Occurrences of Workplace Violence Related to the COVID-19 Pandemic, United States, March 2020 to August 2021.

As businesses dealt with an increasingly anxious public during the COVID-19 pandemic and were frequently tasked with enforcing various COVID-19 prevention policies such as mask mandates, workplace violence and harassment (WPV) emerged as an increasing important issue affecting worker safety and health. Publicly available media reports were searched for WPV events related to the COVID-19 pandemic that occurred during 1 March 2020, and 31 August 2021, using Google News aggregator services scans with data abstraction and verification. The search found 408 unique WPV events related to COVID-19. Almost two-thirds involved mask disputes. Over half (57%) of the 408 events occurred in retail (38%) and food service (19%). We also conducted a comparison of events identified in this search to a similar study of media reports between March 2020 to October 2020 that used multiple search engines to identify WPV events. Despite similar conclusions, a one-to-one comparison of relevant data from these studies found only modest overlap in the incidents identified, suggesting the need to make improvements to future efforts to extract data from media reports. Prevention resources such as training and education for workers may help industries de-escalate or prevent similar WPV events in the future.

Workers' compensation claims among private skilled nursing facilities, Ohio, 2001-2012.

INTRODUCTION: Skilled nursing facilities have one of the highest rates of occupational injury and illness among all industries. This study quantifies the burden of occupational injury and illness in this industry using data from a single state-based workers' compensation (WC) system. METHODS: Ohio Bureau of Workers' Compensation claims from 2001 to 2012 were analyzed among privately owned, state-insured skilled nursing facilities and are presented as claim counts and rates per 100 full-time equivalents (FTE). Worker, employer, incident, and injury characteristics were examined among all claims and by medical-only (medical care expenses and/or less than eight days away from work) and lost-time (eight days or more away from work) claim types. RESULTS: There were 56,442 claims in this population of Ohio skilled nursing facilities from 2001 to 2012. Overexertion and bodily reaction, slips, trips, and falls, and contact with objects and equipment accounted for the majority of all WC claims (89%). Overexertion and bodily reaction, and slips, trips, and falls comprised 85% of the 10,793 lost-time claims. The highest injury event/exposure rates for all claims were for overexertion and bodily reaction (3.7 per 100 FTE for all claims), followed by slip, trips, and falls (2.1), and contact with objects and equipment (1.9). CONCLUSION: Understanding the details surrounding injury events and exposures resulting in WC claims can help better align prevention efforts, such as incorporation of safe patient handling policies and lifting aids, improvement in housekeeping practices, and employee training within skilled nursing facilities to prevent worker injury and mitigate related expenses.

Nonfatal Occupational Injuries to Younger Workers - United States, 2012-2018.

Adolescents and young adults represent approximately 13% of the U.S. workforce (1). Compared with adult workers, young workers (aged 15-24 years) experience higher rates of job-related injury (2,3). To describe injuries among young workers and inform research and prevention activities, CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed national data for 2012-2018 from the occupational supplement to the National Electronic Injury Surveillance System* (NEISS-Work) and for 2018 from the Bureau of Labor Statistics (BLS) Survey of Occupational Injuries and Illnesses (SOII).† During the 7-year period, an estimated 3.2 million (95% confidence interval [CI] = 2.6-3.7) nonfatal, job-related injuries to young workers were treated in hospital emergency departments (EDs). From 2012 to 2018, annual rates of work-related injuries§ treated in the ED (ED-treated injuries) declined overall across all age groups but ranged from 1.2 to 2.3 times higher for workers aged 15-24 years compared with those for adults aged 25-44 years. Workers aged 18-19 years had the highest rate of ED-treated injuries. In 2018, among all age groups, workers in service occupations¶ had the highest percentage of injuries requiring at least 1 day away from work. Among workers aged 15-17 years, those in the leisure and hospitality industry had the highest percentage of work-related injuries requiring at least 1 day away from work. Occupational injuries can have long-term impacts on health (4). The disproportionate risk of injury among young workers highlights the need for sustained, targeted public health efforts to prepare this population with essential workplace safety and health competencies before they enter the workforce and to provide high-quality safety training and close supervision on the job. NIOSH and its partners developed a free curriculum to teach adolescents workplace safety and health competencies, which includes identification of workplace hazards and methods for addressing them, how to understand their rights and responsibilities as workers, and how to voice concerns about work safety issues (5).

Workers' compensation claims for traumatic brain injuries among private employers-Ohio, 2001-2011.

BACKGROUND: The purpose of this analysis was to identify and prioritize high-risk industry groups for traumatic brain injury (TBI) prevention efforts. METHODS: Workers with TBI from 2001 to 2011 were identified from the Ohio Bureau of Workers' Compensation data. To prioritize industry groups by claim type (lost-time (≥8 days away from work) and total claims) and injury event categories, we used a prevention index (PI) that averaged TBI counts and rate ranks (PI = (count rank + rate rank)/2). TBI rates per 10 000 estimated full-time equivalent (FTE = 2000 h/y) workers were calculated. RESULTS: From 2001 to 2011, 12 891 TBIs were identified among private employers, resulting in a rate of 5.1 TBIs per 10 000 FTEs. Of these, 40% (n = 5171) were lost-time TBIs, at a rate of 2.0 per 10 000 FTEs. Spectator Sports had the highest lost-time TBI rate (13.5 per 10 000 FTEs), whereas General Freight Trucking had the greatest number of lost-time TBIs (n = 293). Based on PIs, General Freight Trucking ranked first for lost-time TBIs for all injury events combined. Several industry groups within Construction, General and Specialized Freight Trucking, Services to Building and Dwellings, Employment Services, and Restaurants and Other Eating Places ranked high across multiple injury event categories for lost-time TBIs. CONCLUSIONS: The high-ranking industry groups identified from our study can be used to effectively direct occupational TBI prevention efforts.

Workers' compensation injury claims among workers in the private ambulance services industry-Ohio, 2001-2011.

BACKGROUND: Ambulance service workers frequently transfer and transport patients. These tasks involve occupational injury risks such as heavy lifting, awkward postures, and frequent motor vehicle travel. METHODS: We examined Ohio workers' compensation injury claims among state-insured ambulance service workers working for private employers from 2001 to 2011. Injury claim counts and rates are presented by claim types, diagnoses, and injury events; only counts are available by worker characteristics. RESULTS: We analyzed a total of 5882 claims. The majority were medical-only (<8 days away from work). The overall injury claim rate for medical-only and lost-time cases was 12.1 per 100 full-time equivalents. Sprains and strains accounted for 60% of all injury claims. Overexertion from patient handling was the leading injury event, followed by motor vehicle roadway incidents. CONCLUSIONS: Study results can guide the development or improvement of injury prevention strategies. Focused efforts related to patient handling and vehicle incidents are needed.

Occupational Injuries and Exposures among Emergency Medical Services Workers.

OBJECTIVE: Emergency medical services (EMS) workers incur occupational injuries at a higher rate than the general worker population. This study describes the circumstances of occupational injuries and exposures among EMS workers to guide injury prevention efforts. METHODS: The National Institute for Occupational Safety and Health collaborated with the National Highway Traffic Safety Administration to conduct a follow-back survey of injured EMS workers identified from a national sample of hospital emergency departments (EDs) from July 2010 through June 2014. The interviews captured demographic, employment, and injury event characteristics. The telephone interview data were weighted and are presented in the results as national estimates and rates. RESULTS: Telephone interviews were completed by 572 EMS workers treated in EDs, resulting in a 74% cooperation rate among all EMS workers who were identified and successfully contacted. Study respondents represented 89,100 (95% CI 54,400-123,800) EMS workers who sought treatment in EDs over the four-year period. Two-thirds were male (59,900, 95% CI 35,200-84,600) and 42% were 18-29 years old (37,300, 95% CI 19,700-54,700). Three-quarters of the workers were full-time (66,800, 95% CI 39,800-93,800) and an additional 10% were part-time or on-call (9,300, 95% 4,900-13,700). Among career EMS workers, the injury rate was 8.6 per 100 full-time equivalent EMS workers (95% CI 5.3-11.8). Over half of all injured workers had less than ten years of work experience. Sprains and strains accounted for over 40% of all injuries (37,000, 95% CI 22,000-52,000). Body motion injuries were the leading event (24,900, 95% CI 14,900-35,000), with 90% (20,500, 95% CI 12,800-32,100) attributed to lifting, carrying, or transferring a patient and/or equipment. Exposures to harmful substances were the second leading event (24,400, 95% CI 11,700-37,100). CONCLUSION: New and enhanced efforts to prevent EMS worker injuries are needed, especially those aimed at preventing body motion injuries and exposures to harmful substances. EMS and public safety agencies should consider adopting and evaluating injury prevention measures to improve occupational safety and promote the health, performance, and retention of the EMS workforce.

Characterizing emergency department patients who reported work-related injuries and illnesses.

BACKGROUND: Per a Congressional directive and funding, this study describes worker and workplace characteristics of emergency department (ED) patients who reported their injury/illness to their employer. The study also responds to Congress's request to enumerate injured/ill self-employed workers and workers with chronic conditions. METHODS: We conducted a follow-back study on injured/ill workers, including self-employed, identified from a national ED surveillance system from June 2012 through December 2013. RESULTS: An estimated 3,357,000 (95%CI: 2,516,000-4,199,000) workers treated in EDs reported their injury/illness to their employer or were self-employed. Of those, 202,000 (95%CI: 133,000-272,000) had a chronic condition. Of all reporters, excluding self-employed, 77% indicated they received instructions as to whom to report. CONCLUSION: The study did not identify underreporting issues and revealed that medical records data may not be appropriate for assessing underreporting. Additional research is needed to examine workplace characteristics that encourage injury and illness reporting. Am. J. Ind. Med. 59:610-620, 2016. © 2016 Wiley Periodicals, Inc.

Using emergency department surveillance data to assess occupational injury and illness reporting by workers.

OBJECTIVE: Researchers from the National Institute for Occupational Safety and Health (NIOSH) share detailed methodologies from conducting two follow-back studies initiated in 2010 that were designed to assess whether workers reported their injuries and illnesses to their employers and to identify worker incentives and disincentives for reporting work-related injuries to employers. METHODOLOGY: Study respondents were sampled from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), an emergency department-based surveillance system. Telephone interviews were used to collect information directly from workers. OUTCOMES: Among persons treated in emergency departments who could be identified as working at the time of injury or illness, most reported their injury or illness to their employer. Our studies did not assess if these reported injuries and illnesses were recorded on the Occupational Safety and Health logs. DISCUSSION: Our approach suggests that emergency department-based surveillance data are limited in their utility to investigate underreporting among workers. Am. J. Ind. Med. 59:600-609, 2016. © 2016 Wiley Periodicals, Inc.

Reported work-related injuries and illnesses among Hispanic workers: Results from an emergency department surveillance system follow-back survey.

BACKGROUND: Research suggests Hispanic workers underreport injuries/illnesses to their employer. METHODS: The National Electronic Injury Surveillance System-occupational supplement was used to conduct a follow-back study of workers treated in emergency departments (EDs) from June 2012 through December 2013. RESULTS: An estimated 448,000 (95%CI 230,000-665,000) Hispanic workers treated in EDs for a work-related injury or illness were represented by 362 completed interviews. Of these, an estimated 443,000 (95%CI 228,000-657,000) workers reported the injury or illness to their employer or were self-employed. The majority had not heard of workers' compensation. Only 10% expected workers' compensation to cover their medical payment while 62% expected payment to be covered by their employer. CONCLUSION: We characterized our respondent workforce who reported their injury or illness. We determined that NEISS-Work data are not the most appropriate source to capture underreporting of work-related injuries and illnesses to employers among Hispanic workers. Am. J. Ind. Med. 59:621-629, 2016. © 2016 Wiley Periodicals, Inc.

Fatal traumatic brain injuries in the construction industry, 2003-2010.

BACKGROUND: Research on fatal work-related traumatic brain injuries (TBIs) is limited. This study describes fatal TBIs in the US construction industry. METHODS: Fatal TBIs were extracted from the Bureau of Labor Statistics Census of Fatal Occupational Injuries. RESULTS: From 2003 to 2010, 2,210 fatal TBIs occurred in construction at a rate of 2.6 per 100,000 full-time equivalent (FTE) workers. Workers aged 65 years and older had the highest fatal TBI rates among all workers (7.9 per 100,000 FTE workers). Falls were the most frequent injury event (n = 1,269, 57%). Structural iron and steel workers and roofers had the highest fatal TBI rate per 100,000 FTE workers (13.7 and 11.2, respectively). Fall-related TBIs were the leading cause of death in these occupations. CONCLUSIONS: A large percentage of TBIs in the construction industry were due to falls. Emphasis on safety interventions is needed to reduce these fall-related TBIs, especially among vulnerable workers.

Occupational burns treated in emergency departments.

BACKGROUND: Despite reported declines, occupational burn injuries remain a workplace safety concern. More severe burns may result in costly medical treatment and long-term physical and psychological consequences. METHODS: We used the National Electronic Injury Surveillance System-Occupational Supplement to produce national estimates of burns treated in emergency departments (EDs). We analyzed data trends from 1999 to 2008 and provided detailed descriptions of 2008 data. RESULTS: From 1999 to 2008 there were 1,132,000 (95% CI: ±192,300) nonfatal occupational burns treated in EDs. Burn numbers and rates declined approximately 40% over the 10 years. In 2008, men and younger workers 15-24 years old had the highest rates. Scalds and thermal burns accounted for more than 60% of burns. Accommodation and food service, manufacturing, and construction industries had the largest number of burns. CONCLUSIONS: Despite declining burn rates, emphasis is needed on reducing burn hazards to young food service workers and using job specific hazard analyses to prevent burns.

Occupational injuries among U.S. correctional officers, 1999-2008.

OBJECTIVE: This study describes fatal and nonfatal occupational injuries among U.S. correctional officers. METHODS: Fatal injuries were obtained from the Census of Fatal Occupational Injuries; nonfatal injuries were identified from the National Electronic Injury Surveillance System- Occupational Supplement. RESULTS: From 1999-2008, there were 113 fatalities and an estimated 125,200 (CI=±70,100) nonfatal injuries were treated in emergency departments. Assaults and violent acts (n=45, 40%) and transportation related fatalities (n=45, 40%) were the two primary fatal injury events. Assaults and violent acts (n=47,500 (CI=±24,500), 38%) and bodily reaction and exertion (n=25,400 (CI=±16,800), 20%) were the leading events resulting in nonfatal injuries. CONCLUSIONS: While workplace violence is the primary cause of both fatal and nonfatal injuries among correctional officers, transportation events and bodily reactions are also leading causes of occupational injury. Future research is needed to identify risk factors unique to these events and develop appropriate prevention and intervention efforts. IMPACT ON INDUSTRY: This study adds to the literature on occupational injuries among correctional officers and provides a national level description of fatal and nonfatal injuries across a 10-year period. Given that assaults and violent acts, transportation events, and bodily reaction and exertion were significant injury events, future research should describe detailed injury circumstances and risk factors for correctional officers unique to these events. This would allow appropriate prevention and control efforts to be developed to reduce injuries from these events.

Fatal and nonfatal injuries among emergency medical technicians and paramedics.

BACKGROUND: Emergency medical technicians (EMTs) and paramedics serve as primary providers of urgent medical care and are integral components in disaster response. They are at risk for fatal and nonfatal injuries during these activities. OBJECTIVES: To describe fatal and nonfatal injuries occurring to EMTs and paramedics. METHODS: We analyzed data from the Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI) and the occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work) for the period 2003-2007. RESULTS: We identified 99,400 (95% confidence interval [CI], 71,700, 127,100) nonfatal injuries treated in emergency departments and 65 fatal injuries from the period 2003-2007. Most fatalities were related to motor vehicle incidents (45%) and aircraft crashes (31%). Among compensated EMTs and paramedics, the rate of fatal injuries was 6.3 per 100,000 full-time equivalents. Nonfatal injuries were primarily associated with stress on some part of the body from motion or overexertion (33%). Among all nonfatal injuries, the most common diagnosis was sprains and strains (38%). CONCLUSIONS: Emergency medical technicians and paramedics have higher fatal injury rates when compared with all workers. To reduce fatalities, targeted efforts should be made to prevent ground and air transportation incidents. Reducing nonfatal injuries may be accomplished by developing and evaluating interventions to prevent bodily stress and overexertion injuries.

Occupational injuries among emergency responders.

BACKGROUND: Emergency responders frequently incur injuries while providing medical, fire, and law enforcement services. National surveillance systems provide fragmented perspectives on responder injuries because they omit specific classes of workers (e.g., government or volunteers); they report only selected injuries; and employment information is incomplete. METHODS: We characterized injuries among emergency medical services (EMS), firefighting, and police occupations by using data from the National Electronic Injury Surveillance System-Occupational Supplement (NEISS-Work) for injuries treated in U.S. hospital emergency departments in 2000-2001. RESULTS: Sprains and strains were the leading injury (33-41%) among EMS, firefighter, and police occupations. Police officers and career firefighters had the highest injury rates (8.5 and 7.4 injuries per 100 full-time equivalent workers, respectively). CONCLUSIONS: The physical demands of emergency response are a leading cause of injuries that may benefit from similar interventions across the occupations. To assess risk, improved exposure data need to be acquired, particularly for volunteers.

Underuse of effective measures to prevent and manage pediatric tuberculosis in the United States.

OBJECTIVE: To characterize problems with prevention and management of pediatric tuberculosis (TB) and latent TB infection (LTBI). DESIGN: A multisite, cross-sectional study using data from medical records and public health logs to categorize and define use of routine prevention practices in managing pediatric TB and LTBI. SETTING: Four areas of the United States. PARTICIPANTS: Children younger than 5 years diagnosed with TB from January 1, 2002, through December 31, 2004, and children with LTBI reported during a continuous 12-month period in 2003 to 2004. Main Exposure Mycobacterium tuberculosis. MAIN OUTCOME MEASURES: Underuse or nonuse of standard medical and public health interventions. RESULTS: Almost 40% of children had a TB risk factor related to their country of birth, parental origin, or travel to a country with a high incidence of TB. Children having LTBI were less likely than those having TB to complete treatment (53.7% vs 88.6%, respectively). Almost half (46.3%) of the children with TB came to medical attention late in their course when they already had symptoms. Among 63 adult source patients, 19 (30.2%) previously had LTBI but were not treated, and none of the 40 foreign-born source patients were known to have been evaluated for TB before entry into the United States. CONCLUSIONS: Prevention efforts are unsatisfactory to prevent TB in children. Effective interventions such as treatment of LTBI and TB evaluation of adult immigrants remain less than optimal.

Violence, abuse, and neglect among people with traumatic brain injuries.

BACKGROUND: Violence, abuse, and neglect (VAN) among people with physical and other disabilities has been reported; however, little is known about VAN experiences among people with traumatic brain injuries (TBI). METHODS: Nine people who reported experiencing VAN post-TBI were interviewed for this phenomenological study. The data were analyzed to understand VAN as experienced by those with TBI. RESULTS: Participants detailed many VAN experiences along with contributing factors, barriers in obtaining help, and recommendations for improving preventive and assistance services. CONCLUSIONS: Greater efforts are needed to identify and prevent VAN among people with TBI. Services following VAN must be improved.

Tuberculosis prevention and control in large jails: a challenge to tuberculosis elimination.

BACKGROUND: This study assessed the extent to which 20 large jail systems have implemented national recommendations for tuberculosis (TB) prevention and control in correctional facilities. METHODS: Data were collected through questionnaires to jail medical directors and TB control directors, observation at the jails, and abstraction of medical records of inmates with TB disease and latent TB infection. RESULTS: Twenty percent of jail systems (4/20) had conducted an assessment of risk for TB transmission in their facilities, and 55% (11/20) monitored tuberculin skin test conversions of inmates and staff. Sixty-five percent (13/20) of jails had an aggregate record-keeping system for tracking TB status and treatment, which was usually paper based. Forty-five percent of jails (9/20) had policies to offer HIV counseling and testing to tuberculin skin test-positive patients, and 75% (15/20) screen HIV-infected inmates with chest radiographs. Three quarters of jails (15/20) had policies to always isolate patients with suspected or confirmed pulmonary TB in an airborne infection isolation room. Half of jails with airborne infection isolation rooms (6/12) conformed to Centers for Disease Control and Prevention (CDC) guidelines for monitoring negative pressure. CONCLUSIONS: Improvements are needed in conducting TB risk assessments and evaluations to determine priorities and reduce risk of transmission. Inadequate medical information systems are impeding TB control and evaluation efforts. Although HIV infection is the greatest cofactor for development of TB disease, jails have inadequate information on patients' HIV status to make informed decisions in screening and management of TB and latent TB infection. Jails need to improve the use of environmental controls.

Assessment of tuberculosis screening and management practices of large jail systems.

OBJECTIVE: This descriptive study sought to explore the use and timeliness of tuberculosis (TB) screening and management activities in jail facilities. METHODS: Study personnel visited 20 large U.S. jail systems and reviewed the medical records of 56 inmates who had recently been evaluated for TB disease and 376 inmates who were diagnosed with or confirmed to have latent TB infection (LTBI). Data from these records were analyzed to determine completion and timeliness of screening, diagnostic, and treatment activities. RESULTS: In 14% of 56 inmates evaluated for TB disease and 24% of 376 inmates with LTBI, chest radiographs were either not performed or not documented. Of 48 inmates evaluated for TB disease who were not receiving treatment when admitted to jail, 10 had no record of sputum collection being done. A mean delay of 3.1 days occurred from symptom report to respiratory isolation. Time from tuberculin skin test reading to chest radiograph reading was a mean of 5.3 days in inmates evaluated for TB disease and a mean of 7.0 days in inmates with LTBI. Follow-up was arranged for 91% of released inmates who were on treatment for TB disease and only 17% of released inmates who were on treatment for LTBI. CONCLUSIONS: Jail health information systems should be augmented to better document and monitor inmate health care related to TB. Completion rates and timeliness of TB screening, diagnostic, and treatment measures should be evaluated to identify areas needing improvement. Finally, mechanisms for continuity of care upon inmate release should be enhanced to promote therapy completion and prevent TB transmission in the community.

Traumatic brain injury-related hospital discharges. Results from a 14-state surveillance system, 1997.

PROBLEM/CONDITION: Previous studies indicate that each year in the United States, approximately 1.5 million Americans sustain a traumatic brain injury (TBI). Of those injured, approximately one quarter million are hospitalized. Approximately one third of adults hospitalized with TBI still need help with daily activities 1 year after their discharge. REPORTING PERIOD: This report summarizes surveillance data for TBI in the United States for January-December 1997. DESCRIPTION OF THE SYSTEM: Data are from 14 states that participated in an ongoing CDC-funded TBI surveillance system. State health departments used CDC guidelines to identify TBI cases from hospital discharge data or from other statewide injury data systems. Supplementary information was abstracted from medical records. RESULTS: The overall age-adjusted TBI-related live hospital discharge rate was 69.7/100,000 population. Rates were highest for American Indians and Alaska Natives (75.3/100,000) and Blacks (74.4/100,000). The age-adjusted rate for males was approximately twice as high as for females (91.9 versus 47.7/100,000 respectively). For both sexes, the rates were highest among those aged 15-19 years and >/= 65 years. Motor-vehicle crashes, falls, and assaults were the leading causes of injury for TBI-related discharges (27.9, 22.5, and 7.3/100,000 respectively). TBI-related discharge rates for falls were highest among those aged >/= 65 years (82.3/100,000). Black males and American Indian/Alaska Native males had the highest rates of TBI attributable to assault (31.3 and 29.5 per 100,000, respectively), approximately 4 times the rate for white males. An estimated 46% of injured motor-vehicle occupants, 53% of motorcyclists, and 41% of pedal cyclists reportedly were not using personal protective equipment (PPE) (e.g., seat belts or helmets) at the time of their TBI. With regard to outcome assessed before discharge from the hospital, approximately 17% of persons hospitalized with TBI had moderate to severe disability. INTERPRETATION: Data in this report, the most extensive to date from a multistate population-based TBI surveillance system, indicate the importance of TBI as a public health problem. Population-based information regarding TBI hospitalizations can be useful in assessing the effect of prevention efforts and planning for the service needs of persons with TBI.