Compensation Claim Rates Research Articles

Impact of extreme bushfire seasons on rates of occupational injury and disease compensation claims in first responders.

This study aimed to use workers' compensation (WC) data to explore the impact of the extreme bushfires on injury/disease claim rates amongst first responders (FR) compared with other occupations and off-seasons. Data on WC claims for FR (ambulance officers, paramedics, firefighters, police) and other occupations were obtained from WorkSafe Victoria 2005-2022. Negative binomial regression models adjusting for age, gender and number of employed people were used to estimate incident rate ratios of all injury/disease, mental, musculoskeletal and respiratory claims among FR in summer and extreme bushfires compared to off-season/summer and other occupations. There were 120,022 claims in 2005-2022; 54% were musculoskeletal injuries. Claims rates were significantly higher for all injuries/diseases, mental, musculoskeletal and respiratory conditions in FR than other occupations across off-season, summers and extreme bushfires. FR were 1.5-3.9 times more likely to claim for mental health conditions during extreme bushfires than off-season compared with other occupations. Firefighters were at increased risk of all injury/disease and mental and musculoskeletal injury claims during summer and extreme bushfires than off-seasons. Ambulance officers and paramedics had the highest claim rates, particularly in off-seasons, with a higher risk of all injury/disease and mental claims in extreme bushfires than in summers. Respiratory and mental claims were increased amongst police and other occupations during extreme bushfires. Extreme bushfire events were associated with increased mental claims rates in all FR, with the highest in firefighters. Strategies to better prevent and manage injury/disease risk in FR are urgently required, particularly for mental health conditions.

The impact of regulatory workplace safety inspections on workers' compensation claim rates.

Studies on the impact of workplace safety inspections on work injuries have found mixed effectiveness. Most studies are from the United States, examining Occupational Health and Safety Administration (OSHA) regulatory inspections in manufacturing firms with more than 10 employees. This study examines whether regulatory inspections in Alberta, Canada, result in reductions in workers' compensation claims rates for inspected firms relative to comparable non-inspected firms. Firm and claim-level data from the Workers' Compensation Board of Alberta were linked with regulatory enforcement data from the Government of Alberta for construction, manufacturing, and transportation firms with at least one full-time employee for 37 consecutive months. A matched difference-in-differences study design was used to estimate changes in lost-time claim rates for work-related injuries and musculoskeletal diseases of inspected and comparable non-inspected firms between the year pre-inspection and 2 years, post-inspection, controlling for firm-level characteristics. Inspections were not effective in reducing firm-level claim rates, with the exception of transportation firms with more than one inspection experiencing a 28% decrease in their claim rate in the second year post-inspection, relative to the change in non-inspected firms. In construction, inspected firms experienced a 12% increase in their claim rate in the first year post-inspection. No effect was observed in the manufacturing sector. Regulatory workplace safety inspections in Alberta generally do not result in greater reductions in firm-level claim rates in the construction, manufacturing, and transportation sectors. Inspections alone may not be sufficient to induce compliance or hazard management changes that lead to reductions in firm-level injuries.

Racial and ethnic disparities in workers' compensation claims rates.

Workers of color experience a disproportionate share of work-related injuries and illnesses (WRII), however, most workers' compensation systems do not collect race and ethnicity information, making it difficult to monitor trends over time, or to investigate specific policies and procedures that maintain or could eliminate the unequal burden of WRII for workers of color. The purpose of this study is to apply a Bayesian method to Washington workers' compensation claims data to identify racial and ethnic disparities of WRII by industry and occupation, improving upon existing surveillance limitations. Measuring differences in risk for WRII will better inform prevention efforts and target prevention to those at increased risk. To estimate WRII by race/ethnicity, we applied the Bayesian Improved Surname Geocode (BISG) method to surname and residential address data among all Washington workers' compensation claims filed for injuries in 2013-2017. We then compare worker and injury characteristics by imputed race/ethnicity, and estimate rates of WRII by imputed race/ethnicity within industry and occupation. Black/African Americans had the highest rates of WRII claims across all industry and occupational sectors. Hispanic/Latino WRII claimants also had higher rates than Whites and Asian/Pacific Islanders in almost all industry and occupational sectors. For accepted claims with both medical and non-medical compensation, Bodily reaction/overexertion injuries accounted for almost half of the claims during this reporting period. The high rates of injury we report by racial/ethnic categories is a cause for major concern. Nearly all industry and occupation-specific rates of workers' compensation claims are higher for Black/African American and Hispanic/Latino workers compared to Whites. More work is needed to identify work-related, systemic, and individual characteristics.

Differences in workers' compensation claim rates for within-province and out-of-province workers in British Columbia, Canada, 2010-2017.

Little is known about the work-related injury and illness risk of out-of-province workers. This study examines whether there are differences in work-related injury and illness claim rates between within-province and out-of-province workers in British Columbia (BC), Canada. Workers' compensation claim data for injuries and illnesses in BC from 2010 to 2017 were linked with denominator data from Statistics Canada. Multivariable negative binomial regression estimated the claim rate ratio (RR) and 95% confidence intervals (CI) for out-of-province workers with all, health care-only (HCO), short-term disability, long-term disability, and fatality (SLF), and serious injury (SI) claims, compared to within-province workers. Compared to within-province workers, out-of-province workers had a lower total claim rate (RR: 0.54, 95% CI: 0.52-0.57), adjusting for sex, age, industry sector, and year. Differences in rates differed by claim type, with the largest differences for HCO claims (RR: 0.49, 95% CI: 0.47-0.52) and smallest differences for SI claims (RR: 0.85, 95% CI: 0.78-0.92). Sex-stratified models showed larger differences for males than females, with older female out-of-province workers having elevated SI claim rates. Industry-specific models showed that, even in sectors with high proportions of out-of-province workers' claims, these workers have lower claim rates than within-province workers. Out-of-province workers generally have lower claim rates than within-province workers. The overall duration of work exposure, and underreporting or underclaiming, are factors that may explain these lower claim rates. Understanding the determinants and differences of these claim rates may improve the administration and adjudication of claims while also identifying where further prevention measures may be merited.

Workers’ compensation claim counts and rates by injury event/exposure among state-insured private employers in Ohio, 2007–2017

Introduction: This study analyzed workers’ compensation (WC) claims among private employers insured by the Ohio state-based WC carrier to identify high-risk industries by detailed cause of injury. Methods: A machine learning algorithm was used to code each claim by U.S. Bureau of Labor Statistics (BLS) event/exposure. The codes assigned to lost-time (LT) claims with lower algorithm probabilities of accurate classification or those LT claims with high costs were manually reviewed. WC data were linked with the state’s unemployment insurance (UI) data to identify the employer’s industry and number of employees. BLS data on hours worked per employee were used to estimate full-time equivalents (FTE) and calculate rates of WC claims per 100 FTE. Results: 140,780 LT claims and 633,373 medical-only claims were analyzed. Although counts and rates of LT WC claims declined from 2007 to 2017, the shares of leading LT injury event/exposures remained largely unchanged. LT claims due to Overexertion and Bodily Reaction (33.0%) were most common, followed by Falls, Slips, and Trips (31.4%), Contact with Objects and Equipment (22.5%), Transportation Incidents (7.0%), Exposure to Harmful Substances or Environments (2.8%), Violence and Other Injuries by Persons or Animals (2.5%), and Fires and Explosions (0.4%). These findings are consistent with other reported data. The proportions of injury event/exposures varied by industry, and high-risk industries were identified. Conclusions: Injuries have been reduced, but prevention challenges remain in certain industries. Available evidence on intervention effectiveness was summarized and mapped to the analysis results to demonstrate how the results can guide prevention efforts. Practical Applications: Employers, safety/health practitioners, researchers, WC insurers, and bureaus can use these data and machine learning methods to understand industry differences in the level and mix of risks, as well as industry trends, and to tailor safety, health, and disability prevention services and research.

Workers' Compensation Claim Rates and Costs for Musculoskeletal Disorders Related to Overexertion Among Construction Workers - Ohio, 2007-2017.

Overexertion is a leading cause of work-related musculoskeletal disorders (WMSDs) among construction workers. Nearly 90% of construction jobs require manual handling of materials for approximately one half of the worker's time (1). In 2015, overexertion from lifting and lowering materials caused 30% of WMSDs among construction workers; overexertion involving pushing, pulling, holding, carrying, and catching materials caused an additional 37% of WMSDs (1). This study examined the rate and cost of WMSD claims from overexertion among Ohio construction workers during 2007-2017. Workers' compensation claims related to overexertion that were submitted to the Ohio Bureau of Worker's Compensation (OHBWC) by workers in the construction industry for injuries and illnesses occurring during 2007-2017 were analyzed. Rates and costs of allowed claims were measured by age group. Workers aged 35-44 years experienced the highest claim rate: 63 per 10,000 full-time employees (FTEs) for WMSDs from overexertion. However, claims by workers aged 45-54 years and 55-64 years were more costly on average and resulted in more days away from work. Ergonomic design improvements and interventions are needed to ensure that the majority of construction workers can safely perform jobs throughout their careers. Age-specific WMSD prevention and risk communication efforts also might be helpful.

Occupational safety and health in marine aquaculture in Atlantic Canada: What can be learned from an analysis of provincial occupational injury compensation claims data?

BackgroundCommercial aquaculture employs roughly 19 million workers globally, yet research on aquaculture occupational safety and health is extremely limited, including in developed countries like Canada. Analyses of injury and fatality compensation claims data from Scandinavian countries, Australia, the United States, and Brazil reveal aquaculture is a high-risk industry, associated with multiple hazards and high injury and fatality rates. Marine aquaculture takes place on Canada's east and west coasts. It is expanding in Atlantic Canada where it consists mainly of salmon and shellfish production. This paper presents results from a descriptive analysis of data on accepted compensation claims for injured Atlantic Canada marine aquaculture workers. MethodsWorkers' compensation in Canada falls under provincial jurisdiction. Anonymous claims data between 1996 and 2017, provided by four Atlantic provincial compensation boards, captured injury claims broadly specific to the aquaculture industry, supporting a descriptive analysis of incidence rates and injury characteristics. ResultsAcross provinces, lost time injury rates among aquaculture workers fluctuated over time, but exceeded recent overall average provincial rates from 2010 to 2016. Consistent across provinces, almost half of all marine aquaculture injuries were caused by bodily reaction and (over)exertion (mean = 15.0%; SD = 6.4%), falls (14.4%; SD = 2.3%), or being struck by or against an object (mean = 13.7%; SD = 2.2%). Roughly half of the injuries were of three types: traumatic injuries to muscles, tendons, ligaments, and joints (mean = 33.0%; SD = 3.7%), open wounds (mean = 10.1%; SD = 2.5), and surface wounds and bruises (mean = 10.0%; SD = 5.2%). The back, including spine and spinal cord was the body part most commonly affected by workplace injuries (mean = 17.2%; SD = 1.4%), followed by leg(s) (mean = 10.8%; SD = 0.5%), and finger(s)/ fingernail(s) (mean = 10.4%, SD = 4.4%). ConclusionFindings indicate marine aquaculture workers are suffering from similar injuries (injury event, nature and source of injury, body parts) across provinces and these are similar to aquaculture sector injury claims patterns in Norway, Finland, Australia, and the United States. The high incidence rates are a strong signal that marine aquaculture in Canada, as elsewhere, is a hazardous sector. Compensation claims rates exceed overall provincial averages and have not declined. Ongoing surveillance, hazard assessments, and identification and implementation of prevention strategies could help this expanding industry reduce rates of injuries and illnesses.

Work-related musculoskeletal disorders and injuries among emergency medical technicians and paramedics: A comprehensive narrative review

The aim of this article was to review the current knowledge relating to work-related musculoskeletal disorders (WRMDs) and non-fatal injuries in emergency medical technicians and paramedics (EMTs-Ps). A literature search was conducted in PubMed, Google Scholar, and Clinical Key. The annual prevalence of back pain ranged from 30% to 66%, and back injuries and contusions from 4% to 43%. Falls, slips, trips, and overexertion while lifting or carrying patients or instruments ranged from 10% to 56%, with overexertion being the most common injury. Risk factors were predominantly lifting, working in awkward postures, loading patients into the ambulance, and cardiopulmonary resuscitation procedures. Lack of job satisfaction and social support was associated with WRMDs and injuries. EMTs-Ps had the highest rate of worker compensation claim rates compared to other healthcare professionals. Positive ergonomic intervention results included electrically powered stretchers, backboard wheeler, descent control system, and the transfer sling.

Safety and Health through Integrated, Facilitated Teams (SHIFT): stepped-wedge protocol for prospective, mixed-methods evaluation of the Healthy Workplace Participatory Program

BackgroundHealthcare facilities are notorious for occupational health and safety problems. Multi-level interventions are needed to address interacting exposures and their overlapping origins in work organization features. Worker participation in problem identification and resolution is essential. This study evaluates the CPH-NEW Healthy Workplace Participatory Program (HWPP), a Total Worker Health® protocol to develop effective employee teams for worker safety, health, and wellbeing.MethodsSix public sector, unionized healthcare facilities are enrolled, in three pairs, matched by agency. The unit of intervention is a workplace health and safety committee, adapted here to a joint labor-management “Design Team” (DT). The DT conducts root cause analyses, prioritizes problems, identifies feasible interventions in light of the constraints and needs of the specific setting, makes business-case presentations to facility leadership, and assists in evaluation.Following a stepped-wedge (cross-over) design, one site in each pair is randomly assigned to “immediate intervention” status, receiving the full coached intervention at baseline; in the “lagged intervention” site, coaching begins about half-way through the study. Program effectiveness and cost-effectiveness outcomes are assessed at both organizational (e.g., workers’ compensation claim and absenteeism rates, perceived management support of safety) and individual levels (e.g., self-rated health, sleep quality, leisure-time exercise). Targeted pre-post analyses will also examine specific outcomes appropriate to the topics selected for intervention. Process evaluation outcomes include fidelity of the HWPP intervention, extent of individual DT member activity, expansion of committee scope to include employee well-being, program obstacles and opportunities in each setting, and sustainability (within the available time frame).DiscussionThis study aims for a quantitative evaluation of the HWPP over a time period long enough to accomplish multiple intervention cycles in each facility. The design seeks to achieve comparable study engagement and data quality between groups. We will also assess whether the HWPP might be further improved to meet the needs of U.S. public sector healthcare institutions. Potential challenges include difficulty in pooling data across study sites if Design Teams select different intervention topics, and follow-up periods too short for change to be observed.Trial registrationClinicalTrials.gov NCT04251429 (retrospectively registered January 29, 2020), protocol version 1.

Reducing Injuries, Malingering, and Workers’ Compensation Costs by Implementing Overt Integrity Testing

Workers’ compensation costs are a substantial expense for employers. Given mixed results of training and job redesign interventions designed to reduce accidents leading to claims, organizations may wish to reduce these costs by screening job applicants with integrity tests. Building on theories of workplace safety and malingering (i.e., faking or exaggerating injuries for personal gain), we argue that overt integrity tests predict workers’ compensation claims through both workplace injuries and malingering. Analyses of archival data from three organizations (study 1) found screening job applicants reduced workers’ compensation claim rates and related costs, demonstrating a return on investment of 734% in one sample and 866% in another. In a three-wave survey of working adults (study 2), integrity test scores related directly to malingering, and indirectly to workplace injuries through motivation to work safely and compliance with safety rules. Analyses of three common dimensions of overt integrity tests (substance abuse, aggression, and theft) found theft scores directly related to malingering, and indirectly related to injuries through lower safety compliance. Substance abuse scores were related to higher rates of injury through lower safety motivation and compliance. Aggression scores were not related to malingering or injuries. We conclude that screening job applicants with overt integrity tests can be a cost-effective way to reduce unnecessary workplace injuries, malingering, and the related workers’ compensation claims.

Fewer workers' compensation claims and lower claim costs if employers with high injury rates achieved the rates of their safer peers

Introduction: Employers engaged in similar business activities demonstrate a range of workers' compensation claim rates. Workplace injuries and illnesses could be prevented if employers with high claim rates achieved the claim rates of their safer peers. Methods: We used Washington workers' compensation claims data for years 2013–2015 to calculate rates of compensable claims (eligible for disability or time loss benefits, if unable to work four days after injury) and total accepted claims (compensable plus medical-aid only claims) for each employer. We estimated the number and cost of claims to occur if employers with high claim rates reduced them to the rates of employers at the 25th percentile, adjusted for insurance risk class, employer size, and injury type. To evaluate the impact of setting more or less ambitious goals, we also estimated reductions based on claim rates at the 10th and 50th percentiles. Results: Over 43% of claims and claim costs would be prevented if employers with higher claim rates lowered them to the 25th percentile using either total accepted or compensable claim rates as the benchmark outcome. The estimated claim cost savings from benchmarking to compensable claims was nearly as great as the estimate based on benchmarking to total accepted claims ($308.5 mil annually based on compensable claims vs. $332.4 mil based on total accepted claims). Restaurants and Taverns had the greatest number of potentially prevented compensable claims. Colleges and Universities and Wood Frame and Building Construction had the greatest potential reduction in compensable claim costs among larger and smaller employers, respectively. Conclusion: Substantial reductions in workers' compensation claims and costs are possible if employers achieve the injury rates experienced by their safer peers. Practical application: Evaluating the range of workplace injury rates among employers within industry groups identifies opportunities for injury prevention and offers another approach to resource allocation.

Characteristics of construction firms at risk for future workers' compensation claims using administrative data systems, Washington State

Introduction: Construction is high-hazard industry, and continually ranks among those with the highest workers' compensation (WC) claim rates in Washington State (WA). However, not all construction firms are at equal risk. We tested the ability to identify those construction firms most at risk for future claims using only administrative WC and unemployment insurance data. Methods: We collected information on construction firms with 10–50 average full time equivalent (FTE) employees from the WA unemployment insurance and WC data systems (n=1228). Negative binomial regression was used to test the ability of firm characteristics measured during 2011–2013 to predict time-loss claim rates in the following year, 2014. Results: Claim rates in 2014 varied by construction industry groups, ranging from 0.7 (Land Subdivision) to 4.6 (Foundation, Structure, and Building Construction) claims per 100 FTE. Construction firms with higher average WC premium rates, a history of WC claims, increasing number of quarterly FTE, and lower average wage rates during 2011–2013 were predicted to have higher WC claim rates in 2014. Conclusions: We demonstrate the ability to leverage administrative data to identify construction firms predicted to have future WC claims. This study should be repeated to determine if these results are applicable to other high-hazard industries. Practical Applications: This study identified characteristics that may be used to further refine targeted outreach and prevention to construction firms at risk.

Associations Among Health Care Workplace Safety, Resident Satisfaction, and Quality of Care in Long-Term Care Facilities.

We performed an integrated cross-sectional analysis of relationships between long-term care work environments, employee and resident satisfaction, and quality of patient care. Facility-level data came from a network of 203 skilled nursing facilities in 13 states in the eastern United States owned or managed by one company. K-means cluster analysis was applied to investigate clustered associations between safe resident handling program (SRHP) performance, resident care outcomes, employee satisfaction, rates of workers' compensation claims, and resident satisfaction. Facilities in the better-performing cluster were found to have better patient care outcomes and resident satisfaction; lower rates of workers compensation claims; better SRHP performance; higher employee retention; and greater worker job satisfaction and engagement. The observed clustered relationships support the utility of integrated performance assessment in long-term care facilities.

Factors underlying observed injury rate differences between temporary workers and permanent peers.

Temporary workers face increased risk of injury as compared to permanent workers in similar occupations. This study explores the role played by several potential risk factors. Injured temporary and permanent workers, matched by industry, tenure and demographic characteristics, were interviewed to isolate the association of temporary employment with several injury risk factors. Temporary workers had higher workers' compensation claims rates than their permanent worker-peers. In interviews temporary workers a reported a lower frequency of exposure to hazards. However, they also reported being less likely to be equipped to cope with hazards by such countermeasures as experience screening, safety training and task control. Policies are needed to improve screening and training of temporary workers to assigned tasks, to discourage job-switching, to improve temporary workers' hazard awareness, to protect their right to report unsafe conditions. The responsibilities of agencies and host employers for ensuring the safety of their temporary workers need clarification in regulatory policy.

Injury rates before and after the implementation of a safe resident handling program in the long-term care sector

Manual resident handling (RH) tasks increase risk of musculoskeletal disorders (MSDs) for clinical staff in nursing homes. To reduce the incidence and cost of MSDs, a large healthcare corporation instituted a Safe Resident Handling Program (SRHP) comprising purchase of mechanical lifting equipment, worker training, and detailed usage/maintenance protocols. The program was initially administered by a third-party company; after three years, program responsibility shifted to individual centers.Workers’ compensation claim rates were compared before and after SRHP implementation. Claims and FTEs were classified as “pre-SRHP,” “first post period” (up to 3years post-SRHP), or “second post period” (4–6years post-SRHP), based on claim date relative to implementation date for each center.Complete data were available for 136 nursing homes with average annual employment of 18,571 full-time equivalents. Over the 8-year period, 22,445 claims were recorded. At each time period, the majority of RH claims affected the back (36% low, 15% other) and upper extremity (26%). Workers’ compensation claims were reduced by 11% during the first post period and 14% during the second post period. RH-related claims were reduced by 32% and 38%, respectively. After six years, the rate for all claims had decreased in 72% of centers, and RH claim rates decreased in 82%. Relative risk for post-/pre-SRHP injury rates increased for centers with less developed wellness programs, unionized centers, and centers with higher LPN turnover pre-SRHP. Injury reduction among these nursing home workers is plausibly attributable to the introduction of mechanical lifting equipment within the context of this multi-faceted SRHP.

Improving the Understanding of Psychological Factors Contributing to Horse-Related Accident and Injury: Context, Loss of Focus, Cognitive Errors and Rigidity.

Simple SummaryThere is a high risk of injury for people involved with horses in their work or recreational pursuits. High risks are particularly evident for racing employees and veterinarians. Elevated risks of injury may be associated with misjudging how to handle situations, reduced attention caused by distractions, taking a general view, and failing to consider other strategies that may reduce risks. To improve safety for humans and horses, it is important to identify safety strategies that are flexible, focused and specific.While the role of the horse in riding hazards is well recognised, little attention has been paid to the role of specific theoretical psychological processes of humans in contributing to and mitigating risk. The injury, mortality or compensation claim rates for participants in the horse-racing industry, veterinary medicine and equestrian disciplines provide compelling evidence for improving risk mitigation models. There is a paucity of theoretical principles regarding the risk of injury and mortality associated with human–horse interactions. In this paper we introduce and apply the four psychological principles of context, loss of focus, global cognitive style and the application of self as the frame of reference as a potential approach for assessing and managing human–horse risks. When these principles produce errors that are combined with a rigid self-referenced point, it becomes clear how rapidly risk emerges and how other people and animals may repeatedly become at risk over time. Here, with a focus on the thoroughbred racing industry, veterinary practice and equestrian disciplines, we review the merits of contextually applied strategies, an evolving reappraisal of risk, flexibility, and focused specifics of situations that may serve to modify human behaviour and mitigate risk.

Protecting Construction Worker Health and Safety in Ontario, Canada: Identifying a Union Safety Effect.

Do Ontario unionized construction firms have lower workers' compensation claims rates compared with nonunion firms? Building trade and construction trade association lists of union contractors were linked to Workplace Safety and Insurance Board claims data for 2006 to 2012. Data were pooled for 2006 to 2012, and negative binomial regressions conducted with adjustment to estimate a union safety effect. The sample included 5797 unionized and 38,626 nonunion construction firms. Total claims rates were 13% higher (1.13, 1.09 to 1.18) in unionized firms because of higher allowed no-lost-time claim rates (1.28, 1.23 to 1.34), whereas the lost-time claims rate was 14% lower (0.86, 0.82 to 0.91). Unionized construction firms compared with nonunion firms have higher no-lost-time and lower lost-time claims rates. Unionized firms may encourage occupational injury reporting and reduce risks through training and hazard identification and control strategies.

Age-related injury and compensation claim rates in heavy industry

Although ageing workers face specific health and safety concerns, conflicting evidence exists regarding the effects of age on workplace injury rates and workers' compensation claims. To examine injury and workers' compensation claim rates by age and injury type in an aluminium smelter over a 9-year period. Routinely collected data for workplace injuries and workers' compensation claims were retrieved for the period from 1997 to 2005. The study included a total of 709 workers who experienced 2281 at-work injuries and submitted 446 claims. In 1997, 16% of employees were aged 50 or over; by 2005 that proportion had more than doubled to 35%. Injury and claim rates in all age groups did not change significantly during this period. Workers younger than 30 years of age had the highest injury rates, with differences most significant for injuries other than sprains and strains. Claim rates were not significantly different across age groups. These findings do not provide evidence to support the notion that older workers sustain more injuries and are more likely to claim compensation for their injuries. Our findings demonstrate that in this workplace, older workers were able to maintain their ability to work safely. This contrasts with the finding that younger workers had the highest injury and claim rates. While adapting to the needs of an ageing workforce, employers should not lose sight of the need to nurture a strong culture of working safely among their youngest workers.

Stakeholder perceptions of job stress in an industrialized country: Implications for policy and practice

We used a secondary, qualitative analysis of stakeholder perceptions of work stress in Australia to characterize the context for policy and practice intervention. Themes included: Individual versus contextual descriptions of stress; perceived 'gender' differences in manifesting and reporting of stress; the work/home interface; and perceived sectoral and occupational differences in compensation claim rates. We found that people often still perceive stress as an individual rather than organizational problem and view work stress as a stereotypically feminine weakness that affects only certain people. Organizations downplay and overlook risks, increasing worker reluctance to report stressors, creating barriers to job stress interventions. Our study may be relevant to other industrial countries where researchers currently study job stress interventions to improve their effectiveness. Comprehensive approaches can increase knowledge and decrease stigma about job stress and mental illness, and target both work- and non-work-related influences on mental health.

The impact of regulatory enforcement and consultation visits on workers' compensation claims incidence rates and costs, 1999–2008

Studies of regulatory effectiveness have shown mixed evidence of impact of inspections on injury rates. We examine changes in workers compensation claims rates and costs for Washington employers having either an inspection, with or without citation, or a voluntary consultation activity. We merge 10 years of enforcement and consultation activity with workers compensation records at the individual workplace level for stable firms with a single business location and at least 10 full-time employees. The change in claims incidence rates (CIRs) was estimated, controlling for workplace claims rate history, size, and industry. Separate analyses were performed for non-musculoskeletal and musculoskeletal (MSD) CIRs, claims costs and for enforcement activities with citation and without citation. Enforcement activities are associated with a significant reduction in CIRs and costs. Similar results may also be attributable to consultations. Inspections were associated with a 4% decline in time-loss claims rates relative to uninspected workplaces. The effect strengthens when MSD claims are excluded. Citations for non-compliance are associated with a 20% decline in non-MSD CIRs relative to uninspected workplaces. There is also some evidence for a reduction in MSD claims rates beginning in the second year following inspection. Enforcement and consultation activity is associated with substantial decreases in claims costs. Enforcement activities make a significant contribution to reducing CIRs and costs. Similar results following consultations may also exist. Inspections with citations are more effective than those without. Claims rates for non-MSD injuries, related to hazards covered by specific standards, are more affected in the year following the visit, while those for MSDs take longer to begin falling.