A Hard Day at Work: An Analysis of Occupational Genitourinary Injuries in the United States Workforce

Abstract

ObjectiveTo use national data to identify risk factors for occupational genitourinary (GU) injuries and to expose potential workplace safety issues requiring national regulation. Materials and MethodsThe National Trauma Data Bank was queried to identify all adults who suffered a work-related GU injury from 2007 to 2016. Injury was stratified by individual organ and by organ type: intra-abdominopelvic (IAP) vs external genitalia (EG). Distinct multivariable logistic regression models were used to examine associations between prespecified risk factors and GU injury (organ and type) and to identify predictors of intensive care unit and operating room (OR) transfer. ResultsTwo thousand one hundred thirty-nine patients (total of 2681 GU injuries), were included. A mean of 1.3 GU organ injuries and 7.6 total injuries were suffered per patient. 72% suffered an IAP GU injury, 23% an EG injury, and 5% suffered both. Patients working in agriculture/forestry/fishing, (OR 2.3, P = .003), manufacturing (OR 1.9, P = .05), and natural resources/mining (OR 2.3, P = .012) were at significantly increased risk of EG injury. The penis and urethra were particularly at-risk in agriculture/forestry/fishing (OR 4.0, P = .005; OR 3.0, P = .002) and the urethra in natural resources/mining (OR 3.4, P = .004). IAP GU injury was a significant predictor of intensive care unit transfer (OR 1.8, P <.001), whereas EG injury was a significant predictor of OR transfer (OR 2.5, P <.001). ConclusionOccupational GU injuries remain a major issue for blue-collar workers. External genitalia are particularly at-risk, and injuries often require emergent surgery. National occupational health agencies need to continue to enhance on-the-job safety for those at-risk.