United States Workers Research Articles

Opioid use disorder, job strain, and high physical job demands in US workers

Little is known about the work environmental risk factors for opioid use disorder (OUD) in working populations. The purpose of this study is to examine whether adverse physical and psychosocial working conditions are associated with OUD in a working population of the United States (US). Among the participants of the National Survey of Midlife Development in the United States (MIDUS) II Study (2004-2006), 2134 workers (1059 men and 1075 women; mean age, 51years) were chosen for this study. OUD was measured with self-administered questions in line with the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSD-5). Physical demands (physical efforts, heavy lifting, and crouching/stooping/kneeling) and psychosocial work stressors (skill discretion, decision authority, job control, psychological job demands, supervisor and coworker support at work, job insecurity, and work hours) were measured with a standard questionnaire. The prevalence of OUD was 3.8%. In multivariate analyses, low skill discretion, high psychological job demands, job strain (a combination of low control and high demands), and high physical job demands were significantly associated with OUD. The multivariate prevalence ratios for OUD by job strain and frequent heavy lifting were 1.98 (1.27-3.10) and 2.23 (1.22-4.10), respectively. Job strain was more strongly associated with OUD in men, while high physical job demands were more strongly associated with OUD in women. This study implies that adverse physical and psychosocial working conditions may be important risk factors for OUD in US working populations. Future longitudinal and mechanistic studies are urgently warranted.

Repurposing Orthopaedic Residents Amid COVID-19: Critical Care Prone Positioning Team.

Repurposing Orthopaedic Residents Amid COVID-19: Critical Care Prone Positioning Team.

A longitudinal study of work-related injuries: comparisons of health and work-related consequences between injured and uninjured aging United States adults

BackgroundAge may affect one’s susceptibility to the myriad physical hazards that may pose risks for work-related injuries. Aging workers are not only at risk for work-related injuries but, also, at even higher risk for more severe health and work-related consequences. However, limited longitudinal research efforts have focused on such injuries among the aging workforce. This study aimed to investigate the association between physical work-related factors and injuries among United States (U.S.) workers, and then compare the injured and uninjured workers with regard to consequences including, functional limitations, and reduced working hours post injury. A cohort of 7212 U.S. workers aged 50 years and above from the U.S. Health and Retirement Study were retrospectively followed from 2004 to 2014. Data on exposures were lagged by one survey wave prior to the outcome of work-related injuries and consequences, respectively. Crude and adjusted incident rate ratios, and hazard ratios were estimated using generalized estimating equations and Cox models.ResultsRisk of experiencing a work-related injury event was over two times greater among those whose job had work requirements for physical effort, lifting heavy loads, and stooping/kneeling/crouching, compared to those who did not. Over time, injured compared to uninjured workers had higher risks of functional limitations and working reduced hours.ConclusionsThe aging workforce is at a high risk of experiencing injuries. Further, injured adults were not only more likely to incur a disability prohibiting daily life-related activities, over time, but, also, were more likely to work reduced hours. It will be important to consider accommodations to minimize functional limitations that may impair resulting productivity.

Bearing witness: United States and Canadian maternity support workers' observations of disrespectful care in childbirth.

Disrespectful care and abuse during childbirth are acknowledged global indicators of poor quality care. This study aimed to compare birth doulas' and labor and delivery nurses' reports of witnessing disrespectful care in the United States and Canada. Maternity Support Survey data (2781 respondents) were used to investigate doulas' and nurses' reports of witnessing six types of disrespectful care. Multivariate analysis was conducted to examine the effects of demographics, practice characteristics, region, and hospital policies on witnessing disrespectful care. Nearly two-thirds of respondents reported witnessing providers occasionally or often engaging in procedures without giving a woman time or option to consider them. One-fifth reported witnessing providers occasionally or often engaging in procedures explicitly against the patient's wishes, and nurses were more likely to report witnessing this than doulas. Doulas and nurses who expected to leave their job within three years were significantly more likely to report that they witness most types of disrespectful care occasionally or often (OR 1.78-2.43). Doulas and nurses frequently said that they witnessed verbal abuse in the form of threats to the baby's life unless the woman agreed to a procedure, and failure to provide informed consent. Reports of witnessing some types of disrespectful care in childbirth were relatively uncommon among respondents, but witnessing disrespectful care was associated with an increased likelihood to leave maternity support work within three years, raising implications for the sustainability of doula practice, nursing work force shortages, and quality of maternity care overall.

Progress in assessing and limiting occupational noise exposures in the United States

Occupational noise exposures in the United States (US) have resulted in a substantial occupational health burden on US workers. Despite the presence of regulations mandating exposure assessment and hearing loss prevention measures for highly-exposed workers, the prevalence of noise-induced hearing loss continues to be high. However, several recent efforts may result in progress in reducing exposures to, and health impacts from, occupational noise. First, the American Conference of Governmental Industrial Hygienists has recently proposed revisions to the organization’s Threshold Limit Value (TLV) for Audible Sound, formerly referred to as noise. The proposed revised TLV includes updated documentation as well as notes related to non-auditory health effects of noise (including cardiovascular disease and injuries), which have not previously been considered in an occupational noise exposure limit. Second, a measurement-based national Job Exposure Matrix for Occupational Noise in the US and Canada has been developed at the University of Michigan and is now publicly available (noisejem.sph.umich.edu). This resource represents a useful tool for better understanding exposures to noise by job and industry. These two efforts, along with others, represent important progress in enhancing occupational health by protecting workers from the adverse health effects of noise.

The Economic and Ethical Implications of Living Wages

Although rhetoric about wages and jobs often emphasizes the effects of globalization, questions remain as to whether United States workers are paid adequately to sustain a reasonable standard of living. One solution is to implement a living wage, which is accurate and specific to a local economy but more computationally complex than a one-size-fits-all minimum wage. When considered economically, a living wage has the potential to increase business and production costs as well as lower profits and cause job loss. From ethical viewpoints articulated in Catholic social thought, sustainable wages enhance human dignity by supporting human agency, encouraging creativity, and permitting contributions to the common good. This article explores whether the positive ethical outcomes of implementing a living wage outweigh any possibly negative, unintended economic results.

Occupational fatalities among young workers in the United States: 2001-2012.

While adolescent workers in the United States (US) are protected by child labor laws, they continue to suffer fatal occupational injuries. This study was designed to provide a comprehensive profile of occupational fatalities among this sub-population of US workers. Using Census of Fatal Occupational Injuries data between 2001 and 2012, we calculated descriptive statistics and rates to examine the magnitude and nature of fatalities among workers under age 18. During the study period, there were 406 fatalities among young workers which translated into 24,790 years of potential life lost; 12,241 of which were in agriculture alone. Rates declined since 2001 yet Hispanics, foreign-born workers, males, and those working in agriculture continued to suffer a disproportionate fatality burden. Efforts to reduce young worker fatalities should focus on male Hispanics, particularly those who are foreign-born, as well as agricultural workers as these groups have the greatest fatality risks. Am. J. Ind. Med. 59:445-452, 2016. © 2016 Wiley Periodicals, Inc.

The original intent of workers' compensation: a team approach.

A state's legislation dictates the expectations in the handling of work-related injuries. However, the reality is that positive outcomes depend more on a company's value system, such as whether an organization views its employees as assets rather than liabilities, than on legal protections. This article reviews the workers' compensation system in the United States and the false assumptions that create barriers to effective and timely resolution of claims. The United States workers' compensation system is a very reactive process. Professionals in the workers' compensation field who work with employers, medical providers, and insurance companies regularly encounter deeply ingrained assumptions that create unnecessary barriers to injured workers' opportunities to participate in transitional work and modified duty while recovering from a work-related injury. Regardless of the size or type of the employer, the jurisdiction where the injury occurred, or the type of claim management organization, these perceptions continue to permeate the industry. This article addresses these assumptions and offers suggestions for a more proactive approach to achieve quicker and more successful outcomes.

Workplace Violence in Emergency Medicine: Current Knowledge and Future Directions

BackgroundWorkplace violence (WPV) has increasingly become commonplace in the United States (US), and particularly in the health care setting. Assaults are the third leading cause of occupational injury-related deaths for all US workers. Among all health care settings, Emergency Departments (EDs) have been identified specifically as high-risk settings for WPV. ObjectiveThis article reviews recent epidemiology and research on ED WPV and prevention; discusses practical actions and resources that ED providers and management can utilize to reduce WPV in their ED; and identifies areas for future research. A list of resources for the prevention of WPV is also provided. DiscussionED staff faces substantially elevated risks of physical assaults compared to other health care settings. As with other forms of violence including elder abuse, child abuse, and domestic violence, WPV in the ED is a preventable public health problem that needs urgent and comprehensive attention. ED clinicians and ED leadership can: 1) obtain hospital commitment to reduce ED WPV; 2) obtain a work-site-specific analysis of their ED; 3) employ site-specific violence prevention interventions at the individual and institutional level; and 4) advocate for policies and programs that reduce risk for ED WPV. ConclusionViolence against ED health care workers is a real problem with significant implications to the victims, patients, and departments/institutions. ED WPV needs to be addressed urgently by stakeholders through continued research on effective interventions specific to Emergency Medicine. Coordination, cooperation, and active commitment to the development of such interventions are critical.

Trends in Adherence to Recommended Cancer Screening: The US Population and Working Cancer Survivors.

Introduction: Over the past decade the United States (US) has seen a decrease in advanced cancer diagnoses. There has also been an increase in the number of cancer survivors returning to work. Cancer screening behaviors among survivors may play an important role in their return-to-work process. Adherence to a post-treatment cancer screening protocol increases early detection of secondary tumors and reduces potentially limiting side-effects. We compared screening trends among all cancer survivors, working survivors, and the general population over the last decade. Materials and Methods: Trends in adherence to recommended screening were analyzed by site-specific cancer. We used the Healthy People goals as a measure of desired adherence. We selected participants 18+ years from 1997 to 2010 National Health Interview Survey for years where detailed cancer screening information was available. Using the recommendations of the American Cancer Society as a guide, we assessed adherence to cancer screening across the decade. There were 174,393 participants. Analyses included 7,528 working cancer survivors representing 3.8 million US workers, and 119,374 adults representing more than 100 million working Americans with no cancer history. Results: The US population met the Healthy People 2010 goal for colorectal screening, but declined in all other recommended cancer screening. Cancer survivors met and maintained the HP2010 goal for all, except cervical cancer screening. Survivors had higher screening rates than the general population. Among survivors, white-collar and service occupations had higher screening rates than blue-collar survivors. Conclusion: Cancer survivors report higher screening rates than the general population. Nevertheless, national screening rates are lower than desired, and disparities exist by cancer history and occupation. Understanding existing disparities, and the impact of cancer screening on survivors is crucial as the number of working survivors increases.

Working in retirement: a brief report.

Despite the relatively large number of working retirees, very little research has focused specifically on their job experiences. This brief report aims to address this gap in the literature by examining what facets of workplace environment affect job satisfaction and engagement for people who are working in retirement. Data from the 2008 National Study of the Changing Workforce, a sample representative of United States workers, are used to compare workers aged 50 and above who consider themselves retired (N = 203) to those in the same age group who do not consider themselves retired (N = 936). Results suggest that although the economic security offered by the job is less important to job satisfaction and engagement among those who are working in retirement than it is for other older workers, their relationship with their supervisor may be more important. Implications of these findings are considered along with potential directions for future research.

Personal Accounts: A Peer Saplings Story: Lifting the Veil on Parents With Mental Illness and Their Daughters and Sons

Personal Accounts: A Peer Saplings Story: Lifting the Veil on Parents With Mental Illness and Their Daughters and Sons

The Perplexities of Worker Rights

Rights makes economists nervous. Not all would sub scribe to Bentham's notion that this is just high-minded hot air, what he called nonsense upon stilts. Still, the influence of the utilitarian tradition and its predilection for positive rather than normative science makes most economists want to leave the room when the subject of comes up. Despite the easy acceptance of politics across the polit ical spectrum in the United States, economists' reaction is not necessarily inappropriate. In the nineteenth century the concept of human was so thoroughly criticized by conservative, liberal and socialist writers that it had little credibility in sophis ticated circles. Remarkably, since World War , talk has made a comeback in political discourse to the extent that the assertion of is now often the primary strategy taken by those who want to challenge (or defend) the political-economic status quo. And yet even some of the proponents of a based politics are now wondering what other agendas are crowded out by talk. In the United States workers and their organizations have not generally expressed their demands in terms of rights. Recently the idea that are human rights has taken hold amongst labor advocates and scholars alike. This adoption of language is certainly related to globalization, but a full discussion of its genealogy is beyond my scope here. Rather, I would like to examine some of the perplexities of human in general and some of the contradictory effects we are already aware of?or should be aware of?when the interests of workers are asserted as rights. The idea of human is perplexing. The assertion of has complex effects that are quite sensitive to the context in which they are asserted. There has been little examination of the possible negative effects on Labor's interests when those inter ests are asserted as rights. It is as if claiming that workers are human can only cause good things to happen. But this is inconsistent both with what we know about labor history as well as the history of human movements. In this paper I begin by summarizing the critique of concepts by conservative, liberal and socialist thinkers in the nineteenth century and discussing the reemergence of lan guage in the 1940s. I then summarize well known critiques of human language in contemporary politics that advocates of as human rights often fail to consider. I then present several examples of how the assertion of particular labor has undermined the interests of workers themselves. My point here is cautionary, and I do not intend to provide a general critique of the use of language in the Labor move ment. There are particular times and places when, on a purely pragmatic basis, the claim that worker are human can advance the interests of Labor. I examine some of these moments in the last section.

Our Health Care System at the Crossroads: Single Payer or Market Reform?

Our Health Care System at the Crossroads: Single Payer or Market Reform?

Outsourcing, offshoring and productivity measurement in United States manufacturing

Abstract:Productivity growth in a sector or economy is the economic basis for improvements in workers' wages. Recent growth of domestic and foreign outsourcing in developed economies greatly complicates the measurement and interpretation of this key economic indicator and may result in inflated and misleading increases in productivity statistics. In the context of United States manufacturing, this article points to several pieces of evidence that suggest these effects of outsourcing and offshoring on productivity measures are significant. These factors may help explain why wage growth for most United States workers has been relatively low in spite of high measured productivity growth.

Back Pain Exacerbations and Lost Productive Time Costs in United States Workers

Cross-sectional with follow-up case-control component. To measure the prevalence of back pain (BP) and back pain exacerbations, describe BP features and functional impairment, estimate BP-related lost productive time (LPT) and costs, and assess the relation between pain exacerbations and lost productive time. BP is associated with substantial lost work time. However, little is known about the extent to which BP with or without exacerbation explains lost work time. A national telephone survey of the U.S. workforce identified 320 workers 40 to 65 years of age with BP defined by NHANES I criteria and 91 matched non-BP controls. Participants self-reported pain characteristics, lost productive time (absenteeism and presenteeism) in the previous 2 weeks, activity limitations, and demographics. A population-weighting adjustment was applied to estimates to account for selection bias and ensure that estimates of certain sample demographic subgroups' totals conformed to the Current Population Survey. The 2-week period prevalence of BP was 15.1%; 42% of workers with BP experienced pain exacerbations. BP prevalence was associated with demographic factors, but BP exacerbations were not. BP was reported by 42.6% of all workers. Workers with exacerbations reported more days with BP than those without exacerbations. Workers with exacerbations were significantly more likely than those without such exacerbations to report activity limitation (88.4% vs. 60.7%; P < 0.0001) and BP-related LPT (22.1% vs. 13.0%; P = 0.0259). BP in workers 40 to 65 years of age costs employers an estimated $7.4 billion/year. Workers with BP exacerbations account for 71.6% of this cost. Workers with BP exacerbations account for a disproportionate share of the cost of BP-related lost productive time.

Prevalence and risk factors of work related asthma by industry among United States workers: data from the third national health and nutrition examination survey (1988–94)

Objectives: To estimate the prevalence of work related asthma and work related wheezing in United States workers. To identify high risk industries that could be targeted for future intervention. To...

Social workers' views of parents of emotionally disturbed children: Replicating a US study

This article reports the results of a survey of Australian Association of Social Workers (AASW) members in relation to their views of parents of emotionally disturbed children. The survey involved a random sample of AASW members. It replicates a US study of members of the National Association of Social Workers (NASW) conducted by Johnson, Renaud, Schmidt and Stanek (1998). The study was conducted in order to see if there was any similarity in the views of United States (US) and Australian social workers in regard to their view of these parents. The data from the Australian sample using the US Providers' Beliefs About Parents (PBAP) instrument did not support the conclusions of the study in the US. This result emphasises the importance of replication studies when transferring measurement instruments from one country to another.

Evaluation of diabetes mellitus, serum glucose, and thyroid function among United States workers exposed to 2,3,7,8-tetrachlorodibenzo-p-dioxin.

OBJECTIVE: Some studies suggest that exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin (TCDD) may affect glucose metabolism and thyroid function. To further assess the relation between exposure to TCDD and endocrine function, data from...

Hepatitis B vaccination program at a New York City hospital: Seroprevalence, seroconversion, and declination

Background: Despite implementation of hepatitis B vaccination programs, 2 problems have prevented full vaccine–induced protection of health care workers (HCWs). About 10% to 12% of vaccinated HCWs do not develop antibody, and many HCWs continue to decline vaccination. To determine the effectiveness of our hepatitis B vaccine program, we studied rates of postvaccination seroconversion and vaccine declination. Methods: Employee health service records were used to determine demographic features, hepatitis B surface antibody serostatus at baseline, serologic response to vaccine, and declination or acceptance of vaccine. Results: About 26% of HCWs were seropositive at baseline, including those vaccinated before employment. Higher seroprevalence rates were seen among those born outside the United States, nurses, and laboratory workers. Seroconversion occurred in only 79% of HCWs who completed a 3-vaccine series. Increasing age was the only significant risk for failure to convert. Declination rates overall were about 45% and were lowest in HCWs who have jobs that included potential exposure to blood. Conclusion: Hepatitis B seroprevalence among HCWs at our hospital is higher than in many other urban hospitals in the United States; our postvaccination seroconversion rate is substantially lower; and our declination rate of 45% resembles other published series. Declination of vaccine and failure to respond to vaccine continue to thwart achievement of full control of this preventable occupational infection. (AJIC Am J Infect Control 1998:26:423-7)