Trends in workplace homicides in the U.S., 1994-2021: An end to years of decline.

Workplace and non-workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non-workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non-workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non-workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (p = 0.79), while non-workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (p = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (p < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (p < 0.0001). U.S. workplace and non-workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal-intent-related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal-intent-related workplace homicides.

National Estimates of Home Care Workers Nonfatal Emergency Department-Treated Injuries, United States 2015-2020.

OBJECTIVE: Home care workers (HCWs) are a critical resource contributing to the well-being of others. Presented are data on HCWs nonfatal emergency department (ED)-treated injuries. METHODS: Nonfatal injuries among HCWs were extracted from the NEISS-Work data between 2015 and 2020. RESULTS: Review of NEISS-Work data indicated 117,000 HCWs with nonfatal ED-treated injuries; female HCWs accounted for 93%. Overexertion and bodily reactions accounted for 52% of the injuries. Violence and other injuries by persons or animals accounted for 15% and falls, slips, and trips also accounted for 15% of the HCWs ED-treated injuries. CONCLUSIONS: The growing demand for home care services is increasing the number of workers at risk for injury. Future analyses should prioritize injury events among HCWs to gain a better understanding of the events contributing to injuries among HCWs.

Sharps Injury Rates Reported Among US Workers: National Electronic Injury Surveillance System-Occupational Supplement 2006 to 2020.

OBJECTIVE: To examine sharps injury (SI) rates among US workers treated in hospital emergency departments. METHODS: A national probability-based sample of approximately 67 US hospital emergency departments from the National Electronic Injury Surveillance System-Occupational Supplement was used to examine annual national estimates of SI rates (number of injuries/10,000 full-time equivalents) for US workers from 2006 to 2020. RESULTS: Among the general US worker population, the 25- to 34-year age group experienced the highest annual SI rate. Health care industry workers experienced SI rates up to 16 times the rate of all US workers. CONCLUSION: Younger age (≤34 years) is associated with increased SI risk. Tailored prevention efforts should be developed to address the specific needs of these workers, especially among health care workers. Continual occupational surveillance will maximize the health and safety of US workers.

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

BACKGROUND: Acute nonfatal occupational inhalation injuries are caused by exposures to airborne toxicants and contaminants in the workplace. A 1990s study found that US emergency 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. METHODS: Data from the National Electronic Injury Surveillance System Occupational Supplement were used to identify nonfatal occupational inhalation injuries treated in US hospital 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. RESULTS: 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). CONCLUSIONS: 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.

A National Overview of Youth andInjury Trends on U.S. Farms, 2001-2014.

HIGHLIGHTS The total number of injuries to all youth on farms consistently declined during the 14-year period from 2001 to 2014. Injuries to household farm youth, after initial declines, increased in 2012 and 2014. Although progress in farm youth safety has been made, farms continue to be hazardous places for youth. ABSTRACT. The National Institute for Occupational Safety and Health (NIOSH) conducted injury surveillance for youth on U.S. farms for two decades to measure childhood injury burden, track injury trends, and monitor hazardous injury exposures. The Childhood Agricultural Injury Survey (CAIS), a regionally stratified telephone survey, collected injury and demographic data for all youth less than 20 years of age on U.S. farms. Results from the 2014 survey are provided. Trend analyses for all survey years were conducted using a Poisson regression model with generalized estimating equations. Rate ratios with corresponding 95% confidence intervals were calculated from the model. In 2014, there were an estimated 11,942 youth farm injuries. Of these, 63% occurred to household youth. Youth between the ages of 10 and 15 incurred the most injuries, and 34% of the injuries were work-related. The total number of injuries to all youth on farms consistently declined during the 14-year period from 2001 to 2014, with annual injury rates ranging from 13.5 to 5.7 per 1,000 farms. The injury rates for household youth decreased through 2009 but increased slightly in 2012 and 2014. Farms continue to be hazardous environments for youth. Although there has been a significant decrease in the overall numbers and rates of youth farm injuries over the past decades, researchers should continue to monitor areas that remain a concern. One area that is specifically troublesome is the increase in injury rates observed for household youth in 2014.

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).

National Estimates of Youth and Injuries on U.S. Farms, 2012.

The National Institute for Occupational Safety and Health (NIOSH), in order to provide injury surveillance for youth on farms in the U.S., partnered with the USDA to conduct the Childhood Agricultural Injury Survey (CAIS). CAIS data for all farm youth less than 20 years of age have been collected intermittently since 1998. CAIS data from 2012 indicated that an estimated 25.9 million youth lived on, worked on, or visited U.S. farms. These youth experienced almost 14,000 injuries while on the farm. The majority of these injuries occurred to males (7,290) and youth between the ages of 10 and 15 years (5,766). Approximately 20% (2,739) of the injuries were related to work being done on the farm. Youth living on the farm incurred 56% (7,784) of the injuries. An additional 5,771 injuries occurred to hired and visiting youth. Although youth injuries on farms have declined, the numbers are still unacceptably high. Additional research and detailed assessments of subsets of the youth population would help to better direct safety intervention programs and focus future research activities.

Youth on racial minority operated U.S. farms, 2008: demographics and injuries.

INTRODUCTION: To obtain injury surveillance data for youth on racial minority operated farms, the National Institute for Occupational Safety and Health developed the Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) in collaboration with the U.S. Department of Agriculture. METHODS: Using a regionally stratified telephone survey of U.S. minority operated farm households, M-CAIS data were collected for youth less than 20 years of age. RESULTS: There were an estimated 37,443 youth living on racial minority operated U.S. farms in 2008, almost half (46%) of these youth worked on the farm. Racial minority farm operators hired 6,443 youth, and reported an estimated 775,991 youth relative and other visitors on the farm. These youth suffered an estimated 516 injuries (5.9 injuries/1000 farms). CONCLUSIONS: Household youth had an injury rate of 7.8 injuries/1000 household youth and a work-related injury rate of 6.9 injuries/1000 working household youth. PRACTICAL APPLICATIONS: The research enables agricultural safety and health researchers, practitioners, and educators to identify priorities and design trainings and interventions to minimize the risk of farm hazards to youth on racial minority farm operations in the United States.

Changing farm injury trends by sex for youth living on US farms, 1998-2006.

PURPOSE: To estimate the number and rate of on-farm injuries to youth living on farms in the United States by sex from 1998 to 2006 and compare the trends in youth injury by sex. METHODS: Data from 4 childhood agricultural injury surveys for the years 1998, 2001, 2004, and 2006 were analyzed using a Poisson regression model utilizing generalized estimating equations. Rate ratios with corresponding 95% confidence intervals were calculated from the model, which compared the estimated rates of injury in 2001, 2004, and 2006 to the estimated rate of injury in the baseline year, 1998. RESULTS: There was an overall decline in the estimated number and rate of injuries to youth living on farms from 1998 to 2006, with a linear decline of the rate ratios for all youth on farms that was found to be significant. By sex, the trend in injury rate ratios for male youth significantly declined, while the trend for female youth for the same time period initially increased then returned to the baseline. Nonhomogeneity in trends by age group, work versus nonwork injury, and source of injury was also identified. CONCLUSION: Additional surveillance is needed to determine if injury trends to youth living on farms will continue to differ by sex. More detailed data on exposure to hazards for these youth by sex are needed to determine what factors are associated with these disparate injury trends and to design and implement effective interventions to further reduce injuries to youth living on farms.

Agricultural tractor overturn deaths: Assessment of trends and risk factors.

BACKGROUND: Tractor overturn deaths have been recognized as a public health concern for decades. Studies have reported on the hazards associated with tractor overturns, but none have reported on trends in tractor overturn fatality rates in the United States (US). METHODS: Tractor overturn fatality data from the Bureau of Labor Statistics Census of Fatal Occupational Injuries were used in Poisson regression models to: identify risk factors associated with overturn fatalities; examine trends in tractor overturn fatality rates between 1992 and 2007; and assess trends in overturn fatality rates for specific risk factors. RESULTS: Characteristics found to be associated with tractor overturn fatality rates were age, type of farm, region, and the victim's relationship to the farm (P < 0.0001). Older age groups, crop farms, farms in the Midwest and Northeast, and family workers all had higher fatal tractor overturn risks. Overall, tractor overturn fatality rates declined 28.5% between 1992 and 2007. Significant decreases in tractor overturn fatality rates were found for the Northeast and South regions, hired workers, crop farms, and in every age group except those less than 25 years of age. CONCLUSIONS: Tractor overturn fatality rates decreased between 1992 and 2007. These decreases were not consistent between different categories of the agricultural workforce or regions of the US. Changes in tractor overturn fatality rates may be partially explained by increases in the prevalence of ROPS on farm tractors in the US. ROPS promotion programs are needed to reduce tractor overturn fatalities, especially among those subpopulations at highest risk.

Nonfatal injuries to household youth on Native American operated farms in the U.S., 2000.

In 2000, there were an estimated 7,381 youth living on 9,556 U.S. farms operated by Native Americans. Most of these youth (5,454, 74%) lived on livestock operations (6,833 farms, 72%). In that year, youth living on Native American operated farms sustained an estimated 177 nonfatal injuries. The majority of all injuries to household youth (147, 83%) occurred on livestock operations. Males accounted for 112 (63%) of the injuries to household youth. Overall, household youth on Native American operated farms had an injury rate of 24.0 injuries per 1,000 household youth compared to a rate of 8.1 injuries per 1,000 household youth on all other minority-operated farms. The rate ratio for work-related injuries to household youth on Native American farms compared to other minority-operated farms was 2.1. Although female youth on these farms experienced a similar non-work injury rate of 13.8 injuries per 1,000 female household youth compared to a rate of 15.1 injuries per 1,000 male household youth, the work-related injury rate for male youth (30.2 per 1,000 male household youth) was substantially higher than the work-related injury rate for female household youth (18.3 per 1,000 female household youth). These data indicate an elevated risk of injury for youth living on farms operated by Native Americans. This result is attributed to the large percentage of livestock operations for this population and the hazards associated with this type of farming. However, further research is needed to more fully understand these results and to guide culturally appropriate interventions within this population.

Household youth on minority operated farms in the United States, 2000: exposures to and injuries from work, horses, ATVs and tractors.

INTRODUCTION: It is likely that youth living on minority operated farms (<3% of U.S. farms) face hazards similar to the general farm population; however, since minority youth are not well represented by general farm surveys, this information hasn't been confirmed. METHOD: Nonfatal injury and exposure data were obtained from the 2000 Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS). RESULTS: On racial minority farms, there were an estimated 28,600 household youth. Of these, about 41% worked, 26% rode a horse, 23% drove an ATV, and 23% operated a tractor. On Hispanic farms, there were an estimated 17,998 household youth. Of these, 44% worked, 30% rode a horse, 27% drove an ATV, and 25% operated a tractor. CONCLUSIONS: These results show the value of conducting a survey of minorities to identify high risk groups and target issues that may be unique to the minority farm population.

Injuries to youth living on U.S. farms in 2001 with comparison to 1998.

To obtain sustained injury surveillance data for youth on farms, the National Institute for Occupational Safety and Health developed the Childhood Agricultural Injury Survey (CAIS) in collaboration with the U.S. Department of Agriculture. The first CAIS collected data for youth less than 20 years in 1998 through a regionally stratified telephone survey of 50,000 U.S. farm households; a second CAIS for 2001 was conducted using the same methodology. In 2001, there were approximately 1.2 million youth living on U.S. farms. These youth suffered an estimated 19,397 injuries (15.7/1,000 household youth). Approximately 60% (11,571) of the household youth injuries were to males. For all household youth, 10-15 year olds experienced the most injuries (49%, 9,486). In addition to providing estimates of demographics, injuries, and injury rates for household youth from the 2001 CAIS, this article provides a comparison to results from the 1998 CAIS. The number of household youth injuries on farms from 1998 to 2001 decreased by almost 30% (27,321 vs. 19,397). The results of this study show an overall decrease in the injury rate for youth living on the farm from 1998 to 2001 (18.8/1,000 household youth vs. 15.7/1,000 household youth). However, there was a considerable increase in the number of injuries to household females less than 20 years of age during this same time period. There was also an increase in the number of all terrain vehicle (ATV) and horse-related injuries. Continued surveillance is needed to assess if these are significant trends or the result of changing farm demographics.

Farm fatalities to youth 1995-2000: A comparison by age groups.

PROBLEM: Although a myriad of research illustrates the safety issues related to farm fatalities in youth populations, very little empirical evidence exists that includes work and non-work related farm fatalities to all youths under 20 years of age at the national level. METHODS: This research will use death certificate data for the six years from 1995 to 2000 that were collected by NIOSH from all 50 state vital statistics registries. Demographic data from the 1998 CAIS were used in rate calculations. In addition to providing annual fatality rates and descriptions of the general causes of death, this research will examine the variation between age groups. RESULTS: Analysis of 695 total farm-related youth fatalities shows an average annual fatality rate of 9.3 fatalities per 100,000 youths. Males account for 80% of these fatalities. The most prevalent causes of death are: machinery (25%), motor vehicle (17%), drowning (16%), suicide (8%) and homicide (6%). Of all youth fatalities occurring while at work, 45% are to youths less than 16 years of age. This same age group accounts for 71% of all non-work related fatalities. SUMMARY: This research will provide farm families and researchers more detailed information on farm hazards that contribute to the deaths of youths. As these youths may encounter hazards while working or playing in their daily environment, identification and elimination of these hazards will increase overall safety on the farm. This research also indicates the need to include youths under 16 years of age in future comprehensive farm safety research.