Occupational injury and absence from work among African American, Hispanic, and non-Hispanic White workers in the national longitudinal survey of youth

Long-Term Disability Outcomes for Migrants (and Non-migrants) 12 Years Post-injury: Results from the Prospective Outcomes of Injury Study in New Zealand

To understand, and identify predictors of, long-term post-injury (i.e. 12 years post-injury) disability outcomes for migrants and non-migrants. This 12-year longitudinal study followed participants with entitlement claim injuries registered with New Zealand's universal no-fault injury insurer between 2007 and 2009. Information was collected about migrant status, other sociodemographic, health and disability characteristics, and injury characteristics. Disability outcome information was collected 12 years later. Of 1543 people interviewed 12 years post-injury, 1497 had disability and migrant status data available; 20% were migrants (n = 301). Migrants reporting inadequate pre-injury household income or those who perceived their injury as a threat to life at the time of injury were more likely to experience disability 12 years post-injury (aRR 2.08; 95% CI 1.09-4.03, aRR 2.93; 95%CI 1.17-6.69, respectively). Hospitalised injured migrants were significantly less likely to have long-term disability (aRR 0.18; 95%CI 0.04-0.55) than those not hospitalised. We found sociodemographic and injury-related characteristics were independently associated with long-term disability among migrants. We highlight that some characteristics, ascertained early in the injury pathway, predict risk of long-term disability. Early post-injury interventions focused on improving disability outcomes for migrants may also have long-term impacts.

Racial and Ethnic Inequities in the Return-to-Work of Workers Experiencing Injury or Illness: A Systematic Review

PURPOSE

Non-White workers face more frequent, severe, and disabling occupational and non-occupational injuries and illnesses when compared to White workers. It is unclear whether the return-to-work (RTW) process following injury or illness differs according to race or ethnicity.

OBJECTIVE

To determine racial and ethnic differences in the RTW process of workers with an occupational or non-occupational injury or illness.

METHODS

A systematic review was conducted. Eight academic databases - Medline, Embase, PsycINFO, CINAHL, Sociological Abstracts, ASSIA, ABI Inform, and Econ lit - were searched. Titles/abstracts and full texts of articles were reviewed for eligibility; relevant articles were appraised for methodological quality. A best evidence synthesis was applied to determine key findings and generate recommendations based on an assessment of the quality, quantity, and consistency of evidence.

RESULTS

15,289 articles were identified from which 19 studies met eligibility criteria and were appraised as medium-to-high methodological quality. Fifteen studies focused on workers with a non-occupational injury or illness and only four focused on workers with an occupational injury or illness. There was strong evidence indicating that non-White and racial/ethnic minority workers were less likely to RTW following a non-occupational injury or illness when compared to White or racial/ethnic majority workers.

CONCLUSIONS

Policy and programmatic attention should be directed towards addressing racism and discrimination faced by non-White and racial/ethnic minority workers in the RTW process. Our research also underscores the importance of enhancing the measurement and examination of race and ethnicity in the field of work disability management.

Racial and ethnic disparities in workers' compensation claims rates

BACKGROUND

Workers of color experience a disproportionate share of work-related injuries and illnesses (WRII), however, most workers' compensation systems do not collect race and ethnicity information, making it difficult to monitor trends over time, or to investigate specific policies and procedures that maintain or could eliminate the unequal burden of WRII for workers of color. The purpose of this study is to apply a Bayesian method to Washington workers' compensation claims data to identify racial and ethnic disparities of WRII by industry and occupation, improving upon existing surveillance limitations. Measuring differences in risk for WRII will better inform prevention efforts and target prevention to those at increased risk.

METHODS

To estimate WRII by race/ethnicity, we applied the Bayesian Improved Surname Geocode (BISG) method to surname and residential address data among all Washington workers' compensation claims filed for injuries in 2013-2017. We then compare worker and injury characteristics by imputed race/ethnicity, and estimate rates of WRII by imputed race/ethnicity within industry and occupation.

RESULTS

Black/African Americans had the highest rates of WRII claims across all industry and occupational sectors. Hispanic/Latino WRII claimants also had higher rates than Whites and Asian/Pacific Islanders in almost all industry and occupational sectors. For accepted claims with both medical and non-medical compensation, Bodily reaction/overexertion injuries accounted for almost half of the claims during this reporting period.

DISCUSSION

The high rates of injury we report by racial/ethnic categories is a cause for major concern. Nearly all industry and occupation-specific rates of workers' compensation claims are higher for Black/African American and Hispanic/Latino workers compared to Whites. More work is needed to identify work-related, systemic, and individual characteristics.

Sick Days: Logical Versus Survey Identification of the Foreign-Born Population in the United States

The self-reported number of workdays missed due to injury or illness, or sick days, is a reliable measure of health among working-aged adults. Although sick days is a relatively underexplored health-related outcome in migration studies, it can provide a multidimensional understanding of immigrant wellbeing and integration. Current understandings of the association between migration status and sick days are limited for two reasons. First, in the United States, few nationally representative surveys collect migration status information. Second, researchers lack consensus on the most reliable approach for assigning migration status. We use the 2008 Survey of Income and Program Participation (SIPP) to examine sick days and draw comparisons between two methods for assigning migration status—a logical approach and a survey approach. The logical method assigns migration status to foreign-born respondents based on characteristics such as government employment or welfare receipt, while the survey approach relies on self-reported survey responses. Sick days among immigrants was correlated with and predicted by other health conditions available in the SIPP. Comparisons of sick days by migration status vary based on migration assignment approach. Lawful Permanent Residents (LPRs) reported more sick days than non-LPRs and appear less healthy when migration status is assigned using the logical approach. The logical approach also produced a gap in sick days between LPRs and non-LPRs that is not replicated in the survey approach. The results demonstrate that if migration status is not measured directly in the data, interpretation of migration status effects should proceed cautiously.

Immigrant status, gender and work disability duration: findings from a linked, retrospective cohort of workers' compensation and immigration data from British Columbia, Canada

OBJECTIVES

To compare differences in work disability durations of immigrant men and women injured at work to comparable Canadian-born injured workers in British Columbia, Canada.

METHODS

Data on accepted workers compensation claims and immigration status from 1995 and 2012 were used to compare the number of work disability days paid at the 25%, 50% and 75% for immigrant and Canadian-born injured workers stratified by gender and recency of immigration.

RESULTS

Immigrant workers comprised 8.9% (78 609) of the cohort. In adjusted quantile regression models, recent and established immigrant women received 1.3 (0.8, 1.9) and 4.0 (3.4, 4.6) more paid disability days at the 50% of the disability distribution than Canadian-born counterparts. For recent and established immigrant men, this difference was 2.4 (2.2, 2.6) and 2.7 (2.4, 4.6). At the 75%, this difference increased for recent immigrant men and established immigrant men and women but declined for recent immigrant women.

CONCLUSIONS

Injured immigrants receive more work disability days than their Canadian-born counterparts except for recent immigrant women. Both immigrant status and gender matter in understanding health disparities in work disability after work injury. KEYWORDS WORK DISABILITY: immigrant health; linked administrative data.

Differences in Work Disability Duration for Immigrants and Canadian-Born Workers in British Columbia, Canada

This study aimed to investigate differences in work disability duration among immigrants (categorized as economic, family member or refugee/other classification upon arrival to Canada) compared to Canadian-born workers with a work-related injury in British Columbia. Immigrants and Canadian-born workers were identified from linked immigration records with workers' compensation claims for work-related back strain, connective tissue, concussion and fracture injuries requiring at least one paid day of work disability benefits between 2009 to 2015. Quantile regression investigated the relationship between immigration classification and predicted work disability days (defined from injury date to end of compensation claim, up to 365 days) and modeled at the 25th, 50th and 75th percentile of the distribution of the disability days. With a few exceptions, immigrants experienced greater predicted disability days compared to Canadian-born workers within the same injury cohort. The largest differences were observed for family and refugee/other immigrant classification workers, and, in particular, for women within these classifications, compared to Canadian-born workers. For example, at the 50th percentile of the distribution of disability days, we observed a difference of 34.1 days longer for refugee/other women in the concussion cohort and a difference of 27.5 days longer for family classification women in the fracture cohort. Economic immigrants had comparable disability days with Canadian-born workers, especially at the 25th and 50th percentiles of the distribution. Immigrant workers' longer disability durations may be a result of more severe injuries or challenges navigating the workers' compensation system with delays in seeking disability benefits and rehabilitation services. Differences by immigrant classification speak to vulnerabilities or inequities upon arrival in Canada that persist after entry to the workforce and warrant further investigation for early mitigation strategies.

Injury inequalities among U.S. construction workers

This study explores racial/ethnic inequalities in work-related injuries among U.S. construction workers. Data from the 2004-2017 National Health Interview Survey were used to estimate work-related injuries by race/ethnicity in construction. Disparities in demographic, socioeconomic, and injury status among construction workers were examined by race/ethnicity. Injury differences were also evaluated in multiple logistic regression analyses controlling for potential confounders. Compared to white, non-Hispanic workers, minority workers were more likely to have lower socioeconomic statuses (e.g., lower educational attainment, lack of health insurance coverage, and family income below the poverty level), which considerably increased the likelihood of work-related injuries. The odds of work-related injuries were 70% higher among racial/ethnic minorities than white, non-Hispanics in construction. Injuries were also more severe among minorities than white, non-Hispanic workers. Among workers with a work-related injury, nearly 85% of Hispanics reported missing at least one workday due to injury, 45.6% higher than the proportion of 57.9% for their white, non-Hispanic counterparts. After adjusting for major demographic and socioeconomic factors, the work-related injury difference between race/ethnicity was no longer statistically significant. However, the odds of work-related injury remained significantly higher among workers who were younger (35-54 years vs. ≥ 55 years: aOR = 2.2, 95% CI: 1.3-3.6); male (aOR = 5.3, 95% CI: 2.9-9.8); not college-educated (aOR = 1.5, 95% CI: 1.0-2.2); had a family income below the poverty threshold (aOR = 1.8, 95% CI: 1.2-2.8); or held a blue-collar occupation (aOR = 2.0, 95% CI: 1.2-3.4). These findings suggest that the injury differences between race/ethnicity were strongly associated with demographics and socioeconomic inequalities in these worker groups. The identified injury disparities should be reduced or eliminated, following the hierarchy of controls paradigm.

Reported injury, hospitalization, and injury fatality rates among New Jersey adolescent workers

Background

Workplace injuries are a public health concern, including among adolescents and young adults. Secondary school career-technical-vocational education related injuries are mandated by code under jurisdiction of New Jersey Department of Education to be reported online to New Jersey Safe Schools Program. These are the only U.S. law-based surveillance data for young workers in secondary school career-technical-vocational education. New Jersey Department of Health’s hospitalization and fatality records provide additional information about other secondary school career-technical-vocational education and non- secondary school career-technical-vocational education related injuries not necessarily reported to New Jersey Safe Schools Program. This report compared data available to the New Jersey Department of Health and New Jersey Safe Schools Program on injuries among young workers ages 14–21 years.

Methods

Annual work-related hospitalizations, 2007–2016, were abstracted from hospital discharge data. Denominator data from the U.S. Bureau of Labor Statistics was used to estimate annual crude rate of hospitalizations per 100,000 employed persons. Hospitalization rates were stratified by demographic data from the U.S. Bureau of Labor Statistics. Hospitalization rates for primary diagnoses and job title/status with ≥2 documented cases were reported. Annual crude fatality rates per 100,000 full time equivalent workers, age ≥ 16 years, were estimated for 1990–2016 using annual average full time equivalent workers and the U.S. National Institute Occupational Safety and Health’s Employed Labor Force Query System as denominator.

Results

Annual crude hospitalization rates decreased over time. Hospitalization and fatality rates were higher among young adult workers ages 19–21 years; non-Hispanic Whites; and, males. Percent fatality for ages 19–21 years was greater than ages 14–17 years and 18 years. Declines in hospitalization rates corresponded to decreases in reported injuries among career-technical-vocational education students. Age distribution varied slightly between hospital discharge data and New Jersey Safe Schools Program data.

Conclusion

Hospitalization and fatality rates were higher among males than among females, possibly reflecting a tendency for males to engage in riskier jobs than females. Understanding injury disparities can inform public health prevention efforts. Trainings/interventions should aim at addressing the most frequently diagnosed conditions or nature of reported injuries, within those most impacted career clusters like sales/restaurant workers.

Electronic supplementary material

The online version of this article (10.1186/s40621-019-0216-9) contains supplementary material, which is available to authorized users.

Incident Surveillance in New Jersey Career and Technical Education Programs, 1999 to 2008

Through school-sponsored career and technical education programs in New Jersey, students work part-time during or after school in paid and unpaid structured learning experiences regulated by the New Jersey Department of Education. Schools submit information on “reportable incidents,” injury or illness resulting in physician treatment. Incidents including reported use of personal protective equipment (PPE) were assessed; 1,600 incident reports (1999 to 2008) were received. Attributes such as type and severity, body parts affected, and PPE use for incidents occurring at school among students grades 9 to 12 or labeled as “adults” during school hours ( n = 285) were analyzed. Older teens incurred more injuries. PPE use was consistently low across age and gender. Students most frequently experienced knife injuries involving fingers and hands. Results identified potential injury determinants and training and intervention topics such as PPE, and support development of an enhanced reporting form.

Occupational medicine clinical practice data reveal increased injury rates among Hispanic workers

Background

Minnesota has an ethnically diverse labor force, with the largest number of refugees per capita in the United States. In recent years, Minnesota has been and continues to be a major site for immigrant and refugee resettlement in the United States, with a large population of both immigrant and native born Hmong, Hispanic, and East Africans. This study seeks to evaluate the injury risk among the evolving minority workforce in the Minnesota Twin Cities region.

Methods

A retrospective cohort study identifying work‐related injuries following pre‐employment examinations was performed using electronic health records from a large multi‐clinic occupational medicine practice. Preplacement examinations and subsequent work‐related injuries were pulled from the electronic health record using representative ICD‐10 codes for surveillance examinations and injuries. This study included patient records collected over a 2‐year period from January 1, 2015, through December, 2016. The patients in this cohort worked in a wide‐array of occupations including production, assembly, construction, law enforcement, among others.

Results

Hispanic minority workers were twice as likely to be injured at work compared with White workers. Hispanics were 2.89 times more likely to develop back injuries compared with non‐Hispanic workers, and 1.86 times more likely to develop upper extremity injuries involving the hand, wrist, or elbow.

Conclusion

Clinical practice data shows that Hispanic workers are at increased risk for work‐related injuries in Minnesota. They were especially susceptible to back and upper extremity injuries. Lower injury rates in non‐Hispanic minority workers, may be the result of injury underreporting and require further investigation.

Blue-collar work and women's health: A systematic review of the evidence from 1990 to 2015

Despite the implications of gender and sex differences for health risks associated with blue-collar work, adverse health outcomes among blue-collar workers has been most frequently studied among men. The present study provides a "state-of-the-field" systematic review of the empiric evidence published on blue-collar women's health. We systematically reviewed literature related to the health of blue-collar women published between January 1, 1990 and December 31, 2015. We limited our review to peer-reviewed studies published in the English language on the health or health behaviors of women who were presently working or had previously worked in a blue-collar job. Studies were eligible for inclusion regardless of the number, age, or geographic region of blue-collar women in the study sample. We retained 177 studies that considered a wide range of health outcomes in study populations from 40 different countries. Overall, these studies suggested inferior health among female blue-collar workers as compared with either blue-collar males or other women. However, we noted several methodological limitations in addition to heterogeneity in study context and design, which inhibited comparison of results across publications. Methodological limitations of the extant literature, alongside the rapidly changing nature of women in the workplace, motivate further study on the health of blue-collar women. Efforts to identify specific mechanisms by which blue-collar work predisposes women to adverse health may be particularly valuable in informing future workplace-based and policy-level interventions.

A systematic review of socioeconomic status measurement in 13 years of U.S. injury research

OBJECTIVE

The purpose of this review was to assess the impact of socioeconomic status (SES) on injury and to evaluate how U.S. injury researchers have measured SES over the past 13years in observational research studies.

DESIGN & METHODS

This systematic review included 119 US injury studies indexed in PubMed between January 1, 2002 and August 31, 2015 that used one or more individual and/or area-level measures of SES as independent variables. Study findings were compared to the results of a previous review published in 2002.

RESULTS

Findings indicate SES remains an important predictor of injury. SES was inversely related to injury in 78 (66%) of the studies; inverse relationships were more consistently found in studies of fatal injury (77.4%) than in studies of non-fatal injury (58%). Approximately two-thirds of the studies (n=73, 61%) measured SES along a gradient and 59% used more than one measure of SES (n=70). Studies that used a gradient measure of SES and/or more than one measure of SES identified significant relationships more often. These findings were essentially equivalent to those of a similar 2002 review (Cubbin & Smith, 2002).

CONCLUSIONS

There remains a need to improve measurement of SES in injury research. Public health training programs should include best practices for measurement of SES, which include: measuring SES along a gradient, selecting SES indicators based on the injury mechanism, using the smallest geographic region possible for area-level measures, using multiple indicators when possible, and using both individual and area-level measures as both contribute independently to injury risk. Area-level indicators of SES are not accurate estimates of individual-level SES.

PRACTICAL APPLICATIONS

Injury researchers should measure SES along a gradient and incorporate individual and area-level SES measures that are appropriate to the injury outcome under study.

Explaining racial/ethnic differences in all-cause mortality in the Multi-Ethnic Study of Atherosclerosis (MESA): Substantive complexity and hazardous working conditions as mediating factors

Research on racial/ethnic health disparities and socioeconomic position has not fully considered occupation. However, because occupations are racially patterned, certain occupational characteristics may explain racial/ethnic difference in health. This study examines the role of occupational characteristics in racial/ethnic disparities in all-cause mortality. Data are from a U.S. community-based cohort study (n=6342, median follow-up: 12.2 years), in which 893 deaths (14.1%) occurred. We estimated mortality hazard ratios (HRs) for African Americans, Hispanics, and Chinese Americans compared with whites. We also estimated the proportion of the HR mediated by each of two occupational characteristics, substantive complexity of work (e.g., problem solving, inductive/deductive reasoning on the job) and hazardous conditions (e.g., noise, extreme temperature, chemicals), derived from the Occupational Information Network database (O*NET). Analyses were adjusted for age, sex, nativity, working status at baseline, and study sites. African Americans had a higher rate of all-cause death (HR 1.41; 95% confidence interval [CI]: 1.19–1.66) than whites. Chinese-American ethnicity was protective (HR 0.59, CI: 0.40–0.85); Hispanic ethnicity was not significantly different from whites (HR 0.88; CI: 0.67–1.17). Substantive complexity of work mediated 30% of the higher rate of death for African Americans compared with whites. For other groups, mediation was not significant. Hazardous conditions did not significantly mediate mortality in any racial/ethnic group. Lower levels of substantive complexity of work mediate a substantial part of the health disadvantage in African Americans. This job characteristic may be an important factor in explaining racial health disparities.

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Health disparities research rarely considers occupational characteristics.

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Occupation is strongly patterned by race/ethnicity in the United States.

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Different working conditions may explain racial health disparities.

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Complexity of the job explains one-third of black-white mortality difference.

Work Hours of Immigrant Versus U.S.-Born Female Workers

This study was a secondary analysis of cross-sectional data extracted from the 2011-2012 California Health Interview Survey. Data from 8,931 full-time (i.e., 21 hours or more per week) women workers aged 18 to 85 years were analyzed to examine the nature and prevalence of immigrant female workers’ work hours, overtime, and related factors in the United States compared to U.S.-born female workers. Results showed that foreign-born female workers did not work longer hours than U.S.-born female workers. Foreign-born female workers who reported poor health worked longer hours than did their U.S.-born counterparts. Foreign-born female workers who were self-employed or worked in family businesses tended to work longer hours than did those women who worked for private companies or nonprofit organizations.

Racial And Ethnic Differences In The Frequency Of Workplace Injuries And Prevalence Of Work-Related Disability

Occupational injuries and illnesses lead to significant health care costs and productivity losses for millions of workers each year. This study used national survey data to test for differences between members of minority groups and non-Hispanic white workers in the risk of workplace injuries and the prevalence of work-related disabilities. Non-Hispanic black workers and foreign-born Hispanic workers worked in jobs with the highest injury risk, on average, even after adjustment for education and sex. These elevated levels of workplace injury risk led to a significant increase in the prevalence of work-related disabilities for non-Hispanic black and foreign-born Hispanic workers. These findings suggest that disparities in economic opportunities expose members of minority groups to increased risk of workplace injury and disability.

Midlife Occupational Physical Activity and Risk of Disability Later in Life: National Health and Aging Trends Study

OBJECTIVES

To determine whether midlife occupational physical activity (PA) is associated with disability in older adults and to test disease as a mediating variable.

DESIGN

Cross-sectional study.

SETTING

National Health and Aging Trends Study.

PARTICIPANTS

Individuals aged 65 and older (N = 7,307).

MEASUREMENTS

Participants were classified as to occupational PA levels by linking information from the Occupational Information Network database using standard occupation codes. Disability outcomes and covariates were obtained through in-person interviews. Logistic regression models were used to examine the association between occupational PA and disability. Structural equation modeling (SEM) was fitted to examine the mediating effect of disease.

RESULTS

Occupations with high physically demands were associated with greater decline in functional capacity later in life. Individuals with occupations with high and very high PA were less likely to be able to perform activities of daily living than those with occupations with low PA. SEM showed that occupational PA has a very strong direct effect on disability (P < .001) and has an indirect effect on disability through disease (P = .003). The population attributable fraction for high occupational PA was 11%.

CONCLUSION

Higher midlife occupational PA levels were significantly associated with poorer ability to perform activities of daily living in older age. Performing the optimal level of occupational PA may be instrumental in reducing disability later in life.

Challenges and solutions in immigrant occupational health in the United States: a literature review and comparative analysis

OBJECTIVES

Because of the declining birthrate in Japan, an increasing number of companies are hiring immigrants to fill the labor shortage. Although research on migrant occupational health has progressed in the United States, this topic has received little attention in Japan. The aim of this study was to elucidate the current situation, challenges, and solutions surrounding the occupational health of immigrant workers in the United States.

METHODS

Data and selected studies were reviewed and analyzed. The results are discussed, and a few anecdotal experiences in the United States are introduced and compared.

RESULTS

Possible causes of disparities in immigrant occupational health fell into the following seven categories. (Keywords for each category are shown in parentheses.) (1) Occupation (hazardous job, injury, missed workday, blue-collar worker, low birth weight); (2) Education (academic record, health literacy, training); (3) Culture (culture-specific, community-based); (4) Environment (poor hygiene, regional disparities, environmental change); (5) Access (language, statistics, workers' compensation, health insurance, voluntary restraint); (6) Infection (tuberculosis, human immunodeficiency virus/AIDS, follow-up); and (7) Discrimination (race, assault, harassment). Lack of data on immigrant workers was found to be a common problem. Some businesses and community groups achieved positive results by simultaneously dealing with multiple aforementioned categories.

DISCUSSION

In the United States, the occupational health of immigrant workers has been studied mainly in terms of health disparities. Possible causes of disparities in immigrant occupational health fell into seven categories. Solutions centered on the keywords in each category were inferred. Some businesses and community groups achieved positive results by simultaneously dealing with multiple aforementioned categories. Occupational health professionals have to take each of seven categories into account to improve immigrant occupational health. Even the United States-a developed country facing many migrant occupational health problems-needs further research and better data. To address this issue in Japan, we too need more data and further research on immigrants, along with efforts by businesses and community groups.

Quantifying the Incremental and Aggregate Cost of Missed Workdays in Adults with Diabetes

OBJECTIVE

Although the national cost of missed workdays associated with diabetes has been estimated previously, we use the most recent available national data and methodology to update the individual and national estimates for the U.S population.

METHODS

We identified 14,429 employed individuals ≥ 18 years of age in 2011 Medical Expenditure Panel Survey (MEPS) data. Diabetes and missed workdays were based on self-report, and cost was based on multiplying the daily wage rate for each individual by the number of missed days. Adjusted total national burden of missed workdays associated with diabetes was calculated using a novel two-part model to simultaneously estimate the association of diabetes with the number and cost of missed workdays.

RESULTS

The unadjusted annual mean 2011 cost of missed workdays was $277 (95 % CI 177.0-378.0) for individuals with diabetes relative to $160 (95 % CI $130-$189) for those without. The incremental cost of missed workdays associated with diabetes was $120 (95 % CI $30.7-$209.1). Based on the US population in 2011, the unadjusted national burden of missed workdays associated with diabetes was estimated to be $2.7 billion, while the fully adjusted incremental national burden was estimated to be $1.1 billion.

CONCLUSIONS

We provide more precise estimates of the cost burden of diabetes due to missed workdays on the U.S population. The high incremental and total cost burden of missed workdays among Americans with diabetes suggests the need for interventions to improve diabetes care management among employed individuals.

Understanding the Probability of a Disability Resulting From Work-Related Injuries

OBJECTIVES

To assess the conditions under which the measured risk of a workplace injury resulting in a disability changes.

METHODS

Multivariate regression analysis and administrative claims data build an understanding of the factors that underlie the probability that a workplace injury results in a disability (disability probability).

RESULTS

First, jointly examining injury incidence rates and disability probabilities challenges some conclusions suggested by examining the two separately. Second, some characteristics identified as risk factors for disability when studied in isolation are not risk factors. Third, risk factors are qualitatively consistent across groups of workers but quantitatively different.

CONCLUSIONS

Policymakers might draw incorrect conclusions about the risk of a workplace injury becoming a disability unless the research provides a joint assessment of incidence rates and disability probabilities and a comprehensive analysis of risk factors across worker groups.

Job characteristics and musculoskeletal pain among shift workers of a poultry processing plant in Southern Brazil

OBJECTIVES

The purpose of this study was to evaluate the association between job characteristics and musculoskeletal pain among shift workers employed at a 24-hour poultry processing plant in Southern Brazil.

METHODS

This was a cross-sectional study of 1,103 production line workers aged 18-52 years. The job characteristics of interest were shift (day/night), shift duration, and plant sector ambient temperature. Musculoskeletal pain was defined as self-reported occupational-related pain in the upper or lower extremities and trunk, occurring often or always, during the last 12 months.

RESULTS

The mean (SD) participant age was 30.8 (8.5) years, and 65.7% of participants were women. The prevalence of musculoskeletal pain was greater among female participants than male participants. After adjustment for job characteristics and potential confounders, the prevalence ratios (PR) of lower extremity musculoskeletal pain among female workers employed in extreme-temperature conditions those working the night shift, and those who had been working longer on the same shift were 1.75 (95% CI 1.12, 2.71), 1.69 (95% CI 1.05, 2.70), and 1.64 (95% CI 1.03, 2.62), respectively. In male workers, only extreme-temperature conditions showed a significant association with lower extremity musculoskeletal pain (PR=2.17; 95% CI 1.12, 4.22) after adjustment analysis.

CONCLUSIONS

These findings suggest a need for implementation of measures to mitigate the damage caused by nighttime work and by working under extreme temperature conditions, especially among female shift workers, such as changing positions frequently during work and implementation of rest breaks and a workplace exercise program, so as to improve worker quality of life.

Prevalence of carpal tunnel syndrome among employees at a poultry processing plant

OBJECTIVE

To determine prevalence of carpal tunnel syndrome (CTS) among poultry processing employees while taking into account non-occupational factors and assess any association between CTS prevalence and exposure groups.

METHODS

Performed a cross-sectional survey to assess CTS (n = 318). A CTS case was defined as an employee with self-reported CTS symptoms, an abnormal hand symptom diagram, and an abnormal nerve conduction study (NCS). Log-binomial regression was used to estimate prevalence ratios.

RESULTS

Three hundred and one participants had sufficient symptom information or NCS data to be classified. 126 (42%) of 301 participants had evidence of CTS. In the adjusted analysis, the highest exposure group had CTS prevalence that was significantly higher than that for the lower exposure group [PR: 1.61; 95% CI = (1.20, 2.17)].

CONCLUSIONS

Increasing levels of hand activity and force were associated with increased CTS prevalence among participants. Recommendations were provided to reduce exposure to these risk factors.

Effects of social, economic, and labor policies on occupational health disparities

BACKGROUND

This article introduces some key labor, economic, and social policies that historically and currently impact occupational health disparities in the United States.

METHODS

We conducted a broad review of the peer-reviewed and gray literature on the effects of social, economic, and labor policies on occupational health disparities.

RESULTS

Many populations such as tipped workers, public employees, immigrant workers, and misclassified workers are not protected by current laws and policies, including worker's compensation or Occupational Safety and Health Administration enforcement of standards. Local and state initiatives, such as living wage laws and community benefit agreements, as well as multiagency law enforcement contribute to reducing occupational health disparities.

CONCLUSIONS

There is a need to build coalitions and collaborations to command the resources necessary to identify, and then reduce and eliminate occupational disparities by establishing healthy, safe, and just work for all.

Workplace injustice and self-reported disease and absenteeism in South Korea

BACKGROUND

This study investigated whether experience of workplace injustice was associated with self-reported occupational health using a nationally representative sample of Korean workers.

METHODS

We used the first wave of the Korean Working Conditions Survey (KWCS) and included 7,007 wage employees as the study population. Workplace injustice included the experience of discrimination, violence, or harassment, and occupational health was measured as self-reported health problems and absenteeism. Personal, occupational, and job-related characteristics were included as covariates.

RESULTS

An average of 7.2% of workers reported experiencing at least one workplace injustice over the past 12 months. Female workers were significantly more likely to experience age and gender discrimination, and unwanted sexual attention than male workers. Both male and female workers who experienced any workplace injustice (i.e., discrimination, harassment, or violence) reported approximately two- to threefold increased risk for physical and mental health problems (i.e., backaches, muscular pain, stomach pain, overall fatigue, headaches, anxiety/depression, sleeping problems, and injury) and absenteeism due to accidents or due to health problems.

CONCLUSION

Perceived injustice at work was significantly associated with an increased risk of occupational disease and absenteeism for Korean wage employees.

Differences in exposure to occupational health risks in Spanish and foreign-born workers in Spain (ITSAL Project)

Migrant workers usually show higher rates of work-related health problems than natives. However, little information is available about their exposure to occupational risks. We describe self-reported working exposure in Spanish and foreign-born workers. A cross-sectional survey was conducted as part of the ITSAL Project. Data on sociodemographic and self-reported occupational exposure in 1,841 foreign-born and 509 Spanish workers were collected through face-to-face interviews. Prevalence and adjusted odds ratios-aOR- (by age, education, type of contract) were calculated. Foreign-born men in non-services sectors and those in manual occupations perceived exposure to occupational risks with lower prevalence than Spanish workers. Foreign-born women reported higher prevalence of exposure than Spanish female workers. By occupation, foreign-born female workers were more likely than Spanish workers to report working many hours/day (aOR2.68; 95 % CI 1.06-6.78) and exposure to extreme temperatures (aOR2.19; 95 % CI 1.10-4.38). Some groups of migrant workers may need increased protection regarding some occupational exposures.

Work in multiple jobs and the risk of injury in the US working population

OBJECTIVES

We compared the risk of injury for multiple job holders (MJHs) with that for single job holders (SJHs).

METHODS

We used information from the National Health Interview Survey for the years 1997 through 2011 to estimate the rate of multiple job holding in the United States and compared characteristics and rates of self-reported injury (work and nonwork) for SJHs versus MJHs.

RESULTS

Approximately 8.4% of those employed reported working more than 1 job in the week before the interview. The rate of work and nonwork injury episodes per 100 employed workers was higher for MJHs than for SJHs (4.2; 95% confidence interval [CI] = 3.5, 4.8; vs 3.3; 95% CI = 3.1, 3.5 work injuries and 9.9; 95% CI = 8.9, 10.9; vs 7.4; 95% CI = 7.1, 7.6 nonwork injuries per 100 workers, respectively). When calculated per 100 full-time equivalents (P < .05), the rate ratio remained higher for MJHs.

CONCLUSIONS

Our findings suggest that working in multiple jobs is associated with an increased risk of an injury, both at work and not at work, and should be considered in injury surveillance.

[Work days lost due to health problems in industry]

This cross-sectional study estimated the prevalence of work days lost due to health problems and associated factors among industrial workers. The study population was a simple random cluster sample of 3,403 workers from 16 to 65 years of age in the city of Salvador, Bahia State, Brazil. Data were collected with individual home interviews. Among industrial workers, one-year prevalence of work days lost to health problems was 12.5%, of which 5.5% were directly work-related and 4.1% aggravated by work. There were no statistically significant differences when compared to other worker categories. Self-perceived workplace hazards, history of work-related injury, and poor self-rated health were associated with work days lost due to work-related injuries/diseases. The findings showed that work days lost are common among both industrial and non-industrial workers, thereby affecting productivity and requiring prevention programs.

Agricultural work related injuries among the farmers of West Bengal, India

Agriculture is one of the most hazardous industries with high rates of accidental death, injury and occurrences of work related illnesses. The main objective of the study is to assess types, categories and number of incident rate of the accidents along with the causes of accidents as well as with the affected parts of the different parts of the body among the agricultural workers. The number of injuries that occurred during 2006-2010 for male and female farmers was 214 and 109, respectively, in West Bengal. The leading external causes of farm injury were hand tools (64.7%)), farm machinery (29.1%) and others (6.2%). The most frequently involved tools in hand injuries were spade and sickle. Fingers of both limbs are the most affected parts of the body followed by feet, ankle, hand, wrist and lower back. From this study it was also observed that the male agricultural workers are much more affected than female agricultural workers. The incident rate among male and female agricultural workers was 8.99 per 1000 workers per year and 7.89 per 1000 workers per year, respectively. So due to injuries in both groups of agricultiral workers, their health, productivity and work performance were consequently affected.

Analysis of ethnic disparities in workers' compensation claims using data linkage

OBJECTIVE

The overall goal of this research project was to assess ethnic disparities in monetary compensation among construction workers injured on the job through the linkage of medical records and workers' compensation data.

METHODS

Probabilistic linkage of medical records with workers' compensation claim data.

RESULTS

In the final multivariable robust regression model, compensation was $5824 higher (P = 0.030; 95% confidence interval: 551 to 11,097) for white non-Hispanic workers than for other ethnic groups when controlling for injury severity, affected body region, type of injury, average weekly wage, weeks of temporary total disability, percent permanent partial disability, death, or attorney use.

CONCLUSIONS

The analysis indicates that white non-Hispanic construction workers are awarded higher monetary settlements despite the observation that for specific injuries the mean temporary total disability and permanent partial disability were equivalent to or lower than those in Hispanic and black construction workers.

Occupational health and safety experiences among self-identified immigrant workers living or working in Somerville, MA by ethnicity, years in the US, and English proficiency

In this community based research initiative, we employed a survey instrument predominately developed and administered by Teen Educators to assess occupational health risks for Haitian, Salvadoran, and Brazilian immigrants (n = 405) in Somerville, MA, USA. We demonstrate that a combined analysis of ethnicity, years in the US, and English proficiency better characterized the occupational experience of immigrant workers than considering these variables individually. While years in the US (negatively) and English proficiency (positively) explained the occurrence of health risks, the country of origin identified the most vulnerable populations in the community. Brazilians, Salvadorans, and other Hispanic, all of whom who have been in the US varying length of time, with varying proficiency in English language had twice the odds of reporting injuries due to work compared to other immigrants. Although this observation was not significant it indicates that years in the US and English proficiency alone do not predict health risks among this population. We recommend the initiation of larger studies employing c community based participatory research methods to confirm these differences and to further explore work and health issues of immigrant populations. This study is one of the small number of research efforts to utilize a contemporaneous assessment of occupational health problems in three distinct immigrant populations at the community level within a specific Environmental Justice context and social milieu.

A Comparison of Nonfatal Occupational Injuries and Illnesses Among Hispanic Versus Non-Hispanic Workers in the United States

This article investigates the trends and changes in patterns of nonfatal occupational injuries and illnesses among Hispanic workers versus non-Hispanic minority workers in the United States between 1992 and 2009. Injuries and illnesses are also examined by the severity of cases and across industry sectors. The differences in the mean share of nonfatal injury and illness cases found between Hispanic and non-Hispanic minority workers in the top three industries are tested to determine if they are statistically different. The hypothesis that Hispanic workers experience a relatively higher incidence of injuries and illnesses because of the growing share of Hispanics in the U.S. labor force and relatively lower educational attainment level is established through a vector autoregressive (VAR) framework. These findings suggest greater need for safety efforts with Hispanic workers in industries demonstrating high rates of injuries and illnesses, such as education and training that addresses safety behavior, work conditions, and language and cultural barriers.

Working for mom and dad: are teens more likely to get injured working in family-owned businesses?

Recent controversy regarding the issue of children working in family-owned businesses has come to the forefront, pitting safety and health versus parent's right to teach their children the family trade. While studies have characterized injury among working teens, no studies have assessed work and injury among teens employed in family-owned businesses. This study is the first to examine teenagers working in family-owned businesses and to compare the experiences of teens working in family-businesses to the experiences of other working teens. A questionnaire was distributed to 8,085 teens in high schools throughout the five public health regions of Wisconsin. A total of 6, 810 teens responded (84%). Overall 2,858 high school teens aged 14-17 reported working (42%); of which 963 (34%) worked in a family-business. Teens working in family-businesses were more likely to report that their injury was severe, affecting their activities for more than three days, compared with other working teens (33% vs. 21%, P = 0.05). The percentage of teens working in family-businesses that reported broken bones or crushed body parts was 17% compared to only 5% of other-working teens. Additionally, teens employed in family-businesses were more likely to file for workers' compensation (28% vs. 12%, P = 0.005). Teens working in family-owned businesses may be at a greater risk for more severe injury based on the jobs and tasks they are doing. Teens working in family-owned businesses were more likely to report engaging in dangerous tasks, including some that are illegal under the Hazardous Occupation Orders. More research is needed to assess the dynamics that exist for teens working in family-owned businesses.

Incidence of workers compensation indemnity claims across socio-demographic and job characteristics

BACKGROUND

We hypothesized that low socioeconomic status, employer-provided health insurance, low wages, and overtime were predictors of reporting workers compensation indemnity claims. We also tested for gender and race disparities.

METHODS

Responses from 17,190 (person-years) Americans participating in the Panel Study of Income Dynamics, 1997-2005, were analyzed with logistic regressions. The dependent variable indicated whether the subject collected benefits from a claim.

RESULTS

Odds ratios for men and African-Americans were relatively large and strongly significant predictors of claims; significance for Hispanics was moderate and confounded by education. Odds ratios for variables measuring education were the largest for all statistically significant covariates. Neither low wages nor employer-provided health insurance was a consistent predictor. Due to confounding from the "not salaried" variable, overtime was not a consistently significant predictor.

CONCLUSION

Few studies use nationally representative longitudinal data to consider which demographic and job characteristics predict reporting workers compensation indemnity cases. This study did and tested some common hypotheses about predictors.

Ethnic differences in patterns of occupational exposure in New Zealand

OBJECTIVES

To investigate the differences in occupational exposure between Māori (New Zealand's indigenous people) and non-Māori.

METHODS

Participants were randomly selected from the Electoral Roll. Exposure to occupational risk factors was assessed through telephone interviews and exposure prevalences of Māori (n = 273) and non-Māori (n = 2,724) were compared. Subsequently, Māori were matched with non-Māori on current occupation (n = 482) to assess whether ethnic differences also exist within occupations.

RESULTS

Māori were more likely to report exposure to physical strain (e.g., lifting, standing). Part of these differences remained when Māori were compared with non-Māori in the same job. In addition, Māori women were twice as likely to categorize their job as very or extremely stressful than non-Māori women in the same job, while Māori men were twice as likely to report exposure to dust.

CONCLUSION

Marked ethnic differences exist in risk factors for occupational ill-health, due to both occupational distribution and the distribution of tasks within occupations.

Racial and ethnic disparities in work-related injuries and socio-economic resources among nursing assistants employed in US nursing homes

BACKGROUND

We aimed to estimate the proportion of nursing assistants (NAs) in the US with work-related injuries and insufficient socio-economic resources by race/ethnicity.

METHODS

Data from the 2004 National Nursing Assistant Survey (NNAS), a nationally representative sample survey of NAs employed in United States nursing homes, were analyzed accounting for the complex survey design.

RESULTS

Among 2,880 participants, 44% reported "scratch, open wounds, or cuts" followed by "back injuries" (17%), "black eyes or other types of bruising" (16%), and "human bites" (12%). When compared to non-Hispanic white NAs, the adjusted rate ratio (RR) for wound/cut was 0.74 for non-Hispanic black NAs (95% confidence interval [CI]: 0.65-0.85). RRs for black eyes/bruises were 0.18 for non-Hispanic black NAs (95% CI: 0.12-0.26), and 0.55 for Hispanic NAs (95% CI: 0.37-0.82).

CONCLUSIONS

Minority racial and ethnic groups were less likely to report having experienced injuries compared with non-Hispanic white NAs. Future research should focus on identifying preventable risk factors, such as differences by race and ethnicity in the nature of NA jobs and the extent of their engagement in assisting patients with activities of daily living.

Disparities by ethnicity, language, and immigrant status in occupational health experiences among Las Vegas hotel room cleaners

OBJECTIVE

We examined disparities in workers' occupational health experiences.

METHODS

We surveyed 941 unionized Las Vegas hotel room cleaners about their experiences with work-related pain and with employers, physicians, and workers' compensation. Data were analyzed for all workers and by ethnicity, language, and immigrant status.

RESULTS

Hispanic and English as second language (ESL) workers were more likely than their counterparts to report work-related pain and, along with immigrant workers, to miss work because of this pain. Hispanic, ESL, and immigrant workers were not consistently at a disadvantage with regard to their own responses to work-related pain but were so with respect to reported responses by workers' compensation, physicians, and employers.

CONCLUSIONS

There are indications of disparities in occupational health experiences within this job title. The use of different group classifications, while implying different mechanisms, produced similar results.

Associations between work schedule characteristics and occupational injury and illness

BACKGROUND

Nurses often endure working irregular day, night and evening shifts as well as mandatory overtime (i.e. employer-imposed work time in excess of one's assigned schedule). While these work characteristics are examined as potential risks for nurses' safety and health, it is not clear whether negative health impacts occur simply because of working long hours or in combination with other mechanisms.

AIM

This study investigates how these work characteristics are associated with nurses' work-related injury and illness over and above long work hours.

METHODS

In this cross-sectional study, questionnaire data were collected from a sample of 655 registered nurses in the Philippines. Multiple logistic regression was used to assess associations of shift work and mandatory overtime with four work-related health outcomes.

RESULTS

After weekly work hours, shift length and demographic variables were accounted for, non-day shifts were associated with work-related injury [odds ratio (OR) = 1.54; 95% confidence interval (CI): 1.07, 2.24] and work-related illness (OR = 1.48; 95% CI: 1.02, 2.16). Also, frequency of working mandatory overtime was associated with work-related injury (OR = 1.22; 95% CI: 1.06, 1.41), work-related illness (OR = 1.19; 95% CI: 1.04, 1.37) and missing more than 2 days of work because of a work-related injury or illness (OR = 1.25; 95% CI: 1.08, 1.44).

CONCLUSIONS

These findings suggest that non-day shifts and mandatory overtime may negatively impact nurses' health independent of working long hours. Mechanisms through which these work characteristics affect health, such as circadian rhythm disturbance, nurse-to-patient ratios and work-family conflict, should be examined in future studies.

Are immigrants, ethnic and linguistic minorities over-represented in jobs with a high level of compensated risk? Results from a Montréal, Canada study using census and workers' compensation data

OBJECTIVES

Few Canadian data sources allow the examination of disparities by ethnicity, language, or immigrant status in occupational exposures or health outcomes. However, it is possible to document the mechanisms that can create disparities, such as the over-representation of population groups in high-risk jobs. We evaluated, in the Montréal context, the relationship between the social composition of jobs and their associated risk level.

METHODS

We used data from the 2001 Statistics Canada census and from Québec's workers' compensation board for 2000-2002 to characterize job categories defined as major industrial groups crossed with three professional categories (manual, mixed, non-manual). Immigrant, visible, and linguistic minority status variables were used to describe job composition. The frequency rate of compensated health problems and the average duration of compensation determined job risk level. The relationship between the social composition and risk level of jobs was evaluated with Kendall correlations.

RESULTS

The proportion of immigrants and minorities was positively and significantly linked to the risk level across job categories. Many relationships were significant for women only. In analyses done within manual jobs, relationships with the frequency rate reversed and were significant, except for the relationship with the proportion of individuals with knowledge of French only, which remained positive.

CONCLUSIONS

Immigrants, visible, and linguistic minorities in Montréal are more likely to work where there is an increased level of compensated risk. Reversed relationships within manual jobs may be explained by under-reporting and under-compensation in vulnerable populations compared to those with knowledge of the province's majority language.

Medical care utilization for work-related injuries in the United States 2002-2006

OBJECTIVE

To examine racial-ethnic/gender differences in the odds of injury and in the odds of seeking medical treatment among workers in the United States.

METHODS

Logistic regression models were used to estimate the odds of having a work injury and the odds of seeking medical treatment for these injuries in a sample of non-Latino Black, Latino, and non-Latino white workers from the Medical Expenditure Panel Survey (2002-2006).

RESULTS

Significant variation in the odds of injury was observed across racial-ethnic/gender groups. Although race-gender groups had significant variation in the odds of experiencing a work injury, we found few differences in treatment seeking. Among the 6 subgroups, we found that white women were significantly less likely to report an injury and significantly more likely to seek treatment when injured. Having health insurance played a key role in utilization among injured workers. The odds of seeking treatment were 33% lower for uninsured workers compared with those with private insurance. Publicly insured workers were no different from privately insured workers.

CONCLUSIONS

Our study sheds light on current trends in work injuries and associated medical care utilization among a nationally representative sample of workers.

Work-related injuries among Hispanic construction workers-evidence from the medical expenditure panel survey

BACKGROUND

Although a large number of Hispanic workers have entered the construction industry, few studies have estimated non-fatal work-related injuries for Hispanic construction workers at a national level. This study examines work-related injury conditions among Hispanic construction workers and assesses disparities between Hispanic and white, non-Hispanic workers.

METHODS

Pooled data were analyzed from a large national population survey, the Medical Expenditure Panel Survey (MEPS), between 1996 and 2002. More than 7,000 construction workers were identified from the MEPS data including 1,833 Hispanic workers and 4,533 white, non-Hispanic workers. Univariate and multivariate analyses were conducted using SAS-callable SUDAAN.

RESULTS

Hispanic workers differ from white, non-Hispanic workers in demographic and socioeconomic status. After controlling for major risk factors, Hispanic construction workers were more likely than their white, non-Hispanic counterparts to suffer non-fatal work-related injury conditions (OR = 1.28, 95% CI: 1.00-1.64).

CONCLUSIONS

This study provides important evidence concerning Hispanic workers' safety on construction sites. Enhanced safety and health programs for Hispanic construction workers and improved occupational injury data systems are recommended.

A global perspective of migration and occupational health

BACKGROUND

Global migration has dramatically increased over the past decade and is at an all-time high, approaching 200 million persons per year. Demographics and economic interdependence suggest that immigration will continue for the near future at record high levels.

METHODS

A review of the few studies that have investigated occupational injury and illness rates among immigrant populations.

RESULTS

Existing data indicate that higher rates of fatal and non-fatal injuries are common compared to native populations. This increase is in part due to immigrants working in higher risk occupations (e.g., agriculture, construction), but occupational morbidity and mortality is higher among immigrants than native-born workers within occupational categories.

CONCLUSIONS

Research is needed to identify the causes of increased risk among immigrants and to provide direction to effective public health interventions. Research methods must be adapted to different epidemiologic characteristics of immigrant populations, including lack of standard sampling frames, different language and culture from the dominant culture, and precarious work status.

Hispanic employees in the workplace: higher rate of fatalities

This article reviews the higher fatality and injury rates among the Hispanic population in the United States, whether legal immigrants, citizens, or illegal immigrants; reviews the current government and private industry regulations and safety programs; proposes additional legislation or programs; and describes the role of the occupational and environmental health nurse in reducing injuries and fatalities in this population.

Hispanic Employees in the Workplace

This article reviews the higher fatality and injury rates among the Hispanic population in the United States, whether legal immigrants, citizens, or illegal immigrants; reviews the current government and private industry regulations and safety programs; proposes additional legislation or programs; and describes the role of the occupational and environmental health nurse in reducing injuries and fatalities in this population.

Supervising structured learning experiences for students in New Jersey: training teachers in school-based occupational health and safety practice

This article describes the structured learning experience (SLE) supervisory training curriculum coordinated by the New Jersey Safe Schools Program, a project supported by the New Jersey Department of Education, Office of Career and Technical Education. The New Jersey SLE supervisory training program comprises training courses and resources for teachers who supervise secondary school minors (students aged 16 to 18 years and special needs students up to age 21) enrolled in various programs--college preparatory, general education, career and technical education, career academies, and special education. One goal of the program is to enhance knowledge and awareness of legal and scientific occupational safety and health principles to ensure safe, rewarding work experiences inside and outside classrooms. This article describes our experiences and data available from November 2005 to January 2008. We summarize relevant federal and state laws and agencies; potential exposure agents and microenvironments of concern; stakeholders and training partners; process and immediate impact data from SLE supervisory trainings; and lessons learned to inform states that may adopt similar strategies or regulations.

Race, racial discrimination, and the risk of work-related illness, injury, or assault: findings from a national study

OBJECTIVE

This study examines whether workplace racial harassment or discrimination mediates the relationship between race or ethnicity and work-related illness, injury, or assault across time.

METHODS

A national random digit dial phone survey was conducted at two points in time (W1: 2003-2004; W2: 2004-2005) among a sample of Black, Hispanic and non-Hispanic white workers. As part of the survey, respondents indicated their experiences with racial harassment or discrimination, and occupational illness, injury, or assault in the past 12 months.

RESULTS

Hispanic respondents were more likely than whites to experience work-related illness, injury or assault, and these associations were mediated by experiences of racial harassment or discrimination.

CONCLUSIONS

Interventions to reduce workplace harassment and discrimination may help decrease risk for work-related illness, injury, or assault among Hispanic workers.

Racial/ethnic and gender differences in individual workplace injury risk trajectories: 1988-1998

OBJECTIVES

I examined workplace injury risk over time and across racial/ethnic and gender groups to observe patterns of change and to understand how occupational characteristics and job mobility influence these changes.

METHODS

I used hierarchical generalized linear models to estimate individual workplace injury and illness risk over time ("trajectories") for a cohort of American workers who participated in the National Longitudinal Survey of Youth (1988-1998).

RESULTS

Significant temporal variation in injury risk was observed across racial/ethnic and gender groups. At baseline, White men had a high risk of injury relative to the other groups and experienced the greatest decline over time. Latino men demonstrated a pattern of lower injury risk across time compared with White men. Among both Latinos and non-Latino Whites, women had lower odds of injury than did men. Non-Latino Black women's injury risk was similar to Black men's and greater than that for both Latino and non-Latino White women. Occupational characteristics and job mobility partly explained these differences.

CONCLUSIONS

Disparities between racial/ethnic and gender groups were dynamic and changed over time. Workplace injury risk was associated with job dimensions such as work schedule, union representation, health insurance, job hours, occupational racial segregation, and occupational environmental hazards.

The relationship between job tenure and work disability absence among adults: a prospective study

Little population-based, prospective research has been conducted to examine the demographic and work-related determinants of occupational injury or illness. This study examined the relative contribution of sociodemographic characteristics and work factors to the likelihood of a work-related disability or illness. In a representative sample of adult Canadians 25-70 years old from a prospective survey, a hazard modelling approach of time to work disability absence from the start of a new job was estimated with the following predictors: age, gender, type of job (manual, non-manual, and mixed), hours worked, highest education achieved, multiple concurrent job, job tenure, school activity, union membership and living in a rural or urban area. Workers holding manual or mixed jobs and having a low education level were factors independently associated with the increased likelihood of a work disability absence. Gender was not independently associated with work disability absences. A strong job tenure gradient in the unadjusted work disability absence rates was virtually eliminated when controlling for demographic/individual and other work factors. In multivariate analyses, work-related factors remained predictors of work disability absence whereas individual characteristics such as gender did not. The exception was workers with less education who appeared to be particularly vulnerable, even after controlling of physical demands on the job. This may be due to inadequate job training or increased hazard exposure even in the same broad job category.