Work Injuries Research Articles

Disability of enterprise employees in Chelyabinsk region of Russia due to poor environmental conditions

The research is based on analysis of the survey for identification of reasons for injuries and following disability of staff which was organized in November and December 2020. Experts-respondents were 415 employees of 258 enterprises and organization in Chelyabinsk region. As the main reason for disability was named mental outside of work injuries. The second reason is physical outside of work injuries. The 3rd place in the list is physical injuries at work. The fourth reason is mental injuries at work. Thus, the working activity of respondents is 2.4 times less traumatic than outside of work activity. Experts named the reduction of attentiveness as the most valuable reason of injuries and following disability (24.3%). Then follow the omission of technical control over the content of materials, equipment performance and tool quality (19.2%), the omission of control over employees’ behavior (19.1%), risky behavior of employees at work (18.6%), problems of the legislative framework for safety and health (8.7%), no-fault incidents (5.8%).

The recent development of 3D printing in developing lower-leg exoskeleton: A review

The research in wearable lower limb exoskeletons is showing an increasing interest in the last few years. An exoskeleton is a structure that helps paralyzed patients stand and walk. Nowadays, wearable exoskeletons have a growing interest in healthcare, as they help make patient's rehabilitation process more comfortable and more natural. External exoskeletons help people recover after accidents; they may help older people keep their habitual lives. Besides, they can be used for constructors, army soldiers, and workers to reduce the possibility of a work injury, making the work process less painful and tiring as they help distribute the load evenly. This review paper presents current techniques and methods implemented in medical rehabilitation. The work briefly describes the main types of medical exoskeletons, their technical characteristics, main features, and the detailed connection to the area's existing trends. The study also focused on the development of 3D printed leg exoskeletons, their drawbacks, fabricating challenges, and prospects. Various methods that are being developed may influence and increase the potential of 3D printed leg exoskeletons for biomedical applications. The application of 3D printing in rehabilitation opens the opportunity to decrease the weight and the development cost of the exoskeletons, as well as make human rehabilitation more affordable.

Occupational Safety and Health (OSH) Practices and Its Influenced Factor - Review OSH in Malaysia

High occupational accident in Malaysia as reported by Department of Occupational Safety and Health (DOSH) Malaysia shows the urgently applied a occupational safety and health (OSH) practices in workplaces. This study purposed to review the OSH practices in Malaysia and its influence factor. The factor of that influence to accident cases, good OSH practice and OSH system and framework as well as agencies that has authority with OSH was briefly explained. Factor that influence the accident was consists of stress and fatigue, unsafe act, machinery/tools, design of workplace and training procedure, factor that influenced to achieve good OSH practices was consists of training, safe work procedure, consultation, reporting safety, management commitment and injury management, several OSH agencies that has been developed in Malaysia such as NIOS, NCOSH, DOSH and SOCSO as program in the institution. Institution contribute an important factor due to in institution teach a fundamental of OSH that may applied in the workplaces.

Sleeping Well: The Gateway to Employee Wellness

Our study of 419 white-collar professionals and 275 rotating shift workers indicates that 79.2 per cent of the white-collar participants and 11 per cent of the rotating shift workers endured poor sleep quality. Forty-eight per cent of white-collar participants and 18 per cent of the shift workers reported suffering from excessive daytime sleepiness. Poor sleep quality has been associated with obesity, hypertension, diabetes and a host of other adverse health outcomes including poor mental health. Studies show that among organisations offering lifestyle management programme as part of their employee wellness programmes, the most targeted behaviours encompass nutrition/weight control activities (79%), smoking (77%) and fitness (72%). However, there is hardly any organisation that offers a well-planned intervention to promote healthy sleep behaviour. Sleep appears to represent a neglected dominion of health behaviour in terms of employee wellness. If sleep health and wellness programmes are endorsed in the workplace, there are several positive outcomes such as productivity enhancement, less work injury, increasing employee satisfaction, good physical and mental health that are likely to supervene, all of which generate a better working environment.

Development and Initial Validation of a Harmonised Multi-Jurisdiction Work Injury Compensation Database

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector.
 Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with >60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement.
 ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed.
 Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.

Challenges in Data Linkage – Experiences from An Upper Gastrointestinal Cancer Data Linkage Study

IntroductionNearly one quarter of a million Australian workers experience a work injury annually and make a benefit claim through one of the nation’s eleven workers’ compensation (WC) systems. The total cost to Australian society has most recently been estimated at $61.8 billion or 4.1% of GDP. The disaggregation of legislative responsibility between jurisdictions has contributed to a lack of common data standards, and thus minimal understanding of the efficiency or effectiveness of service provision in the Australian WC sector.
 Objectives and ApproachThis project developed a new multi-jurisdictional work disability database including detailed information on work disability duration, health and social care service provision. Service level payment data contained in structured WC insurance claims datasets held by five large WC jurisdictions with >60% coverage of the Australian labour force was collected for all cases of work-related low back pain, fractures and limb soft tissue disease over between 2010 and 2015. Database development involved creation and coding of harmonised service-level indicators for individual episodes of healthcare provision and weekly periods of wage replacement.
 ResultsA total of 253,000 cases and 10.7 million service episodes are included in the database. Initial exploratory analyses focused on the frequency, prevalence, timing, intensity and continuity of General Practitioner (GP) services to each of the injury groups. Regression modelling examined occupational, injury, demographic and jurisdictional factors affecting GP service use outcomes. As anticipated, service patterns varied by injury type, age, gender and occupational group. Significant differences in service use between WC jurisdictions were observed.
 Conclusion / ImplicationsThis exploratory study demonstrates the feasibility of developing a population-based service level database for monitoring health service delivery to injured Australian workers. Future studies will examine the impact of jurisdictional policy differences on service delivery, and the relationship between service delivery and outcomes such as disability duration.

Radical Histories versus Liberal Histories in Work Injury Law: Nate Holdren, Injury Impoverished: Workplace Accidents, Capitalism, and the Law in the Progressive Era

Radical Histories versus Liberal Histories in Work Injury Law: Nate Holdren, <i>Injury Impoverished: Workplace Accidents, Capitalism, and the Law in the Progressive Era</i>

Analysis of Human Error Risk with Human Reliability Methods in Construction Projects

Work injury rates in Indonesia are relatively high, resulting in an urgency to maintain the safety of workers whose numbers are increasing. The biggest sector contributing to work accidents in Indonesia is the construction area, including building construction and causing large physical and financial losses. Workplace accidents are usually caused by human error and are strongly related to human reliability. The use of Fuzzy Cognitive Reliability and Error Analysis Method (Fuzzy CREAM) method is aimed at research to analyze patterns of worker behavior that affect the risk of workplace accidents combined with Bayesian Network simulation. 176 construction workers in the Jakarta and surrounding areas became the object of research. The value of Human Error Probability (HEP) was successfully obtained and the solution was given based on the characteristics of workers in the Control Mode category.

Predictors of long-term opioid use and opioid use disorder among construction workers: Analysis of claims data.

Construction workers have high rates of work-related musculoskeletal disorders, which lead to frequent opioid use and opioid use disorder (OUD). This paper quantified the incidence of opioid use and OUD among construction workers with and without musculoskeletal disorders. We conducted a retrospective study using union health claims from January 2015 to June 2018 from 19,909 construction workers. Claims for diagnoses of chronic musculoskeletal disorders, acute musculoskeletal injuries, musculoskeletal surgery, and other conditions were linked to new opioid prescriptions. We examined the effects of high doses (≥50 morphine mg equivalents per day), large supply (more than 7 days per fill), long-term opioid use (60 or more days supplied within a calendar quarter), and musculoskeletal disorders, on the odds of a future OUD. There were high rates (42.8% per year) of chronic musculoskeletal disorders among workers, of whom 24.1% received new opioid prescriptions and 6.3% received long-term opioid prescriptions per year. Workers receiving opioids for chronic musculoskeletal disorders had the highest odds of future OUD: 4.71 (95% confidence interval 3.09-7.37); workers prescribed long-term opioids in any calendar quarter had a nearly 10-fold odds of developing an OUD. Among construction workers, opioids initiated for musculoskeletal pain were strongly associated with incident long-term opioid use and OUD. Musculoskeletal pain from physically demanding work is likely one driver of the opioid epidemic in occupations like construction. Prevention of work injuries and alternative pain management are needed for workers at risk for musculoskeletal injuries.

Radical Histories / Liberal Histories in Work Injury Law

Nate Holdren has written a brilliant, impassioned, and intellectually stimulating book on the legal history of industrial accidents. According to Holdren, work injuries were at their core a form of labor exploitation. He describes the law of work accidents as a machinery of injustice that bolstered the legitimacy of a violent and inhuman capitalist system. He fiercely critiques the workers’ compensation reforms enacted by progressive reformers a century ago as legitimating a form of systematic labor violence. He insists on recognizing and attending to the dignity of each accident victim, both in the content of his argument and as a matter of literary form. Injury Impoverished is a welcome if unsettling rebuke to complacent accounts of the field, perhaps my own among them. But Holdren’s analysis also raises many questions. Holdren attributes little value to the dramatically safer workplaces of the middle of the twentieth century. His cautious admiration for the litigation system of the years before workers’ compensation rests on a fantastical conception of the way 19th-century tort law actually worked. He calls for an impossibly demanding form of justice as recognition from the law. He misses the ways in which workers co-opted new forms of accident law and turned them to their own interests. And his single-minded focus on commodification and the point of production leads him to discount the surrounding political and legal institutions that shaped the social meaning of work injuries.

Shorter work boot shaft height improves ankle range of motion and decreases the oxygen cost of work

Work boots featuring design elements implemented to protect the foot and lower limb are common in many industries. However, boot design can have negative unintended consequences such as increases in work related fatigue and injury risk. This study compared joint kinematics and the physiological cost of two commercially available steel-toed work boots with different shaft designs worn throughout a simulated work task. A boot with a lower-cut and scalloped shaft allowed greater sagittal plane range of motion at the ankle joint compared to a boot with a higher-cut straight shaft, particularly in the late stance phase of the gait cycle. This was coupled with a decreased physiological cost of treadmill walking (2.6 and 3.1% improvement in oxygen consumption and walking economy, respectively), likely caused by a more efficient gait pattern. A lower-cut and scalloped shaft could lead to decreases in work-related fatigue and the subsequent risk of injuries in workers. Practitioner summary: Gait kinematics and the physiological cost of work boots with different shaft heights has not previously been investigated. A randomised cross-over study design found that a boot with a lower shaft height and scalloped collar improved ankle range of motion and reduced the physiological cost experienced by the wearers. Abbreviations: ROM: range of motion; FS: full shaft; SS: scalloped shaft; COM: centre of mass; HR: heart rate; RPE: rating of perceived exertion; ES: effect size.

Content validation of the Kamath and Stothard questionnaire for carpal tunnel syndrome diagnosis: a cognitive interviewing study

BackgroundAccurate diagnosis of carpal tunnel syndrome (CTS) is essential for directing appropriate treatment; and for making decisions about work injury claims. The Kamath and Stothard Questionnaire (KSQ) is a self-reported tool used for the diagnosis of CTS. Comprehensibility and comprehensiveness of this questionnaire are critical to diagnostic performance and need to be established. The purpose of the study was to describe how potential respondents, clinicians, and measurement researchers interpret KSQ questions in order to identify and resolve potential sources of misclassification.MethodsHand therapists, measurement researchers, participants with CTS, and a control group were interviewed using cognitive interviewing techniques (talk aloud, semi-structured interview probes) in Hamilton, Canada. All interviews were recorded and transcribed verbatim. A directed content analysis was done to analyze the interviews using a previously established framework.FindingsEighteen participants were interviewed. Areas, where questions were unclear to some participants, were recorded and categorized into five themes: Clarity and Comprehension (52%), Relativeness (38%), Inadequate Response Definition (4%), Perspective Modifiers (4%), and Reference Point (2%). Respondents also identified several symptoms of CTS that are not covered by the KSQ that might be of diagnostic value, e.g., weakness and dropping items.ConclusionThe content validity of the current iteration of the KSQ was not established. The problematic questions identified in the study have been reported to have low specificity and negative predictive values in a previous quantitative study. The content validity issues identified may explain the poor performance. Recommendations were made to modify the wording of the KSQ and the potential addition of three new questions. Future studies should determine whether the modified questionnaire can provide better diagnostic accuracy and psychometric properties. The results of this study may assist in ruling in or out CTS diagnosis to a wide variety of target audience, such as hand specialists, physical and occupational therapists, as well as family doctors.

Факторы оценки степени вины пострадавшего при несчастном случае на производстве

The aim of this work is to improve the procedure for investigating industrial incidents. The article offers the methodology for assessing the degree of fault of the incident participants, including work injuries, based on a factor analysis of the event causes. Causal factors are divided into 20 groups, allowing to cover the entire spectrum of possible causes of any event. Br ief description is given concerning the most often used methodology of incident analysis in the companies of fuel and energy complex. Based on the methods — Scale of events, Fault tree, and Five why — one of the most common incidents were analyzed, namely, falling on a flight of stairs of the office building during employee descending stairs. This incident belongs to the conditional group of End-to-end risks, that is risks inherent in all the workplaces at any enterprise. The causal factors and the exposure level on the participants of this event were determined, and the percentage of the victim’s fault was calculated. The proposed methodology is based on the practice of internal investigation of incidents of the leading companies of fuel and energy complex. This methodology will help to eliminate gaps in the legislation, bring clarity and transparency to the procedure for investigating an industrial incident in terms of determining the degree of fault of the insured (victim) in case of gross negligence. The proposed methodology will be useful for specialists in the field of occupational and industrial safety, state labor inspectors and representatives of the trade unions. It can be assumed that this methodology will motivate the employees of fuel and energy complex to work safely and increase the level of safety culture.

Cannabis use and work-related injuries: a cross-sectional analysis.

Although the association of cannabis use with automobile accidents has been well-studied, the impact of cannabis on workplace safety and injuries is less clear. The purpose of this study was to examine the relationship between work-related injury and cannabis use in the past year. We performed a cross-sectional analysis of the Canadian Community Health Survey (2013-16) of working individuals. We used multiple logistic regression modelling to calculate the odds of experiencing a work-related injury (defined as non-repetitive strain injury) among workers who reported using cannabis more than once during the prior 12 months as compared to non-users. We repeated the analysis among participants working in high injury risk occupational groups only. Among the 136 536 working participants, 2577 (2%) had a work-related injury in the last 12 months. Of these 2577 who had a work-related injury, 4% also reported being a cannabis user in the same period. We found no association between past-year cannabis use and work-related injury (odds ratio for work injury among users 0.81, 95% confidence interval 0.66-0.99). The association was unchanged in the subgroup analysis limited to high injury risk occupational groups. We found no evidence that cannabis users experienced higher rates of work-related injuries. While awaiting prospective studies, occupational medicine practitioners should take a risk-based approach to drafting workplace cannabis policies.

Characteristics of eye injuries in urgently hospitalized adults in the Perm region

A retrospective analysis of 136 medical histories of patients with eye injuries who applied to the city and regional centers of emergency ophthalmological care and were hospitalized in two specialized ophthalmological departments during one calendar year was carried out. 89% of patients were men, 11% were women; 20% contacted hospitals in winter, 21% – in spring, 30% – in summer and 29% – in autumn. Out of 139 injured eyes, 50% were wounded, 40% were contused, 10% had burns. In cases of eye injuries, 7 (10%) were injuries of the appendages of the eye, 57 (81%) were penetrating injuries, 66% were corneal injuries, 25% – scleral injuries, 9% – corneal-scleral injuries, all of which were severe; 3% – non-penetrating injuries of the cornea, 6% – penetrating injuries of the orbit. Among 56 contused eyes, appendages of the eye were damaged in 4 (7%) eyes, all of them were of 2nd degree of severity. Eyeball damage was diagnosed in 35 (63%) eyes: 17 were of 2nd degree of severity, 15 – of 3rd degree of severity, 3 – of 4th degree of severity. Multisystem injuries of the eyeball and appendages of the eye were diagnosed in 17 (30%) eyes. Corneal, conjunctival and eyelid burns of the 2nd degree were diagnosed in 9 eyes, while burns of the 3rd degree were diagnosed in 4 eyes. All cases were chemical burns. 87% cases were civilian injuries, 11.5% were work injuries, while 1.5% were caused by criminal actions. In 2 eyes with non-penetrating corneal injuries, the visual acuity increased after discharge from hospital. Out of 57 eyes with penetrating injuries, the visual acuity increased in 34 eyes and decreased in 8 eyes; in 3 cases of visual acuity decrease, an ophthalmectomy was performed; in 15 eyes the visual acuity remained unchanged. In cases of contusion of the eyeball, out of 52 eyes the visual acuity increased in 39, decreased in 1 eye and remained unchanged in 12 eyes. In cases of burns, out of 13 eyes the visual acuity increased in 10 eyes and remained unchanged in 2 eyes. One patient underwent a blepharorrhaphy.Conflict of interest: Gavrilova T.V. is the member of the editorial board of the journal and has been recused from review process and from making decision regarding acceptance of this article.

Work Schedule Irregularity and the Risk of Work-Related Injury among Korean Manual Workers.

Work schedules comprise various variables and generate health and safety outcomes, including work-related injury, which causes socioeconomic problems, such as productivity loss and damage to worker health. We investigated the association between work schedule irregularity and the incidence of work-related injury among South Korean manual workers using data from the 5th Korean Working Conditions Survey. In total, 18,330 manual workers were included. A multivariate logistic regression analysis was performed to understand the association between work schedule and work-related injury and the influence of sufficient safety information and work schedule on work-related injury. We calculated the influence of an irregular work schedule on occupational injury after controlling for personal and work environment-related factors. The adjusted odds ratio (OR) for work-related injury was 1.66 (95% confidence interval (CI) 1.32–2.09) for an irregular work schedule. The interaction had an additive effect when the work schedule was irregular, even when sufficient safety information was provided. Manual workers had a higher incidence of injury (2.1%). Even in adjusted analyses, work schedule irregularity conferred greater risks of work injury, particularly when not working the same number of days weekly (OR 1.52, 95% CI 1.21–1.90). Policymakers and health professionals need to consider the impact of work schedule irregularity on worker safety and health.

Nosocomial Rabies Encephalitis: Lessons Learned From Exposures in a Large Healthcare System

Background: In October 2018 a patient presented to hospital A’s emergency department (ED) for a work injury, arm spasms, and inability to drink liquids. He developed rapid neurologic decline and was transferred to hospital B for neurocritical care. He developed a fever, was intubated, and had an unrevealing infectious diseases (ID) consultation. He became comatose, had refractory seizures, and was transferred to hospital C. A second ID consultation revealed that he had many bats in his home, and his symptoms were consistent with rabies encephalitis. Antemortem specimens of serum, CSF, skin biopsy, and saliva were all positive for rabies virus PCR, and/or rabies serologies. Objective: We describe the response of a multihospital system to the exposure of employees across 3 facilities to rabies-infected body fluids. Methods: Three hospitals in 1 system (222 caregivers) cared for the index patient (hospital A, n = 8; hospital B, n = 107; hospital C, n = 107; 19 students and residents), as did 2 additional facilities outside the system. These included physicians (n = 21), registered nurses (n = 57), respiratory therapists (n = 29), imaging technicians (n = 24), phlebotomists (n = 12), laboratorians (n = 8) and others (n = 71). Infection prevention, employee health, and pharmacy leadership created a centralized team to ensure that all exposed caregivers were screened, and if exposed, were vaccinated. An electronic screening tool developed and administered by the Utah Department of Health via Research Electronic Data Capture (Redcap), rapidly assessed caregiver body fluid exposure risks (saliva, tears, neurologic tissue), and use of personal protective equipment in patient care. After completion, caregivers received notification that he or she (1) had no exposure (no further action), (2) had exposure and should report to employee health for vaccination, or (3) had unclear exposure and should contact the employee health department. Results: Caregivers feared that the tool underestimated exposure risk. Many caregivers (n = 48), repeated the assessment more than once, changing answers. The most common reasons cited were incomplete forms (n = 21), caregiver did not recall using personal protective equipment with contact with saliva (n = 8) or did not understand rabies transmission (n = 3). All vaccinations were initiated by 11 of 26 care givers, 18 days after initial deployment of the tool. All exposed caregivers completed the course. No caregivers developed symptoms of rabies encephalitis. Conclusions: An online tool can safely assess large healthcare exposure such as rabies. A team comprising infection preventionists, employee health representatives, pharmacists, and public health department representatives made the assessment of many geographically dispersed caregivers rapid and effective. Caregivers should employ the basic tenets of standard precautions in the daily care of patients to avoid unknown exposures to common bodily fluids.Funding: NoneDisclosures: None

A RARE TWIST: LYMPHANGIOLEIOMYOMATOSIS PLUS DIFFUSE LARGE B-CELL LYMPHOMA

SESSION TITLE: Medical Student/Resident Diffuse Lung Disease SESSION TYPE: Med Student/Res Case Rep Postr PRESENTED ON: October 18-21, 2020 INTRODUCTION: Lymphangioleiomyomatosis (LAM) is a rare systemic disease resulting in cystic lung destruction, recurrent pneumothoraces, chylous pleural effusions, and abdominal tumors. This multisystem disease most commonly affects women of childbearing age, resulting in stepwise decline in pulmonary function, with clinically apparent hypoxemia developing in most patients within a decade after onset of symptoms. Here we present a rare case of late-onset LAM with concurrent high grade B-cell lymphoma. CASE PRESENTATION: The patient is a 62-year-old female nonsmoker with a remote history of spontaneous pneumothorax who presented due to pleuritic chest pain at rest. Chest CT revealed innumerable pulmonary cysts up to 15 mm, few solid noncalcified pulmonary nodules, multiple complex mediastinal lesions, and a 30% left anterior pneumothorax. Chest tube was placed; the patient was admitted. A nontender swelling was noted on the skull which the patient attributed to a work injury several months prior. MRI showed a 5 cm lytic lesion involving the left frontal bone and subgaleal space with hypercellular diffusion pattern. Craniectomy with resection was performed; pathology revealed high-grade B cell lymphoma. CT abdomen revealed a 4x4 cm right-sided irregular exophytic renal mass. The patient had VEGF-D level of 1382 pg/mL, which, combined with diffuse cystic lung disease, was consistent with a diagnosis of LAM. The patient was discharged and underwent chemotherapy and radiation in the outpatient setting. Two months later, she was readmitted with recurrent left pneumothorax. She failed doxycycline chemical pleurodesis (as there was a nation-wide talc shortage) and went for VATS decortication, pleurectomy, LLL wedge resection, and mechanical pleurodesis. Immunohistochemistry studies on lung pathology confirmed LAM (Table 1). DISCUSSION: LAM may develop sporadically, or may arise in a patient with preexisting tuberous sclerosis complex. The clinical presentation varies and may include cough, dyspnea, recurrent pneumothorax, pleural effusion, or respiratory failure. Overall, the patient’s family history and clinical presentation was not consistent with tuberous sclerosis complex. This is a case of likely sporadic LAM in a patient with recurrent pneumothorax, the first being 5 years prior to this presentation. The concurrent diffuse large B cell lymphoma of the skull adds an interesting twist, as there have only been case reports of LAM occurring with malignant lymphoma. CONCLUSIONS: Although LAM is diagnosed at a median age of 35, more women are being diagnosed at an older age. Pleurodesis after the first occurrence of pneumothorax should be considered due to the high rate of recurrence, as seen in this patient who had multiple pneumothoraces and failed chemical pleurodesis. Sirolimus is also recommended for LAM but this patient’s concurrent treatment for lymphoma complicates her treatment options. Reference #1: McCormack FX, Gupta N, Finlay GR, et al. Official American Thoracic Society/Japanese Respiratory Society Clinical Practice Guidelines: Lymphangioleiomyomatosis Diagnosis and Management. Am J Respir Crit Care Med. 2016;194(6):748-761. doi:10.1164/rccm.201607-1384ST Reference #2: Park S, Lee EJ. Diagnosis and treatment of cystic lung disease. Korean J Intern Med. 2017 Mar;32(2):229-238. doi: 10.3904/kjim.2016.242. Epub 2017 Feb 28. Reference #3: Jawad H, Walker CM, Wu CC, Chung JH. Cystic interstitial lung diseases: recognizing the common and uncommon entities. Curr Probl Diagn Radiol. 2014 May-Jun;43(3):115-27. doi: 10.1067/j.cpradiol.2014.01.001. DISCLOSURES: No relevant relationships by Helen Li Mitchell, source=Web Response No relevant relationships by Sushant Soni, source=Web Response No relevant relationships by Justin Thomas, source=Web Response No relevant relationships by Shawnt Tosonian, source=Web Response

12-Year longitudinal study linking within-person changes in work and family transitions and workplace injury risk

Introduction: Despite the rich tradition of research on predictors of workplace injury, most studies rely on cross-sectional, between-person designs. Furthermore, prior research has often overlooked the possibility that factors outside the work domain can influence the occurrence of actual injuries at work. To address these limitations, the current study examined the effects of work and family demands on the occurrence of workplace injury. Drawing on the intuition of the work-home resources model (W-HR), we investigated how within-person level changes in demands and resources from both domains influence work injuries over a 12-year period. Method: We used 12 years of longitudinal data (N = 7,820) to study the long-term within-person changes in work and family domains and to capture the event of low frequency incidence such as workplace injury. Specifically, we conducted multilevel analyses to study the links between within-person change in time and energy resources both in work and family domains and within-person change in the likelihood of experiencing a workplace injury. Results and conclusion: The findings showed that within-person changes in work hours, spousal work hours, income and number of children, were significantly associated with changes in the likelihood of experiencing a workplace injury. We conclude with a discussion of implications for theory and future research of workplace injuries. Practical application: The research provided useful insights on the intimate association between work and family domains in the context of safety management.

Labor contracts and parents’ educational expectations for children: Income effect or expected effect?

Abstract Parental educational expectations have an important effect on children’s human capital accumulation. Using the data from the China Family Panel Studies in 2016 (CFPS-2016), this article studies the impact and mechanism of whether parents sign labor contracts on their educational expectations for children. The findings are follows: (i) signing the labor contracts can encourage parents to raise their educational expectations for children; (ii) signing the contracts influence their educational expectations for children mainly through the expected effect brought out by the “five social insurances (pension, medical, unemployment, work injury and maternity) and one housing fund”, but the income effect does not work; (iii) signing the labor contracts will only raise parental educational expectations for boys; (iv) compared with fathers, the labor contracts of mothers do not affect the educational expectations for children. Therefore, we believe that the improvement and implementation of the labor contracts system as well as a good employment and social protection is of great significance to further promote the human capital level and the long-term economic growth, especially for the developing countries.