1
|
Kramer A, Cho S, Gajendran RS. 12-Year longitudinal study linking within-person changes in work and family transitions and workplace injury risk. JOURNAL OF SAFETY RESEARCH 2020; 75:140-149. [PMID: 33334471 DOI: 10.1016/j.jsr.2020.08.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 11/09/2019] [Accepted: 08/31/2020] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Despite the rich tradition of research on predictors of workplace injury, most studies rely on cross-sectional, between-person designs. Furthermore, prior research has often overlooked the possibility that factors outside the work domain can influence the occurrence of actual injuries at work. To address these limitations, the current study examined the effects of work and family demands on the occurrence of workplace injury. Drawing on the intuition of the work-home resources model (W-HR), we investigated how within-person level changes in demands and resources from both domains influence work injuries over a 12-year period. METHOD We used 12 years of longitudinal data (N = 7,820) to study the long-term within-person changes in work and family domains and to capture the event of low frequency incidence such as workplace injury. Specifically, we conducted multilevel analyses to study the links between within-person change in time and energy resources both in work and family domains and within-person change in the likelihood of experiencing a workplace injury. RESULTS AND CONCLUSION The findings showed that within-person changes in work hours, spousal work hours, income and number of children, were significantly associated with changes in the likelihood of experiencing a workplace injury. We conclude with a discussion of implications for theory and future research of workplace injuries. Practical application: The research provided useful insights on the intimate association between work and family domains in the context of safety management.
Collapse
Affiliation(s)
- Amit Kramer
- School of Labor and Employment Relations, University of Illinois at Urbana-Champaign, 504 E. Armory Ave, 247E LER Building, Champaign, IL 61820, United States.
| | - Seonghee Cho
- Department of Psychology, North Carolina State University, 640 Poe Hall, 2310 Katharine Stinson Dr., Raleigh, NC 27695-7650, United States.
| | - Ravi S Gajendran
- Department of Management and International Business, College of Business, Florida International University, Modesto A. Maidique Campus, 11200 S.W. 8th St, MANGO 472, Miami, FL 33199, United States.
| |
Collapse
|
2
|
Schmidt S, Sparks PJ. Disparities in injury morbidity among young adults in the USA: individual and contextual determinants. J Epidemiol Community Health 2018; 72:458-464. [PMID: 29439190 PMCID: PMC6152816 DOI: 10.1136/jech-2017-210259] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Injuries have been recognised as important public health concerns, particularly among adolescents and young adults. Few studies have examined injuries using a multilevel perspective that addresses individual socioeconomic status (SES) and health behaviours and local socioeconomic conditions in early adolescence. We offer a conceptual framework incorporating these various components. METHODS We test our conceptual framework using population data from the National Longitudinal Study of Adolescent Health Wave 4 when respondents were young adults and linked them to contextual level data from when they were middle-schoolers. We use logistic and multilevel regression models to examine self-reported injury risk in young adults by sex (n=14 356). RESULTS Logistic regression models showed that men were more likely to experience serious injuries than women (OR 1.75, P<0.0001), but SES and health behaviours operated differently by sex. In stratified models, men with lower education had consistently higher injury risk, while only women with some college had increased injury risk (OR 1.40, P=0.0089) than college graduates. Low household income (OR 1.54, P=0.0011) and unemployment (OR 1.50, P=0.0008) increased female injury risk, but was non-significant for men. Alcohol consumption increased injury risk for both sexes, while only female smokers had elevated injury risk (OR 1.38, P=0.0154). In multilevel models, significant county-level variation was only observed for women. Women living in disadvantaged neighbourhoods during adolescence had increased injury risk (OR 1.001, P<0.0001). CONCLUSIONS These findings highlight the importance of investigating mechanisms that link early-life contextual conditions to early adult SES and health behaviours and their linkage to injury risk, particularly for women.
Collapse
Affiliation(s)
- Susanne Schmidt
- Department of Epidemiology and Biostatistics, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - P Johnelle Sparks
- Department of Demography, University of Texas at San Antonio, San Antonio, Texas, USA
| |
Collapse
|
3
|
Rha EY, Han K, Park Y, Yoo G. Socioeconomic Disparities in the Prevalence of Blepharoptosis in the South Korean Adult Population Based on a Nationwide Cross-Sectional Study. PLoS One 2016; 11:e0145069. [PMID: 26727468 PMCID: PMC4699707 DOI: 10.1371/journal.pone.0145069] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 11/26/2015] [Indexed: 11/30/2022] Open
Abstract
Purpose We investigated the association between socioeconomic status (SES) and the prevalence of blepharoptosis in a representative South Korean population. Methods This cross-sectional study was based on data obtained in the Korea National Health and Nutrition Examination Survey from 2010 to 2012. In total, 17,178 Korean adults (7,261 men and 9,917 women) aged 19 years or older were enrolled. Blepharoptosis was defined as a marginal reflex distance 1 (MDR 1) lower than 2 mm. Household income and education level were used as indicators of SES. Univariate and multiple logistic regression analyses were conducted to analyze the relationship between SES and the prevalence of blepharoptosis. Results Household income was inversely associated with the prevalence of blepharoptosis in women [adjusted odds ratio (aOR) and corresponding 95% confidence interval (95% CI) was 1.894 (1.336, 2.685)], and educational level was inversely associated with blepharoptosis in both men and women [aORs and 95% CIs were 1.572 (1.113, 2.219) and 1.973 (1.153, 3.376), respectively]. After adjusting for household income and educational level, low SES was associated with a high prevalence of blepharoptosis in women only. Conclusions Socioeconomic disparities in the prevalence of blepharoptosis were found among women. Indeed, future research using a prospective design to determine the causal relationship between SES and blepharoptosis may identify SES as a risk factor for this condition.
Collapse
Affiliation(s)
- Eun Young Rha
- Department of Plastic and Reconstructive Surgery, Incheon St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Kyungdo Han
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yongkyu Park
- Department of Biostatistics, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Gyeol Yoo
- Department of Plastic and Reconstructive Surgery, Yeouido St. Mary’s hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- * E-mail:
| |
Collapse
|
4
|
de la Fuente VS, López MAC, González IF, Alcántara OJG, Ritzel DO. The impact of the economic crisis on occupational injuries. JOURNAL OF SAFETY RESEARCH 2014; 48:77-85. [PMID: 24529095 DOI: 10.1016/j.jsr.2013.12.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2012] [Revised: 09/03/2013] [Accepted: 12/21/2013] [Indexed: 06/03/2023]
Abstract
INTRODUCTION The potential influence of the current economic crisis on occupational accident rates and accident severity is studied in an analysis of all workplace accidents that occurred in Spain throughout the period 2000-2009. METHOD AND RESULTS The investigation confirms that occupational accidents in Spain are affected by the current economic crisis, which has provoked a sharp fall in both the number of accidents and the probability of having one. This may be justified by certain factors such as age, gender, length of service, size of the firm, and the employment stability of the injured worker. The influence of these factors is analyzed. PRACTICAL APPLICATIONS The economic crises seems to provoke a sort of "natural selection" in the labor market and only the best adapted tend to remain (older workers, with more experience, a higher percentage of women, more workers in larger companies and permanent contracts), all of which means that the probability of workers having an injury is considerably reduced.
Collapse
Affiliation(s)
| | | | | | | | - Dale O Ritzel
- Safety Center, Southern Illinois University, Carbondale, IL 62901-6731, USA.
| |
Collapse
|
5
|
Kim SK, Kim H, Lee K, Kang HT, Oh SS, Ko SB. The Relationship between Injury and Socioeconomic Status in Reference to the Fourth Korean National Health and Nutrition Examination Survey. Ann Occup Environ Med 2014; 26:1. [PMID: 24472308 PMCID: PMC3916067 DOI: 10.1186/2052-4374-26-1] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 11/12/2013] [Indexed: 11/10/2022] Open
Abstract
Objectives This study aims to investigate the relationship between the total injury experience rate and socioeconomic status based on the fourth Korea National Health and Nutrition Examination Survey (KNHANES). Methods By analyzing data from the fourth KNHANES conducted from 2007 to 2009, we estimated the injury experience rate according to socioeconomic status, including the occupational characteristics of 11,837 subjects. Setting the injury experience rate as a dependent variable and socioeconomic status as an independent variable, we performed logistic regression to calculate odds ratios reflecting the likelihood of injury according to socioeconomic status while controlling for relevant covariates. Results In 797 subjects who had injury experience over the past 1 year, 290 persons (36.4%) had a work-related injury. As their income, home value, and educational status increased, their injury experiences decreased. Among occupational groups, the craft, equipment, machine operating, and assembling workers showed the highest rate (10.6%) of injury experience, and the lowest rate (5.7%) was found in the unemployed group. After adjusting for the confounding variables, the experience of injury was significantly related to several socioeconomic factors: high income (OR = 0.54; 95% CI: 0.34-0.86), high home value (OR = 0.65; 95% CI: 0.43-0.96), low education status (OR = 1.28; 95% CI: 1.07-1.52), and specific occupations such as craft, equipment, machine operating, and assembling work (OR = 1.99; 95% CI: 1.60-2.47), skilled agriculture, forestry and fishery work (OR = 1.43; 95% CI: 1.02-2.01), and simple labor (OR = 1.38; 95% CI: 1.04-1.82). Conclusions The injury experience rate differed depending on the socioeconomic status. A negative correlation was found between the injury experience rate and income, low home value, and education level. Moreover, a higher rate of injury experience was found in occupation groups and physical worker groups in comparison to the unemployed group and white-collar worker groups. This study would be useful in selecting appropriate priorities for injury management in Korea.
Collapse
Affiliation(s)
- Sung-Kyung Kim
- Department of Occupational and Environmental Medicine, Wonju Severance Christian's Hospital, Yonsei University, Wonju, Korea.
| | | | | | | | | | | |
Collapse
|
6
|
Analysis of ethnic disparities in workers' compensation claims using data linkage. J Occup Environ Med 2013; 54:1246-52. [PMID: 22776807 DOI: 10.1097/jom.0b013e31825a34d1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
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.
Collapse
|
7
|
Luo H, Beckles GLA, Fang X, Crews JE, Saaddine JB, Zhang X. Socioeconomic Status and Lifetime Risk for Workplace Eye Injury Reported by a US Population Aged 50 Years and Over. Ophthalmic Epidemiol 2012; 19:103-10. [DOI: 10.3109/09286586.2011.639977] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
|
8
|
Tiesman HM, Hendricks SA, Bell JL, Amandus HA. Eleven years of occupational mortality in law enforcement: The census of fatal occupational injuries, 1992-2002. Am J Ind Med 2010; 53:940-9. [PMID: 20564516 DOI: 10.1002/ajim.20863] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Occupational injury deaths remain high for Law Enforcement Officers (LEOs). This study describes and compares intentional and transportation-related fatality rates in US LEOs between 1992 and 2002. METHODS Workplace injury deaths among LEOs from 1992 to 2002 were categorized into "Intentional," "Transportation-related," and "Other," using the Census of Fatal Occupational Injuries. Occupations included in this analysis were sheriffs and bailiffs, police and detectives, non-public service guards, and correctional officers. Fatality rates were compared among law enforcement occupations, cause of death, and demographics with rate ratios and 95% confidence intervals. RESULTS During the 11-year period, 2,280 workers died from an occupational injury, for a fatality rate of 11.8 per 100,000 across all LEO occupations. Forty-seven percent were homicides (n = 1,072, rate 5.6 per 100,000), 36% transportation-related (n = 815, rate 4.2 per 100,000), 11% were due to other causes (n = 249, rate 1.3 per 100,000), and 5% were workplace suicides (n = 122, rate 0.6 per 100,000). The proportion of fatalities by cause of death differed significantly between occupations (P < 0.0001). Sheriffs and bailiffs experience a high risk for occupational injury death compared to other law enforcement occupations. Of the transportation-related fatalities, LEOs were operating a motor-vehicle in 58% of the incidents and 22% of the fatalities were struck by incidents. CONCLUSIONS Transportation-related deaths were nearly as common as homicides as a cause of occupational injury death among US LEOs. Struck by vehicle incidents remain an important and overlooked cause of death. This research points to opportunities for the prevention of transportation-related deaths in law enforcement.
Collapse
Affiliation(s)
- Hope M Tiesman
- National Institute for Occupational Safety and Health, Division of Safety Research, Analysis and Field Evaluations Branch, Morgantown, West Virginia 26506, USA.
| | | | | | | |
Collapse
|
9
|
Mallika P, Tan A, Asok T, Faisal H, Aziz S, Intan G. Pattern of ocular trauma in kuching, malaysia. MALAYSIAN FAMILY PHYSICIAN : THE OFFICIAL JOURNAL OF THE ACADEMY OF FAMILY PHYSICIANS OF MALAYSIA 2008; 3:140-5. [PMID: 25606139 PMCID: PMC4170369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVES To analyze the causes and characteristics of ocular injuries presenting to Sarawak General Hospital (SGH), Kuching. DESIGN It is a prospective hospital-based study done for a period of 1 year. SETTING Department of Ophthalmology, Sarawak General Hospital, Malaysia. PARTICIPANTS All ocular injury patients seen for the first time in the Eye Department during the period January 2006 to December 2006 were included in the study. Eye injury patients on follow-up and treated elsewhere were excluded. RESULTS A total of 233 patients, and 257 eyes, were studied. Men had six-fold higher rates of injury than women. The average age of presentation was 30 years. The predominant age group was between 21-30 years, 26.2 % (n=61). Eye injuries related to work were seen in 36.9% of patients. There was a gross negligence in the use of personal protective devices in the work-related group. The common settings in which the injuries occurred included home 34.3% (n=80) and industrial premises 31.8% (n=74). Assault-related injuries 7.7% (n=18) were seen mostly among young men in the age between 20-30 years. The initial presenting visual acuity of the patients with blunt ocular trauma was better than penetrating injury. CONCLUSION Ocular injuries were common in young males. Work related eye injuries were noted in a significant number of cases. Health education and preventive strategies both in the working place and at home will help to decrease the occurrence of ocular injuries.
Collapse
|
10
|
|
11
|
Li X, Sundquist S, Johansson SE. Effects of neighbourhood and individual factors on injury risk in the entire Swedish population: a 12-month multilevel follow-up study. Eur J Epidemiol 2008; 23:191-203. [PMID: 18193169 DOI: 10.1007/s10654-007-9219-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2007] [Accepted: 12/20/2007] [Indexed: 12/01/2022]
Abstract
In this cumulative incidence study of the entire population of Sweden, we examined the association between neighbourhood income level and injury risks across a comprehensive set of individual variables. The population, stratified by age (0-14, 15-64, and > or =65 years), was followed for incident injury events in 1998. Multilevel logistic regression was used to examine the associations between neighbourhood income level and injury, including deaths from injury. Risks were analyzed, taking individual demographic and socioeconomic variables and alcohol/substance abuse into account. Falls were the most frequent non-fatal injuries in all age groups. People (0-14 years and 15-64 years) in the most deprived neighbourhoods exhibited higher odds of injuries (OR = 1.15; CI = 1.08-1.22 and OR = 1.34; CI = 1.26-1.43, respectively) than those in the same age groups in the most affluent neighbourhoods (OR = 1). In the full model, injury odds ratios decreased but remained significant in people 0-14 years. The large between-neighbourhood variance in all age groups indicated variation between neighbourhoods in injury incidence. Our results suggest that interventions focused on contextual aspects of neighbourhoods, in addition to individual behaviours, may have a positive impact on injury prevention.
Collapse
Affiliation(s)
- Xinjun Li
- Center for Family and Community Medicine, Department of Neurobiology, Caring Sciences and Society, Karolinska Institutet, Alfred Nobels allé 12, 141 83, Huddinge, Sweden.
| | | | | |
Collapse
|
12
|
Fleming LE, Lee DJ, Martinez AJC, Leblanc WG, McCollister KE, Bridges KC, Christ SL, Arheart KL, Pitman T. The health behaviors of the older US worker. Am J Ind Med 2007; 50:427-37. [PMID: 17503458 DOI: 10.1002/ajim.20468] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND As the US workforce ages, lifestyle factors will increasingly affect their health, yet little information is available on their prevalence in older working populations. METHODS Using the nationally representative 1997-2003 National Health Interview Survey (NHIS), reported current smoking, risky drinking and leisure-time physical activity behaviors of older workers (> or =65 years) were compared with older non-workers. These behaviors were evaluated by age, gender, race, ethnicity, and occupation, as well as prototype "healthy" and "risky" persons. RESULTS The study population of 4,946 older US workers and 38,313 older non-workers represented an estimated 3.9 million older workers and 28.9 million older non-workers annually. Relative to older non-workers, older workers reported more current smoking and risky drinking, but higher levels of leisure-time physical activity with variations by subpopulations. CONCLUSIONS Less than 4% of the older US worker population reported overall healthy behaviors. Certain occupations and other subpopulations can be targeted for age-appropriate behavioral interventions.
Collapse
Affiliation(s)
- Lora E Fleming
- Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL 33136, USA.
| | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Smith GS, Sorock GS, Wellman HM, Courtney TK, Pransky GS. Blurring the distinctions between on and off the job injuries: similarities and differences in circumstances. Inj Prev 2007; 12:236-41. [PMID: 16887945 PMCID: PMC2586787 DOI: 10.1136/ip.2006.011676] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To compare the causes of non-fatal work and non-work injuries and the places or environments where they occur. It has been suggested that many injuries may have similar etiologies on and off the job and thus involve some common prevention strategies. However lack of comparable data on work relatedness has prevented testing this proposition. METHODS The National Health Interview Survey (NHIS) now collects information on the cause, location, and work relatedness of all medically attended injuries. National US estimates of non-fatal work and non-work injuries were compared by cause and place/location for working age adults (18-64 years). RESULTS Overall 28.6% of injuries to working age adults were work related (37.5% among employed people). The causes and locations of many work and non-work injuries were similar. Falls, overexertion, and struck/caught by were leading causes for work and non-work injuries. Motor vehicle injuries were less likely to be work related (3.4% at work v 19.5% non-work) and overexertion injuries more likely to be work related (27.1% v 13.8%). Assaults were less than 1% of work injuries and 1.8% of non-work injuries. Both work and non-work injuries occurred in every location examined-including the home where 3.5% of injuries were work related. CONCLUSIONS Work and non-work injuries share many similarities suggesting opportunities to broaden injury prevention programs commonly restricted to one setting or the other. Comprehensive efforts to prevent both non-work and work injuries may result in considerable cost savings not only to society but also directly to employers, who incur much of the associated costs.
Collapse
Affiliation(s)
- G S Smith
- Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA.
| | | | | | | | | |
Collapse
|
14
|
Zierold KM, Anderson HA. Racial and ethnic disparities in work-related injuries among teenagers. J Adolesc Health 2006; 39:422-6. [PMID: 16919806 DOI: 10.1016/j.jadohealth.2006.01.011] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2005] [Revised: 01/12/2006] [Accepted: 01/24/2006] [Indexed: 11/23/2022]
Abstract
PURPOSE No current data exist on the difference in occurrence of work-related injury among minority teens, compared with white teens. Therefore, this study investigated the differences in workplace injury among white teens, African-American teens, and Hispanic teens. METHODS An anonymous questionnaire was administered to teens in five Wisconsin school districts in May 2003. The questionnaire assessed work, characteristics of work, injury, characteristics of injury, and school performance. RESULTS There were 3574 teens who worked during the 2002-2003 school year. The distribution of jobs worked was similar among the races/ethnicities. Both Hispanic and African-American teens were more likely to report working more than 23 hours per week, compared with white teens. Both minority groups were significantly more likely to report having sustained a serious injury compared with white teenagers (adjusted odds ratio [AOR] = 3.07, 95% confidence interval [CI] = 1.86-5.04 for African-American teens; AOR = 2.27 95% CI = 1.27-4.05 for Hispanic teens). CONCLUSIONS Minority teens are more likely to report sustaining injuries at work. Although the jobs minority teens were working were similar to white teens, some of the characteristics of their jobs may be responsible for more hazardous working conditions, leading to a greater number of injuries.
Collapse
Affiliation(s)
- Kristina M Zierold
- Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA.
| | | |
Collapse
|
15
|
Smith GS, Lincoln AE, Wong TY, Bell NS, Vinger PF, Amoroso PJ, Lombardi DA. Does occupation explain gender and other differences in work-related eye injury hospitalization rates? J Occup Environ Med 2005; 47:640-8. [PMID: 15951724 PMCID: PMC2141690 DOI: 10.1097/01.jom.0000165746.26873.d1] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE We sought to determine whether demographic differences in eye injury rates persist after adjusting for occupational exposure. METHODS On-duty eye injury hospitalizations were linked to occupation among active-duty US Army personnel. RESULTS Eye injury rates were higher for white soldiers, men, and for younger soldiers, even after adjusting for occupational group and specific job titles using multivariate models. CONCLUSIONS This finding contrasts with studies of other injuries, suggesting that occupation does not fully account for variations in eye injury risk. Because protective eye-wear can prevent most serious eye injuries, we hypothesize that differences in protective eye-wear use between men and women may contribute to differences in eye injury rates, although follow-up studies are needed to confirm this. Prevention efforts should consider targeting high-risk demographic groups in addition to high-risk occupations.
Collapse
Affiliation(s)
- Gordon S Smith
- Liberty Mutual Research Institute for Safety, Hopkinton, Massachusetts 01748, USA.
| | | | | | | | | | | | | |
Collapse
|
16
|
Caban AJ, Lee DJ, Fleming LE, Gómez-Marín O, LeBlanc W, Pitman T. Obesity in US workers: The National Health Interview Survey, 1986 to 2002. Am J Public Health 2005; 95:1614-22. [PMID: 16051934 PMCID: PMC1449406 DOI: 10.2105/ajph.2004.050112] [Citation(s) in RCA: 114] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2004] [Indexed: 11/04/2022]
Abstract
OBJECTIVES Obesity has emerged as one of the most important public health issues in the United States. We assessed obesity prevalence rates and their trends among major US occupational groups. METHODS Self-reported weight and height were collected annually on US workers, aged 18 years or older, from the 1986 to 1995 and the 1997 to 2002 National Health Interview Surveys. Overall, occupation-, race-, and gender-specific rates of obesity (defined as a body mass index>30.0 kg/m2) were calculated with data pooled from both study periods (n>600,000). Annual occupation-specific prevalence rates were also calculated, and their time trends were assessed. RESULTS Obesity rates increased significantly over time among employed workers, irrespective of race and gender. The average yearly change increased from 0.61% (+/-.04) during the period from 1986 to 1995 to 0.95% (+/-.11) during the period from 1997 to 2002. Average obesity prevalence rates and corresponding trends varied considerably across occupational groups; pooled obesity prevalence rates were highest in motor vehicle operators (31.7% in men; 31.0% in women). CONCLUSIONS Weight loss intervention programs targeting workers employed in occupational groups with high or increasing rates of obesity are urgently needed.
Collapse
Affiliation(s)
- Alberto J Caban
- Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, FL 33136, USA
| | | | | | | | | | | |
Collapse
|
17
|
Smith GS, Wellman HM, Sorock GS, Warner M, Courtney TK, Pransky GS, Fingerhut LA. Injuries at work in the US adult population: contributions to the total injury burden. Am J Public Health 2005; 95:1213-9. [PMID: 15983273 PMCID: PMC1449342 DOI: 10.2105/ajph.2004.049338] [Citation(s) in RCA: 97] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We estimated the contribution of nonfatal work-related injuries on the injury burden among working-age adults (aged 18-64 years) in the United States. METHODS We used the 1997-1999 National Health Interview Survey (NHIS) to estimate injury rates and proportions of work-related vs non-work-related injuries. RESULTS An estimated 19.4 million medically treated injuries occurred annually to working-age adults (11.7 episodes per 100 persons; 95% confidence interval [CI]=11.3, 12.1); 29%, or 5.5 million (4.5 per 100 persons; 95% CI=4.2, 4.7), occurred at work and varied by gender, age, and race/ethnicity. Among employed persons, 38% of injuries occurred at work, and among employed men aged 55-64 years, 49% of injuries occurred at work. CONCLUSIONS Injuries at work comprise a substantial part of the injury burden, accounting for nearly half of all injuries in some age groups. The NHIS provides an important source of population-based data with which to determine the work relatedness of injuries. Study estimates of days away from work after injury were 1.8 times higher than the Bureau of Labor Statistics (BLS) workplace-based estimates and 1.4 times as high as BLS estimates for private industry. The prominence of occupational injuries among injuries to working-age adults reinforces the need to examine workplace conditions in efforts to reduce the societal impact of injuries.
Collapse
Affiliation(s)
- Gordon S Smith
- Liberty Mutual Research Institute for Safety, Hopkinton, MA 01748, USA. gordon.
| | | | | | | | | | | | | |
Collapse
|
18
|
Strong LL, Zimmerman FJ. Occupational injury and absence from work among African American, Hispanic, and non-Hispanic White workers in the national longitudinal survey of youth. Am J Public Health 2005; 95:1226-32. [PMID: 15983275 PMCID: PMC1449344 DOI: 10.2105/ajph.2004.044396] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined how race and ethnicity influence injury and illness risk and number of days of work missed as a result of injury or illness. METHODS We fit logistic regression and negative binomial regression models using generalized estimating equations with data from 1988 to 2000 on currently employed African American, Hispanic, and non-Hispanic White participants in the National Longitudinal Survey of Youth. RESULTS Occupational factors-having a blue-collar occupation, working full-time, having longer tenure, working 1 job versus 2, and working the late shift-were associated with increased odds of an occupational injury or illness. Although racial/ethnic minority workers were no more likely than Whites to report an occupational injury or illness, they reported missing more days of work. African American and Hispanic men missed significantly more days of work than non-Hispanic White men, and African American women missed significantly more days of work than non-Hispanic White women. CONCLUSIONS Factors associated with occupational health are multifaceted and complex. Our findings suggest that race/ethnicity influences the duration of work absence owing to injury or illness both indirectly (by influencing workers' occupational characteristics) and directly (by acting independently of occupational factors).
Collapse
Affiliation(s)
- Larkin L Strong
- Department of Health Services, School of Public Health and Community Medicine, University of Washington, Seattle, 98109, USA.
| | | |
Collapse
|
19
|
van Lenthe FJ, van Beeck EF, Gevers E, Mackenbach JP. Education was associated with injuries requiring hospital admission. J Clin Epidemiol 2004; 57:945-53. [PMID: 15504637 DOI: 10.1016/j.jclinepi.2003.11.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2003] [Indexed: 11/22/2022]
Abstract
OBJECTIVES We describe educational inequalities in the incidence of injuries resulting in hospital admission and explore the contribution of exposure variables and chronic diseases, alcohol consumption, and sedative use to the observed inequalities. STUDY DESIGN AND SETTING Data from the Dutch prospective GLOBE study were linked to the National Hospital Discharge Register after 7 years of follow-up. RESULTS Significantly higher hazard ratios (HRs) of traffic injuries in lower compared with higher educational groups were substantially reduced after adjustment for differences in the use of cars and mopeds between these groups. Significantly increased HRs in occupational, home, and sports (OHS) injuries in lower compared with higher educational groups were reduced after adjustment for higher prevalence rates of chronic diseases, very excessive alcohol consumption, and sedative use in lower educational groups. CONCLUSION Exposure variables, chronic diseases, alcohol consumption, and sedative use contribute to educational inequalities in traffic and OHS injuries resulting in hospital admission.
Collapse
Affiliation(s)
- Frank J van Lenthe
- Department of Public Health, Erasmus Medical Centre, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands.
| | | | | | | |
Collapse
|
20
|
McCall BP, Horwitz IB, Kammeyer-Mueller JD. Have health conditions associated with latex increased since the issuance of universal precautions? Am J Public Health 2003; 93:599-604. [PMID: 12660204 PMCID: PMC1447797 DOI: 10.2105/ajph.93.4.599] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/04/2002] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study explored whether the prevalence of latex-related health conditions has increased among individuals employed in medical occupations relative to those employed in nonmedical occupations since the issuance of universal precautions in 1987. METHODS Data derived from the 1983 to 1994 versions of the National Health Interview Survey were used to obtain odds ratios comparing prevalence rates of latex-related symptoms over time. RESULTS No statistical evidence was found that the universal precautions resulted in increased prevalence rates of latex-related health conditions among medical workers relative to those employed in nonmedical occupations. CONCLUSIONS Increased use of latex gloves among health care personnel subsequent to the implementation of universal precautions appears to have had no effect on latex allergic reactions experienced by these workers.
Collapse
Affiliation(s)
- Brian P McCall
- Industrial Relations Center, University of Minnesota, Minneapolis, USA
| | | | | |
Collapse
|
21
|
Fleming LE, Gómez-Marín O, Zheng D, Ma F, Lee D. National Health Interview Survey mortality among US farmers and pesticide applicators. Am J Ind Med 2003; 43:227-33. [PMID: 12541279 DOI: 10.1002/ajim.10162] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND The mortality experience of pesticide-exposed workers across the US has not been thoroughly studied. METHODS Cox regression mortality analyses adjusted for the complex sample survey design were performed on mortality-linked 1986-1994 National Health Interview Survey (NHIS) data. RESULTS Nine thousand four hundred seventy-one farmers and pesticide applicators with 571 deaths were compared to 438,228 other US workers with 11,992 deaths. Age-adjusted risk of accidental death, as well as cancers of the nervous and lymphatic/hematopoietic systems, was significantly elevated in male and female pesticide-exposed workers; breast, prostate, and testicular cancer mortality risks were not elevated. CONCLUSIONS Compared to all other workers, farmers and pesticide applicators were at greater risk of accidental mortality. These pesticide-exposed workers were not at an increased risk of cancers possibly associated with exposure to estrogen analogue compounds, but were at an increased risk of hematopoietic and nervous system cancers. NHIS mortality follow-up represents an important occupational health surveillance instrument.
Collapse
Affiliation(s)
- Lora E Fleming
- Department of Epidemiology and Public Health, University of Miami School of Medicine, Miami, Florida 33136, USA.
| | | | | | | | | |
Collapse
|
22
|
Murray LR. Sick and tired of being sick and tired: scientific evidence, methods, and research implications for racial and ethnic disparities in occupational health. Am J Public Health 2003; 93:221-6. [PMID: 12554573 PMCID: PMC1447720 DOI: 10.2105/ajph.93.2.221] [Citation(s) in RCA: 99] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The extent of racial/ethnic disparities in occupational health have not been well studied. The author reviews the evidence about workers of color and occupational injuries and disease. Patterns of employment in the U.S. workforce according to education, gender, and race/ethnicity are discussed, and how these patterns might cause disproportionate exposure leading to disproportionate disease and injury. Methodological issues are explored that have hampered research about occupational health disparities, and future research needs are identified.
Collapse
Affiliation(s)
- Linda Rae Murray
- Cook County Bureau of Health Services, Woodlawn Health Center, Chicago, Ill 60637, USA.
| |
Collapse
|
23
|
Abstract
Injuries continue to place a tremendous burden on the public's health and rates vary widely among different groups in the population. Increasing attention has recently been given to the effects of socioeconomic status (SES) as a determinant of health among both individuals and communities. However, relatively few studies have focused on the influence of SES and injuries. Furthermore, those that have, and the other injury studies that have included measures of SES in their analysis, have varying degrees of conceptual and methodological rigor in their use of this measure. Recent advances in data linkage and analytic techniques have, however, provided new and improved methods to assess the relationship between SES and injuries. This review summarizes the relevant literature on SES and injuries, with particular attention to study design, and the measurement and interpretation of SES. We found that increasing SES has a strong inverse association with the risk of both homicide and fatal unintentional injuries, although the results for suicide were mixed. However, the relationship between SES and nonfatal injuries was less consistent than for fatal injuries. We offer potential explanatory mechanisms for the relationship between SES and injuries and make recommendations for future research in this area.
Collapse
Affiliation(s)
- Catherine Cubbin
- Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, 1000 Welch Road, Palo Alto, California 94304-1825, USA.
| | | |
Collapse
|
24
|
Ni H, Barnes P, Hardy AM. Recreational injury and its relation to socioeconomic status among school aged children in the US. Inj Prev 2002; 8:60-5. [PMID: 11928978 PMCID: PMC1730809 DOI: 10.1136/ip.8.1.60] [Citation(s) in RCA: 38] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study described epidemiologic patterns of recreational injuries among school aged children in the US and assessed the relation of these patterns to socioeconomic status. METHODS Combined data from the 1997-98 National Health Interview Surveys for 38 458 children aged 6-17 years regarding non-fatal recreational injury episodes that received medical attention, reported by a household adult, were analysed. Logistic regression analysis was used to assess the association between recreational injury and socioeconomic status while controlling for confounding factors. RESULTS The annualized rate of recreational injury was 91.2 episodes per 1,000 children, with an increased risk associated with a higher family income status or being non-Hispanic white. For children from not poor families, most injury episodes occurred in sport facilities, whereas for children from poor and near poor families, most occurred outside the home. CONCLUSION Recreational injury is a significant health problem for school aged children in the US. Non-Hispanic white children and children from affluent families are at increased risk of recreational injury.
Collapse
Affiliation(s)
- H Ni
- Division of Health Interview Statistics, National Center for Health Statistics, Center for Disease Control, Hyattsville, Maryland 20782, USA.
| | | | | |
Collapse
|
25
|
Sulsky SI, Mundt KA, Bigelow C, Amoroso PJ. Case-control study of discharge from the U.S. Army for disabling occupational knee injury: the role of gender, race/ethnicity, and age. Am J Prev Med 2000; 18:103-11. [PMID: 10736546 DOI: 10.1016/s0749-3797(99)00175-0] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
BACKGROUND Occupational injuries are responsible for more lost time from work, productivity, and working years of life than any other health condition in either civilian or noncombat military sectors. Injuries, not illnesses, are the leading cause of morbidity and mortality among U.S. Army personnel. We examined the separate and joint roles of gender, race/ethnicity, and age in the odds of discharge from the Army for disabling knee injury. METHODS A total of 860 women and 7868 men were discharged from the Army between 1980 and 1995 for knee-related disability and met all inclusion criteria for this study. All women and a subsample of 1005 men were included in these analyses, along with a simple random sample of three controls per case, stratified by gender, drawn from the population of all active-duty enlisted soldiers in each year from 1980 to 1995. We identified predictors of the occurrence or nonoccurrence of discharge from the Army for disabling knee injury using unconditional multiple logistic regression analyses. RESULTS We found relations between the risk of knee-related disability and age and race, with marked effect modification by gender. Non-Caucasian men and women were at lower risk than Caucasians at all ages. At most ages, Caucasian women were at higher risk than Caucasian men, and non-Caucasian women were at lower risk than non-Caucasian men. Within race/ethnicity and gender, the risks for men showed an inverted "U" shape with increasing age, and the risks for women showed a "J" shape with increasing age. CONCLUSIONS Age, race/ethnicity, and gender interactions are important in occupational injury. Differences in risk may be related to differences in work assignments, leisure activities, physical or physiological differences, or the ways in which disability compensation is granted.
Collapse
Affiliation(s)
- S I Sulsky
- University of Massachusetts School of Public Health and Health Sciences, Amherst, MA 01002, USA.
| | | | | | | |
Collapse
|
26
|
Cubbin C, LeClere FB, Smith GS. Socioeconomic status and the occurrence of fatal and nonfatal injury in the United States. Am J Public Health 2000; 90:70-7. [PMID: 10630140 PMCID: PMC1446109 DOI: 10.2105/ajph.90.1.70] [Citation(s) in RCA: 173] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES This study examined the contribution of socioeconomic status (SES) to the risk of injury mortality and morbidity among working-age adults. METHODS The sample consisted of respondents to the National Health Interview Survey (1987-1994), and separate analyses were conducted for injury deaths to respondents by linking to the National Death Index. Proportional hazards regression models were used to analyze mortality. Logistic regression models were used to analyze morbidity. RESULTS The effects of SES varied substantially by cause of injury mortality and indicator of SES. In the multivariate models, blue-collar workers were at significantly increased odds of nonfatal injury. Education was unrelated to total injury morbidity, although associations were observed after stratification of the outcome by severity and place of occurrence. Black persons were at increased risk for homicide, and Black and Hispanic persons were at decreased risk for suicide and nonfatal injuries, after adjustment for SES. CONCLUSIONS SES is an important determinant of injury, although the effect depends on the indicator of SES and the cause and severity of injury.
Collapse
Affiliation(s)
- C Cubbin
- Stanford Center for Research in Disease Prevention, Stanford University School of Medicine, Palo Alto, Calif. 94304-1825, USA.
| | | | | |
Collapse
|
27
|
Jones BH, Knapik JJ. Physical training and exercise-related injuries. Surveillance, research and injury prevention in military populations. Sports Med 1999; 27:111-25. [PMID: 10091275 DOI: 10.2165/00007256-199927020-00004] [Citation(s) in RCA: 207] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
Athletes and soldiers must both develop and maintain high levels of physical fitness for the physically demanding tasks they perform; however, the routine physical activity necessary to achieve and sustain fitness can result in training-related injuries. This article reviews data from a systematic injury control programme developed by the US Army. Injury control requires 5 major steps: (i) surveillance to determine the size of the injury problem; (ii) studies to determine causes and risk factors for these injuries; (iii) studies to ascertain whether proposed interventions actually reduce injuries; (iv) implementation of effective interventions; and (v) monitoring to see whether interventions retain their effectiveness. Medical surveillance data from the US Army indicate that unintentional (accidental) injuries cause about 50% of deaths, 50% of disabilities, 30% of hospitalisations and 40 to 60% of outpatient visits. Epidemiological surveys show that the cumulative incidence of injuries (requiring an outpatient visit) in the 8 weeks of US Army basic training is about 25% for men and 55% for women; incidence rates for operational infantry, special forces and ranger units are about 10 to 12 injuries/100 soldier-months. Of the limited-duty days accrued by trainees and infantry soldiers who were treated in outpatient clinics, 80 to 90% were the result of training-related injuries. US Army studies document a number of potentially modifiable risk factors for these injuries, which include high amounts of running, low levels of physical fitness, high and low levels of flexibility, sedentary lifestyle and tobacco use, amongst others. Studies directed at interventions showed that limiting running distance can reduce the risk for stress fractures, that the use of ankle braces can reduce the likelihood of ankle sprains during airborne operations and that the use of shock-absorbing insoles does not reduce stress fractures during training. The US Army continues to develop a comprehensive injury prevention programme encompassing surveillance, research, programme implementation and monitoring. The findings from this programme, and the general principles of injury control therein, have a wide application in civilian sports and exercise programmes.
Collapse
Affiliation(s)
- B H Jones
- US Army Center for Health Promotion and Preventive Medicine, Aberdeen Proving Ground, Maryland, USA
| | | |
Collapse
|
28
|
McCaig LF, Burt CW, Stussman BJ. A comparison of work-related injury visits and other injury visits to emergency departments in the United States, 1995-1996. J Occup Environ Med 1998; 40:870-5. [PMID: 9800171 DOI: 10.1097/00043764-199810000-00006] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Estimates of nonfatal work-related injuries range from 6 to 13 million annually, and the most serious of these injuries are presented to hospital emergency departments (EDs). To describe work-related injury ED visits in the United States, we examined data from the 1995-1996 National Hospital Ambulatory Medical Care Survey, which is a national probability sample survey of visits to EDs of non-federal, short-stay, and general hospitals. In 1995-1996, an annual average of 4 million work-related injury ED visits were made by persons 16 years of age and over. The average annual rate of work-related injury visits was 3.5 per 100 workers, and the rate of nonwork-related injury visits was 11.2 per 100 persons. Persons 16-19 years of age had a higher work-related injury visit rate (6.9 per 100 full-time equivalents [FTEs]) than did those 20 years of age and over (3.4 per 100 FTEs). Males had higher work-related injury visit rates (4.3 per 100 FTEs) than females (2.4 per 100 FTEs). The leading cause of injury and diagnosis for work-related injury ED visits were "cuts" (16%) and "open wound" (22%), respectively. Determining appropriate preventive action will reduce the number of workers injured and may result in financial savings for industries and health care systems.
Collapse
Affiliation(s)
- L F McCaig
- Ambulatory Care Statistics Branch, National Center for Health Statistics, Centers for Disease Control and Prevention, Hyattsville, Md. 20782, USA
| | | | | |
Collapse
|
29
|
Overpeck MD, Jones DH, Trumble AC, Scheidt PC, Bijur PE. Socioeconomic and racial/ethnic factors affecting non-fatal medically attended injury rates in US children. Inj Prev 1997; 3:272-6. [PMID: 9493623 PMCID: PMC1067853 DOI: 10.1136/ip.3.4.272] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Using a representative survey of US children, the purpose was to evaluate separate effects of socioeconomic and racial/ethnic factors, including access to care, on medically attended non-fatal injury rates. METHODS Multivariate linear regression models were used to determine associations between injuries and health care coverage (insurance or Medicaid), having a place to go for care, race/ethnicity, maternal education, number of adults and children in the household, poverty, and urbanicity. The 1988 Child Health Supplement to the National Health Interview Survey included questions on medically attended injuries, and their cause, location, and effects on the child. Injury categories included total, consequential, occurrence at home or school, falls, and being struck or cut. RESULTS Lack of health care coverage was consistently associated with lower medically attended injury rates in non-Hispanic blacks or whites and Mexican-Americans, but affected total rates for each group differently due to unequal distribution of health care coverage. Injuries occurred about 40% more frequently to children and adolescents living in single adult households compared with two adult homes for all injury categories except for injuries occurring at school. CONCLUSIONS Preventive interventions targeted to specific populations based on assumptions that poverty, lack of education, or minority status result in greater risks for injuries require a closer look. Efficient targeting should address underlying factors such as differences in exposures and environments associated with single adult homes or recreational activities. Data sources used to target high risk populations for interventions need to address bias due to access to care.
Collapse
Affiliation(s)
- M D Overpeck
- Epidemiology Branch, National Institute of Child Health and Human Development, Bethesda, MD 20892, USA
| | | | | | | | | |
Collapse
|
30
|
Abstract
Action to improve women's occupational health has been slowed by a notion that women's jobs are safe and that any health problems identified among women workers can be attributed to unfitness for the job or unnecessary complaining. With increasing numbers of women in the labor force, the effects of work on women's health have recently started to interest health care providers, health and safety representatives and researchers. We begin our summary of their discoveries with a discussion of women's place in the workplace and its implications for occupational health, followed by a brief review of some gender-insensitive data-gathering techniques. We have then chosen to concentrate on the following four areas: methods and data collection; directing attention to women's occupational health problems; musculoskeletal disease; mental and emotional stress. We conclude by pointing out some neglected occupational groups and health issues.
Collapse
Affiliation(s)
- K Messing
- Centre pour l'étude des interactions biologiques entre la santé et l'environnement (CINBIOSE), Université du Québec à Montréal
| |
Collapse
|
31
|
Layne LA, Landen DD. A descriptive analysis of nonfatal occupational injuries to older workers, using a national probability sample of hospital emergency departments. J Occup Environ Med 1997; 39:855-65. [PMID: 9322169 DOI: 10.1097/00043764-199709000-00009] [Citation(s) in RCA: 41] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
An estimated 136,985 nonfatal, work-related injuries to workers 55 years of age and older were presented for treatment in hospital emergency departments across the United States during 1993. Men accounted for 63.7% of the injuries and had an injury rate of 1.06 per 100 workers, compared with a rate of 0.76 among women. Among the oldest workers (65+ years), injuries were more likely to be fractures or dislocations, to result from falls on the same level, or to involve hospitalization. The services industry had the largest number of injuries (31.9%), whereas the highest injury rate occurred in the agriculture/forestry/fishing industry (1.50 per 100 workers). The types of injuries most frequently requiring hospitalization were fractures or dislocations that resulted from a fall. Because older workers' employment demographics and injury patterns differ from the remainder of the labor force, interventions need to be developed which are specific to the workplace for this older working population.
Collapse
Affiliation(s)
- L A Layne
- Division of Safety Research, National Institute for Occupational Safety and Health, Morgantown, WVa 26505, USA
| | | |
Collapse
|
32
|
Sane J, Ylipaavalniemi P, Turtola L, Niemi T, Laaka V. Traumatic injuries among university students in Finland. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 1997; 46:21-24. [PMID: 9248238 DOI: 10.1080/07448489709595582] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
A questionnaire dealing with the incidence of traumatic injuries was sent to 1,000 randomly selected 3rd-year university students in Finland; 617 students responded adequately. Of those, 177 (28.7%) reported a combined total of 281 accidents and 323 separate injuries requiring medical or dental treatment during the preceding 3 years. The accidents resulted in 1,061 days of official sick leave, and one third of the accidents caused permanent sequelae to the affected students. Almost half of all accidents had been sustained during sports activities and 14% in traffic. Only 0.5% of the accidents were classified as having occurred in the university environment or during activities directly related to studies. Alcohol was involved in 10.1% of the accidents; 45% of the injuries affected the lower extremities, and 22% the upper extremities. Most of the injuries were related to the students' active lifestyles and keen interest in sports.
Collapse
Affiliation(s)
- J Sane
- Finnish Student Health Service, Helsinki
| | | | | | | | | |
Collapse
|
33
|
Scheidt PC, Harel Y, Trumble AC, Jones DH, Overpeck MD, Bijur PE. The epidemiology of nonfatal injuries among US children and youth. Am J Public Health 1995; 85:932-8. [PMID: 7604916 PMCID: PMC1615546 DOI: 10.2105/ajph.85.7.932] [Citation(s) in RCA: 197] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES National data are not routinely available regarding the incidence of and associated risk factors for nonfatal injuries in children and youth. The Child Health Supplement to the 1988 National Health Interview Survey provided an opportunity to determine accurate national estimates of childhood injury morbidity by demographic factors, location, external cause, nature of injury, and other factors. METHODS The closest adult for 17,110 sampled children was asked whether the child had had an injury, accident, or poisoning during the preceding 12 months and about the cause, location, and consequences of the event. An analysis for potential underreporting from 12 months of recall provided adjustments of annual rates to those for a 1-month recall period. RESULTS On the basis of 2772 reported injuries, the national estimated annual rate for children 0 to 17 years of age was 27 per 100 children after adjustment to 1-month recall. Boys experienced significantly higher rates than girls (risk ratio [RR] = 1.52, 95% confidence interval [CI] = 1.37, 1.68), and adolescents experienced the highest overall rate (38 per 100 children) and proportion of serious injuries. CONCLUSIONS Approximately one fourth of US children experience a medically attended injury each year, but the risks vary considerably depending on the characteristics of subgroups and the injury cause.
Collapse
Affiliation(s)
- P C Scheidt
- National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | | | | | | | | | | |
Collapse
|
34
|
Sterling T, Rosenbaum W, Weinkam J. Income, race, and mortality. J Natl Med Assoc 1993; 85:906-11. [PMID: 8126740 PMCID: PMC2568210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This study was undertaken to clarify the complex relationship between poverty and race with disease-specific mortality. Data from the 1987 National Health Interview Survey and the 1986 National Mortality Followback Survey were used to estimate standardized mortality ratios (SMRs) for various categories (all causes, all cancers, noncancerous medical causes, lung and breast cancers, ischemic heart disease, and cerebrovascular disease) associated with income below the poverty line and were compared with those with adequate or better than adequate income. All SMRs were substantially elevated. The SMRs were not appreciably affected by adjustments for confounding by alcohol consumption, occupation, or smoking. Sex-specific SMRs of blacks relative to whites with the exception of ischemic heart disease were significantly elevated for males but not for females with the exception of the SMR for all causes. However, when adjusted for per capita income within the family, black mortality never significantly exceeded that of whites. These results strongly support the conclusion that mortality differences between blacks and whites are due to differences in income and related factors. However, it is unclear why poverty should be associated with elevation in cancer relative risk.
Collapse
Affiliation(s)
- T Sterling
- School of Computing Science, Faculty of Applied Sciences, Simon Fraser University, Burnaby, BC, Canada
| | | | | |
Collapse
|
35
|
Wray LA. Health policy and ethnic diversity in older Americans. Dissonance or harmony? West J Med 1992; 157:357-61. [PMID: 1413784 PMCID: PMC1011294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The rapid growth and diversity of the older population have long-term implications for health care policies in the United States. Current policies designed for a homogeneous population are increasingly obsolete. To ameliorate obstacles that handicap many ethnic minority elders and to provide equal access to adequate and acceptable health care, several factors need to be considered. Enhanced data collection and analytic techniques are needed. The effects of race or ethnicity must be separated from other biologic, environmental, socioeconomic, cultural, and temporal factors on health status and behavior. Health care professionals and organizations serving minority elders must continue to expand their advocacy efforts to articulate the findings and their concerns to policymakers. Policymakers must understand and acknowledge the implications of an increasingly diverse society and determine what will constitute adequate, accessible, and acceptable health care within continuing fiscal constrains. Program planning, implementation, and evaluation methods must be revised to meet future health care needs effectively and efficiently.
Collapse
Affiliation(s)
- L A Wray
- Ethel Percy Andrus Gerontology Center, Leonard Davis School of Gerontology, University of Southern California, Los Angeles 90089-0191
| |
Collapse
|