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Dean A, McCallum J, Venkataramani AS, Michaels D. The Effect Of Labor Unions On Nursing Home Compliance With OSHA's Workplace Injury And Illness Reporting Requirement. Health Aff (Millwood) 2023; 42:1260-1265. [PMID: 37669485 DOI: 10.1377/hlthaff.2023.00255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/07/2023]
Abstract
All US nursing homes are required to report workplace injury and illness data to the Occupational Safety And Health Administration (OSHA). Nevertheless, the compliance rate for US nursing homes during the period 2016-21 was only 40 percent. We examined whether unionization increases the probability that nursing homes will comply with that requirement. Using a difference-in-differences design and proprietary data on union status from the Service Employees International Union for all forty-eight continental US states from the period 2016-21, we found that two years after unionization, nursing homes were 31.1 percentage points more likely than nonunion nursing homes to report workplace injury and illness data to OSHA. Data on injuries occurring in specific workplaces play a central role in injury prevention. Further unionization could help improve workplace safety in nursing homes, a sector with one of the highest occupational injury and illness rates in the US.
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Affiliation(s)
- Adam Dean
- Adam Dean , George Washington University, Washington, D.C
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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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An introduction to "discrete choice experiments" for behavior analysts. Behav Processes 2022; 198:104628. [PMID: 35354088 PMCID: PMC9885321 DOI: 10.1016/j.beproc.2022.104628] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 03/18/2022] [Accepted: 03/22/2022] [Indexed: 02/01/2023]
Abstract
In this paper, we introduce discrete choice experiments (DCEs) and provide foundational knowledge on the topic. DCEs are one of the most popular methods within econometrics to study the distribution of choices within a population. DCEs are particularly useful when studying the effects of categorical variables on choice. Procedurally, a DCE involves recruiting a large sample of individuals exposed to a set of choice arrays. The factors that are suspected to affect choice are varied systematically across the choice arrays. Most commonly, DCE data are analyzed with a multinomial logit statistical model with a goal of determining the relative utility of each relevant factor. We also discuss DCEs in comparison with behavioral choice models, such as those based on the matching law, and we show an example of a DCE to illustrate how a DCE can be used to understand choice with behavioral, social, and organizational factors.
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Work Organization Factors Associated with Health and Work Outcomes among Apprentice Construction Workers: Comparison between the Residential and Commercial Sectors. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18178899. [PMID: 34501489 PMCID: PMC8430912 DOI: 10.3390/ijerph18178899] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Revised: 08/19/2021] [Accepted: 08/21/2021] [Indexed: 12/17/2022]
Abstract
There are substantial differences in work organization between residential and commercial construction sectors. This paper examined differences in work factors between construction sectors and examined the association between sector and health behaviors, health outcomes, and work outcomes. We surveyed 929 male construction apprentices (44% residential and 56% commercial) and found that residential apprentices reported fewer workplace safety policies, higher frequency of heavy lifting, and greater likelihood of reporting musculoskeletal pain compared to apprentices in commercial work. Residential apprentices reported higher job strain, lower supervisor support, more lost workdays due to pain or injury, and lower productivity related to health than commercial apprentices. Multivariate Poisson regression models controlling for multiple work factors showed that residential construction work, high job strain, heavy lifting, low coworker support, and low supervisor support were each independently associated with one or more work or health outcomes. These findings suggest that interventions should seek to improve coworker and supervisory supportive behaviors, decrease job strain, and reduce organizational stressors, such as mandatory overtime work. Our study shows disparities in health and safety between construction sectors and highlights the need for interventions tailored to the residential sector.
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Clinical Guidance to Optimize Work Participation After Injury or Illness: The Role of Physical Therapists. J Orthop Sports Phys Ther 2021; 51:CPG1-CPG102. [PMID: 34338006 DOI: 10.2519/jospt.2021.0303] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Work rehabilitation refers to the process of assisting workers to remain at work or return to work (RTW) in a safe and productive manner, while limiting the negative impact of restricted work, unemployment, and work disability. The primary purpose of this clinical practice guideline (CPG) is to systematically review available scientific evidence and provide a set of evidence-based recommendations for effective physical therapy evaluation, treatment, and management of individuals experiencing limitations in the ability to participate in work following injury or illness. J Orthop Sports Phys Ther 2021;51(8):CPG1-CPG102. doi:10.2519/jospt.2021.0303.
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When the Tension Is Rising: A Simulation-Based Study on the Effects of Safety Incentive Programs and Behavior-Based Safety Management. SAFETY 2021. [DOI: 10.3390/safety7010009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
When an organization’s management creates a goal conflict between workplace safety and the profitability of the organization, workers perceive work-safety tension. This leads to reduced safety-related behavior, culminating in higher rates of occupational injuries. In this study, we explored design components of behavior-based safety programs: audit results and process communication, reward and punishment, and the framing of production goals as gains or losses. This allowed us to directly observe the effects of the goal conflicts and of the countermeasures that we designed in this study. We examined the perceived work-safety tension using a simulated water treatment plant in a laboratory study with 166 engineering students. Participants had the task of conducting a start-up procedure. The operators’ goal conflict was created by a choice between a safe and mandatory (less productive) procedure and an unsafe and forbidden (more productive) one. As participants were told that their payment for the study would depend on their performance, we expected that rule violations would occur. We found acceptance of measures and their design as important for rule related behavior. Work-safety tension emerged as a strong driver for violating safety rules. We conclude that safety incentive programs can become ineffective if goal conflicts create work-safety tension.
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Wirth O, Foreman AM, Friedel JE, Andrew ME. Two discrete choice experiments on laboratory safety decisions and practices. JOURNAL OF SAFETY RESEARCH 2020; 75:99-110. [PMID: 33334498 PMCID: PMC7755112 DOI: 10.1016/j.jsr.2020.08.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 04/17/2020] [Accepted: 08/12/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The path toward enhancing laboratory safety requires a thorough understanding of the factors that influence the safety-related decision making of laboratory personnel. METHOD We developed and administered a web-based survey to assess safety-related decision making of laboratory personnel of a government research organization. The survey included two brief discrete choice experiments (DCEs) that allowed for quantitative analysis of specific factors that potentially influence safety-related decisions and practices associated with two different hypothetical laboratory safety scenarios. One scenario related to reporting a laboratory spill, and the other scenario involved changing protective gloves between laboratory rooms. The survey also included several brief self-report measures of attitude, perception, and behavior related to safety practices. RESULTS Risk perception was the most influential factor in safety-related decision making in both scenarios. Potential negative consequences and effort associated with reporting an incident and the likelihood an incident was detected by others also affected reporting likelihood. Wearing gloves was also affected somewhat by perceived exposure risk, but not by other social or work-related factors included in the scenarios. CONCLUSIONS The study demonstrated the promise of DCEs in quantifying the relative impact of several factors on safety-related choices of laboratory workers in two hypothetical but realistic scenarios. Participants were faced with hypothetical choice scenarios with realistic features instead of traditional scaling techniques that ask about attitudes and perceptions. The methods are suitable for addressing many occupational safety concerns in which workers face tradeoffs in their safety-related decisions and behavior. Practical Application: Safety-related decisions regarding laboratory practices such as incident reporting and use of PPE were influenced primarily by workers' perceptions of risk of exposure and severity of risks to health and safety. This finding suggests the importance of providing laboratory workers with adequate and effective education and training on the hazards and risks associated with their work. DCEs are a promising research method for better understanding the relative influences of various personal, social, and organizational factors that shape laboratory safety decisions and practices. The information gained from DCEs may lead to more targeted training materials and interventions.
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Affiliation(s)
- Oliver Wirth
- Bioanalytics Branch (BB), Health Effects Laboratory Division (HELD), National Institute for Occupational Safety Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV 26508, United States.
| | - Anne M Foreman
- Bioanalytics Branch (BB), Health Effects Laboratory Division (HELD), National Institute for Occupational Safety Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV 26508, United States
| | - Jonathan E Friedel
- Bioanalytics Branch (BB), Health Effects Laboratory Division (HELD), National Institute for Occupational Safety Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV 26508, United States
| | - Michael E Andrew
- Bioanalytics Branch (BB), Health Effects Laboratory Division (HELD), National Institute for Occupational Safety Health (NIOSH), Centers for Disease Control and Prevention (CDC), Morgantown, WV 26508, United States
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Anton D, Bray M, Hess JA, Weeks DL, Kincl LD, Vaughan A. Prevalence of work-related musculoskeletal pain in masonry apprentices. ERGONOMICS 2020; 63:1194-1202. [PMID: 32450781 DOI: 10.1080/00140139.2020.1772380] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Accepted: 05/11/2020] [Indexed: 06/11/2023]
Abstract
The construction industry, specifically masonry, reports more work-related musculoskeletal disorders (WMSD) rates than the general industry. Masonry apprentices are assumed to be healthy, yet may have WMSDs. The purpose of this study was to evaluate the prevalence of musculoskeletal symptoms (MSS), time loss, and healthcare use among apprentices. 183 brick and block masonry apprentices completed surveys on demographics, work history, MSS, and functional well-being. The prevalence of MSS was calculated by body region, time loss, and healthcare use. The relationship between MSS, and perceived global physical and mental health was assessed. Approximately 78% of apprentices reported MSS, most in several body regions. Low back and wrists/hands were most prevalent, although few missed work or sought healthcare. Lower functional health and well-being was reported. Apprentices reported MSS comparable to previous studies of journey-level masons. Apprenticeship programmes could integrate ergonomics education to help apprentices develop safety culture early in their careers. Practitioner Summary: New masonry workers (apprentices) are assumed to be healthy yet work-related musculoskeletal symptoms (MSS) may be common early in their career. The prevalence of MSS was assessed among apprentices. Approximately 78% of apprentices reported MSS, most in several body regions, comparable to journey-level masons. Abbreviations: WMSD: work-related musculoskeletal disorders; MSS: musculoskeletal symptoms; SAVE: SAfety voice for ergonomics; MNQ: modified nordic questionnaire; FTE: full-time equivalent; SF-12: short from-12v2.
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Affiliation(s)
- Dan Anton
- Department of Physical Therapy, Eastern Washington University, Spokane, WA, USA
| | - Matthew Bray
- Department of Physical Therapy, Eastern Washington University, Spokane, WA, USA
| | - Jennifer A Hess
- Labor Education and Research Center, University of Oregon, Eugene, OR, USA
| | - Douglas L Weeks
- Department of Rehabilitation Research, St. Luke's Rehabilitation Institute, Spokane, WA, USA
| | - Laurel D Kincl
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
| | - Amelia Vaughan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR, USA
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Schwartz A, Gerberich SG, Albin T, Kim H, Ryan AD, Church TR, Green DR, McGovern PM, Erdman AG, Arauz RF. The association between janitor physical workload, mental workload, and stress: The SWEEP study. Work 2020; 65:837-846. [PMID: 32310213 DOI: 10.3233/wor-203135] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Approximately 2.38 million janitors are employed in the U.S. While high physical workload may explain a lost-work days rate 2.7 times greater than other occupations, little is known about the association between janitors' physical workload, mental workload, and stress. OBJECTIVE The objective of this study was to assess the associations between physical (ergonomic) and mental workload exposures and stress outcomes among janitors. METHODS Questionnaire data, focused on ergonomic workload, mental workload and stress, were collected from Minnesota janitors for a one-year period. Physical workload was assessed with Borg Scales and Rapid Entire Body Assessments (REBA). Mental workload assessment utilized the NASA Task Load Index (TLX). Stress assessments utilized single-item ordinal stress scale (SISS) and Perceived Stress Scale-4 (PSS-4) measures. Descriptive and multivariable analyses, including bias adjustment, were conducted. RESULTS Odds ratios (OR) and 95% confidence intervals (CI) for ergonomic workload (task frequency) effects on SISS were: REBA (1.18 OR, 1.02-1.37 CI); Borg (1.25 OR, 1.00-1.56 CI); combined REBA and Borg (1.10 OR, 1.01-1.20 CI). Mental workload was associated with higher PSS-4 levels (0.15 Mean Difference, 0.08-0.22 CI) and a 3% increased risk for each one-unit increase in the SISS scale (1.03 OR, 1.02-1.05 CI). CONCLUSIONS This research demonstrated a moderate effect of physical and mental workloads on stress among janitors.
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Affiliation(s)
- Adam Schwartz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Susan Goodwin Gerberich
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas Albin
- High Plains Engineering Services, Minneapolis, MN, USA
| | - Hyun Kim
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Andrew D Ryan
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Timothy R Church
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Deirdre R Green
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Patricia M McGovern
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Arthur G Erdman
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rony F Arauz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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Schwartz A, Gerberich SG, Kim H, Ryan AD, Church TR, Albin TJ, McGovern PM, Erdman AE, Green DR, Arauz RF. Janitor ergonomics and injuries in the safe workload ergonomic exposure project (SWEEP) study. APPLIED ERGONOMICS 2019; 81:102874. [PMID: 31422267 DOI: 10.1016/j.apergo.2019.102874] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Revised: 06/04/2019] [Accepted: 06/06/2019] [Indexed: 06/10/2023]
Abstract
INTRODUCTION A Minnesota union identified to researchers at the University of Minnesota a concern relevant to a possible relation between their daily workload and outcome of occupational injuries among a population of janitors. OBJECTIVE To assess if the ergonomic workload is related to injuries among janitors. METHODS Following an initial group discussion among janitors, which identified common and hazardous tasks potentially leading to occupational injuries, a questionnaire was developed, pre-tested, and distributed to the janitors. Questions addressed various exposures, including workload, and comprehensive information regarding injury occurrence over two six-month sequential periods (May 2016-October 2016, November 2016-April 2017). Quantitative ergonomic analyses were performed on a sub-group of janitors (n = 30); these included data collection to identify Borg Perceived Exertion (Borg) and Rapid Entire Body Assessment (REBA) scores. Descriptive, multivariable with bias adjustment analyses were conducted on the resulting data. RESULTS Eight tasks were found to be common for janitors. All average REBA scores for the tasks were identified in the high-risk category. The task of repeatedly emptying small trash cans (<25lb) was significantly related to injuries. Average Borg scores fell between the very light perceived exertion and somewhat difficult perceived exertion categories. Multivariable regression analyses indicated that age-sex-standardized ergonomic workload, measured by task frequencies and REBA or Borg scores, was positively related to injury occurrence. CONCLUSIONS Standardized ergonomic workload was positively related to injury occurrence. This information serves as a basis for further research and potential intervention efforts.
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Affiliation(s)
- Adam Schwartz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Susan G Gerberich
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
| | - Hyun Kim
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Andrew D Ryan
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Timothy R Church
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | | | - Patricia M McGovern
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Arthur E Erdman
- Department of Mechanical Engineering, College of Science and Engineering, University of Minnesota, Minneapolis, MN, USA
| | - Deirdre R Green
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Rony F Arauz
- Midwest Center for Occupational Health and Safety Education and Research Center, Division of Environmental Health Sciences, School of Public Health, University of Minnesota, Minneapolis, MN, USA
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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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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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13
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Manjourides J, Dennerlein JT. Testing the associations between leading and lagging indicators in a contractor safety pre-qualification database. Am J Ind Med 2019; 62:317-324. [PMID: 30724373 DOI: 10.1002/ajim.22951] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2018] [Indexed: 11/08/2022]
Abstract
BACKGROUND Safety prequalification assessing contractors' safety management systems and safety programs lack validation in predicting construction worker injuries. METHODS Safety assessments of leading indicators from 2198 construction contractors, including Safety Management Systems (SMS), Safety Programs (e.g., falls, hearing protection), and Special Elements (drug testing, return to work) scales as well as the history of citations from the Occupational Safety and Health Administration (OSHA) were compared to contractors' lagging indicators of recordable injury case rates (RC) and rates of injuries involving days away, restricted, or transferred (DART). RESULTS Increased SMS scores were related to lower injury rates. Each one-point increase in SMS values was associated with 34% reduced odds of a recordable case rate greater than zero (Odds ratio (OR): 0.66, 95% Confidence Interval (CI): (0.57, 0.79)), and a 9% reduced recordable case rate, if one occurs (Risk Ratio (RR): 0.91, 95% CI: (0.88, 0.94)). A one-point increase in SMS was associated with 28% reduced odds of a DART (OR = 0.72, 95%CI (0.56, 0.91)), and 9% reduced DART rate, if one occurs (RR = 0.91, 95%CI (0.87, 0.95)). Safety programs did not show consistent associations with injury outcomes. Having additional Special Elements related to drug and alcohol programs was associated with lower injury rates while the Special Element related to return to work showed no consistent associations with injury. Having more OSHA Citations was associated with lower injury rates for companies with injuries. CONCLUSIONS These results support pre-qualification methods based on SMS and suggest the need for safety management systems in contractors.
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Affiliation(s)
- Justin Manjourides
- Department of Health SciencesBouvé College of Health SciencesNortheastern UniversityBostonMassachusetts
| | - Jack T. Dennerlein
- Department of Physical Therapy, Movement, and Rehabilitation SciencesBouvé College of Health SciencesNortheastern UniversityBostonMassachusetts
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14
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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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Besen E, Young A, Gaines B, Pransky G. Lag times in the work disability process: Differences across diagnoses in the length of disability following work-related injury. Work 2018; 60:635-648. [PMID: 30149487 DOI: 10.3233/wor-182771] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022] Open
Abstract
BACKGROUND The amount of time between key points in the work disability and workers' compensation process, referred to as lag times, has been shown to relate to work disability outcomes but little research has examined how this finding may differ based on the diagnosis associated with the cause of work disability. OBJECTIVE To examine whether relationships between lag times in the work disability process and disability duration vary by diagnosis in a sample of workers' compensation claims. METHODS Using workers' compensation claims, Analysis of Covariance was used to estimate differences in disability duration across three lag times (days from the date of injury to: reporting the injury, seeking medical care, and starting lost work time paid by the workers' compensation insurer) and injury diagnosis groups (Work-related Musculoskeletal Disorders (WRMSD) and fractures). RESULTS WRMSD tended to have longer lag times than fractures, whereas disability duration tended to be longer for fractures than WRMSD. Overall, shorter lag times were associated with shorter disability duration, but the relationships varied across diagnosis groups, and greater variation in disability duration was observed for WRMSD compared to fractures. CONCLUSIONS The findings suggest the importance of responding to work-related injuries by reporting the injury, receiving medical care, and taking time off of work if necessary, in a timely fashion.
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Affiliation(s)
- Elyssa Besen
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Amanda Young
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Brittany Gaines
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
| | - Glenn Pransky
- Center for Disability Research, Liberty Mutual Research Institute for Safety, Hopkinton, MA, USA
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Schoenfisch AL, Lipscomb H, Sinyai C, Adams D. Effectiveness of OSHA Outreach Training on carpenters' work-related injury rates, Washington State 2000-2008. Am J Ind Med 2017; 60:45-57. [PMID: 27779309 DOI: 10.1002/ajim.22665] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2016] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Despite the size and breadth of OSHA's Outreach Training program for construction, information on its impact on work-related injury rates is limited. METHODS In a 9-year dynamic cohort of 17,106 union carpenters in Washington State, the effectiveness of OSHA Outreach Training on workers' compensation claims rate was explored. Injury rates were calculated by training status overall and by carpenters' demographic and work characteristics using Poisson regression. RESULTS OSHA Outreach Training resulted in a 13% non-significant reduction in injury claims rates overall. The protective effect was more pronounced for carpenters in their apprenticeship years, drywall installers, and with increasing time since training. CONCLUSIONS In line with these observed effects and prior research, it is unrealistic to expect OSHA Outreach Training alone to have large effects on union construction workers' injury rates. Standard construction industry practice should include hazard awareness and protection training, coupled with more efficient approaches to injury control. Am. J. Ind. Med. 60:45-57, 2017. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Ashley L. Schoenfisch
- Duke University School of Nursing; Durham North Carolina
- Division of Occupational and Environmental Medicine; Department of Community and Family Medicine; Duke University School of Medicine; Durham North Carolina
| | - Hester Lipscomb
- Division of Occupational and Environmental Medicine; Department of Community and Family Medicine; Duke University School of Medicine; Durham North Carolina
| | - Clayton Sinyai
- CPWR-The Center for Construction Research and Training; Silver Spring Maryland
| | - Darrin Adams
- Safety and Health Assessment and Research Program (SHARP); Department of Labor and Industries; State of Washington; Olympia Washington
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17
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Hall A. Trust, uncertainty and the reporting of workplaces hazards and injuries. HEALTH, RISK & SOCIETY 2016. [DOI: 10.1080/13698575.2016.1264576] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Alan Hall
- Department of Sociology, Memorial University, St. John’s, Canada
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Sparer EH, Catalano PJ, Herrick RF, Dennerlein JT. Improving safety climate through a communication and recognition program for construction: a mixed methods study. Scand J Work Environ Health 2016; 42:329-37. [PMID: 27158914 PMCID: PMC4948113 DOI: 10.5271/sjweh.3569] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVES This study aimed to evaluate the efficacy of a safety communication and recognition program (B-SAFE), designed to encourage improvement of physical working conditions and hazard reduction in construction. METHODS A matched pair cluster randomized controlled trial was conducted on eight worksites (four received the B-SAFE intervention, four served as control sites) for approximately five months per site. Pre- and post-exposure worker surveys were collected at all sites (N=615, pre-exposure response rate of 74%, post-exposure response rate of 88%). Multi-level mixed effect regression models evaluated the effect of B-SAFE on safety climate as assessed from surveys. Focus groups (N=6-8 workers/site) were conducted following data collection. Transcripts were coded and analyzed for thematic content using Atlas.ti (version 6). RESULTS The mean safety climate score at intervention sites, as measured on a 0-50 point scale, increased 0.5 points (1%) between pre- and post-B-SAFE exposure, compared to control sites that decreased 0.8 points (1.6%). The intervention effect size was 1.64 (3.28%) (P-value=0.01) when adjusted for month the worker started on-site, total length of time on-site, as well as individual characteristics (trade, title, age, and race/ethnicity). At intervention sites, workers noted increased levels of safety awareness, communication, and teamwork compared to control sites. CONCLUSIONS B-SAFE led to many positive changes, including an improvement in safety climate, awareness, teambuilding, and communication. B-SAFE was a simple intervention that engaged workers through effective communication infrastructures and had a significant, positive effect on worksite safety.
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Affiliation(s)
- Emily H Sparer
- Department of Physical Therapy, Movement, and Rehabilitation Sciences, Bouvé College of Health Sciences, Northeastern University, 301 Robinson Hall, 360 Huntington Ave, Boston, MA 02115, USA.
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Rappin CL, Wuellner SE, Bonauto DK. Employer reasons for failing to report eligible workers' compensation claims in the BLS survey of occupational injuries and illnesses. Am J Ind Med 2016; 59:343-56. [PMID: 26970051 PMCID: PMC5069593 DOI: 10.1002/ajim.22582] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/11/2016] [Indexed: 11/06/2022]
Abstract
Background Little research has been done to identify reasons employers fail to report some injuries and illnesses in the Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses (SOII). Methods We interviewed the 2012 Washington SOII respondents from establishments that had failed to report one or more eligible workers’ compensation claims in the SOII about their reasons for not reporting specific claims. Qualitative content analysis methods were used to identify themes and patterns in the responses. Results Non‐compliance with OSHA recordkeeping or SOII reporting instructions and data entry errors led to unreported claims. Some employers refused to include claims because they did not consider the injury to be work‐related, despite workers’ compensation eligibility. Participant responses brought the SOII eligibility of some claims into question. Conclusion Systematic and non‐systematic errors lead to SOII underreporting. Insufficient recordkeeping systems and limited knowledge of reporting requirements are barriers to accurate workplace injury records. Am. J. Ind. Med. 59:343–356, 2016. © 2016 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.
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Affiliation(s)
- Christina L. Rappin
- Safety and Health Assessment and Research for Prevention (SHARP) ProgramWashington State Department of Labor and IndustriesOlympiaWashington
| | - Sara E. Wuellner
- Safety and Health Assessment and Research for Prevention (SHARP) ProgramWashington State Department of Labor and IndustriesOlympiaWashington
| | - David K. Bonauto
- Safety and Health Assessment and Research for Prevention (SHARP) ProgramWashington State Department of Labor and IndustriesOlympiaWashington
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20
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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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Lipscomb HJ, Schoenfisch AL, Cameron W, Kucera KL, Adams D, Silverstein BA. Contrasting patterns of care for musculoskeletal disorders and injuries of the upper extremity and knee through workers' compensation and private health care insurance among union carpenters in Washington State, 1989 to 2008. Am J Ind Med 2015; 58:955-63. [PMID: 25939759 DOI: 10.1002/ajim.22455] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2015] [Indexed: 11/07/2022]
Abstract
BACKGROUND Musculoskeletal symptoms and disorders (MSDIs) are common reasons for visits to medical providers in the general population and they are common work-related complaints. Prior reports raise concerns as to whether declines in workers' compensation (WC) rates represent true improvement in occupational health and safety or shifting of care to other payment systems. METHODS By linking administrative records, we compared patterns of WC claims and private health care utilization for disorders of the upper extremity (UE) and knee among a large cohort of union carpenters over a 20-year period. RESULTS As WC claim rates declined, private health care utilization increased. The increase was muted somewhat but sustained when adjusting for other patterns of health care utilization. CONCLUSIONS Findings suggest the decline of WC claim rates do not solely represent improved occupational safety in this population, but also a considerable shifting of care to their private insurance coverage over time.
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Affiliation(s)
- Hester J. Lipscomb
- Division of Occupational and Environmental Medicine; Duke University Medical Center; Durham North Carolina
| | - Ashley L. Schoenfisch
- Division of Occupational and Environmental Medicine; Duke University Medical Center; Durham North Carolina
| | - Wilfrid Cameron
- Strategic Solutions for Safety, Health and Environment; Seattle Washington
| | - Kristen L. Kucera
- Department of Exercise and Sport Science; University of North Carolina; Chapel Hill North Carolina
| | - Darrin Adams
- Safety and Health Assessment and Research Program (SHARP); Department of Labor and Industries; State of Washington; Olympia Washington
| | - Barbara A. Silverstein
- Safety and Health Assessment and Research Program (SHARP); Department of Labor and Industries; State of Washington; Olympia Washington
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22
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Marin LS, Cifuentes M, Roelofs C. Results of a community-based survey of construction safety climate for Hispanic workers. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2015; 21:223-31. [PMID: 26145454 DOI: 10.1179/2049396714y.0000000086] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
BACKGROUND Hispanic construction workers experience high rates of occupational injury, likely influenced by individual, organizational, and social factors. OBJECTIVES To characterize the safety climate of Hispanic construction workers using worker, contractor, and supervisor perceptions of the workplace. METHODS We developed a 40-item interviewer-assisted survey with six safety climate dimensions and administered it in Spanish and English to construction workers, contractors, and supervisors. A safety climate model, comparing responses and assessing contributing factors was created based on survey responses. RESULTS While contractors and construction supervisors' (n = 128) scores were higher, all respondents shared a negative perception of safety climate. Construction workers had statistically significantly lower safety climate scores compared to supervisors and contractors (30·6 vs 46·5%, P<0·05). Safety climate scores were not associated with English language ability or years lived in the United States. CONCLUSIONS We found that Hispanic construction workers in this study experienced a poor safety climate. The Hispanic construction safety climate model we propose can serve as a framework to guide organizational safety interventions and evaluate safety climate improvements.
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Lipscomb HJ, Schoenfisch AL, Cameron W. Non-reporting of work injuries and aspects of jobsite safety climate and behavioral-based safety elements among carpenters in Washington State. Am J Ind Med 2015; 58:411-21. [PMID: 25676039 DOI: 10.1002/ajim.22425] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/17/2014] [Indexed: 11/09/2022]
Abstract
BACKGROUND Declining work injury rates may reflect safer work conditions as well as under-reporting. METHODS Union carpenters were invited to participate in a mailed, cross-sectional survey designed to capture information about injury reporting practices. Prevalence of non-reporting and fear of repercussions for reporting were compared across exposure to behavioral-based safety elements and three domains of the Nordic Safety Climate Questionnaire (NOSACQ-50). RESULTS The majority (>75%) of the 1,155 participants felt they could report work-related injuries to their supervisor without fear of retribution, and most felt that the majority of injuries on their jobsites got reported. However, nearly half indicated it was best not to report minor injuries, and felt pressures to use their private insurance for work injury care. The prevalence of non-reporting and fear of reporting increased markedly with poorer measures of management safety justice (NOSACQ-50). CONCLUSIONS Formal and informal policies and practices on jobsites likely influence injury reporting.
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Affiliation(s)
- Hester J. Lipscomb
- Division of Occupational and Environmental Medicine; Duke University Medical Center Durham; North Carolina
| | - Ashley L. Schoenfisch
- Division of Occupational and Environmental Medicine; Duke University Medical Center Durham; North Carolina
| | - Wilfrid Cameron
- Strategic Solutions for Safety; Health and Environment Seattle; Washington
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Sparer EH, Herrick RF, Dennerlein JT. Development of a safety communication and recognition program for construction. New Solut 2015; 25:42-58. [PMID: 25815741 DOI: 10.1177/1048291115569025] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Leading-indicator-based (e.g., hazard recognition) incentive programs provide an alternative to controversial lagging-indicator-based (e.g., injury rates) programs. We designed a leading-indicator-based safety communication and recognition program that incentivized safe working conditions. The program was piloted for two months on a commercial construction worksite and then redesigned using qualitative interview and focus group data from management and workers. We then ran the redesigned program for six months on the same worksite. Foremen received detailed weekly feedback from safety inspections, and posters displayed worksite and subcontractor safety scores. In the final program design, the whole site, not individual subcontractors, was the unit of analysis and recognition. This received high levels of acceptance from workers, who noted increased levels of site unity and team-building. This pilot program showed that construction workers value solidarity with others on site, demonstrating the importance of health and safety programs that engage all workers through a reliable and consistent communication infrastructure.
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Affiliation(s)
- Emily H Sparer
- Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | | | - Jack T Dennerlein
- Harvard T. H. Chan School of Public Health, Boston, MA, USA Northeastern University, Boston, MA, USA
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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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26
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Davis LK, Grattan KM, Tak S, Bullock LF, Ozonoff A, Boden LI. Use of multiple data sources for surveillance of work-related amputations in Massachusetts, comparison with official estimates and implications for national surveillance. Am J Ind Med 2014; 57:1120-32. [PMID: 24782244 DOI: 10.1002/ajim.22327] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/05/2014] [Indexed: 11/10/2022]
Abstract
BACKGROUND Accurate surveillance of work-related injuries is needed at national and state levels. We used multiple sources for surveillance of work-related amputations, compared findings with Survey of Occupational Injuries and Illnesses (SOII) estimates, and assessed generalizability to national surveillance. METHODS Three data sources were used to enumerate work-related amputations in Massachusetts, 2007-2008. SOII eligible amputations were compared with SOII estimates. RESULTS 787 amputations were enumerated, 52% ascertained through hospital records only, exceeding the SOII estimate (n = 210). The estimated SOII undercount was 48% (95% CI: 36-61%). Additional amputations were reported in SOII as other injuries, accounting for about half the undercount. Proportionately more SOII estimated than multisource cases were in manufacturing and fewer in smaller establishments. CONCLUSION Multisource surveillance enhanced our ability to document work-related amputations in Massachusetts. While not feasible to implement for work-related conditions nationwide, it is useful in states. Better understanding of potential biases in SOII is needed.
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Affiliation(s)
- Letitia K. Davis
- Occupational Health Surveillance Program, Massachusetts Department of Public Health; Boston Massachusetts
| | - Kathleen M. Grattan
- Occupational Health Surveillance Program, Massachusetts Department of Public Health; Boston Massachusetts
| | - Sangwoo Tak
- Southern California NIOSH Education and Research Center, UCLA; Los Angeles California
| | - Lucy F. Bullock
- Occupational Health Surveillance Program, Massachusetts Department of Public Health; Boston Massachusetts
| | - Al Ozonoff
- Center for Patient Safety and Quality Research; Boston Children's Hospital; Boston Massachusetts
| | - Leslie I. Boden
- Professor of Environmental Health; Boston University School of Public Health; Boston Massachusetts
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Arcury TA, Summers P, Carrillo L, Grzywacz JG, Quandt SA, Mills TH. Occupational safety beliefs among Latino residential roofing workers. Am J Ind Med 2014; 57:718-25. [PMID: 24006046 DOI: 10.1002/ajim.22248] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/05/2013] [Indexed: 11/06/2022]
Abstract
BACKGROUND This analysis describes beliefs about work safety and personal protective equipment (PPE) among Latino roofing workers, it delineates their perceptions of work environment characteristics that affect work safety and PPE use, and it describes how they experience work injuries and the consequences of these injuries. METHODS In-depth interviews were completed with 10 current and former Latino residential roofers. Interview transcripts were subjected to systematic qualitative analysis. RESULTS Participants' valued productivity over safety, and this had a negative influence on their safety behavior and reduced their PPE use. They understood that roofing was hazardous. They limited use of PPE when they felt it reduced productivity and when it was uncomfortable. Work environment characteristics that affected safety included company size, the physical demands of the job, lack of training, the need for work, general life stress, and distractions at work. An injury had to result in lost work time to be considered significant. Access to health care is limited by employers not providing Workers' compensation. DISCUSSION Future research is needed to substantiate these descriptive results and to delineate factors that are associated with safety behavior and use of PPE. Interventions, based on a lay health educator model, are needed to improve safety in this population. Safety regulations need to be evaluated and their enforcement needs to be improved.
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Affiliation(s)
- Thomas A. Arcury
- Department of Family and Community Medicine; Wake Forest School of Medicine; Winston-Salem North Carolina
- Center for Worker Health; Wake Forest School of Medicine
| | - Phillip Summers
- Department of Family and Community Medicine; Wake Forest School of Medicine; Winston-Salem North Carolina
- Center for Worker Health; Wake Forest School of Medicine
| | - Lourdes Carrillo
- Department of Epidemiology and Prevention; Sciences; Division of Public Health Sciences; Wake Forest School of Medicine
- Center for Worker Health; Wake Forest School of Medicine
| | - Joseph G. Grzywacz
- Department of Human Development and Family Science; Oklahoma State University
- Center for Family Resilience; Oklahoma State University
| | - Sara A. Quandt
- Department of Epidemiology and Prevention; Sciences; Division of Public Health Sciences; Wake Forest School of Medicine
- Center for Worker Health; Wake Forest School of Medicine
| | - Thomas H. Mills
- Myers-Lawson School of Construction; Virginia Polytechnic Institute and State University
- Occupational Safety and Health Research Center; Virginia Polytechnic Institute and State University
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Lipscomb HJ, Schoenfisch AL, Cameron W, Kucera KL, Adams D, Silverstein BA. How well are we controlling falls from height in construction? Experiences of union carpenters in Washington State, 1989-2008. Am J Ind Med 2014; 57:69-77. [PMID: 24038233 DOI: 10.1002/ajim.22234] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 11/08/2022]
Abstract
BACKGROUND Falls from height (FFH) continue to cause significant morbidity and mortality across the construction industry. METHODS By linking data on work hours with workers' compensation records, rates of work-related injuries resulting from FFH and associated days away from work were evaluated among a large cohort (n = 24,830) of union carpenters in Washington State from 1989 to 2008. Using Poisson regression we assessed rates of FFH over the 20-year period while adjusting for temporal trend in other work-related injuries. Patterns of paid lost days (PLDs) were assessed with negative binomial regression. RESULTS Crude rates of FFH decreased 82% over the 20-year period. Reductions were more modest and without demonstrable change since 1996 when adjusting for the temporal reduction in other injuries. Younger workers had higher injury rates; older workers lost more days following falls. Rates of PLDs associated with falls decreased over time, but there was not a consistent decline in mean lost days per fall. CONCLUSION These patterns are consistent with decreased FFH for several years surrounding state (1991) and then federal (1994) fall standards; the decline during this time period exceeded those seen in injury rates overall in this cohort. While crude rates of FFH have continued to decline, the decline is not as substantial as that seen for other types of injuries. This could reflect a variety of things including more global efforts designed to control risk (site planning, safety accountability) and changes in reporting practices.
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Affiliation(s)
- Hester J. Lipscomb
- Division of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | - Ashley L. Schoenfisch
- Division of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | - Wilfrid Cameron
- Strategic Solutions for Safety; Health and Environment; Seattle Washington
| | - Kristen L. Kucera
- Division of Occupational Medicine; Duke University Medical Center; Durham North Carolina
| | - Darrin Adams
- Safety and Health Assessment and Research Program (SHARP); Department of Labor and Industries, State of Washington; Olympia Washington
| | - Barbara A. Silverstein
- Safety and Health Assessment and Research Program (SHARP); Department of Labor and Industries, State of Washington; Olympia Washington
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Sorensen G, McLellan D, Dennerlein JT, Pronk NP, Allen JD, Boden LI, Okechukwu CA, Hashimoto D, Stoddard A, Wagner GR. Integration of health protection and health promotion: rationale, indicators, and metrics. J Occup Environ Med 2013; 55:S12-8. [PMID: 24284762 PMCID: PMC4184212 DOI: 10.1097/jom.0000000000000032] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE To offer a definition of an "integrated" approach to worker health and operationalize this definition using indicators of the extent to which integrated efforts are implemented in an organization. METHODS Guided by the question-How will we know it when we see it?-we reviewed relevant literature to identify available definitions and metrics, and used a modified Delphi process to review and refine indicators and measures of integrated approaches. RESULTS A definition of integrated approaches to worker health is proposed and accompanied by indicators and measures that may be used by researchers, employers, and workers. CONCLUSIONS A shared understanding of what is meant by integrated approaches to protect and promote worker health has the potential to improve dialogue among researchers and facilitate the research-to-practice process.
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Affiliation(s)
- Glorian Sorensen
- Dana-Farber Cancer Institute, Boston, MA
- Harvard School of Public Health, Boston, MA
| | | | | | - Nicolaas P. Pronk
- Harvard School of Public Health, Boston, MA
- HealthPartners, Inc., Minneapolis, MN
| | | | | | | | - Dean Hashimoto
- Partners HealthCare, Inc., Boston, MA
- Boston College Law School, Newton Centre, MA
| | | | - Gregory R Wagner
- Harvard School of Public Health, Boston, MA
- National Institute for Occupational Safety and Health, Washington, DC
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