1
|
Kreshpaj B, Wegman DH, Burstrom B, Davis L, Hemmingsson T, Håkansta C, Jonsson J, Johansson G, Kjellberg K, Sanchez Martinez N, Matilla-Santander N, Orellana C, Bodin T. Precarious employment and occupational injuries in Sweden between 2006 and 2014: a register-based study. Occup Environ Med 2023; 80:179-185. [PMID: 36585247 PMCID: PMC10086457 DOI: 10.1136/oemed-2022-108604] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 12/01/2022] [Indexed: 12/31/2022]
Abstract
BACKGROUND Precarious employment (PE) has been suggested as a risk factor for occupational injuries (OIs). However, several issues such as under-reporting and time at risk pose obstacles to obtaining unbiased estimates of risk OBJECTIVE: To investigate if PE is a risk factor for OIs in Sweden. METHODS This register-based study included employed workers aged 18-65, resident in Sweden between 2006 and 2014. PE was operationalised as a multidimensional construct (score) and by its five items (contract insecurity, contractual temporariness, multiple jobs/multiple sectors, income level, collective bargaining agreement). Our outcome was OI in the following year. Pooled ORs for OIs in relation to PE and PE items were calculated by means of multivariate logistic regression models for women and men separately. RESULTS Precarious workers were at lower risk of OIs as compared with non-precarious workers among both males and females (OR <1) also when applying weights for under-reporting and adjusting for time at risk (part-time work). Male agencies workers had a higher risk of OIs (OR 1.19, 95% CI 1.15 to 1.23), as did male and female workers in multiple jobs/sectors (OR 1.25, 95% CI 1.23 to 1.28 and OR 1.10, 95% CI 1.07 to 1.13 respectively), and female workers in the low-income groups (OR 1.11, 95% CI 1.09 to 1.12). Low coverage of collective bargaining agreements was associated with a lower risk of OIs for both men and women (OR 0.30, 95% CI 0.29 to 0.31 and OR 0.26, 95% CI 0.24 to 0.27, respectively). CONCLUSIONS While several mechanisms may explain why precarious workers in Sweden present lower risks of OIs, several dimensions of PE such as temp agency work and multiple job-holding could be important risk factors for OIs and merit further research.
Collapse
Affiliation(s)
- Bertina Kreshpaj
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden .,Section of Epidemiology, Department of Public Health, University of Copenhagen, Kobenhavn, Denmark
| | - David H Wegman
- Department of Public Health, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Bo Burstrom
- Department of Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Letitia Davis
- Occupational Health Surveillance Program, Massachusetts Department of Public Health, Boston, Massachusetts, USA
| | - Tomas Hemmingsson
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Carin Håkansta
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Department of Working Life Science, Karlstad University, Karlstad, Sweden
| | - Johanna Jonsson
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gun Johansson
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Stockholms Lans Landsting, Stockholm, Sweden
| | - Katarina Kjellberg
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Stockholms Lans Landsting, Stockholm, Sweden
| | - Nestor Sanchez Martinez
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Nuria Matilla-Santander
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Cecilia Orellana
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Theo Bodin
- Unit of Occupational Medicine, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Stockholms Lans Landsting, Stockholm, Sweden
| |
Collapse
|
2
|
Lundstrom EW, Hendricks SA, Marsh SM, Groth CP, Smith GS, Bhandari R. Temporal trends in occupational injuries treated in US emergency departments, 2012-2019. Inj Epidemiol 2023; 10:13. [PMID: 36899403 PMCID: PMC9999541 DOI: 10.1186/s40621-023-00423-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 02/20/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019. METHODS Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019. RESULTS Occupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI = ± 10.5%), transportation incidents (- 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI = ± 8.9%). CONCLUSIONS This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.
Collapse
Affiliation(s)
- Eric W Lundstrom
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA.
| | - Scott A Hendricks
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Suzanne M Marsh
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WV, USA
| | - Caroline P Groth
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Gordon S Smith
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
| | - Ruchi Bhandari
- Department of Epidemiology and Biostatistics, School of Public Health, West Virginia University, 64 Medical Center Dr, Morgantown, WV, 26506, USA
| |
Collapse
|
3
|
Morrissey MC, Kerr ZY, Brewer GJ, Tishukaj F, Casa DJ, Stearns RL. Analysis of Exertion-Related Injuries and Fatalities in Laborers in the United States. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2683. [PMID: 36768049 PMCID: PMC9916328 DOI: 10.3390/ijerph20032683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/06/2022] [Revised: 01/27/2023] [Accepted: 01/28/2023] [Indexed: 06/18/2023]
Abstract
Laborers are particularly vulnerable to exertional injuries and illnesses, as they often engage in heavy physical work for prolonged hours, yet no studies have examined the top causes of catastrophic exertional injuries and fatalities among this population. The purpose of the investigation was to characterize the top causes of exertional injury and fatality within open access, Occupational Safety and Health Administration (OSHA) reportable data. A secondary analysis of OSHA reported injury and fatality data was performed through open access records from OSHA Severe Injury Reports (2015-2022) and OSHA fatality inspection data (2017-2020), respectively. The research team characterized each reported injury and fatality as "exertion-related" or "non-exertion-related. Injury and fatality rates were reported per 100,000 equivalent full-time worker years and included 95% confidence intervals (95% CI). Of 58,648 cases in the OSHA Severe Injury Report database from 2015-2020, 1682 cases (2.9%) were characterized as exertional (0.20 injuries per 100,000 full-time worker years, 95% CI: 0.19, 0.22). Heat-related injuries encompassed 91.9% of the exertional injuries (n = 1546). From the 2017-2022 OSHA fatality inspection database, 89 (1.9%) of 4598 fatalities were characterized as exertion-related (fatality rate: 0.0160 per 100,000 full-time equivalent workers, 95% CI: 0.009, 0.0134). The exertion-related fatalities primarily consisted of heat-related cases (87.6%). Exertion-related injuries and fatalities were most reported in Southeast states, in the construction and excavation industry, and among nonunionized workers. As heat stress continues to be recognized as an occupational health and safety hazard, this analysis further highlights the need for targeted interventions or further evaluation of the impact of heat stress on construction and excavation workers, nonunionized workers, and workers in Southeastern states.
Collapse
Affiliation(s)
- Margaret C. Morrissey
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Zachary Yukio Kerr
- Department of Exercise and Sport Science, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA
| | - Gabrielle J. Brewer
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Faton Tishukaj
- Department of Physical Education and Sport, University of Prishtina, 10000 Prishtina, Kosovo
| | - Douglas J. Casa
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| | - Rebecca L. Stearns
- Korey Stringer Institute, Department of Kinesiology, University of Connecticut, Storrs, CT 06269, USA
| |
Collapse
|
4
|
Schofield KE, Ryan AD, Stroinski C. Risk factors for occupational injuries in schools among educators and support staff. JOURNAL OF SAFETY RESEARCH 2022; 80:67-77. [PMID: 35249629 DOI: 10.1016/j.jsr.2021.11.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/25/2021] [Accepted: 11/18/2021] [Indexed: 06/14/2023]
Abstract
INTRODUCTION School districts employ a large number of employees who work in educational (e.g., teachers) or other support roles, including educational assistants, custodians, food service, bus drivers, and community and recreation workers. District employees perform a wide array of job tasks and experience a wide spectrum of work-related risks and injuries. METHODS Workers' compensation data were coupled with Minnesota Department of Education district employee denominator data to evaluate risk factors for injury and severity. Variables included district location and type, employee job classification, age, and gender. Rates of injury and rate ratios were calculated to measure comparative injury risk using negative binomial regression and 95% confidence internals. Incidence and frequency of injury cause, nature, and body part we calculated. RESULTS Saint Paul and Minneapolis metropolitan area (versus non-metro) districts had higher risk (RR = 1.35, 95%CI = 1.18-1.54) of employee injuries. All job classifications in support roles had increased risk of injury claims versus educators, however food service (RR = 5.14, 95%CI = 4.61-5.74), custodial (RR = 3.85, 95%CI = 3.41-4.34), and transportation (RR = 4.15, 95%CI = 3.38-5.10) exhibited the highest comparative risk to educators; significant risk of lost-time injury was also present in these workers. Males and females had similar risk of injury for all claims, however males had elevated risk of lost-time injury (RR = 1.46, 95%CI = 1.26-1.69) versus females. All age groups >41-years-old exhibited increased risk of injury as compared to 31-40-year-olds. The magnitude of lost-time injury risk also increased with age. Falls and slips (29.1%), strains/sprains/ruptures (45.2%), and upper extremities (31.3%) most frequent cause, nature, and body part injured, respectively. CONCLUSIONS Characteristics of districts, schools, workers, and their jobs tasks and hazards vary. Many categories of support staff in schools have elevated risk of injury, including lost-time injury, as compared to educators. Practical Applications: Injury prevention in schools should be approached by targeting job classifications; high risk jobs can be prioritized for prevention.
Collapse
Affiliation(s)
- Katherine E Schofield
- Katherine E. Schofield, University of Minnesota Duluth, Department of Mechanical and Industrial Engineering, Voss Kovach Hall 105, 1305 Ordean Court, Duluth, MN 55812-3042, USA.
| | - Andrew D Ryan
- Environmental Health Sciences, University of Minnesota, Minneapolis, MN, USA
| | | |
Collapse
|
5
|
Robson LS, Landsman V, Latour-Villamil D, Lee H, Mustard C. Unionisation and injury risk in construction: a replication study. Occup Environ Med 2021; 79:169-175. [PMID: 34544893 PMCID: PMC8862097 DOI: 10.1136/oemed-2021-107617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2021] [Accepted: 08/18/2021] [Indexed: 11/24/2022]
Abstract
Objective To replicate, in a more recent time period, a previous cross-sectional study to estimate the association between unionisation and the risk of workers’ compensation injury claims. Methods The sampling frame was workers’ compensation company account records in the industrial, commercial and institutional construction sector in the province of Ontario, Canada, 2012–2018. Company unionisation status was determined through linkage with records of unionised contractors. Outcomes were cumulative counts of workers’ compensation injury claims, aggregated to company business. Risk ratios were estimated with multivariable negative binomial regression models. Models were also fit separately to lost-time claims stratified by company size. Results Business unionisation was associated with a lower lost-time claim incidence (crude risk ratio, CRR=0.69, 95% CI 0.65 to 0.74); adjusted risk ratio, ARR=0.75, 95% CI 0.71 to 0.80). In subgroup analyses, the magnitude of the ARR declined as company size decreased and was not statistically significant for the smallest-sized companies of ≤4 full-time equivalent employees. Unionisation was associated (positively) with the incidence of no-lost-time claims in a crude model, but not in an adjusted one (CRR=1.80, 95% CI 1.71 to 1.89; ARR=1.04, 95% CI 0.98 to 1.09). Conclusions Company unionisation was associated with a lower risk of lost-time workers’ compensation injury claims, corroborating a similar study from an earlier time period. The protective effect of unionisation declined as company size decreased. In contrast to the previous study, a positive relationship between company unionisation and no-lost-time claim incidence was not found, due in part to a methodological refinement.
Collapse
Affiliation(s)
| | | | | | - Hyunmi Lee
- Institute for Work & Health, Toronto, Ontario, Canada
| | | |
Collapse
|