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Early retirement due to occupational injury: who is at risk?

BACKGROUND: As the workforce is rapidly ageing, research on the consequences of occupational injuries in older workers is becoming more important. One adverse outcome unique to older workers, early retirement, has significant negative social and economic consequences for workers and employers. Although linked to poor worker health, the roles of workplace factors and occupational injury have not been well-defined. METHOD: Changes in retirement plans attributed to an occupational injury were studied in a population-based sample of 1,449 New Hampshire workers aged <or=55, using a mailed survey. Questions addressed pre-and post-injury health, job satisfaction, work capacity, nature and severity of injury, medical care, employer response, work status, pain, and financial problems. RESULT: Eleven percent planned to retire earlier due to their work injury, and their outcomes were significantly worse. In a multivariate model, pre-injury dissatisfaction with the job and with medical care, and poor physical and mental health status were related to intent to retire early. CONCLUSION: These factors may represent opportunities for early identification and intervention with individuals at high risk for poor post-injury outcomes. Longitudinal studies are needed to confirm the importance of these preliminary findings.

Age Factors↗

[Occupational injuries with biological risk].

The aim of the present study was to identify the way the occupational injuries with biological risk can happen in order to find the right measures of prevention and protection and to periodically verify their efficacy. The study started in January 1996 and ended in December 2001 and included 2750 subjects working in the sanitary field. A module (module A), was created to collect all the accident data. For every occupational injury with biological risk, a specific procedure is activated, including: Emergency Room, Sanitary Direction, Infective Diseases Division, Competent Physician. The injuries were classified, according to: sex, age, work qualify, division, object causing injury, modality, anatomical location, type of injury, working turn, and time phase. Most of the division underlined a higher risk the procedures that expose the subjects to accidental punctures with infected needle, such as injection therapy, blood tests, butterfly insertion and removal, etc. Old and bad attitudes, such as needle recapping are still used, even if the law is clear. None occupational injury showed serum conversion. It could be a consequence of the post exposition prophylaxis performed by the infectivologists and of the HBV prophylaxis.

Accidents, Occupational↗

Relationships of working conditions and individual characteristics to occupational injuries: a case-control study in coal miners.

This study assessed the relationship of age, poor perception of working condition, poor safety environment, poor management and supervision, risk-taking behavior, emotional instability, negative job involvement, job dissatisfaction, job stress, and poor safety performance of workers to occupational injuries. This case-control study was conducted on 202 male coal miners with at least one occupational injury during a five-year period and 202 male controls with no occupational injury, matched on the job. A standardized questionnaire administered by individual interviewers was used. Data were analysed by the logistic regression method. For all workers combined, the factors with significant adjusted odds ratios (ORs) found were: 30-45 and >45 yr age groups (OR vs. <30 yr age group: 1.80, 95% CI 1.02-3.17 and 2.59, 1.38-4.85 respectively), poor perception of working conditions (1.61, CI 1.00-3.18), emotional instability (2.33, 1.04-5.22), job stress (1.83, 1.00-3.46) and poor safety performance of workers (3.10, 1.45-6.63). No significant interaction was found between these risk factors and the job. It was concluded that older age, poor perception of work conditions, poor work environment, and human behavioral factors played significant roles in occupational injuries. This information would help in implementing preventive programs to improve working conditions and management quality and to help the workers to develop positive psychological traits, but workers with negative traits such as emotional instability and older workers should be employed in less demanding jobs.

Accidents, Occupational↗

1983 occupational injury hospital admissions in Iowa: a comparison of the agricultural and non-agricultural sectors.

An occupational injury surveillance project was conducted in 15 of Iowa's 99 counties. Trained abstractors reviewed the medical records of persons admitted for trauma to hospitals during 1983. Based on these chart reviews, subsequent mail-out questionnaires and phone contacts were made, and rate estimates for occupational injury hospitalization for farmers and non-farmers were generated. The 1980 U.S. census data for occupation and market area data for the sample hospitals were used for the rate calculations. Approximately 14.7% of hospitalizations for trauma in the sample area were for work-related injuries. Farmers were hospitalized for occupational injuries at a rate of 1,521/100,000 compared to non-farmers at a rate of 497/100,000. There were no significant differences in the mean number of days per hospitalization for farmers versus non-farmers, (7.4 days for farmers and 6.7 days for non-farmers). Based on the questionnaire data, farmers were much less likely to receive any form of remuneration for injury, (odds ratio = 0.26, p less than 5 x 10(-6]. Farmers also reported less time off from work, with a mean of 79 days compared to non-farmers with a mean of 289 days.

Accidents, Occupational↗

Development of point mass occupant injury criteria using event data recorders.

This paper presents an estimate of the probability of serious occupant injury in frontal crashes based on vehicle kinematics information. Occupant injury risk is developed by modeling the human as a point mass and computing the occupant impact velocity (OIV) using the flail space model. Event Data Recorder data provide vehicle kinematics information for real world crashes with known injury outcomes. A data set of 211 cases is used for methodology development and preliminary insight to the injury prediction capability of the metric. Using logistic regression, injury risk curves are generated for all data, a belted occupant subset and an unbelted occupant subset. Based on the models, an occupant restrained by an airbag and safety belt is found to have a lower risk of injury than an occupant only restrained by an airbag. A 50% probability of serious injury is found to correspond to an OIV of 11.2 m/s and 15.9 m/s for unbelted and belted occupants, respectively.

Acceleration↗

Occupational injuries reported to insurance companies in Norway from 1991 to 1996.

Occupational injuries represent a relatively high proportion of the total number of injuries in Norway and thereby deserve more attention than they are currently receiving. Occupational injury claims made to insurance companies in Norway from 1991 to 1996 were analyzed for determination of their patterns. The types of injury with the highest incidence rates among men were fractures; among women, the highest rates were for those for sprains. The injury rates were more than twice as high in young men as in young women; this difference declined with increasing age. Young men had an increased risk of finger injuries, compared with older age groups. The injury rates increased with increasing age, especially for fractures and contusions. A somewhat higher number of injuries per working day occurred in January and February than in the other months. Action should be taken to prevent fractures and contusions among older workers.

Adolescent↗

Adolescent occupational injuries: Texas, 1990-1996.

BACKGROUND: A comprehensive surveillance system for occupational injuries to adolescents does not exist in Texas, as in most states. Therefore, the magnitude, severity, nature, and source of injuries to working adolescents have not been well described in Texas. METHODS: The investigators used three data sources to investigate work-related injuries and deaths in Texas: (1) Texas Workers' Compensation Commission (TWCC) claims data from 1991 through April 1996; (2) 1993 TWCC/Bureau of Labor Statistics (BLS) Annual Survey of Occupational Injuries and Illnesses; and (3) work-related fatalities identified from Texas death certificates from 1990-1995. RESULTS: There were 9,027 injuries reported to the TWCC for adolescents 14-17 years of age during slightly more than 5 years. Injuries for which indemnity payments were made (more than 7 days out of work) occurred among 21.7% of the adolescents. Based on BLS data in 1993, of 992 non-fatal injuries involving days away from work, 35% were caused by contact with objects, 27% by bodily reaction, and 24% by falls. Two-thirds of these injuries occurred while working in eating and drinking places and grocery stores. Three-quarters of the 30 deaths from 1990-1995 were accounted for equally by motor vehicle and homicide. CONCLUSIONS: In conclusion, a substantial number of adolescents are injured or killed in the workplace each year in Texas. Although improved population-based surveillance is needed, sufficient knowledge exists to begin prevention efforts now.

Accidents, Occupational↗

Depression and occupational injury: results of a pilot investigation.

OBJECTIVE: Even mild clinical depression can cause decreased vigilance, attention span, increased irritability, and insomnia-all well-known precursors to occupational injury. This pilot project explores the relationship between occupational injury and depression. METHOD: One hundred twenty-one individuals with recent work-related injuries and 140 without work-related injuries completed a self-administered depression screening instrument (PHQ-9). We compared the two groups using bivariate analyses. The impact of depression on injury was examined using logistic regression analysis controlling for employment history, marital status, age, and sex. RESULTS: Overall, injured workers in this study were not more likely to be depressed than a comparison group of uninjured workers. However, injured women had significantly higher depression scores than non-injured women (P = 0.04); no such difference was found for men. CONCLUSIONS: These data suggest that depression may serve as a precursor to occupational injury for women.

Adult↗

Diversity of trends in occupational injury mortality in the United States, 1980-96.

OBJECTIVES: Although the United States has generally enjoyed declining rates of fatal occupational injury, the rate of decline has not been uniform. To examine the heterogeneity of trends, changes in fatal occupational injury rates from 1980 to 1996 were estimated by occupation, industry, geographic region, and demographic group. METHODS: Deaths due to injury at work during 1980-96 were identified from the US National Traumatic Occupational Fatality database and populations at risk were estimated from the census of population. Mortality rates were computed for unintentional injuries, homicides, and all injuries combined. The annual rate of change was estimated using Poisson regression to model the death rate as a function of time. RESULTS: The estimated average rates for all fatal occupational injuries and for unintentional injuries declined by 3% per year, while the estimated rate of homicide declined <1% per year. The improvement was faster for men (3% per year) than for women (<1% per year) and for younger relative to older workers (7% per year v 2%-3% per year). Trends were also geographically heterogeneous, with the most rapid declines (7%-8% per year) in the South and West. Injury rates for most occupations and industries declined at near the average rate, but some experienced no change or an increase. The rate of homicide also increased in a number of occupations and industries. CONCLUSIONS: Broad downward trends in occupational fatality rates may be explained by several factors, including organized safety efforts, product and process changes, and the ongoing shift of employment toward safer sectors. Disparities in fatal injury trends draw attention to potential opportunities to reduce risk: work settings with increasing injury rates are of particular concern.

Accidents, Occupational↗

Occupational injuries among adolescents in Dunedin, New Zealand, 1990-1993.

STUDY OBJECTIVE: In this study we describe occupational injuries among adolescents (ages 15 through 19 years) presenting at a hospital ED in Dunedin, New Zealand, 1990-1993. METHODS: We used a new database to identify work-related injuries, as well as type of injury, cause of injury, injury site, occupation, industry, age, and sex. RESULTS: During the 4 years of the study, 1,361 work-related injuries were treated at the ED, for an injury rate of 13.8 per 200,000 hours worked (100 full-time equivalents). Males had a rate of 20.6 injuries, females 5.8 injuries, per 200,000 hours. Compared with injury rates from other studies, rates were lower than, but reasonably comparable to, those rates estimated through more detailed surveys. Main injury sites included upper extremities (mostly hands), head (mostly eyes), and lower extremities. Laceration was the main type of injury, followed by sprain/strain and foreign body. External cause of injury was mainly cutting/piercing objects, followed by foreign body and being struck by or against an object. The rate was highest for the 16- and 17-year-olds and decreased for 18- and 19-year-olds. The rates of injuries in the construction sector were the highest of all occupational groups, at 27 injuries per 200,000 hours, followed by transportation/ communication, manufacturing (including meat and fish processing), and business and repair services. Laborers were the highest occupational risk group, with 36 injuries per 200,000 hours, followed by machine operators, precision production workers, and service workers. CONCLUSION: These findings may be helpful in focusing prevention efforts in high-incidence areas. This study demonstrates how a well-planned data-collection system can overcome some of the previously described difficulties of getting prevention-oriented information from EDs.

Accidents, Occupational↗

Nonfatal occupational injuries and illnesses treated in hospital emergency departments--United States, 1998.

The National Electronic Injury Surveillance System (NEISS) includes data about nonfatal occupational injuries and illnesses treated in U.S. hospital emergency departments (EDs). This report summarizes 1998 injury and illness estimates based on NEISS, which indicate that the magnitude and patterns of nonfatal occupational injuries and illnesses were comparable to estimates reported for 1996 (1). Younger workers continue to have the highest rates of work-related injuries and illnesses; therefore, interventions should address the health and safety needs of young workers, most of whom lack substantial experience in the work place.

Accidents, Occupational↗

Occupational injury deaths of 16 and 17 year olds in the US: trends and comparisons with older workers.

OBJECTIVE: To examine patterns of occupational injury deaths of 16 and 17 year olds in the United States for the three year period 1990-2, examine trends since the 1980s, and compare fatality rates with those of older workers. METHODS: Occupational injury deaths were analyzed using the death certificate based National Traumatic Occupational Fatalities (NTOF) surveillance system. Fatality rates were calculated using estimates of full time equivalent (FTE) workers based on data from the Current Population Survey, a monthly household survey. RESULTS: There were 111 deaths of 16 and 17 year olds for the years 1990-2. The average yearly rate was 3.5 deaths/100,000 FTE. The leading causes of death were motor vehicle related, homicide, and machinery related. All causes occupational injury fatality rates for 16 and 17 year olds were lower than for adults for 1990-2. Rates for the leading causes of death (motor vehicle related, homicide, and machinery related) were comparable or slightly higher than the rates for young and middle aged adult workers. Although rates decreased dramatically from 1980 to 1983, the decreasing trend attenuated in later years. CONCLUSIONS: Comparisons of youth fatality rates to those of adult workers should address differences in patterns of employment, most importantly hours of work. Comparisons to narrow age groupings of adults is preferable to a single category of all workers 18 years and older. Increasing compliance with federal child labor regulations could help reduce work related deaths of youth. Other measures are needed, however, as there are many work hazards, including those associated with homicides, that are not addressed by United States federal child labor law regulations.

Accidents, Occupational↗

The current hiatus in occupational injury research in Australia.

OBJECTIVE: In late 1999, the Safety Institute of Australia (SIA) noted the difficulty of accessing and reviewing Australian research into occupational injuries and asked for a register of research in this field to be created. It offered the use of its website as a continuing location for a possible register. The creation of the initial database was the primary objective of this work. METHOD: Data collection was by survey form, which was distributed by mail to relevant organisations and individuals and was also downloadable from the SIA website. Responses were accepted by mail, fax and e-mail. RESULTS: By April 2000, responses which included publications in peer-reviewed journals since 1995 totalled just 154. This seemed to support the Institute's opinion that the amount of research in progress was inadequate to reduce the incidence of workplace injuries in Australia. CONCLUSIONS AND IMPLICATIONS: The small number of responses was partly due to the 1996 restructuring of the National Occupational Health and Safety Commission. Additionally, present arrangements give no role for investigator-initiated and investigator-driven research which has been the essential prerequisite for success in other areas of public health. The Australian workforce is now disadvantaged in contrast to overseas competitors who have national occupational injuries research organisations. To remedy this situation, a new science-based research grant organisation, with annual funds of about $25 million, administered by a new Occupational Injuries Research Council is proposed.

Accidents, Occupational↗

[Occupational injuries among construction workers in Hong Kong].

OBJECTIVE: To explore the nature and severity of occupational injuries among construction workers and its risk factors in Hong Kong. METHODS: One hundred and twenty-two injured construction workers in a public hospital and an equal number of workmate controls were studied. Contents included socio -demographic characteristics, the availability and use of safety equipment, smoking and alcohol consumption, etc. Abbreviated injury scale (AIS) and injury severity score (ISS) were employed for describing the nature, pattern and severity of injuries. RESULTS: Single injuries were seen in 80% of cases. Of 149 injuries classified by body region, 49% were external, 26% involved either the upper or lower extremities, and 11% were spinal injuries. Working at height was associated with the injury severity score. Safety hazards were identified in the work environment in 68% of the cases. Significant odds ratios for accidents were obtained for 'no formal education', 'non safety training' and 'current smokers'. CONCLUSIONS: The results implicated that construction was a hazardous occupation in Hong Kong. Improving the work environment and promoting safety education among construction workers would be helpful for minimizing or eliminating occupational injuries in construction occupation in Hong Kong.

Accidents, Occupational↗

Trends in fatal occupational injuries and industrial restructuring in North Carolina in the 1980s.

OBJECTIVES: This study examined the relationship between changes in employment in North Carolina in the 1980s and fatal occupational injury rates. METHODS: Unintentional fatal occupational injuries (n = 1989) in North Carolina between 1978 and 1991 were identified via the medical examiner's system. RESULTS: Overall fatal injury rates declined during the 1980s, but rates increased 9.6% per year among manufacturing industries that declined in employment size; rates fell among service sector and manufacturing industries that grew. CONCLUSIONS: Increasing occupational fatal injury rates accompanied the decline in workforce in North Carolina's traditional, labor-intensive manufacturing industries during the 1980s, while service sector and expanding manufacturing industries have experienced declining fatal injury rates.

Accidents, Occupational↗

Occupational injury in female aerospace workers.

We conducted a population-based case-control study in women in high-risk manufacturing occupations to examine occupational injury and its association with possible risk factors inside and outside the work place. The primary hypothesis was that women with young children are at greater risk of occupational injury than are women without young children, owing to the responsibility and fatigue associated with raising young children. The odds of reported injury was 2.9 times greater in women with a child less than 6 years of age than in women without children less than age 6 [odds ratio (OR) = 2.9; 95% confidence interval (CI) = 1.5-5.6]. The same effect was not observed for women with older children. Other predictors of injury were a history of previous injury (OR = 2.7; 95% CI = 1.8-3.9) and a body mass index greater than or equal to 25 (OR = 1.6; 95% CI = 1.08-2.4). We found small or zero effects for age, years of work experience, total number of children at home, ethnicity, marital status, and shift worked. These findings indicate that factors outside the work place, such as the presence of young children at home, may increase the risk of occupational injury for women employed in manufacturing jobs.

Accidents, Occupational↗