Category Archives: Health & Safety

Using emergency department surveillance data to assess occupational injury and illness reporting by workers

Source: Suzanne M. Marsh, Audrey A. Reichard, Ruchi Bhandari and Theresa R. Tonozzi, American Journal of Industrial Medicine, Vol. 59 Issue 8, August 2016
(subscription required)

From the abstract:
Objective: Researchers from the National Institute for Occupational Safety and Health (NIOSH) share detailed methodologies from conducting two follow-back studies initiated in 2010 that were designed to assess whether workers reported their injuries and illnesses to their employers and to identify worker incentives and disincentives for reporting work-related injuries to employers.

Methodology: Study respondents were sampled from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), an emergency department-based surveillance system. Telephone interviews were used to collect information directly from workers.

Outcomes: Among persons treated in emergency departments who could be identified as working at the time of injury or illness, most reported their injury or illness to their employer. Our studies did not assess if these reported injuries and illnesses were recorded on the Occupational Safety and Health logs.

Discussion: Our approach suggests that emergency department-based surveillance data are limited in their utility to investigate underreporting among workers.

Characterizing emergency department patients who reported work-related injuries and illnesses
Source: Ruchi Bhandari, Suzanne M. Marsh, Audrey A. Reichard and Theresa R. Tonozzi, American Journal of Industrial Medicine, Vol. 59 Issue 8, August 2016
(subscription required)

From the abstract:
Background: Per a Congressional directive and funding, this study describes worker and workplace characteristics of emergency department (ED) patients who reported their injury/illness to their employer. The study also responds to Congress’s request to enumerate injured/ill self-employed workers and workers with chronic conditions.

Methods: We conducted a follow-back study on injured/ill workers, including self-employed, identified from a national ED surveillance system from June 2012 through December 2013.

Results: An estimated 3,357,000 (95%CI: 2,516,000–4,199,000) workers treated in EDs reported their injury/illness to their employer or were self-employed. Of those, 202,000 (95%CI: 133,000–272,000) had a chronic condition. Of all reporters, excluding self-employed, 77% indicated they received instructions as to whom to report.

Conclusion: The study did not identify underreporting issues and revealed that medical records data may not be appropriate for assessing underreporting. Additional research is needed to examine workplace characteristics that encourage injury and illness reporting.

Reported work-related injuries and illnesses among Hispanic workers: Results from an emergency department surveillance system follow-back survey
Source: Theresa R. Tonozzi, Suzanne M. Marsh, Audrey A. Reichard and Ruchi Bhandari, American Journal of Industrial Medicine, Vol. 59 Issue 8, August 2016
(subscription required)

From the abstract:
Background: Research suggests Hispanic workers underreport injuries/illnesses to their employer.

Methods: The National Electronic Injury Surveillance System—occupational supplement was used to conduct a follow-back study of workers treated in emergency departments (EDs) from June 2012 through December 2013.

Results: An estimated 448,000 (95%CI 230,000–665,000) Hispanic workers treated in EDs for a work-related injury or illness were represented by 362 completed interviews. Of these, an estimated 443,000 (95%CI 228,000–657,000) workers reported the injury or illness to their employer or were self-employed. The majority had not heard of workers’ compensation. Only 10% expected workers’ compensation to cover their medical payment while 62% expected payment to be covered by their employer.

Conclusion: We characterized our respondent workforce who reported their injury or illness. We determined that NEISS-Work data are not the most appropriate source to capture underreporting of work-related injuries and illnesses to employers among Hispanic workers.

New Studies of Gig Economy Workers’ Rights

Source: National Employment Law Project, 2016

Three new policy briefs from NELP take a closer look at “gig economy” workers’ rights.

On-Demand Workers Should Be Covered by Workers’ Compensation
Many on-demand companies operate in dangerous industries with high workplace injury and fatality rates. Yet they classify their workers as “independent contractors” and thereby avoid the responsibility of providing workers’ compensation and other employee protections. This practice presents real costs to the workers hired by these companies and shifts the cost of work-related injuries onto the backs of workers and the general public. The job-related dangers to which these workers are exposed makes it critical that they be covered by workers’ comp.

Flexibility and the On-Demand Economy
On-demand companies often tout flexibility as one of the main reasons why people choose to work for them. This brief challenges that premise, however, showing that monetary pressures, peak demand periods, and company-imposed rules and incentives mean workers have much less flexibility than the companies claim. The brief also debunks the assertion that flexibility is incompatible with employee status. 

Ensuring Fairness in Background Checks for On-Demand Work
On-demand companies promote the idea that they provide work opportunities for people in communities with high unemployment. But many of these companies fall short when it comes to complying with the civil rights and consumer laws regulating the use of background checks for employment. Strong protections are needed to ensure that companies use non-discriminatory hiring practices. 

Work-related deaths among youth: Understanding the contribution of US child labor violations

Source: Kimberly J. Rauscher, Douglas J. Myers, and Mary E. Miller, American Journal of Industrial Medicine, Early View, Version of Record online: June 27, 2016
(subscription required)

From the abstract:
Background: Evidence shows that violations of the United States (US) child labor regulations are common. The main purpose of this study was to investigate the magnitude and nature of work-related deaths among youth involving violations of US child labor regulations.

Methods: We analyzed Census of Fatal Occupational Injury data from 2001 to 2012 using descriptive statistics and Chi-square tests.

Results: Between 2001 and 2012, 406 workers under age 18 were recorded in the CFOI as having suffered a fatal work-related injury. Among these cases, 233 were covered by the US child labor regulations. Forty-three percent of these cases involved at least one violation. The majority of cases that were not covered by the regulations involved decedents working on their family’s farms.

Conclusions: Violations of federal child labor regulations are a significant contributor to work-related deaths among youth in the United States. Increased investment in enforcement is needed to prevent further young worker deaths involving child labor violations.

Employee assistance programs, drug testing, and workplace injury

Source: Geetha M. Waehrer, Ted R. Miller, Delia Hendrie, Deborah M. Galvin, Journal of Safety Research, Volume 57, June 2016
(subscription required)

From the abstract:
Introduction: Little is known about the effects of employee assistance programs (EAPs) on occupational injuries.
Materials and methods: Multivariate regressions probed a unique data set that linked establishment information about workplace anti-drug programs in 1988 with occupational injury rates for 1405 establishments.
Results: EAPs were associated with a significant reduction in both no-lost-work and lost-work injuries, especially in the manufacturing and transportation, communication and public utilities industries (TCPU). Lost-work injuries were more responsive to specific EAP characteristics, with lower rates associated with EAPs staffed by company employees (most likely onsite). Telephone hotline services were associated with reduced rates of lost-work injuries in manufacturing and TCPU. Drug testing was associated with reductions in the rate of minor injuries with no lost work, but had no significant relationship with lost-work injuries.
Practical applications: This associational study suggests that EAPs, especially ones that are company-staffed and ones that include telephone hotlines, may prevent workplace injuries.

• In 1989, employers with EAPs had significantly less no-lost-work and lost-work injuries.
• Lost-work injury rates were lower in companies with EAPs staffed by company employees.
• EAP hotlines were associated with lower lost-work injury rates in manufacturing and transportation/communications/public utilities.
• Evidence of an association between drug testing and the occupational injury rate was weak.

Danger and Dignity: Immigrant Day Laborers and Occupational Risk

Source: Jayesh Rathod, American University – Washington College of Law, WCL Research Paper No. 2016-09, March 21, 2016

From the abstract:     
The plight of immigrant workers in the United States has captured significant scholarly attention in recent years. Despite the prevalence of discourses regarding this population, one set of issues has received relatively little attention: immigrant workers’ exposure to unhealthy and unsafe working conditions, and their corresponding susceptibility to workplace injuries and illnesses. Researchers have consistently found that immigrant workers suffer disproportionately from occupational injuries and fatalities, even when controlling for industry and occupation. Why, then, are foreign-born workers at greater risk for workplace injuries and fatalities, when compared with their native-born counterparts? This Article seeks to develop answers to that question with the aid of empirical research and to build upon a growing interdisciplinary literature.

This Article presents findings from a qualitative research study designed to explore the factors that shape occupational risks for immigrants. The study, conducted over several months in 2014, centered on in-depth interviews of eighty-four immigrant day laborers seeking employment in different parts of Northern Virginia. The workers’ responses present a complex picture of the immigrant worker experience, reflecting persistent dangers alongside powerful expressions of worker dignity: while the Virginia day laborers continue to encounter significant occupational risks, many comfortably asserted their rights, complicating standard narratives of immigrant worker subordination and vulnerability.

The results of the study also point to ongoing economic insecurities, and regulatory failures relating to the provision of training, use of protective equipment, and oversight of smaller worksites. The findings also signal the need for a more holistic approach to workplace regulation that concomitantly examines a range of workplace concerns, including wage violations, hostile work environments, and health and safety risks. Finally, the day laborers’ experiences reveal that worker centers are well positioned to insulate immigrant workers from workplace risks, by promoting transparency and accountability in the employer-employee relationship.

Zika: Resources at Your Fingertips

Source: U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR), Current as of June 6, 2016

This document provides Zika virus disease resources and an overview of public health and healthcare system considerations and implications that are applicable to professionals in those systems, emergency management stakeholders, and other audiences. Appendix A contains resources from the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Preparedness and Response (ASPR) and relevant contact links. Appendix B includes citations with annotations for additional relevant resources and Zika Guidance. Finally, individuals can review ASPR TRACIE (Technical Resources, Assistance Center, and Information Exchange) Topic Collections, which provide a wide array of materials and resources for further research.
About the Zika Virus Planning Resources
Source: U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Preparedness and Response (ASPR), June 2, 2016

Global warming to expose more people to Zika-spreading mosquito Aedes aegypti

Source: Andrew Monaghan, The Conversation, June 16, 2016

As Americans ready themselves for the arrival of mosquitoes this summer, many may be wondering whether they are at risk for tropical diseases like Zika and whether climate change will raise the risks of infection.

My colleagues and I recently completed a study examining how projected changes in climate and human population may increase global exposure to the mosquito that spreads these viruses: Aedes aegypti.
We found that both climate change and human population change will play a part in driving future human exposure to Aedes aegypti globally. In the United States, specifically, warming temperatures from climate change mean that this disease-spreading mosquito will be increasingly abundant in the southern and eastern U.S….
The potential impacts of 21st century climatic and population changes on human exposure to the virus vector mosquito Aedes aegypti
Source: Andrew J. Monaghan, K. M. Sampson, D. F. Steinhoff, K. C. Ernst, K. L. Ebi, B. Jones, M. H. Hayden, Climatic Change, First Online: 25 April 2016
(subscription required)

From the abstract:
The mosquito Aedes (Ae). aegypti transmits the viruses that cause dengue, chikungunya, Zika and yellow fever. We investigate how choosing alternate emissions and/or socioeconomic pathways may modulate future human exposure to Ae. aegypti. Occurrence patterns for Ae. aegypti for 2061–2080 are mapped globally using empirically downscaled air temperature and precipitation projections from the Community Earth System Model, for the Representative Concentration Pathway (RCP) 4.5 and 8.5 scenarios. Population growth is quantified using gridded global population projections consistent with two Shared Socioeconomic Pathways (SSPs), SSP3 and SSP5. Change scenarios are compared to a 1950–2000 reference period. A global land area of 56.9 M km2 is climatically suitable for Ae. aegypti during the reference period, and is projected to increase by 8 % (RCP4.5) to 13 % (RCP8.5) by 2061–2080. The annual average number of people exposed globally to Ae. aegypti for the reference period is 3794 M, a value projected to statistically significantly increase by 298–460 M (8–12 %) by 2061–2080 if only climate change is considered, and by 4805–5084 M (127–134 %) for SSP3 and 2232–2483 M (59–65 %) for SSP5 considering both climate and population change (lower and upper values of each range represent RCP4.5 and RCP8.5 respectively). Thus, taking the lower-emissions RCP4.5 pathway instead of RCP8.5 may mitigate future human exposure to Ae. aegypti globally, but the effect of population growth on exposure will likely be larger. Regionally, Australia, Europe and North America are projected to have the largest percentage increases in human exposure to Ae. aegypti considering only climate change.

Women And The Zika Virus: Smart Questions And A Few Solid Answers

Source: Shefali Luthra, Kaiser Health News, June 13, 2016

….. What’s the danger? A lot is up in the air, since there’s not a ton of research on the virus. Here’s a quick breakdown of the smart questions to ask and what we do actually know.
• I’m a woman of childbearing age. What if I get Zika? …..
• I am pregnant. What steps should I take to protect myself? …..
• I went somewhere where Zika-carrying mosquitoes have been detected, but I feel fine. Can I carry on as normal? …..
• I have Zika, and I’m pregnant. What do I do? …..
• This is scary, and it’s a lot of information. How else can I stay up to date? …..

Gaps In Women’s Health Care May Derail Zika Prevention In Texas, Florida
Source: Shefali Luthra, Kaiser Health News, June 14, 2016

The War on Workers’ Comp

Source: Stephen Franklin, In These Times, Working in These Times blog, June 13, 2016

For nearly a century, millions of workers have endured punishing jobs in construction, mining and factory work—jobs with high levels of work-related disability and injury. As a tradeoff for the dangers, they’ve had the assurance of workers’ compensation if injured permanently on the job. Employers accepted this deal, albeit sometimes grudgingly, because it  removed the possibility of being sued over work-related injuries. 

But as labor has weakened and Republicans have won control of more and more statehouses, states have slowly chipped away at workers’ compensation benefits.

Since just 2003, more than 30 states have passed laws that have “reduced benefits for injured workers, created hurdles for medical care or made it more difficult for workers to qualify,” according to a recent investigative series by ProPublica and NPR. Some of the harshest cuts came in California, Arizona, Florida, Oklahoma, North Dakota, Kansas, Indiana and Tennessee. Today, according to the federal Occupational Safety and Health Administration (OSHA), many injured and disabled workers “never enter the workers’ compensation system.” OSHA also estimates that workers’ compensation covers only about 21 percent of the lost wages and medical bills encountered by injured workers and their families…..