Examining occupational health and safety disparities using national data: a cause for continuing concern.

BACKGROUND: Occupational status, a core component of socioeconomic status, plays a critical role in the well-being of U.S. workers. Identifying work-related disparities can help target prevention efforts. METHODS: Bureau of Labor Statistics workplace data were used to characterize high-risk occupations and examine relationships between demographic and work-related variables and fatality. RESULTS: Employment in high-injury/illness occupations was independently associated with being male, Black, ≤high school degree, foreign-birth, and low-wages. Adjusted fatal occupational injury rate ratios for 2005-2009 were elevated for males, older workers, and several industries and occupations. Agriculture/forestry/fishing and mining industries and transportation and materials moving occupations had the highest rate ratios. Homicide rate ratios were elevated for Black, American Indian/Alaska Native/Asian/Pacific Islanders, and foreign-born workers. CONCLUSIONS: These findings highlight the importance of understanding patterns of disparities of workplace injuries, illnesses and fatalities. Results can improve intervention efforts by developing programs that better meet the needs of the increasingly diverse U.S. workforce.

Mixed messages and COVID-19 prevention: Why information isn't always enough to protect meat processing workers.

Introduction: The objective of this project was to investigate U.S. meat and poultry processing workers' knowledge of COVID-19, perceived ability to protect themselves from infection, and perspectives on COVID-19 vaccines to inform COVID-19 prevention efforts within this linguistically, racially, and ethnically diverse workforce. Methods: Qualitative semi-structured in-depth interviews were conducted with Mexican, Central American, Congolese refugee, and Black or African American meat/poultry processing workers from Mississippi, Minnesota, Virginia, and Kentucky (N=40). Data were collected from December 5, 2020, to January 28, 2021. Interview audio was transcribed, and rapid qualitative data analysis was used to analyze transcripts. Results: Most participants expressed receiving mixed messages about COVID-19 protection measures: they were told how to protect themselves (n=38), but workplace policies (such as lack of paid sick leave) often undermined their efforts. Participants who were asked about COVID-19 vaccines (n=31) were aware there were one or more vaccines available to protect them from COVID-19; one-third were eager to get vaccinated. Conclusions: Community-based efforts may consider supplementing large scale unified information campaigns in order to prevent mixed messages, address worker needs to accurately gauge the threat of illness to their families and communities and empower them to prevent infection.

Daily self-reports resulted in information bias when assessing exposure duration to computer use.

BACKGROUND: Self-reported exposure duration to computer use is widely used in exposure assessment, and this study examined the associated information bias in a repeated measures setting. METHODS: For 3 weeks, 30 undergraduate students reported daily cumulative computer-use duration and musculoskeletal symptoms at four random times per day. Usage-monitor software installed onto participant's personal computers provided the reference measure. We compared daily self-reported and software-recorded duration, and modeled the effect of musculoskeletal symptoms on observed differences. RESULTS: The relationships between daily self-reported and software-recorded computer-use duration varied greatly across subject with Spearman's correlations ranging from -0.22 to 0.8. Self-reports generally overestimated computer use when software-recorded durations were less than 3.6 hr, and underestimated when above 3.6 hr. Experiencing symptoms was related to a 0.15-hr increase in self-reported duration after controlling for software-recorded duration. CONCLUSIONS: Daily self-reported computer-use duration had a weak-to-moderate correlation with software-recorded duration, and their relationship changed slightly with musculoskeletal symptoms. Self-reports resulted in both non-differential and differential information bias.

Upper extremity pain and computer use among engineering graduate students: a replication study.

BACKGROUND: Recent literature identified upper extremity musculoskeletal symptoms at a prevalence of >40% in college populations. The study objectives were to determine weekly computer use and the prevalence of upper extremity musculoskeletal symptoms in a graduate student population, and make comparisons with previous graduate and undergraduate cohorts. METHODS: One hundred sixty-six graduate students completed a survey on computing and musculoskeletal health. Associations between individual factors and symptom status, functional limitations, academic impact, medication use, and health services utilization were determined. Logistic regression analyses evaluated the association between symptom status and computing. Cross-study comparisons were made. RESULTS: More symptomatic participants experienced functional limitations than asymptomatic participants (74% vs. 32%, P < 0.001) and reported medication use for computing pain (34% vs. 10%, P < 0.01). More participants who experienced symptoms within an hour of computing used health services compared to those who experienced symptoms after an hour of computer use (60% vs. 12%, P < 0.01). Years of computer use (OR = 1.59, 95% CI 1.05-2.40) and number of years in school where weekly computer use was more than 10 hr (OR = 1.56, 95% CI 1.04-2.35) were associated with pain within an hour of computing. Cross-study comparisons found college populations more similar than different. CONCLUSION: The overall findings reinforced previous literature documenting the prevalence of upper extremity musculoskeletal symptoms in college populations, suggesting an important population for participating in public health interventions designed to support healthy computing practices and identify risk factors important to evaluate in future cohort studies. Am. J. Ind. Med. 52:113-123, 2009. (c) 2008 Wiley-Liss, Inc.

Undergraduate college students' upper extremity symptoms and functional limitations related to computer use: a replication study.

PURPOSE: To replicate Hupert et al.'s [5] evaluation of computer-related upper extremity musculoskeletal symptoms, functional limitations, academic performance impact, medication use and health services utilization among a college student population. SUBJECTS AND METHODS: A cross-sectional survey of undergraduate students living in a single residential dormitory at a private southwestern university who agreed to participate completed the College Computing & Health Survey in the Spring of 2001. RESULTS: Of the 127 dormitory residents, 116 students participated and 54% reported experiencing symptoms associated with computer usage. Sixty-two percent of students surveyed experienced functional limitations. More women than men reported symptoms, functional limitations and neck and shoulder pain; those with functional limitations reported higher use of medications than other participants. CONCLUSION: These findings, which match the general findings of the previous research study conducted with the same instrument but in a different college student population, suggest a high level of computer-use-related musculoskeletal symptoms among college students. Universities may want to consider providing ergonomic training designed for college students to: conduct workstation assessments; identify computer related problems (risk factors); and, propose ergonomic solutions.

A multi-method study evaluating computing-related risk factors among college students.

PURPOSE: To characterize undergraduate computer use using different data collection methods, emphasizing computing-related postures, use patterns and upper extremity musculoskeletal symptoms. SUBJECTS AND METHODS: In Spring, 2004, undergraduate students from a single dormitory at a private university agreed to complete a College Computing & Health Survey. For three separate data collection periods each lasting a week, we observed postures during computer once per period and continuously measured computer input device usage. During these three periods, students self-reported computer usage and symptoms 3-5 times daily. RESULTS: Thirty students participated and all completed the study. Eighty-six percent reported ever experiencing symptoms after computer work. There were no time-related trends across data collection periods for posture, symptoms, and computing activities and patterns. Typed work and communicating (when compared with playing games) were usually the predominant computing activities throughout the semester. There was significantly greater self-reported computer use than that directly measured (p<0.05). CONCLUSION: This is the first study that utilized several methods of exposure assessment to describe computing postures, use patterns and upper extremity musculoskeletal symptoms among a college student cohort. Epidemiological studies need to explore time-related changes such as time of day, weekday, and days into the semester to further understand symptoms, posture, and computer use changes.

6th National Occupational Injury Research Symposium: Advancing Occupational Injury Research Through Integration and Partnership.

INTRODUCTION: The National Occupational Injury Research Symposium (NOIRS) is the only regularly held forum exclusively dedicated to occupational injury research and prevention. METHOD: The 2015 conference theme, advancing occupational injury research through integration and partnership, shaped the conference and is reflected in articles selected for this special issue. RESULTS' CONCLUSION: The 6th NOIRS, held May 19-21, 2015, brought together more than 250 researchers, occupational safety practitioners and students to share and discuss occupational injury research. Articles in this special issue highlight some of the research presented at the conference, reflect multiple scientific disciplines and approaches, cover a breadth of occupational injury causes and worker populations, and provide examples of research advanced by partnerships. PRACTICAL APPLICATIONS: The next NOIRS, tentatively scheduled for 2018, will build upon the theme of integration and partnership as well as feedback from conference attendees.

A post-conference evaluation of the 2015 National Occupational Injury Research Symposium.

INTRODUCTION: The National Occupational Injury Research Symposium (NOIRS) is the only national forum focused on occupational injury research findings, data and methods, and prevention strategies; it has been convened every 3-5years since 1997. Held in May 2015, the 6th symposium's theme was "Advancing Occupational Injury Research through Integration and Partnership." Organizers requested that attendees complete a post-meeting evaluation to assess meeting impact, and gather information useful in planning subsequent meetings and activities. METHOD: The questionnaire was publicized via a quick response code and link to the survey on symposium book cover, and mentioned at each scientific session. The online survey was designed to be completed in ≤15min; no identifying information was collected. Survey link remained open for seven days post-symposium. RESULTS: About 50% of registered attendees responded. Almost half were attending their first NOIRS. Most were researchers (69%); 45% were affiliated with government and 38% with university or research institute. Five of six reported that the symposium mostly or completely met expectations. Reasons for attending included gaining exposure to new areas of research (87%), sharing their research (80%), and to develop new ideas for conducting research (79%). The majority (90%) reported that the symposium provided adequate networking opportunities. The conference venue was reported as good or better by 69%, moreso among repeat attendees (77%) compared to first-timers (61%). DISCUSSION: The evaluation demonstrated that NOIRS was valuable to attendees, and provided a forum for sharing research results, developing new research ideas, and networking. Respondents provided input on different aspects of NOIRS and suggestions useful in planning next NOIRS, tentatively scheduled for 2018. NOIRS 2015 objectives for integration across disciplines and partnership with industry and safety professionals were partially met. In planning NOIRS 2018, more attention should be paid to attracting and engaging a broader spectrum of attendees.

Cities with camera-equipped taxicabs experience reduced taxicab driver homicide rates: United States, 1996-2010.

BACKGROUND: Driving a taxicab remains one of the most dangerous occupations in the United States, with leading homicide rates. Although safety equipment designed to reduce robberies exists, it is not clear what effect it has on reducing taxicab driver homicides. FINDINGS: Taxicab driver homicide crime reports for 1996 through 2010 were collected from 20 of the largest cities (>200,000) in the United States: 7 cities with cameras installed in cabs, 6 cities with partitions installed, and 7 cities with neither cameras nor partitions. Poisson regression modeling using generalized estimating equations provided city taxicab driver homicide rates while accounting for serial correlation and clustering of data within cities. Two separate models were constructed to compare (1) cities with cameras installed in taxicabs versus cities with neither cameras nor partitions and (2) cities with partitions installed in taxicabs versus cities with neither cameras nor partitions. Cities with cameras installed in cabs experienced a significant reduction in homicides after cameras were installed (adjRR = 0.11, CL 0.06-0.24) and compared to cities with neither cameras nor partitions (adjRR = 0.32, CL 0.15-0.67). Cities with partitions installed in taxicabs experienced a reduction in homicides (adjRR = 0.78, CL 0.41-1.47) compared to cities with neither cameras nor partitions, but it was not statistically significant. CONCLUSIONS: The findings suggest cameras installed in taxicabs are highly effective in reducing homicides among taxicab drivers. Although not statistically significant, the findings suggest partitions installed in taxicabs may be effective.

Disparities in work-related homicide rates in selected retail industries in the United States, 2003-2008.

PROBLEM: Segments within the retail industry have a substantially higher rate of work-related fatality due to workplace violence compared to the retail industry overall. Certain demographic subgroups may be at higher risk. METHOD: National traumatic injury surveillance data were analyzed to characterize the distribution of fatality rates due to workplace violence among selected retail workers in the United States from 2003 through 2008. RESULTS: Overall, the highest fatality rates due to work-related homicide occurred among men, workers aged ≥65years, black, Asian, foreign-born and Southern workers. Among foreign-born workers, those aged 16-24years, non-Hispanic whites and Asians experienced substantially higher fatality rates compared to their native-born counterparts. CONCLUSIONS: The burden of work-related homicide in the retail industry falls more heavily on several demographic groups, including racial minorities and the foreign-born. Further research should examine the causes of these trends. Interventions designed to prevent workplace violence should target these groups.

Nonfatal work-related injuries and illnesses - United States, 2010.

In 2012, the U.S. civilian labor force comprised an estimated 155 million workers. Although employment can contribute positively to a worker's physical and psychological health, each year, many U.S. workers experience a work-related injury or illness. In 2011, approximately 3 million workers in private industry and 821,000 workers in state and local government experienced a nonfatal occupational injury or illness. Nonfatal workplace injuries and illnesses are estimated to cost the U.S. economy approximately $200 billion annually. Identifying disparities in work-related injury and illness rates can help public health authorities focus prevention efforts. Because work-related health disparities also are associated with social disadvantage, a comprehensive program to improve health equity can include improving workplace safety and health.

Fatal work-related injuries - United States, 2005-2009.

In 2012, the U.S. civilian labor force comprised an estimated 155 million workers. Although employment can contribute positively to a worker's physical and psychological health, each year, many U.S. workers are fatally injured at work. In 2011, a total of 4,700 U.S. workers died from occupational injuries. Workplace deaths are estimated to cost the U.S. economy approximately $6 billion annually. Identifying disparities in work-related fatality rates can help public health authorities focus prevention efforts. Because work-related health disparities also are associated with social disadvantage, a comprehensive program to improve health equity should include improving workplace safety and health.

A field intervention examining the impact of an office ergonomics training and a highly adjustable chair on visual symptoms in a public sector organization.

OBJECTIVE: Examine the effect of a multi-component office ergonomics intervention on visual symptom reductions. METHODS: Office workers were assigned to either a group receiving a highly adjustable chair with office ergonomics training (CWT), a training-only group (TO) or a control group (C). A work environment and health questionnaire was administered 2 and 1 month(s) pre-intervention and 3, 6, and 12 months post-intervention. Multi-level statistical models tested hypotheses. RESULTS: The CWT intervention lowered daily visual symptoms (p < 0.01) post-intervention. The TO group did not significantly differ from the control group. The CWT group differed significantly from the TO group (p = 0.01) post-intervention. CONCLUSION: Workers who received a highly adjustable chair and office ergonomics training had reduced visual symptoms and the effect was maintained through twelve months post-intervention. The lack of a training-only group effect supports implementing training in conjunction with the highly adjustable chair to reduce visual symptoms.

A replicated field intervention study evaluating the impact of a highly adjustable chair and office ergonomics training on visual symptoms.

OBJECTIVE: Examine the effects of two office ergonomics interventions in reducing visual symptoms at a private sector worksite. METHODS: A quasi-experimental study design evaluated the effects of a highly adjustable chair with office ergonomics training intervention (CWT group) and the training only (TO group) compared with no intervention (CO group). Data collection occurred 2 and 1 month(s) pre-intervention and 2, 6 and 12 months post-intervention. During each data collection period, a work environment and health questionnaire (covariates) and daily health diary (outcomes) were completed. Multilevel statistical models tested hypotheses. RESULTS: Both the training only intervention (p<0.001) and the chair with training intervention (p=0.01) reduced visual symptoms after 12 months. CONCLUSION: The office ergonomics training alone and coupled with a highly adjustable chair reduced visual symptoms. In replicating results from a public sector worksite at a private sector worksite the external validity of the interventions is strengthened, thus broadening its generalizability.

A validation study comparing two self-reported upper extremity symptom surveys with clinical examinations for upper extremity musculoskeletal disorders.

OBJECTIVE: Evaluate the validity of two self-report symptoms surveys with two disorder classification protocols. PARTICIPANTS: 100 graduate students at a private school in the Southwest United States. METHODS: Study participants completed two self-report upper extremity musculoskeletal symptoms surveys: a nine item 10 cm Visual Analogue Scale (VAS) and a nine item Likert categorical scale anchored from "None" to "Very severe". Clinical examinations were administered using two musculoskeletal disorder classification protocols. RESULTS: For the nine body regions, concordance between the two self-report symptoms scales ranged from 0.49-0.75. Overall there was greater than 80% agreement for the two disorder classification protocols. Using either symptom survey with either disorder classification protocol provided high sensitivities and specificities (Youden's J ≥ 0.70). Three of possible six symptom survey/classification protocol pairings provided high sensitivities and specificities across all disorder groups. CONCLUSION: In this graduate student sample, none of the self-report symptom survey-classification protocol pairings was demonstratively more useful than any other pairing for studies of musculoskeletal disorders among computer users.

Computer use patterns associated with upper extremity musculoskeletal symptoms.

INTRODUCTION: Over half of surveyed college students are experiencing pain they are attributing to computer use. The study objective was to evaluate the effect of computing patterns on upper extremity musculoskeletal symptoms. METHODS: Symptom experiences and computing/break patterns were reported several times daily over three weeks for 30 undergraduate students over a semester. Two-level logistic regression models described the daily association between each computing pattern and both any and moderate or greater symptom experienced, adjusting for covariates. RESULTS: The associations between most computing/break patterns and experiencing any symptoms were positive: total hours of computer use adjOR = 1.1 (90% CI 1.1-1.2), 1-2 breaks versus none adjOR = 1.3 (90% CI 0.9-1.9), 3-6 breaks versus none adjOR = 1.5 (90% CI 1.1-2.2), >15 min break versus none adjOR = 1.6 (90% CI 1.1-2.2), and number of stretch breaks adjOR = 1.3 (90% CI 1.1-1.5). However, breaks for less than 15 min were negatively associated with experiencing any symptoms: adjOR = 0.6 (90% CI 0.5-0.9). The associations between most computing/break patterns and experiencing moderate or greater symptoms were positive: total hours of computer use OR = 1.1 (90% CI 1.1-1.2), 1-2 breaks and 5-6 breaks versus none OR = 1.8 (90% CI 1.1-2.9), 7-8 breaks versus none OR = 2.0 (1.0-4.2), >15 min break versus none 1.8 (1.1-3.1), and number of stretch breaks OR = 1.3 (1.0-1.5). CONCLUSION: Computing/break patterns were consistently associated with experiencing symptoms. Our findings suggest evaluating breaks with computing duration (computing patterns) is more informative than assessing computing duration alone and can be used to better design ergonomic training programs for student populations that incorporate break times.

Daily computer usage correlated with undergraduate students' musculoskeletal symptoms.

BACKGROUND: A pilot prospective study was performed to examine the relationships between daily computer usage time and musculoskeletal symptoms on undergraduate students. METHODS: For three separate 1-week study periods distributed over a semester, 27 students reported body part-specific musculoskeletal symptoms three to five times daily. Daily computer usage time for the 24-hr period preceding each symptom report was calculated from computer input device activities measured directly by software loaded on each participant's primary computer. General Estimating Equation models tested the relationships between daily computer usage and symptom reporting. RESULTS: Daily computer usage longer than 3 hr was significantly associated with an odds ratio 1.50 (1.01-2.25) of reporting symptoms. Odds of reporting symptoms also increased with quartiles of daily exposure. CONCLUSIONS: These data suggest a potential dose-response relationship between daily computer usage time and musculoskeletal symptoms.