation claims data from 2014 to 2015 were manually reviewed and coded with the Occupational Injury and Illness Classification System and associated work activity. Workforce data were utilized to calculate rates. RESULTS 2,889 claims of nonfatal injuries/illnesses were accepted for compensation. The average annual claim rate was 63 per 1000 workers. This was significantly higher than Alaska's all-industry rate of 44 claims per 1000 workers (RR = 1.42, 95%CI = 1.37-1.48). The most frequently occurring injuries/illnesses, were by nature, sprains/strains/tears (n = 993, 36%); by body part, upper limbs (1212, 43%); and by event, contact with objects/equipment (1020, 37%) and overexertion/bodily reaction (933, 34%). Incidents associated with seafood processing/canning/freezing (n = 818) frequently involved: repetitive motion; overexertion while handling pans, fish, and buckets; and contact with fish, pans, and machinery. CONCLUSIONS Ergonomic and safety solutions should be implemented to prevent musculoskeletal injuries/illnesses in seafood processing.
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Affiliation(s)
- Laura N. Syron
- Western States Division, National Institute for Occupational Safety and Health, Centers for Disease Control
and Prevention, Anchorage, Alaska
| | - Devin L. Lucas
- Western States Division, National Institute for Occupational Safety and Health, Centers for Disease Control
and Prevention, Anchorage, Alaska
| | - Viktor E. Bovbjerg
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
| | - Laurel D. Kincl
- College of Public Health and Human Sciences, Oregon State University, Corvallis, Oregon
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16
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Saxton DI, Stuesse A. Workers' Decompensation: Engaged Research with Injured Im/migrant Workers. ANTHROPOLOGY OF WORK REVIEW 2018. [DOI: 10.1111/awr.12147] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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17
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Topete L, Forst L, Zanoni J, Friedman L. Workers' compensation and the working poor: Occupational health experience among low wage workers in federally qualified health centers. Am J Ind Med 2018; 61:189-197. [PMID: 29388222 DOI: 10.1002/ajim.22813] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2017] [Indexed: 11/06/2022]
Abstract
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.
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Affiliation(s)
- Liza Topete
- University of Illinois at Chicago School of Public Health; Chicago Illinois
| | - Linda Forst
- University of Illinois at Chicago School of Public Health; Chicago Illinois
| | - Joseph Zanoni
- University of Illinois at Chicago School of Public Health; Chicago Illinois
| | - Lee Friedman
- University of Illinois at Chicago School of Public Health; Chicago Illinois
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18
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Marcum J, Adams D. Work-related musculoskeletal disorder surveillance using the Washington state workers' compensation system: Recent declines and patterns by industry, 1999-2013. Am J Ind Med 2017; 60:457-471. [PMID: 28295479 DOI: 10.1002/ajim.22708] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2017] [Indexed: 11/05/2022]
Abstract
BACKGROUND Work-related musculoskeletal disorders (WMSDs) are common and place large economic and social burdens on workers and their communities. We describe recent WMSD trends and patterns of WMSD incidence among the Washington worker population by industry. METHODS We used Washington State's workers' compensation compensable claims from 1999 to 2013 to describe incidence and cost of WMSD claims by body part and diagnosis, and to identify high-risk industries. RESULTS WMSD claim rates declined by an estimated annual 5.4% (95% CI: 5.0-5.9%) in Washington State from 1999 to 2013, but WMSDs continue to account for over 40% of all compensable claims. High risk industries identified were Construction; Transportation and Warehousing; Health Care and Social Assistance; and Manufacturing. CONCLUSIONS As documented in other North American contexts, this study describes an important decline in the incidence of WMSDs. The Washington State workers' compensation system provides a rich data source for the surveillance of WMSDs.
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Affiliation(s)
- Jennifer Marcum
- Safety and Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor and Industries; Washington Department of Labor and Industries; Olympia Washington
| | - Darrin Adams
- Safety and Health Assessment and Research for Prevention (SHARP), Washington State Department of Labor and Industries; Washington Department of Labor and Industries; Olympia Washington
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Wuellner SE, Adams DA, Bonauto DK. Workers' compensation claims not reported in the Survey of Occupational Injuries and Illnesses: Injury and claim characteristics. Am J Ind Med 2017; 60:264-275. [PMID: 28144976 DOI: 10.1002/ajim.22685] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/14/2016] [Indexed: 11/10/2022]
Abstract
BACKGROUND Underreporting in the nation's primary source of non-fatal occupational injury and illness data are well documented, but worker-level characteristics of unreported cases have not been fully explored. METHODS Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses (SOII) data were linked to Washington workers' compensation claims to identify injury and claim characteristics associated with unreported cases. Workers' compensation administrative date data were used to characterize timing of disability and SOII case eligibility. RESULTS Based on claim date data, one in five lost time claims with an injury date in the survey year were likely ineligible for SOII case reporting during the survey year. Among SOII-eligible claims, those involving sprains or strains, employer protests, and those not eligible for work disability payments until months after the initial injury were least likely to be reported in SOII. CONCLUSIONS SOII case capture is limited both by its cross sectional survey design and employer underreporting. Am. J. Ind. Med. 60:264-275, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Sara E. Wuellner
- Safety and Health Assessment and Research for Prevention (SHARP); Washington State Department of Labor & Industries; Olympia Washington
| | - Darrin A. Adams
- Safety and Health Assessment and Research for Prevention (SHARP); Washington State Department of Labor & Industries; Olympia Washington
| | - David K. Bonauto
- Safety and Health Assessment and Research for Prevention (SHARP); Washington State Department of Labor & Industries; Olympia Washington
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20
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The Usage of the AMA Guides for the Determination of Psychological Injury Within the State and Federal Workers’ Compensation Systems. PSYCHOLOGICAL INJURY & LAW 2016. [DOI: 10.1007/s12207-016-9273-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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21
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Injured workers and their return to work. EVIDENCE-BASED HRM: A GLOBAL FORUM FOR EMPIRICAL SCHOLARSHIP 2016. [DOI: 10.1108/ebhrm-02-2015-0002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
– The purpose of this paper is to study the factors affecting the return to work (RTW) of injured workers in an institutional setting where workers’ earnings are fully compensated during the disability period.
Design/methodology/approach
– The authors use a unique data set matching employer-employee panel data with Italian workers’ compensation records. The authors estimate survival models accounting for workers’ unobserved heterogeneity.
Findings
– Workers with higher wage growth, higher relative wages and from firms with better histories of stable employment, RTW sooner. More vulnerable workers – immigrants, females, members of smaller firms – also tend to return sooner. But even when we control for such measures of commitment, status, and job security, high-wage workers RTW sooner.
Research limitations/implications
– The authors use proxies as measures of commitment and status. The authors study blue-collar workers without finer job qualifications. The authors estimate a reduced form model.
Practical implications
– In an institutional environment where the immediate cost of workers’ compensation benefits falls largely on firms, employers seem to pressure those workers whose time off is more costly, i.e., high-wage workers. The lack of evidence of ex post moral hazard behavior also demands for a better understanding of the relationship between benefits and RTW.
Social implications
– Workers who are induced to RTW before full recovery jeopardize their long- term health and employability. Firms that put such pressure on employees might generate social costs that can be particularity high in the case of high productivity workers.
Originality/value
– The paper offers the first quantitative analysis of an institutional setting where injured workers face 100 percent benefits replacement rate and have job security. This allows focus on other workers’ or employers’ reasons to speed RTW. It is one of very few economics studies on this topic in the European context, providing implications for human resource managers, state regulators, and unions.
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22
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Dong XS, Wang X, Largay JA, Sokas R. Economic consequences of workplace injuries in the United States: Findings from the National Longitudinal Survey of Youth (NLSY79). Am J Ind Med 2016; 59:106-18. [PMID: 26771100 DOI: 10.1002/ajim.22559] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/11/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND This study explored economic consequences of work-related injuries using a longitudinal data source. METHODS Data were from the National Longitudinal Survey of Youth, 1979 cohort (n = 12,686). Short-term consequences were measured when the injury was reported. "Difference-in-differences" approach was applied to estimate income and wealth disparities between injured and non-injured workers before and after injury. Fixed effects models were used to identify variations over time. RESULTS The annual earnings growth was $3,715 (in 2000 dollars) less for workers with DAFW injury and $1,152 less for workers with NDAFW injury compared to non-injured workers during a 10-year follow-up. Lost wages and disability following injury contributed to income loss for injured workers, but the loss was moderated by union membership. After controlling for confounders, income disparities persisted, but family wealth differences did not. CONCLUSIONS Occupational injuries exacerbate income inequality. Efforts to reduce such disparities should include workplace safety and health enforcement.
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Affiliation(s)
- Xiuwen Sue Dong
- CPWR-The Center for Construction Research and Training, Data Center, Silver Spring, Maryland
| | - Xuanwen Wang
- CPWR-The Center for Construction Research and Training, Data Center, Silver Spring, Maryland
| | - Julie A Largay
- CPWR-The Center for Construction Research and Training, Data Center, Silver Spring, Maryland
| | - Rosemary Sokas
- Department of Human Science, Georgetown University School of Nursing and Health Studies, Washington, DC
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Reeb-Whitaker CK, Eckert CM, Anderson NJ, Bonauto DK. Occupational Hydrofluoric Acid Injury from Car and Truck Washing — Washington State, 2001–2013. MMWR-MORBIDITY AND MORTALITY WEEKLY REPORT 2015; 64:874-7. [PMID: 26292206 PMCID: PMC5779585 DOI: 10.15585/mmwr.mm6432a4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Affiliation(s)
- Carolyn K. Reeb-Whitaker
- Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries
- Corresponding author: Carolyn Reeb-Whitaker, , 360-902-5615
| | - Carly M. Eckert
- Department of Environmental and Occupational Health Sciences, University of Washington
| | - Naomi J. Anderson
- Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries
| | - David K. Bonauto
- Safety and Health Assessment and Research for Prevention Program, Washington State Department of Labor and Industries
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24
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Shi J, Wheeler KK, Lu B, Bishai DM, Stallones L, Xiang H. Medical expenditures associated with nonfatal occupational injuries among U.S. workers reporting persistent disabilities. Disabil Health J 2015; 8:397-406. [DOI: 10.1016/j.dhjo.2014.10.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2014] [Revised: 09/04/2014] [Accepted: 10/16/2014] [Indexed: 10/24/2022]
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25
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Spieler EA, Wagner GR. Counting matters: implications of undercounting in the BLS survey of occupational injuries and illnesses. Am J Ind Med 2014; 57:1077-84. [PMID: 25223513 DOI: 10.1002/ajim.22382] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/16/2014] [Indexed: 11/06/2022]
Affiliation(s)
- Emily A. Spieler
- Edwin W. Hadley Professor of Law Northeastern University School of Law; Boston Massachusetts
| | - Gregory R. Wagner
- National Institute for Occupational Safety and Health; Washington District of Columbia
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26
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Reeb-Whitaker CK, Bonauto DK. Respiratory disease associated with occupational inhalation to hop (Humulus lupulus) during harvest and processing. Ann Allergy Asthma Immunol 2014; 113:534-8. [PMID: 25216973 DOI: 10.1016/j.anai.2014.07.029] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 07/03/2014] [Accepted: 07/30/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND There is little published evidence for occupational respiratory disease caused by hop dust inhalation. In the United States, hops are commercially produced in the Pacific Northwest region. OBJECTIVE To describe occupational respiratory disease in hop workers. METHODS Washington State workers' compensation claims filed by hop workers for respiratory disease were systematically identified and reviewed. Incidence rates of respiratory disease in hop workers were compared with rates in field vegetable crop farm workers. RESULTS Fifty-seven cases of respiratory disease associated with hop dust inhalation were reported from 1995 to 2011. Most cases (61%) were diagnosed by the attending health care practitioner as having work-related asthma. Seven percent of cases were diagnosed as chronic obstructive pulmonary disease, and the remaining cases were diagnosed as allergic respiratory disorders (eg, allergic rhinitis) or asthma-associated symptoms (eg, dyspnea). Cases were associated with hop harvesting, secondary hop processing, and indirect exposure. The incidence rate of respiratory disease in hop workers was 15 cases per 10,000 full-time workers, which was 30 times greater than the incidence rate for field vegetable crop workers. A strong temporal association between hop dust exposure and respiratory symptoms and a clear association between an increase in hop dust concentrations and the clinical onset of symptoms were apparent in 3 cases. CONCLUSION Occupational exposure to hop dust is associated with respiratory disease. Respiratory disease rates were higher in hop workers than in a comparison group of agricultural workers. Additional research is needed before hop dust can be confirmed as a causative agent for occupational asthma.
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Affiliation(s)
- Carolyn K Reeb-Whitaker
- Washington State Department of Labor & Industries, Safety and Health Assessment and Research for Prevention Program, Olympia, Washington.
| | - David K Bonauto
- Washington State Department of Labor & Industries, Safety and Health Assessment and Research for Prevention Program, Olympia, Washington
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27
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Wong IS, Smith PM, Mustard CA, Gignac MAM. Work-injury absence and compensation among partnered and lone mothers and fathers. Am J Ind Med 2014; 57:960-9. [PMID: 24953226 DOI: 10.1002/ajim.22351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/30/2014] [Indexed: 01/09/2023]
Abstract
BACKGROUND The purpose of this study is to examine the risk of a work-injury absence and the likelihood of receiving compensation among partnered and lone mothers and fathers. METHODS This study utilized data from an annual survey of Canadian residents. Logistic regression models examined the association between family status and the receipt of workers' compensation, and absences due to work-related injury or illnesses of 7 or more days. RESULTS Being a lone mother was significantly associated with the risk of work-injury absence. Gender differences were observed for workers' compensation: mothers were half as likely as fathers to receive workers' compensation benefits, which may be attributed to differences in work experiences between men and women. CONCLUSIONS Findings may help in understanding whether some parental situations are more vulnerable than others and may contribute to identifying policies that could help workers sustain employment or return to work following an injury.
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Affiliation(s)
| | - Peter M. Smith
- Institute for Work and Health; Toronto ON Canada
- School of Public Health & Preventive Medicine; Monash University; Melbourne VIC Australia
- Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
| | - Cameron A. Mustard
- Institute for Work and Health; Toronto ON Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
| | - Monique A. M. Gignac
- Institute for Work and Health; Toronto ON Canada
- Dalla Lana School of Public Health; University of Toronto; Toronto ON Canada
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28
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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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29
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Leijon O, Lindahl E, Torén K, Vingård E, Josephson M. First-time decisions regarding work injury annuity due to occupational disease: a gender perspective. Occup Environ Med 2013; 71:147-53. [PMID: 24142986 DOI: 10.1136/oemed-2013-101489] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES This study presents an investigation of first-time decisions regarding work injury annuity due to occupational disease. Focus is a number of potential underlying factors behind the gender gap, where women are disadvantaged, in the granting of work injury annuity. METHODS All 99 subjects (80 men and 19 women) who met the conditions of long-lasting reduction of work ability due to occupational disease (not occupational accident) in the Swedish Work Injury Insurance Act and were granted work injury annuity in 2010, together with a random sample of 118 subjects (55 men and 63 women) who were denied annuity in the same year, were selected for analysis. Each subject's case file from the Social Insurance Agency was examined with regards to cause of disease, diagnosis and the Social Insurance Agency's management and decision making of claims. The data were analysed by logistic regression analysis. RESULTS Men had a higher probability of being granted work injury annuity than women for musculoskeletal disorders (OR 4.16), mental disorders (OR 7.93) and diseases in other diagnostic chapters (OR 3.65). After adjustment for age, country of birth, diagnosis, work exposure factors and decision support factors, the higher probability for men of being granted work injury annuity remained (full model: OR 2.67, 95% CI 1.20 to 5.94). CONCLUSIONS Actions are necessary in order to establish equitable and gender-neutral treatment of work injury insurance claims. There is a need for more detailed knowledge of exposures in female-dominated jobs and the relationship between these exposures and occupational disease.
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Affiliation(s)
- O Leijon
- Swedish Social Insurance Inspectorate, Stockholm, Sweden
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30
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Yassi A, Lockhart K. Work-relatedness of low back pain in nursing personnel: a systematic review. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2013; 19:223-44. [PMID: 23885775 DOI: 10.1179/2049396713y.0000000027] [Citation(s) in RCA: 81] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Although non-specific low back pain (LBP) is known to be multifactorial, studies from across the globe have documented their higher prevalence in nurses. This systematic review was conducted to ascertain whether this much-documented association constitutes a causal relationship, and whether there is a discernible threshold of exposures associated with this elevated risk. METHODS PRISMA guidelines were followed and standard critical appraisal tools were applied. The outcome of interest was non-specific LBP or back injury; exposure was "performing nursing duties." Applicable studies, published in English during 1980-2012, were identified through database searches, screened against preset inclusion/exclusion criteria. Ergonomic assessments of nursing tasks were included along with epidemiological studies. Bradford Hill considerations for causation were utilized as a framework for discussing findings. FINDINGS Of 987 studies identified, 89 qualified for inclusion, comprising 21 longitudinal, 36 cross-sectional analytic, 23 descriptive biomechanical/ergonomic, and 9 review studies. Overall studies showed that nursing activities conferred increased risk for, and were associated with back disorders regardless of nursing technique, personal characteristics, and non-work-related factors. Patient handling appears to confer the highest risk, but other nursing duties are also associated with elevated risk, and confound dose-response assessments related to patient handling alone. Associations were strong, consistent, temporally possible, plausible, coherent, and analogous to other exposure-outcomes, with risk estimates ranging from 1·2 to 5·5 depending on definitions. A threshold of nursing activities below which the risk of back disorders is not elevated has not been established. INTERPRETATION Notwithstanding the bio-psycho-social nature of LBP, and complexities of studying this area, sufficient evidence exists of a causal relationship between nursing tasks and back disorders to warrant new policies.
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Affiliation(s)
- Annalee Yassi
- The University of British Columbia, Vancouver, BC, Canada
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31
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Groenewold MR, Baron SL. The proportion of work-related emergency department visits not expected to be paid by workers' compensation: implications for occupational health surveillance, research, policy, and health equity. Health Serv Res 2013; 48:1939-59. [PMID: 23662682 DOI: 10.1111/1475-6773.12066] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE To examine trends in the proportion of work-related emergency department visits not expected to be paid by workers' compensation during 2003-2006, and to identify demographic and clinical correlates of such visits. DATA SOURCE A total of 3,881 work-related emergency department visit records drawn from the 2003-2006 National Hospital Ambulatory Medical Care Surveys. STUDY DESIGN Secondary, cross-sectional analyses of work-related emergency department visit data were performed. Odds ratios and 95 percent confidence intervals were modeled using logistic regression. PRINCIPAL FINDINGS A substantial and increasing proportion of work-related emergency department visits in the United States were not expected to be paid by workers' compensation. Private insurance, Medicaid, Medicare, and workers themselves were expected to pay for 40 percent of the work-related emergency department visits with this percentage increasing annually. Work-related visits by blacks, in the South, to for-profit hospitals and for work-related illnesses were all more likely not to be paid by workers' compensation. CONCLUSIONS Emergency department-based surveillance and research that determine work-relatedness on the basis of expected payment by workers' compensation systematically underestimate the occurrence of occupational illness and injury. This has important methodological and policy implications.
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Affiliation(s)
- Matthew R Groenewold
- National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Cincinnati, OH
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32
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Lipscomb HJ, Nolan J, Patterson D, Sticca V, Myers DJ. Safety, incentives, and the reporting of work-related injuries among union carpenters: "you're pretty much screwed if you get hurt at work". Am J Ind Med 2013; 56:389-99. [PMID: 23109103 DOI: 10.1002/ajim.22128] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2012] [Indexed: 11/12/2022]
Abstract
BACKGROUND In the high-risk construction industry little is known about the prevalence or effects of programs offering rewards for workers and/or their supervisors for improved safety records or those that punish workers in some way for injury. METHODS We conducted an anonymous survey of 1,020 carpenter apprentices in three union training programs to document prevalence of their exposure to such efforts. We explored associations between perceptions of the reporting of work-related injury and elements of these programs. RESULTS Fifty-eight percent (58%; n = 592) reported some safety incentive or negative consequence of work-related injuries on their current jobsite. Reporting of work-related injuries was 50% less prevalent when workers were disciplined for injury experiences. Otherwise, we saw minimal evidence of association between injury reporting practices and safety incentive programs. However, considerable evidence of fear of reprisal for reporting injuries was revealed. Less than half (46.4%) reported that work-related injuries were reported in their current workplace all or most of the time; over 30% said they were almost never or rarely reported. CONCLUSIONS There are multiple layers of disincentives to the reporting of work-related injuries that hamper understanding of risk and pose threats to workplace safety and productivity. These pressures do not arise in a vacuum and are likely influenced by a host of contextual factors. Efforts that help us understand variation across jobsites and time could be enlightening; such inquiries may require mixed methodologies and should be framed with consideration for the upper tiers of the public health hierarchy of hazard control.
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Affiliation(s)
- Hester J Lipscomb
- Division of Occupational and Environmental Medicine, Duke University Medical Center, Durham, NC 27710, USA.
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García Gómez M, Urbaneja Arrúe F, Markowitz S, Castañeda López R, Menduiña PL. Occupational diseases compensated in the Basque Country (Spain) from 1990 to 2008. Am J Ind Med 2013; 56:326-34. [PMID: 23299989 DOI: 10.1002/ajim.22158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/07/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Spain, and some of its regions in particular, report higher rates of occupational diseases than many other countries in Europe. We describe the distribution and temporal trend of compensated occupational diseases among the working population of the Basque Country, a heavy industrialized Spanish region, from 1990 to 2008. METHODS Employment data and occupational disease data were obtained from the Spanish Institute of Statistics and the Basque and Spanish Social Security Departments, respectively. Annual incidence of occupational diseases and temporal trends were computed. RESULTS Occupational diseases (33,547) were reported among workers in the Basque Country between 1990 and 2008. The occupational disease incidence increased sixfold during the study period, mainly due to less severe cases. The most frequent occupational diseases were caused by physical agents (85%), principally musculoskeletal disorders. The occupational disease incidence in Basque Country was two to six times higher than in most other regions of Spain and Europe. CONCLUSIONS The rise in compensated occupational illnesses in the Basque Country is likely due to a mixture of better recognition of such illnesses and changes in laws, regulations, and administrative procedures. Chronic occupational diseases such as cancer and chronic respiratory diseases, however, remain under-reported, and care for people with such illnesses represents an undue financial burden on the public health care system and on their families.
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Abstract
Injured workers, particularly those with more severe injuries, have long experienced workers' compensation systems as stressful and demeaning, have found it difficult to obtain benefits, and, when able to obtain benefits, have found them inadequate. Moreover, the last two decades have seen a substantial erosion of the protections offered by workers' compensation. State after state has erected additional barriers to benefit receipt, making the workers' compensation experience even more difficult and degrading. These changes have been facilitated by a framing of the political debate focused on the free market paradigm, employer costs, and worker fraud and malingering. The articles in this special issue propose an alternate framework and analysis, a human rights approach, that values the dignity and economic security of injured workers and their families.
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Affiliation(s)
- Leslie I Boden
- Department of Environmental Health, Boston University School of Public Health, Massachusetts, USA.
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