Nonfatal Occupational Injuries Research Articles

The relationship between the rate on unemployment and occupational injuries: A case of Russia

This study aims to reveal how growth or decline in the rate of unemployment determines occupational injuries in Russia. Based on the regional statistics from 2009 to 2021 with the help of linear panel models we estimate the relationship between the rate of unemployment and fatal or non-fatal occupational injuries rates. The results show that when the economy is decreasing employees or employers prefer to underreport workplace accidents. This effect is especially strong in conditions of rising unemployment due to the release of workers, layoffs or liquidation of enterprises. At the same time, the fluctuations of unemployment do not change the fatal accidents; that is, injuries per se do not have a cyclical behavior. Thus, though there is a decreasing trend in the rate of occupational injuries in Russia, there is a problem of underreporting of accidents as we observe in high-income economies.

Determinants of the duration of sick leave due to occupational injuries: Evidence from Spanish manufacturing

Introduction: Despite the significant economic impact of occupational injuries on companies and society, studies focused on analyzing the determinants of workdays lost due to sick leave remain scarce and incomplete. This paper contributes to this issue by (a) analyzing the drivers of sick leave duration, distinguishing factors that explain the health recovery time from those that could lead workers to a voluntary extension of the absence period, and (b) formulating and empirically testing the effect of gender, citizenship, temporary work, job tenure, amount of disability benefit, and size of the injured worker's firm on the number of days the employee is off work after the injury. Method: Hypotheses are tested on a comprehensive dataset that includes all nonfatal occupational injuries causing sick leave that occurred in the manufacturing sector in Spain during 2015–2019, with more than 400,000 injuries. We conduct ordinary least squares and count data regression models in which the number of days off work is regressed on employees and work characteristics while accounting for a set of variables to control the injury's nature and severity. Results: The results show that after considering the intrinsic characteristics of the injury and the severity of the worker's injuries, women, native workers, workers with more seniority, workers with higher salaries, and those working in larger companies have longer periods of sick leave. The results suggest that moral hazard considerations significantly impact the time to return to work after an occupational injury. Practical applications: Based on the findings, several insights for company managers and public decision-makers are discussed. Specifically, interventions aimed at improving the organization of work and the working conditions of workers in manufacturing industries are highlighted, as well as the need to improve control and supervision mechanisms during the recovery process of injured workers.

Trending Occupational Fatalities and Injuries: An Assessment of Projected Climate Change Related Impacts in the United States since 1992

Background: Some impacts of climate change that are expected to affect the American workforce are rising temperatures, greater prevalence of wildland fires, increase in Lyme disease, and exposure to insecticides. The purpose of this study was to assess how fatal and non-fatal occupational injuries due to environmental heat, forest/brush fires, Lyme disease, and exposure to insecticides have changed over time in the United States and if there were any significant relationships between national occupational injury/illness data and national temperature trends. Methods: Linear regression models assessed fatal and non-fatal injuries/illnesses since 1992 by both the frequency of incidents and the proportion of total incidents and the effects of national average temperatures. Results: There were significant increases in occupational fatalities and illnesses due to exposure to environmental heat and national average annual temperatures were predictive of heat exposure fatalities and illnesses. Conclusion: Heat exposure is an occupational hazard that must be managed carefully in the coming years. Organizations will need to take more aggressive heat exposure control measures as temperatures continue to rise and remain hotter for longer periods during the year. While not currently showing increasing trends on a national scale, the prevalence of occupational incidents due to forest/brush fires, Lyme disease, and insecticides should be monitored as the United States experiences more of the projected impacts of climate change.

Development and refinement of a corner-based injury prevention programme for Latino day labourers.

Latino day labourers (LDLs) in the USA are at increased risk for non-fatal and fatal occupational injuries, which are compounded by stressors that include wage theft, job insecurity and discrimination. This paper describes the development and refinement of Vales+Tú (You are Worthy of More), an injury prevention programme currently being evaluated as part of a cluster randomised trial in which health promotion is taken directly to the 'corners' (e.g. street corners, home improvement store parking lots, and public parks) where workers gather to seek employment. Vales+Tú comprises two corner-based intervention approaches, group problem-solving (small group discussions) and brief motivational interviewing (one-on-one dialogue), that aim to activate LDL agency to control their safety and that of their peers. Corners in Houston, Texas, where LDLs seek employment. Intervention Mapping informed the refinement of Vales+Tú for the current trial. We provide a narrative review of the development process based on needs assessment and formative development activities (surveys, focus group discussions and pilot tests). In addition to documenting the need for LDL injury prevention, with 20.2%-41.6% of Houston-based LDLs surveyed between 2013-2014 and 2019 reporting a severe work-related injury in the past year, we describe key facets of the Vales+Tú corner-based intervention approaches - including their theoretical basis and LDL-centred activities, as well as enhancements made informed by formative evaluation. The community-engaged development process of Vales+Tú resulted in two practical intervention approaches that can be adopted by worker centres and other organisations to promote LDL worker safety.

Dynamic Aggregation of Wages and Job Risk: A Case Study of Pakistan

This study examines the relationship between job risk and wages in Pakistan using data on fatal and non-fatal occupational injuries. By employing the Hedonic Wage Function (HWF), the study estimates the Value of Statistical Life (VSL) for Pakistan. Additionally, the Autoregressive Distributed Lag (ARDL) and Error Correction Model (ECM) techniques are used to analyze the wage-risk nexus dynamics and estimate the VSL from 1990 to 2019. The results reveal a positive relationship between job risk and wages, suggesting that workers in Pakistan are compensated for the risks associated with their jobs. Furthermore, the VSL estimated in this study is higher than in previous studies, indicating that workers in Pakistan value their safety more and are willing to pay more to reduce their risk of occupational injury. These findings confirm the hypothesis of Compensating Wage Differential (CWD) for Pakistan and underscore the importance of developing efficient occupational safety and health systems to protect workers and promote economic growth.

Temporal trends in occupational injuries treated in US emergency departments, 2012–2019

BackgroundEvidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019.MethodsMonthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system—occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019.ResultsOccupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (− 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (− 26.9%; 95% CI = ± 10.5%), transportation incidents (− 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (− 18.1%; 95% CI = ± 8.9%).ConclusionsThis study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.

Workers’ compensation injury claims among firefighters in Ohio, 2001–2017

Background: Firefighters are at high risk for nonfatal and fatal occupational injuries. While some past research has quantified firefighter injuries using various data sources, Ohio workers’ compensation injury claims data largely have not been used. Methods: Public and private firefighter claims, including volunteer and career firefighters, from Ohio’s workers’ compensation data for 2001–2017 were identified based on occupational classification codes and manual review of the occupation title and injury description. The task during injury (firefighting, patient care, training, other/unknown, etc.) was manually coded based on the injury description. Injury claim counts and proportions were described across claim type (medical-only or lost-time), worker demographics, task during injury, injury events, and principal diagnoses. Results: 33,069 firefighter claims were identified and included. Most claims were medical-only (66.28%, <8 days away from work) and involved males (93.81%) aged 25-54 years (86.54%). While the task during injury could not be categorized for many narratives (45.96%), the largest percentage that could be categorized occurred during firefighting (20.48%) and patient care (17.60%). The most common injury events were overexertion involving outside sources (31.33%) and struck by objects or equipment (12.68%). The most frequent principal diagnoses were back, lower extremity, and upper extremity sprains (16.02%, 14.46%, and 11.98%, respectively). Conclusions: This study provides a preliminary basis for the development of focused firefighter injury prevention programming and training. Obtaining denominator data, enabling rate calculation, would strengthen the risk characterization. Based on the current data, prevention efforts focusing on the most frequent injury events and diagnoses may be warranted.

Traumatic injuries among Alaska’s young workers: Linking cases from four data systems

BackgroundYoung workers (aged 15–24 years) experience higher rates of job-related injury compared with workers aged 25–44 years in the United States. Young workers may have limited or no prior work experience or safety training, which can contribute to their injury risk. In 2018, Alaska had the second highest work-related fatality rate and 14th highest non-fatal injury rate in the United States. This study aimed to characterize nonfatal and fatal occupational injuries among young workers in Alaska.MethodsTo describe injury patterns among Alaska young workers from 2014–2018, we used data from four datasets: Alaska Workers’ Compensation, Alaska Occupational Injury Surveillance System, Alaska Trauma Registry, and Alaska Fishermen’s Fund. The datasets were merged two at a time and filtered by the worker characteristics (e.g., age and sex) and incident characteristics (e.g., date of injury). Duplicates were then manually identified between the datasets using the variables above. The injury narrative and Occupational Injury and Illness Classification System codes were used last to verify true duplicates. Descriptive analyses were performed after the duplicates were merged.ResultsDuring the 5-year study period 2014–2018, young workers experienced 20 fatal and 12,886 nonfatal injuries. Residents of Alaska comprised 85% of nonfatal and 70% of fatal injuries. The top three major occupation groups with the highest number of injuries were production (1,391, 14%), food preparation (1,225, 12%), and transportation/material moving (1,166, 11%). The most common events leading to injuries were struck by object or equipment (2,027, 21%), overexertion involving outside sources (1,385, 14%), and struck against object or equipment (905, 9%). The most common nature of injuries were sprains/strains/tears (3,024, 29%), cuts/lacerations (1,955, 19%), and bruises/contusions (1,592, 15%).ConclusionAlthough progress has been made in reducing worker injuries, Alaskan young workers still experience injuries and fatalities frequently. Based on findings, there is a clear need for employers, researchers, public health professionals, parents, and young workers to prioritize young worker safety through an integrated approach, from education and training to adequate workplace supervision and support.

Nonfatal Occupational Injuries Among Artisanal and Small-scale Gold Mining Workers in Ethiopia

Artisanal and Small-scale Gold Mining (ASGM) is widely practiced in Ethiopia. Injuries are among the public health concerns in the mining sector. This study aimed to assess the prevalence of nonfatal occupational injuries and associated factors among workers in ASGM in Ethiopia. A cross-sectional study design was employed from April to June 2020. A total of 403 participants were selected with a simple random sampling technique. A structured questionnaire was utilized for the data collection. Descriptive statistics were used to characterize the information and binary logistic regression was applied to test the association. Predictor variables with P-value < .05 with an Odds ratio of 95% CI in multivariable analysis were considered as associated factors. A total of 403 participants were interviewed with a response rate of 95.5%. The prevalence of nonfatal occupational injury was 25.1% in the past 12 months. About one-third of the injuries, 32 (31.7%), were on the upper extremity and feet, 18 (17.8%). Symptoms of mercury toxicity (AOR: 2.39, 95% CI [1.27-4.52]), 1 to 4 years of work experience (AOR: 4.50, 95% CI [1.57-12.9]), full work shift (AOR: 6.06, 95% CI [1.97-18.7]), and job in the task of mining activities (AOR: 4.83, 95% CI [1.48-15.7]) were associated with the injury. A substantially high prevalence of injuries was observed. Work-related factors were found to be significantly associated with the occurrence of injury. The government body, mining sector, and workers are advised to apply interventions focusing on the improvement of working conditions and safety practices to minimize injury.

Missed reporting of nonfatal occupational injuries: estimation using the International Labor Organization datasets.

Most previous studies about missed reporting of nonfatal occupational injuries have four limitations: (i) mostly qualitative methods, (ii) arbitrary fraction used to estimate missed nonfatal occupational injuries based on subjective opinions, (iii) use of datasets derived from only one country, and (iv) use of a relatively simple estimation method. In contrast, (i) using quantitative approaches, this study will calculate the (ii) objective estimates on (iii) a multinational scale. (iv) A newly devised logical approach for estimation will be applied. Through this study, the fraction of missed reports of nonfatal occupational injuries will be estimated in a new way. Four International Labor Organization (ILO) datasets were analyzed in this study: (i) fatal occupational injuries per 100,000 workers by sex and migrant status, (ii) nonfatal occupational injuries per 100,000 workers by sex and migrant status, (iii) inspectors per 10,000 employed persons, and (iv) labor inspection visits per inspector. The ratification status of 27 ILO conventions, classified into 12 categories, was used for the analyses. The GDP dataset from the World Bank Open Data was also used. In addition to basic descriptive analyses, a multilevel Poisson regression method was applied. The primary outcome was the risk ratio of the above-mentioned four selected measures when an ILO convention was ratified compared to when the convention was not ratified. Finally, for the estimation of the fraction of missed reports of nonfatal occupational injuries, a newly devised estimation method was applied. This method was devised based on a unique characteristic of reporting systems for fatal occupational injuries (duplicate reporting through multiple reporting systems). The ratio of discovered nonfatal occupational injuries to total estimated nonfatal occupational injuries ranged from 0.13 (95% CI 0.13-0.14) to 0.89 (95% CI 0.84-0.95). In other words, the minimum estimate of the percentage of missed injury reports is 11% (1-0.89 = 0.11) and the maximum is 87% (1-0.13 = 0.87). The mean value of the ratios of discovered nonfatal occupational injuries to total estimated nonfatal occupational injuries was 0.52. In other words, the most likely estimate for the fraction of missed injury reports is 48% (1-0.52 = 0.48). Underreporting of nonfatal occupational injuries could hinder the efforts of governments to address and improve the occupational safety and health status of the country. Accurate assessment of the current status of nonfatal occupational injuries is important for devising effective strategies to reduce this type of injury.

Surveillance of acute nonfatal occupational inhalation injuries treated in UShospital emergency departments, 2014-2017.

Acute nonfatal occupational inhalation injuries are caused by exposures to airborne toxicants and contaminants in the workplace. A 1990s study found that USemergency department (ED)-based inhalation injury rates were higher than those seen in the United Kingdom and Canada. This study examines 4 years of hospital ED data to estimate current rates of occupational inhalation injuries. Data from the National Electronic Injury Surveillance System Occupational Supplement were used to identify nonfatal occupational inhalation injuries treated in UShospital EDs from 2014 to 2017. A workplace inhalation injury was defined as any worker treated in an ED as a result of inhaling a harmful substance at work. From 2014 to 2017, there were an estimated 2.2 occupational inhalation injuries per 10,000 full-time equivalents(FTE) (95% confidence interval [CI]: 1.6-2.8) treated in EDs, a rate nearly four times that found in Bureau of Labor Statistics data. Although men incurred 60% (95% CI: 56%-64%) of the injuries, the overall injury rates for men and women were similar at 2.3 (95% CI: 1.7-2.9) and 2.1 (95% CI: 1.4-2.7) per 10,000 FTE, respectively. By age group, workers less than 25 years of age were at greater risk of injury at 4.1 injuries per 10,000 FTE (95% CI: 2.8-5.3). These results illustrate the burden of nonfatal occupational inhalation injuries, providing an understanding of how injuries are distributed based on demographics. While inhalation injury rates have declined over the last two decades,additional research is needed to determine whether interventions have reduced risk, or if the availability of alternate sources of medical treatment is a factor.

Association Between Fatal Occupational Injuries and State Minimum-Wage Laws, 2003–2017

Low wages are associated with an increased risk of occupational injuries. Increasing the minimum wage is one way to increase workers' wages; however, a previous study found that higher state minimum wage was associated with an increase in nonfatal occupational injuries and illnesses. This study aims to examine the association between state minimum-wage laws and fatal occupational injuries. Fatal occupational injury data (2003-2017) for the 50 U.S. states were obtained from the Census of Fatal Occupational Injuries. State minimum-wage law information was obtained from Temple's LawAtlas website. Linear and Poisson regression models were used to analyze the association between state minimum-wage laws and the rates of fatal occupational injury per 100,000 workers. All data were analyzed in 2020. Having a state minimum wage higher than the federal minimum had no statistically significant association with fatal occupational injury rate, (-4.0%, 95% CI= -9.1, 1.5). State minimum wage amount was also not associated with fatal occupational injuries (-4.0%, 95% CI= -9.1, 1.5). Although previous research suggested that state minimum-wage laws were associated with increased rates of nonfatal occupational injuries, these findings indicate that these laws are not associated with an increased risk of fatal occupational injuries. Concerns that raising the minimum wage will lead to worse workplace safety may be unfounded.

Occupational posttraumatic stress disorder and workplace violence in workers' compensation claims.

Acts of violence are the fifth leading cause of nonfatal occupational injuries in the United States. Experiencing a traumatic event at work can have serious mental health consequences, including the development of posttraumatic stress disorder (PTSD). This study aimed to quantify the prevalence of PTSD caused by workplace violence (WPV) in a statewide workers' compensation system and compare the outcomes and treatment of WPV cases versus those caused by other traumatic events. Using a retrospective cohort study design, workers who reported PTSD as the primary reason for a workers' compensation claim and had no coexisting physical injuries were found in California during 2009-2018. A total of 3,772 PTSD cases were identified, 48.9% of which were attributed to WPV. Demographic risk factors associated with WPV PTSD included lower income, younger age, female gender, and employment in retail or finance, p < .001-p = .007. For individuals who returned to work, claims due to WPV resulted in longer medically approved time away from work than non-WPV causes (Mdn = 132.5 days vs. Mdn = 91 days, respectively), p < .001. Three of the top 10 most frequently prescribed medications were administered against evidence-based guidelines. This study found that many treatments prescribed to PTSD patients are based on insufficient evidence, and the provision of existing empirically supported treatments is needed, particularly in generalized populations. The findings support the need for additional recognition of the cause of workplace PTSD to facilitate appropriate referrals to WPV or PTSD specialists to support return-to-work efforts.

Non-Fatal Occupational Injury Prevalence and Associated Factors in an Integrated Large-Scale Textile Industry in Addis Ababa, Ethiopia.

Occupational injuries disproportionately impact workers of the textile industry in low-income countries. The present study investigates the prevalence of non-occupational injury and its associated factors among workers in an integrated textile industry in Addis Ababa, Ethiopia. A cross-sectional study was conducted from 17–26 May 2021. A total of 311 workers were eligible for participation. The information was collected through an interview-administered questionnaire. The findings were presented with descriptive statistics and the relationship among variables was assessed with multi-variable analyses. A total of 291 (93.6%) participants were interviewed. The prevalence of non-fatal occupational injury was 11% [95% CI: 7.7–15.5] in the past 12 months. The hands and fingers were the most affected body parts. Male gender [AOR: 3.40; 95% CI (1.13–10.5)], the age group of 18–29 years [AOR: 6.69; 95% CI (1.35–32.7)], sleeping less than seven hours in a night [AOR: 2.67; 95% CI (1.03–6.97)], machine-based jobs [AOR: 3.59; 95% CI (1.02–12.6)], the workplace housekeeping [AOR: 5.87; 95% CI (1.45–23.8)], and inadequate empowerment to prevent injury accident [AOR: 4.6; 95% CI (1.01–20.9)] were associated factors with occupational injury. The prevalence of non-fatal occupational injuries is lower than the previous studies among textile workers. As a result, improving workplace safety, changing sleeping habits, and empowering workers to participate in injury prevention should be a priority in intervention.

Pattern of traumatic occupational injuries in Saudi Arabia: A cross-sectional study.

In the Kingdom of Saudi Arabia (KSA), the labor market is thriving, employing a large workforce in occupations that carry a high risk for traumatic injuries such as construction, transportation, and manufacturing. These jobs usually involve physical exertion, power tools, high-voltage electricity, working at heights, and exposure to bad weather conditions that could potentially lead to injury. This study aimed to determine patterns of traumatic occupational injuries in Riyadh, KSA. A cross-sectional study was conducted at King Khalid Hospital and Prince Sultan Centre for Healthcare, Prince Sattam bin Abdulaziz University Hospital, and the Al-Kharj Military Industries Corporation Hospital in Al-Kharj City in the KSA between July 2021 and 2022. Descriptive analysis elucidated the type, severity, and patterns of management of non-fatal traumatic occupational injuries. A Kaplan-Meier survival curve and Weibull model for length of hospital stay adjusted for age, gender, nationality, cause for injury, and injury severity scale (ISS) scores were constructed. A total of 73 patients with a mean age of 33.8 ± 14.1 years were included in the study. The most common cause of occupational injury was falling from height (87.7%). The median length of hospital stay was 6 days (IQR: 4 - 7), with no mortalities. In the adjusted survival model, compared to migrants, Saudi nationals had a 45% lower median hospital stay (-62 to - 21), P < 0.01, and every 1-point increase in ISS was associated with a 5% increase in median length of hospital stay (CI: 3 - 7, P < 0.01). Being a Saudi national and having lower ISS scores were associated with shorter durations of hospital stay. Our findings indicate the need for improved occupational safety measures, especially among migrant, foreign-born, and ethnic minority workers.

Risk factors for musculoskeletal problems in paddy field workers in northern iran: A community-based study.

Paddy cultivation of rice requires substantial physical strength, perseverance and manual labor. During the manual harvesting of paddy rice in Iran, laborers are exposed to several work-related physical risks. Paddy cultivation has been reported as one of the most important causes of nonfatal occupational injuries and accidents among farmers. With the aim of identifying which parts of the musculoskeletal structure are mostly affected as a result of working on paddy rice fields, the present study aimed to investigate the potential risk factors for musculoskeletal problems in paddy field workers in Mazandaran Province, Iran. A cross-sectional, analytical study was conducted among paddy field workers via multistage sampling in 2019. Prior to the interviews based on the Nordic Musculoskeletal Questionnaire, the participants were briefed about the objectives of the research and their consent was obtained for voluntary participation. Through interviews, data were collected on demographics, agricultural utilization systems, use of paddy tractors, frequency of tiller and tractor use, injuries sustained during the daytime, and outcomes of injuries by paddy field working. Responses were obtained from 384 workers using structured interviews. The respondents were asked to describe problems and pain in their neck, shoulders, elbows, wrists and hands, upper back, hip and lower back. Logistic regression models were used to identify potential risk factors for musculoskeletal problems in specific body regions. The most commonly reported ailments were back pain (n = 29; 7.6%), cardiovascular disease (n = 25, 6.5%) and hypertension (n = 22, 5.7%). The results of logistic regression analysis indicated that the odds of back and shoulder injuries was higher among workers who used tillers and combine harvesters (2.85 and 1.66), transplanting machine (3.68), and those who did not use safe footwear (7). Knee injury risk was higher among those who cultivated rice manually (odds ratio [OR] = 1.35) and who used safety footwear (OR = 1.93), but was lower among those who used tractors (OR = 0.53). There was a small increase in the risk of knee injury with age (OR = 1.03). Confirming earlier works, musculoskeletal problems were found to be highly prevalent among rice workers. Disorders in certain body regions could be explained by specific individual and work-related factors. While the prevalence of work-related injury was high, mostly due to ignorance and disregard for personal convenience of the workers, the findings call for improvements in mechanization and division of labor time and force. Another highlight is that social worth is not given sufficiently to the health of paddy field workers. These should be worked on in future research to find ways of allocating machinery and worth to the workers.

Estimating the Nonfatal Injury Undercount in Agriculture from 2004 to 2019

HighlightsGovernment estimates of nonfatal occupational injuries and illnesses understate the hazards in U.S. agriculture.From 2004 to 2019, government estimates only captured 13% to 26% of the true number of nonfatal injuries.Estimates of nonfatal injuries are more accurate for crop production than for animal production.Estimates are more accurate over time, with a decline in self-employed and unpaid family labor in agriculture.Abstract. The U.S. Bureau of Labor Statistics provides annual estimates of nonfatal occupational injuries and illnesses by U.S. industry sector. We performed a series of corrections to these estimates for each year from 2004 through 2019 to account for institutional and behavioral drivers of the undercount in the sample used to construct these estimates for the U.S. agricultural industry. Institutional factors consisted of the exclusion of small farms and self-employed and family workers, as well as the employment undercount due to the highly seasonal nature of agricultural work. Behavioral factors consisted of willful and negligent underreporting by employers. We updated the estimates using information on the number of people employed in the excluded portions of the agricultural industry and estimates of the underreporting rate from prior work. Over this period, we show that the government estimates only captured 13% to 26% of the true number of nonfatal injuries and illnesses, missing 74% to 87% of the true case counts each year. The government estimates were more accurate for crop production, missing an average of 77% of cases, than for animal production, missing an average of 83% of cases. Willful and negligent underreporting was the largest contributor to the undercount, followed by the exclusion of self-employed and unpaid family workers. Keywords: Agriculture, Nonfatal injuries and illnesses, Occupational injuries, Survey of Occupational Injuries and Illnesses, Undercount.

Under-reporting of non-fatal occupational injuries among precarious and non-precarious workers in Sweden

BackgroundUnder-reporting of occupational injuries (OIs) among precariously employed workers in Sweden challenges effective surveillance of OIs and targeted preventive measures.ObjectiveTo estimate the magnitude of under-reporting of OIs among precarious and...

Health Services Use and Health Outcomes among Informal Economy Workers Compared with Formal Economy Workers: A Systematic Review and Meta-Analysis

BACKGROUND AND AIM: There are approximately two billion informal workers globally. Compared to the formal economy, workers in the informal economy are often marginalised with minimal benefits from occupational health and safety regulations and labour laws as well as decreased access to social protection and health care. Thus these informal economy workers may have higher occupational health risks compared to their formal counterparts. The aim was to systematically review and meta-analyse evidence on health services use and health outcomes among informal economy workers, compared with formal economy workers. METHODS: We searched for studies between 1999–2020 in March 2020. The eligible population was informal economy workers. The comparator was formal economy workers. The outcomes were: use of general and occupational health services, fatal and non-fatal occupational injuries, HIV, tuberculosis, musculoskeletal disorders, noise induced hearing loss, respiratory infections and depression. Two authors independently screened records, extracted data, and assessed risk of bias and quality of evidence. Inverse variance meta-analyses were conducted with random-effects. RESULTS:Twelve studies with 1 637 297 participants from seven countries in four WHO regions (Africa, Americas, Eastern Mediterranean and Western Pacific) were included. Compared with formal economy workers, informal economy workers were found to be less likely to use any health services (odds ratio 0.89, 95% confidence interval 0.85–0.94, four studies, 195 667 participants, I2 =89%, low quality of evidence) and more likely to have any common mental disorder (odds ratio 5.02, 95% confidence interval 2.72–9.27, three studies, 26 260 participants, I2 = 87%, low quality of evidence). We are uncertain about the other outcomes due to the very low quality of evidence. CONCLUSIONS:Informal economy workers are less likely than formal economy workers to use any health services and more likely to have depression. The evidence is uncertain for the other eligible outcomes and warrants further research to strengthen the body of evidence. KEYWORDS: Occupational exposures, Occupational epidemiology, Outcomes

Occupational injuries in California's health care and social assistance industry, 2009 to 2018.

Background and AimThe health care and social assistance industry has one of the highest rates of non‐fatal occupational injuries and illnesses, both in California and nationally. In the coming years, the health care industry will face added pressure as both the population and workforce age. The aim of this study is to identify targeted populations that may benefit from interventions to prevent future injuries, keep the workforce healthy, and decrease injury‐related costs.MethodsThis retrospective study analyzed California workers' compensation claims from 2009 to 2018 in the health care and social assistance industry.ResultsAcross the four industry sub‐groups, the highest number of claims came from hospitals (n = 243 605; 38.9%), followed by ambulatory care (n = 187 010; 29.9%), nursing/residential care (n = 133 206; 21.3%), and social assistance (n = 62 211; 9.9%). Nursing/residential care settings reported the highest proportion of both lifting injuries (15.8%) and low back injuries (16.9%) as compared to the other settings. Across all settings within California, nurses had the highest proportion of injuries (22.1%), followed by aides/assistants (20.4%), services staff (13.2%), administrative staff (11.0%), and technicians (10.3%). Thirty‐five of California's counties had an increasing rate of population‐adjusted claims during the study period.ConclusionThis study found that while hospitals have the highest number of injuries, ambulatory care employee injuries are increasing. Employees involved in non‐patient care tasks, such as those working in facility service roles, would likely benefit from additional injury prevention interventions.