1
|
Holm Ingelsrud M. Estimating the relationship between precarious employment and occupational injury: do the registry data tell the whole story? Occup Environ Med 2023; 80:177-178. [PMID: 36737240 DOI: 10.1136/oemed-2022-108773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/16/2023] [Indexed: 02/05/2023]
|
2
|
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
|
3
|
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
|
4
|
Weerahandi H, Li L, Bao H, Herrin J, Dharmarajan K, Ross JS, Kim KL, Jones S, Horwitz LI. Risk of Readmission After Discharge From Skilled Nursing Facilities Following Heart Failure Hospitalization: A Retrospective Cohort Study. J Am Med Dir Assoc 2020; 20:432-437. [PMID: 30954133 DOI: 10.1016/j.jamda.2019.01.135] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 01/15/2019] [Accepted: 01/16/2019] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Discharge to skilled nursing facilities (SNFs) is common in patients with heart failure (HF). It is unknown whether the transition from SNF to home is risky for these patients. Our objective was to study outcomes for the 30 days after discharge from SNF to home among Medicare patients hospitalized with HF who had subsequent SNF stays of 30 days or less. DESIGN Retrospective cohort study. SETTING AND PARTICIPANTS All Medicare fee-for-service beneficiaries 65 and older admitted during 2012-2015 with a HF diagnosis discharged to SNF then subsequently discharged home. MEASURES Patients were followed for 30 days following SNF discharge. We categorized patients by SNF length of stay: 1 to 6 days, 7 to 13 days, and 14 to 30 days. For each group, we modeled time to a composite outcome of unplanned readmission or death after SNF discharge. Our model examined 0-2 days and 3-30 days post-SNF discharge. RESULTS Our study included 67,585 HF hospitalizations discharged to SNF and subsequently discharged home. Overall, 16,333 (24.2%) SNF discharges to home were readmitted within 30 days of SNF discharge. The hazard rate of the composite outcome for each group was significantly increased on days 0 to 2 after SNF discharge compared to days 3 to 30, as reflected in their hazard rate ratios: for patients with SNF length of stay 1 to 6 days, 4.60 (4.23-5.00); SNF length of stay 7 to 13 days, 2.61 (2.45-2.78); SNF length of stay 14 to 30 days, 1.70 (1.62-1.78). CONCLUSIONS/IMPLICATIONS The hazard rate of readmission after SNF discharge following HF hospitalization is highest during the first 2 days home. This risk attenuated with longer SNF length of stay. Interventions to improve postdischarge outcomes have primarily focused on hospital discharge. This evidence suggests that interventions to reduce readmissions may be more effective if they also incorporate the SNF-to-home transition.
Collapse
Affiliation(s)
- Himali Weerahandi
- Division of General Internal Medicine and Clinical Innovation, Department of Medicine, NYU School of Medicine, New York, NY.
| | - Li Li
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT
| | - Haikun Bao
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT
| | - Jeph Herrin
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | | | - Joseph S Ross
- Center for Outcomes Research & Evaluation, Yale University, New Haven, CT; Section of General Internal Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, CT
| | - Kunhee Lucy Kim
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| | - Simon Jones
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| | - Leora I Horwitz
- Division of Healthcare Delivery Science, Department of Population Health, NYU School of Medicine, New York, NY
| |
Collapse
|
5
|
Elser H, Neophytou AM, Tribett E, Galusha D, Modrek S, Noth EM, Meausoone V, Eisen EA, Cantley LF, Cullen MR. Cohort Profile: The American Manufacturing Cohort (AMC) study. Int J Epidemiol 2020; 48:1412-1422j. [PMID: 31220278 DOI: 10.1093/ije/dyz059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2019] [Indexed: 12/13/2022] Open
Affiliation(s)
- Holly Elser
- Division of Epidemiology, UC Berkeley School of Public Health, Berkeley, CA, USA.,Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Andreas M Neophytou
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA.,Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, CO, USA
| | - Erika Tribett
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Deron Galusha
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Sepideh Modrek
- Department of Economics, San Francisco State University, College of Business, San Francisco, CA, USA
| | - Elizabeth M Noth
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Valerie Meausoone
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Ellen A Eisen
- Division of Environmental Health Sciences, UC Berkeley School of Public Health, Berkeley, CA, USA
| | - Linda F Cantley
- Department of Internal Medicine, Yale University School of Medicine, New Haven, CT, USA
| | - Mark R Cullen
- Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| |
Collapse
|
6
|
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.
Collapse
Affiliation(s)
- Khaled Abdulrahman Altassan
- Department of Occupational and Environmental Medicine, Yale University School of Medicine, New Haven, Connecticut
| | | | | | | | | | | |
Collapse
|
7
|
Cantley LF, Tessier-Sherman B, Slade MD, Galusha D, Cullen MR. Expert ratings of job demand and job control as predictors of injury and musculoskeletal disorder risk in a manufacturing cohort. Occup Environ Med 2015; 73:229-36. [PMID: 26163544 PMCID: PMC4819649 DOI: 10.1136/oemed-2015-102831] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2015] [Accepted: 06/22/2015] [Indexed: 11/17/2022]
Abstract
Objective To examine associations between workplace injury and musculoskeletal disorder (MSD) risk and expert ratings of job-level psychosocial demand and job control, adjusting for job-level physical demand. Methods Among a cohort of 9260 aluminium manufacturing workers in jobs for which expert ratings of job-level physical and psychological demand and control were obtained during the 2 years following rating obtainment, multivariate mixed effects models were used to estimate relative risk (RR) of minor injury and minor MSD, serious injury and MSD, minor MSD only and serious MSD only by tertile of demand and control, adjusting for physical demand as well as other recognised risk factors. Results Compared with workers in jobs rated as having low psychological demand, workers in jobs with high psychological demand had 49% greater risk of serious injury and serious MSD requiring medical treatment, work restrictions or lost work time (RR=1.49; 95% CI 1.10 to 2.01). Workers in jobs rated as having low control displayed increased risk for minor injury and minor MSD (RR=1.45; 95% CI 1.12 to 1.87) compared with those in jobs rated as having high control. Conclusions Using expert ratings of job-level exposures, this study provides evidence that psychological job demand and job control contribute independently to injury and MSD risk in a blue-collar manufacturing cohort, and emphasises the importance of monitoring psychosocial workplace exposures in addition to physical workplace exposures to promote worker health and safety.
Collapse
Affiliation(s)
- Linda F Cantley
- Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Baylah Tessier-Sherman
- Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Martin D Slade
- Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Deron Galusha
- Occupational and Environmental Medicine Program, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Mark R Cullen
- Stanford Center for Population Health Sciences, Stanford University School of Medicine, Stanford, California, USA
| |
Collapse
|
8
|
Cantley LF, Galusha D, Cullen MR, Dixon-Ernst C, Rabinowitz PM, Neitzel RL. Association between ambient noise exposure, hearing acuity, and risk of acute occupational injury. Scand J Work Environ Health 2015; 41:75-83. [PMID: 25137556 PMCID: PMC4337395 DOI: 10.5271/sjweh.3450] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
OBJECTIVE This study aimed to examine the associations between acute workplace injury risk, ambient noise exposure, and hearing acuity, adjusting for reported hearing protection use. METHODS In a cohort of 9220 aluminum manufacturing workers studied over six years (33 300 person-years, 13 323 person-jobs), multivariate mixed effects models were used to estimate relative risk (RR) of all injuries as well as serious injuries by noise exposure category and hearing threshold level (HTL) adjusting for recognized and potential confounders. RESULTS Compared to noise <82 dBA, higher exposure was associated with elevated risk in a monotonic and statistically significant exposure-response pattern for all injuries and serious injuries with higher risk estimates observed for serious injuries [82-84.99 dBA: RR 1.26, 95% confidence interval (95% CI) 0.96-1.64; 85-87.99 dBA: RR 1.39, 95% CI 1.05-1.85; ≥88 dBA: RR 2.29, 95% CI 1.52-3.47]. Hearing loss was associated with increased risk for all injuries, but was not a significant predictor of risk for the subset of more serious injuries. Compared to those without hearing loss, workers with HTL ≥25 dB had 21% increased all injury risk (RR 1.21, 95% CI 1.09-1.33) while those with HTL 10-24.99 dB had 6% increased risk (RR 1.06, 95% CI 1.00-1.13). Reported hearing protection type did not predict injury risk. CONCLUSION Noise exposure levels as low as 85 dBA may increase workplace injury risk. HTL was associated with increased risk for all, but not the subset of serious, injuries. Additional study is needed both to confirm the observed associations and explore causal pathways.
Collapse
Affiliation(s)
- Linda F Cantley
- University of Michigan, Department of Environmental Health Sciences, 1415 Washington Heights, 6611D SPH I, Ann Arbor MI 48109, USA.
| | | | | | | | | | | |
Collapse
|
9
|
Cantley LF, Galusha D, Cullen MR, Dixon-Ernst C, Tessier-Sherman B, Slade MD, Rabinowitz PM, Neitzel RL. Does tinnitus, hearing asymmetry, or hearing loss predispose to occupational injury risk? Int J Audiol 2014; 54 Suppl 1:S30-6. [PMID: 25549168 DOI: 10.3109/14992027.2014.981305] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To determine the relative contributions of tinnitus, asymmetrical hearing loss, low frequency hearing loss (pure tone average of 0.5, 1, 2, 3 kHz; PTA.5123), or high frequency hearing loss (pure tone average of 4, 6 kHz; PTA46), to acute injury risk among a cohort of production and maintenance workers at six aluminum manufacturing plants, adjusting for ambient noise exposure and other recognized predictors of injury risk. DESIGN Retrospective analysis. STUDY SAMPLE The study considered 9920 workers employed during 2003 to 2008. The cohort consisted of 8818 workers (89%) whose complete records were available. RESULTS Adjusting for noise exposure and other recognized injury predictors, a 25% increased acute injury risk was observed among workers with a history of tinnitus in conjunction with high-frequency hearing loss (PTA46). Low frequency hearing loss may be associated with minor, yet less serious, injury risk. We did not find evidence that asymmetry contributes to injury risk. CONCLUSION These results provide evidence that tinnitus, combined with high-frequency hearing loss, may pose an important safety threat to workers, especially those who work in high-noise exposed environments. These at risk workers may require careful examination of their communication and hearing protection needs.
Collapse
Affiliation(s)
- Linda F Cantley
- * Yale Occupational and Environmental Medicine Program, Yale University School of Medicine , New Haven , USA
| | | | | | | | | | | | | | | |
Collapse
|
10
|
Souza K, Cantley LF, Slade MD, Eisen EA, Christiani D, Cullen MR. Individual-level and plant-level predictors of acute, traumatic occupational injuries in a manufacturing cohort. Occup Environ Med 2014; 71:477-83. [PMID: 24727737 PMCID: PMC4078708 DOI: 10.1136/oemed-2013-101827] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Objectives Workplace and contextual factors that may affect risk for worker injury are not well described. This study used results from an employee job satisfaction survey to construct aggregate indicators of the work environment and estimate the relative contribution of those factors to injury rates in a manufacturing cohort. Methods Principal components analysis was used to construct four plant-level factors from responses to a 32 question survey of the entire workforce, administered in 2006. Multilevel Poisson regression was used to evaluate the relationship between injury rate, individual-level and plant-level risk factors, unionisation and plant type. Results Plant-level ‘work stress’ (incident rate ratio (IRR)=0.50, 95% CI 0.28 to 0.90) was significant in the multilevel model, indicating the rate of injury for an average individual in that plant was halved (conditional on plant) when job stress decreased by a tertile. ‘Overall satisfaction’, ‘work environment’ and ‘perception of supervisor’ showed the same trend but were not significant. Unionisation was protective (IRR=0.40, 95% CI 0.17 to 0.95) as was any plant type compared with smelter. Conclusions We demonstrated utility of data from a human resources survey to construct indicators of the work environment. Our research suggests that aspects of the work environment, particularly work stress and unionisation, may have a significant effect on risk for occupational injury, emphasising the need for further multilevel studies. Our work would suggest monitoring of employee perceptions of job stress and the possible inclusion of stress management as a component of risk reduction programmes.
Collapse
Affiliation(s)
- Kerry Souza
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Linda F Cantley
- Department of Occupational & Environmental Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Martin D Slade
- Department of Occupational & Environmental Medicine, Yale School of Medicine, New Haven, Connecticut, USA
| | - Ellen A Eisen
- Department of Environmental Health Sciences, Berkeley School of Public Health, Berkeley, California, USA
| | - David Christiani
- Department of Epidemiology, Harvard School of Public Health, Boston, Massachusetts, USA Departments of Environmental Health, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Mark R Cullen
- Division of General Medical Disciplines, Stanford School of Medicine, Stanford, California, USA
| |
Collapse
|
11
|
Kubo JT, Cullen MR, Desai M, Modrek S. Associations between employee and manager gender: impacts on gender-specific risk of acute occupational injury in metal manufacturing. BMC Public Health 2013; 13:1053. [PMID: 24207014 PMCID: PMC3924331 DOI: 10.1186/1471-2458-13-1053] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 10/31/2013] [Indexed: 11/10/2022] Open
Abstract
Background Prior research has shown increased risk of injury for female employees compared to male employees after controlling for job and tasks, but have not explored whether this increased risk might be moderated by manager gender. The gender of one’s manager could in theory affect injury rates among male and female employees through their managers’ response to an employee’s psychosocial stress or through how employees differentially report injuries. Other explanations for the gender disparity in injury experience, such as ergonomic factors or differential training, are unlikely to be impacted by supervisor gender. This study seeks to explore whether an employee’s manager’s gender modifies the effect of employee gender with regards to risk of acute injury. Methods A cohort of employees and managers were identified using human resources and injury management data between January 1, 2002 and December 31, 2007 for six facilities of a large US aluminum manufacturing company. Cox proportional hazards models were employed to examine the interaction between employee gender and whether the employee had female only manager(s), male only manager(s), or both male and female managers on injury risk. Manager gender category was included as a time varying covariate and reassessed for each employee at the midpoint of each year. Results The percentage of departments with both female and male managers increased dramatically during the study period due to corporate efforts to increase female representation in management. After adjustment for fixed effects at the facility level and shared frailty by department, manager gender category does not appear to moderate the effect of employee gender (p = 0.717). Manager category was not a significant predictor (p = 0.093) of time to first acute injury. Similarly, having at least one female manager did not modify the hazard of injury for female employees compared to males (p = 0.899) and was not a significant predictor of time to first acute injury (p = 0.601). Conclusions Prior findings suggest that female manufacturing employees are at higher risk for acute injury compared to males; this analysis suggests that this relationship is not affected by the gender of the employee’s manager(s).
Collapse
Affiliation(s)
- Jessica T Kubo
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, CA, USA.
| | | | | | | |
Collapse
|
12
|
Kubo J, Goldstein BA, Cantley LF, Tessier-Sherman B, Galusha D, Slade MD, Chu IM, Cullen MR. Contribution of health status and prevalent chronic disease to individual risk for workplace injury in the manufacturing environment. Occup Environ Med 2013; 71:159-66. [PMID: 24142977 PMCID: PMC3932962 DOI: 10.1136/oemed-2013-101653] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Objectives An ‘information gap’ has been identified regarding the effects of chronic disease on occupational injury risk. We investigated the association of ischaemic heart disease, hypertension, diabetes, depression and asthma with acute occupational injury in a cohort of manufacturing workers from 1 January 1997 through 31 December 2007. Methods We used administrative data on real-time injury, medical claims, workplace characteristics and demographics to examine this association. We employed a piecewise exponential model within an Andersen–Gill framework with a frailty term at the employee level to account for inclusion of multiple injuries for each employee, random effects at the employee level due to correlation among jobs held by an employee, and experience on the job as a covariate. Results One-third of employees had at least one of the diseases during the study period. After adjusting for potential confounders, presence of these diseases was associated with increased hazard of injury: heart disease (HR 1.23, 95% CI 1.11 to 1.36), diabetes (HR 1.17, 95% CI 1.08 to 1.27), depression (HR 1.25, 95% CI 1.12 to 1.38) and asthma (HR 1.14, 95% CI 1.02 to 1.287). Hypertension was not significantly associated with hazard of injury. Associations of chronic disease with injury risk were less evident for more serious reportable injuries; only depression and a summary health metric derived from claims remained significantly positive in this subset. Conclusions Our results suggest that chronic heart disease, diabetes and depression confer an increased risk for acute occupational injury.
Collapse
Affiliation(s)
- Jessica Kubo
- Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California, USA
| | | | | | | | | | | | | | | |
Collapse
|