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.

Temporal trends in occupational injuries treated in US emergency departments, 2012-2019.

BACKGROUND: Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019. METHODS: Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019. RESULTS: Occupational injuries occurred at an average rate of 176.2 (95% CI = ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI = ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI = ± 10.5%), transportation incidents (- 23.2%; 95% CI = ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI = ± 8.9%). CONCLUSIONS: This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.

Workplace Violence and the Mental Health of Public Health Workers During COVID-19.

INTRODUCTION: During the COVID-19 pandemic, public health workers were at an increased risk for violence and harassment due to their public health work and experienced adverse mental health conditions. This article quantifies the prevalence of job-related threats, harassment, and discrimination against public health workers and measures the association of these incidents with mental health symptoms during the COVID-19 pandemic. METHODS: A nonprobability convenience sample of state, local, and tribal public health workers completed a self-administered, online survey in April 2021. The survey link was emailed to members of national public health associations and included questions on workplace violence, demographics, workplace factors, and mental health symptoms. Mental health symptoms were measured using standardized, validated tools to assess depression, anxiety, post-traumatic stress disorder, and suicidal ideation. Multivariable Poisson models calculated adjusted prevalence ratios of mental health symptoms, with workplace violence as the primary risk factor. Analyses were conducted in 2021-2022. RESULTS: Experiencing any type or combination of workplace violence was significantly associated with an increased likelihood of reporting depression symptoms (prevalence ratio=1.21, 95% CI=1.15, 1.27), anxiety (prevalence ratio=1.21, 95% CI=1.15, 1.27), post-traumatic stress disorder (prevalence ratio=1.31, 95% CI=1.25, 1.37), and suicidal ideation (prevalence ratio=1.26, 95% CI=1.14, 1.38), after adjusting for confounders. A dose‒response relationship was found between the number of workplace violence events experienced by a public health worker and the likelihood of reporting mental health symptoms. CONCLUSIONS: Violence targeted at the public health workforce is detrimental to workers and their communities. Ongoing training, workplace support, and increased communication after a workplace violence incident may be helpful. Efforts to strengthen public health capacities and support the public health workforce are also needed.

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.

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.

Malignant Mesothelioma Mortality - United States, 1999-2015.

Malignant mesothelioma is a neoplasm associated with occupational and environmental inhalation exposure to asbestos* fibers and other elongate mineral particles (EMPs) (1-3). Patients have a median survival of approximately 1 year from the time of diagnosis (1). The latency period from first causative exposure to malignant mesothelioma development typically ranges from 20 to 40 years but can be as long as 71 years (2,3). Hazardous occupational exposures to asbestos fibers and other EMPs have occurred in a variety of industrial operations, including mining and milling, manufacturing, shipbuilding and repair, and construction (3). Current exposures to commercial asbestos in the United States occur predominantly during maintenance operations and remediation of older buildings containing asbestos (3,4). To update information on malignant mesothelioma mortality (5), CDC analyzed annual multiple cause-of-death records† for 1999-2015, the most recent years for which complete data are available. During 1999-2015, a total of 45,221 deaths with malignant mesothelioma mentioned on the death certificate as the underlying or contributing cause of death were reported in the United States, increasing from 2,479 deaths in 1999 to 2,597 in 2015 (in the same time period the age-adjusted death rates§ decreased from 13.96 per million in 1999 to 10.93 in 2015). Malignant mesothelioma deaths increased for persons aged ≥85 years, both sexes, persons of white, black, and Asian or Pacific Islander race, and all ethnic groups. Despite regulatory actions and the decline in use of asbestos the annual number of malignant mesothelioma deaths remains substantial. The continuing occurrence of malignant mesothelioma deaths underscores the need for maintaining measures to prevent exposure to asbestos fibers and other causative EMPs and for ongoing surveillance to monitor temporal trends.

Compliance to two city convenience store ordinance requirements.

BACKGROUND: Robbery-related homicides and assaults are the leading cause of death in retail businesses. Robbery reduction approaches focus on compliance to Crime Prevention Through Environmental Design (CPTED) guidelines. PURPOSE: We evaluated the level of compliance to CPTED guidelines specified by convenience store safety ordinances effective in 2010 in Dallas and Houston, Texas, USA. METHODS: Convenience stores were defined as businesses less than 10 000 square feet that sell grocery items. Store managers were interviewed for store ordinance requirements from August to November 2011, in a random sample of 594 (289 in Dallas, 305 in Houston) convenience stores that were open before and after the effective dates of their city's ordinance. Data were collected in 2011 and analysed in 2012-2014. RESULTS: Overall, 9% of stores were in full compliance, although 79% reported being registered with the police departments as compliant. Compliance was consistently significantly higher in Dallas than in Houston for many requirements and by store type. Compliance was lower among single owner-operator stores compared with corporate/franchise stores. Compliance to individual requirements was lowest for signage and visibility. CONCLUSIONS: Full compliance to the required safety measures is consistent with industry 'best practices' and evidence-based workplace violence prevention research findings. In Houston and Dallas compliance was higher for some CPTED requirements but not the less costly approaches that are also the more straightforward to adopt.

Notes from the Field: Update: Silicosis Mortality - United States, 1999-2013.

Silicosis is a potentially fatal but preventable occupational lung disease caused by inhaling respirable crystalline silica (silica). Chronic silicosis, the most common form, occurs after exposure to relatively low silica concentrations for >10 years. Accelerated silicosis occurs after 5-10 years of exposure to higher silica levels, and acute silicosis can occur after only weeks or months of exposure to extremely high silica concentrations. New national mortality data for silicosis have become available since a previous report on silicosis surveillance was published earlier this year. CDC reviewed multiple cause-of-death mortality files from the National Center for Health Statistics to analyze deaths from silicosis (International Classification of Diseases, 10th Revision diagnosis code J62: a pneumoconiosis due to dust containing silica) reported during 1999-2013. Each record lists one underlying cause of death (the disease or injury that initiated the chain of events that led directly and inevitably to death), and up to 20 contributing causes of death (other significant conditions contributing to death but not resulting in underlying cause). Available death certificates from 35 states were reviewed for the period 2004-2006 to identify occupations associated with silicosis among decedents aged 15-44 years. Results indicate that despite substantial progress in eliminating silicosis, silicosis deaths continue to occur. Of particular concern are silicosis deaths in young adults (aged 15-44 years). These young deaths likely reflect higher exposures than those causing chronic silicosis mortality in older persons, some of sufficient magnitude to cause severe disease and death after relatively short periods of exposure. A total of 12 such deaths occurred during 2011-2013, with nine that had silicosis listed as the underlying cause of death.

Silicosis mortality trends and new exposures to respirable crystalline silica - United States, 2001-2010.

Silicosis is a preventable occupational lung disease caused by the inhalation of respirable crystalline silica dust and can progress to respiratory failure and death. No effective specific treatment for silicosis is available; patients are provided supportive care, and some patients may be considered for lung transplantation. Chronic silicosis can develop or progress even after occupational exposure has ceased. The number of deaths from silicosis declined from 1,065 in 1968 to 165 in 2004. Hazardous occupational exposures to silica dust have long been known to occur in a variety of industrial operations, including mining, quarrying, sandblasting, rock drilling, road construction, pottery making, stone masonry, and tunneling operations. Recently, hazardous silica exposures have been newly documented during hydraulic fracturing of gas and oil wells and during fabrication and installation of engineered stone countertops. To describe temporal trends in silicosis mortality in the United States, CDC analyzed annual multiple cause-of-death data for 2001-2010 for decedents aged ≥15 years. During 2001-2010, a total of 1,437 decedents had silicosis coded as an underlying or contributing cause of death. The annual number of silicosis deaths declined from 164 (death rate† = 0.74 per 1 million population) in 2001 to 101 (0.39 per 1 million) in 2010 (p = 0.002). Because of new operations and tasks placing workers at risk for silicosis, efforts to limit workplace exposure to crystalline silica need to be maintained.

Cigarette smoking trends among U.S. working adult by industry and occupation: findings from the 2004-2012 National Health Interview Survey.

OBJECTIVE: To examine trends in age-adjusted cigarette smoking prevalence among working adults by industry and occupation during 2004-2012, and to project those prevalences and compare them to the 2020 Healthy People objective (TU-1) to reduce cigarette smoking prevalence to ≤12%. METHODS: We analyzed the 2004-2012 National Health Interview Survey (NHIS) data. Respondents were aged ≥18 years working in the week prior to the interview. Temporal changes in cigarette smoking prevalence were assessed using logistic regression. We used the regression model to extrapolate to the period 2013-2020. RESULTS: Overall, an estimated 19.0% of working adults smoked cigarettes: 22.4% in 2004 to 18.1% in 2012. The largest declines were among workers in the education services (6.5%) industry and in the life, physical, and social science (9.7%) occupations. The smallest declines were among workers in the real estate and rental and leasing (0.9%) industry and the legal (0.4%) occupations. The 2020 projected smoking prevalences in 15 of 21 industry groups and 13 of the 23 occupation groups were greater than the 2020 Healthy People goal. CONCLUSIONS: During 2004-2012, smoking prevalence declined in the majority of industry and occupation groups. The decline rate varied by industry and occupation groups. Projections suggest that certain groups may not reach the 2020 Healthy People goal. Consequently, smoking cessation, prevention, and intervention efforts may need to be revised and strengthened, particularly in specific occupational groups.

Diseases attributable to asbestos exposure: years of potential life lost, United States, 1999-2010.

BACKGROUND: Although asbestos use has been restricted in recent decades, asbestos-associated deaths continue to occur in the United States. OBJECTIVES: We evaluated premature mortality and loss of potentially productive years of life attributable to asbestos-associated diseases. METHODS: Using 1999-2010 National Center for Health Statistics mortality data, we identified decedents aged ≥25 years whose death certificate listed asbestosis and malignant mesothelioma as the underlying cause of death. We computed years of potential life lost to life expectancy (YPLL) and to age 65 (YPLL65 ). RESULTS: During 1999-2010, a total of 427,005 YPLL and 55,184 YPLL65 were attributed to asbestosis (56,907 YPLL and 2,167 YPLL65 ), malignant mesothelioma (370,098 YPPL and 53,017 YPLL65 ). Overall and disease-specific asbestos-attributable total YPLL and YPLL65 and median YPLL and YPLL65 per decedent did not change significantly from 1999 to 2010. CONCLUSIONS: The continuing occurrence of asbestos-associated diseases and their substantial premature mortality burden underscore the need for maintaining prevention efforts and for ongoing surveillance to monitor temporal trends in these diseases.

Effectiveness of taxicab security equipment in reducing driver homicide rates.

BACKGROUND: Taxicab drivers historically have had one of the highest work-related homicide rates of any occupation. In 2010 the taxicab driver homicide rate was 7.4 per 100,000 drivers, compared to the overall rate of 0.37 per 100,000 workers. PURPOSE: Evaluate the effectiveness of taxicab security cameras and partitions on citywide taxicab driver homicide rates. METHODS: Taxicab driver homicide rates were compared in 26 major cities in the U.S. licensing taxicabs with security cameras (n=8); bullet-resistant partitions (n=7); and cities where taxicabs were not equipped with either security cameras or partitions (n=11). News clippings of taxicab driver homicides and the number of licensed taxicabs by city were used to construct taxicab driver homicide rates spanning 15 years (1996-2010). Generalized estimating equations were constructed to model the Poisson-distributed homicide rates on city-specific safety equipment installation status, controlling for city homicide rate and the concurrent decline of homicide rates over time. Data were analyzed in 2012. RESULTS: Cities with cameras experienced a threefold reduction in taxicab driver homicides compared with control cities (RR=0.27; 95% CI=0.12, 0.61; p=0.002). There was no difference in homicide rates for cities with partitions compared with control cities (RR=1.15; 95% CI=0.80, 1.64; p=0.575). CONCLUSIONS: Municipal ordinances and company policies mandating security cameras appear to be highly effective in reducing taxicab driver deaths due to workplace violence.

Non-fatal workplace violence injuries in the United States 2003-2004: a follow back study.

OBJECTIVE: Contribute to the prevention of workplace violence by providing information about the nature and circumstances of nonfatal assaults among U.S. workers. METHODS: Data were collected from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work), a stratified probability sample of U.S. hospitals. Workplace violence victims identified from NEISS-Work voluntarily completed a followback interview detailing the nature and circumstances surrounding their workplace violence incident. RESULTS: The majority of workplace violence injuries treated in emergency departments resulted from simple assaults that did not involve any lost time from work. Almost two-thirds of these workplace violence victims filed only an internal report. Eighty percent of the victims returned to their same jobs and will not change the way they do their jobs as a result of the violent incident. CONCLUSIONS: Nonfatal workplace violence is an important risk for U.S. workers, particularly in some occupations and industries. Prevention strategies need to be tailored by occupation and work environment. Results from the healthcare section of this survey indicate high numbers of incidents during times when the healthcare workers were assisting patients with medical and non-medical needs.

Eleven years of occupational mortality in law enforcement: The census of fatal occupational injuries, 1992-2002.

BACKGROUND: Occupational injury deaths remain high for Law Enforcement Officers (LEOs). This study describes and compares intentional and transportation-related fatality rates in US LEOs between 1992 and 2002. METHODS: Workplace injury deaths among LEOs from 1992 to 2002 were categorized into "Intentional," "Transportation-related," and "Other," using the Census of Fatal Occupational Injuries. Occupations included in this analysis were sheriffs and bailiffs, police and detectives, non-public service guards, and correctional officers. Fatality rates were compared among law enforcement occupations, cause of death, and demographics with rate ratios and 95% confidence intervals. RESULTS: During the 11-year period, 2,280 workers died from an occupational injury, for a fatality rate of 11.8 per 100,000 across all LEO occupations. Forty-seven percent were homicides (n = 1,072, rate 5.6 per 100,000), 36% transportation-related (n = 815, rate 4.2 per 100,000), 11% were due to other causes (n = 249, rate 1.3 per 100,000), and 5% were workplace suicides (n = 122, rate 0.6 per 100,000). The proportion of fatalities by cause of death differed significantly between occupations (P < 0.0001). Sheriffs and bailiffs experience a high risk for occupational injury death compared to other law enforcement occupations. Of the transportation-related fatalities, LEOs were operating a motor-vehicle in 58% of the incidents and 22% of the fatalities were struck by incidents. CONCLUSIONS: Transportation-related deaths were nearly as common as homicides as a cause of occupational injury death among US LEOs. Struck by vehicle incidents remain an important and overlooked cause of death. This research points to opportunities for the prevention of transportation-related deaths in law enforcement.

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.

Trends in workplace homicides in the U.S., 1993-2002: a decade of decline.

BACKGROUND: Trends in workplace homicide rates are compared to the trends in U.S. homicides from 1993 to 2002, inclusively. The homogeneity of workplace homicide rates by victim demographics, circumstances, and types of events are also addressed. METHODS: Using publicly available data from several sources, Poisson models are used to statistically compare the trends of workplace homicide rates versus U.S. homicide rates and to compare trends within categories of workplace homicides. RESULTS: Overall, there was a significant decline in the rates of occupational homicide of approximately 6% per year during the study time period; this decline was found to be statistically greater than the decline of all U.S. homicides (5% per year). Taxi cab drivers and chauffeurs demonstrated the greatest decline of all occupational subgroups. When looking at the circumstances of workplace homicides, only the rate of homicides committed during a robbery or other crime demonstrated a significant decline. CONCLUSIONS: While workplace homicides have declined in the U.S., the declines have not occurred uniformly across demographic and occupational categories.