Spatial clustering of occupational injuries in communities

Enhancing detection of labor violations in the agricultural sector: A multilevel generalized linear regression model of H-2A violation counts

Agricultural workers are essential to the supply chain for our daily food, and yet, many face harmful work conditions, including garnished wages, and other labor violations. Workers on H-2A visas are particularly vulnerable due to the precarity of their immigration status being tied to their employer. Although worksite inspections are one mechanism to detect such violations, many labor violations affecting agricultural workers go undetected due to limited inspection resources. In this study, we identify multiple state and industry level factors that correlate with H-2A violations identified by the U.S. Department of Labor's Wage and Hour Division using a multilevel zero-inflated negative binomial model. We find that three state-level factors (average farm acreage size, the number of agricultural establishments with less than 20 employees, and higher poverty rates) are correlated with H-2A violations. These findings offer valuable insights into where H-2A violations are being detected at the state and industry levels.

Occupational Safety and Health Equity Impacts of Artificial Intelligence: A Scoping Review

Artificial intelligence (AI) has the potential to either reduce or exacerbate occupational safety and health (OSH) inequities in the workplace, and its impact will be mediated by numerous factors. This paper anticipates challenges to ensuring that the OSH benefits of technological advances are equitably distributed among social groups, industries, job arrangements, and geographical regions. A scoping review was completed to summarize the recent literature on AI's role in promoting OSH equity. The scoping review was designed around three concepts: artificial intelligence, OSH, and health equity. Scoping results revealed 113 articles relevant for inclusion. The ways in which AI presents barriers and facilitators to OSH equity are outlined along with priority focus areas and best practices in reducing OSH disparities and knowledge gaps. The scoping review uncovered priority focus areas. In conclusion, AI's role in OSH equity is vastly understudied. An urgent need exists for multidisciplinary research that addresses where and how AI is being adopted and evaluated and how its use is affecting OSH across industries, wage categories, and sociodemographic groups. OSH professionals can play a significant role in identifying strategies that ensure the benefits of AI in promoting workforce health and wellbeing are equitably distributed.

Employment Precarity and Increased Risk of Hazardous Occupational Exposures Among Residents of High Socioeconomic Hardship Neighborhoods

BACKGROUND

While there is evidence that workers in nonstandard employment arrangements are disproportionately exposed to recognized occupational hazards, existing studies have not comprehensively examined associations between employment precarity and exposure to occupational hazards for these workers in the USA. The aim of this study was to examine relationships between employment precarity and occupational hazards in two contiguous high socio-economic hardship neighborhoods in Chicago.

METHODS

Using a community-based participatory research approach, community researchers administered a community-developed survey to 489 residents of Greater Lawndale who reported current or recent employment in a job that met at least one characteristic of precarious employment (e.g. unpredictable schedule, insecure work, no living wage/benefits). Employment precarity was calculated using a modified version of the Employment Precarity Index (EPI) developed by the Poverty and Employment Precarity in Southern Ontario group. We modeled the association between employment precarity and occupational exposures using logistic regression models.

RESULTS

We identified a high prevalence of precarious employment in this sample, as well as a high prevalence of self-reported exposure to recognized occupational hazards. Increases in relative employment precarity were significantly associated with self-reported exposure to chemical and biological hazards, physical hazards, and slip, trip, strike, fall, trap or crush hazards at work.

CONCLUSIONS

Results highlight the importance of using community research approaches and robust measures of employment characteristics, such as the EPI, to evaluate associations between employment precarity and hazardous exposures. These results suggest that variability in employment situations and resultant relative employment precarity are important predictors of exposure to recognized occupational hazards. Findings also suggest that health inequities observed among precariously employed workers may be partly explained by increased risk for exposure to occupational hazards, which has implications for community health and should be investigated in future longitudinal research.

Community Resident Perceptions of and Experiences with Precarious Work at the Neighborhood Level: The Greater Lawndale Healthy Work Project

Work is a key social determinant of health. Community health and well-being may be impacted in neighborhoods with high proportions of people engaged in precarious work situations compounded by health inequities produced by other social determinants associated with their residential geography. However, little is known about how community residents experience work at the neighborhood level nor how work impacts health at the community-level, particularly in communities with a high proportion of residents engaged in precarious work. We sought to understand, through participatory research strategies, how work is experienced at the community level and to identify community interventions to establish a culture of healthy work. As part of a mixed-methods community health assessment, community researchers conducted focus groups with residents in two high social and economic hardship neighborhoods on Chicago’s southwest side. Community and academic researchers engaged in participatory data analysis and developed and implemented member-checking modules to engage residents in the data interpretation process. Twelve focus group discussions (77 community resident participants) were completed. Three major themes emerged: systematic marginalization from the pathways to healthy work situations; contextual and structural hostility to sustain healthy work; and violations in the rights, agency, and autonomy of resident workers. Findings were triangulated with findings from the concept-mapping research component of the project to inform the development of a community health survey focused on work characteristics and experiences. Listening to residents in communities with a high proportion of residents engaging in precarious work allows for the identification of nuanced community-informed intervention points to begin to build a culture of healthy work.

Impact of precarious work on neighborhood health: Concept mapping by a community/academic partnership

OBJECTIVE

As part of community-based participatory research (CBPR) examining precarious employment and community health, academic, and community researchers used concept mapping to explore how residents in two high hardship neighborhoods perceive the impact of work on health.

METHODS

Between January and May 2017, 292 individuals who lived or worked in two contiguous Chicago neighborhoods were engaged in brainstorming, sorting, and rating activities. Multidimensional scaling and hierarchical cluster analysis were applied, and findings were interpreted by a community-academic partnership.

RESULTS

Brainstorming resulted in 55 unique ways that work impacts health, each of which was rated on its perceived impact on health and prevalence in the neighborhood. Four major themes emerged: Healthy Aspects of Work, Systemic/Structural Injustices, Lack of Control/Exploitation, and Psychological/Physical Stress, which was a multidimensional, cross-cutting theme.

CONCLUSION

These findings provide critical insight into community perceptions of the mechanisms by which work influences health, providing a basis for community-driven, sustainable, work-focused interventions that promote community health.

Predictors and Spatial Variation of Radon Testing in Illinois, 2005-2012

CONTEXT

Radon is the second leading cause of lung cancer, but exposure can be reduced through testing one's home and mitigating if levels are high.

OBJECTIVE

To determine what factors predict radon testing and to identify, through spatial analysis, areas in Illinois with lower or higher than expected testing rates.

DESIGN, SETTING, PARTICIPANTS, AND MAIN OUTCOMES

An ecological study design was used to evaluate data on radon tests performed in Illinois by a licensed professional or a home radon test kit analyzed by a state-approved laboratory between 2005 and 2012. Zip code-level rates of testing per 1000 occupied residences were calculated for all testing methods combined and for licensed professional testing and home kit testing separately. The following zip code-level factors associated with radon testing were considered: Environmental Protection Agency (EPA) radon zones (ie, categorization of areas by predicted radon risk), socioeconomic characteristics, homeowner occupancy, and rurality. Univariate and multivariable incidence rate ratios were calculated to examine what factors were associated with each testing type. Hotspot analysis was performed to identify zip codes with lower than expected and higher than expected testing rates (ie, "coldspots" and "hotspots," respectively).

RESULTS

Radon testing rates varied across EPA zone, socioeconomic characteristics, and level of rurality. In multivariable analysis, EPA zone, education, and median household income positively predicted all testing types combined. Median home value was associated with licensed testing, whereas rurality was negatively associated with licensed testing. Owner occupancy positively predicted home kit testing. Between 19.6% and 31.1% of zip codes were coldspots for radon testing rates, dependent upon testing type. Coldspots of all testing method rates were concentrated in the southern part of the state.

CONCLUSION

Public health professionals can benefit from understanding what area-level factors predict radon testing and what geographic areas may under-utilize testing. Such information can aid the development of geographically targeted, cost-effective interventions that increase radon testing and subsequently reduce lung cancer risk.

Mortality and Morbidity during Extreme Heat Events and Prevalence of Outdoor Work: An Analysis of Community-Level Data from Los Angeles County, California

Heat is a well-recognized hazard for workers in many outdoor settings, yet few investigations have compared the prevalence of outdoor work at the community level and rates of heat-related mortality and morbidity. This analysis examines whether heat-related health outcomes occur more frequently in communities with higher proportions of residents working in construction, agriculture, and other outdoor industries. Using 2005–2010 data from Los Angeles County, California, we analyze associations between community-level rates of deaths, emergency department (ED) visits, and hospitalizations during summer heat events and the prevalence of outdoor work. We find generally higher rates of heat-related ED visits and hospitalizations during summer heat events in communities with more residents working outdoors. Specifically, each percentage increase in residents working in construction resulted in an 8.1 percent increase in heat-related ED visits and a 7.9 percent increase in heat-related hospitalizations, while each percentage increase in residents working in agriculture and related sectors resulted in a 10.9 percent increase in heat-related ED visits. The findings suggest that outdoor work may significantly influence the overall burden of heat-related morbidity at the community level. Public health professionals and healthcare providers should recognize work and employment as significant heat risk factors when preparing for and responding to extreme heat events.

An overview of geospatial methods used in unintentional injury epidemiology

Background

Injuries are a leading cause of death and disability around the world. Injury incidence is often associated with socio-economic and physical environmental factors. The application of geospatial methods has been recognised as important to gain greater understanding of the complex nature of injury and the associated diverse range of geographically-diverse risk factors. Therefore, the aim of this paper is to provide an overview of geospatial methods applied in unintentional injury epidemiological studies.

Methods

Nine electronic databases were searched for papers published in 2000–2015, inclusive. Included were papers reporting unintentional injuries using geospatial methods for one or more categories of spatial epidemiological methods (mapping; clustering/cluster detection; and ecological analysis). Results describe the included injury cause categories, types of data and details relating to the applied geospatial methods.

Results

From over 6,000 articles, 67 studies met all inclusion criteria. The major categories of injury data reported with geospatial methods were road traffic (n = 36), falls (n = 11), burns (n = 9), drowning (n = 4), and others (n = 7). Grouped by categories, mapping was the most frequently used method, with 62 (93%) studies applying this approach independently or in conjunction with other geospatial methods. Clustering/cluster detection methods were less common, applied in 27 (40%) studies. Three studies (4%) applied spatial regression methods (one study using a conditional autoregressive model and two studies using geographically weighted regression) to examine the relationship between injury incidence (drowning, road deaths) with aggregated data in relation to explanatory factors (socio-economic and environmental).

Conclusion

The number of studies using geospatial methods to investigate unintentional injuries has increased over recent years. While the majority of studies have focused on road traffic injuries, other injury cause categories, particularly falls and burns, have also demonstrated the application of these methods. Geospatial investigations of injury have largely been limited to mapping of data to visualise spatial structures. Use of more sophisticated approaches will help to understand a broader range of spatial risk factors, which remain under-explored when using traditional epidemiological approaches.

Electronic supplementary material

The online version of this article (doi:10.1186/s40621-016-0097-0) contains supplementary material, which is available to authorized users.