"Caminando Con Riesgo": perceptions of occupational injury, workplace safety and workers rights among Spanish-speaking hospitalized patients.

Introduction: Occupational health disparities are well documented among immigrant populations and occupational injury remains a high cause of morbidity and mortality among immigrant populations. There are several factors that contribute to the high prevalence of work-related injury among this population and those without legal status are more likely to experience abusive labor practices that can lead to injury. While the work-related injuries and experiences of Spanish-speaking workers have been explored previously, there is a paucity of literature documenting injury among hospitalized patients. Additionally, there are few documented hospital-based occupational injury prevention programs and no programs that implement workers rights information. The purpose of this study was to further explore the context of work related injuries primarily experienced by Spanish speaking patients and knowledge of their rights in the workplace. Methods: This was a semi-structured qualitative interview study with Spanish speaking patients admitted to the hospital for work related injuries. The study team member conducting interviews was bilingual and trained in qualitative methodology. An interview guide was utilized for all interviews and was developed with an immigrant workers rights organization and study team expertise, and factors documented in the literature. Participants were asked about the type and context of the injury sustained, access and perceptions of workplace safety, and knowledge of participants rights as workers. All interviews were conducted in Spanish, recorded, transcribed in Spanish and then translated into English. A codebook was developed and refined iteratively and two independent coders coded all English transcripts using Dedoose. Interviews were conducted until thematic saturation was reached and data was analyzed using a thematic analysis approach. Results: A total of eight interviews were completed. All participants reported working in hazardous conditions that resulted in an injury. Participants expressed a relative acceptance that their workplace environment was dangerous and acknowledged that injuries were common, essentially normalizing the risk of injury. There were varying reports of access to and utilization of safety information and equipment and employer engagement in safety was perceived as a facilitator to safety. Most participants did have some familiarity with Occupational Safety and Health Administration (OSHA) inspections but were not as familiar with OSHA procedures and their rights as workers. Discussion: We identified several themes related to workplace injury among Spanish speaking patients, many of which raise concerns about access to workplace safety, re-injury and long-term recovery. The context around immigration is particularly important to consider and may lead to unique risk factors for injury, recovery, and re-injury both in the workplace and beyond the workplace, suggesting that perhaps immigration status alone may serve as a predisposition to injury. Thus, it is critical to understand the context around work related injuries in this population considering the tremendous impact of employment on one's health and financial stability. Further research on this topic is warranted, specifically the exploration of multiple intersecting layers of exposure to injury among immigrant populations. Future work should focus on hospital-based strategies for injury prevention and know your rights education tailored to Spanish speaking populations.

Developing a risk framework for assembly construction based on stakeholder theory and structural equation modelling.

Occupational injuries in the construction industry have plagued many countries, and many cases have shown that accidents often occur because of a combination of project participants. Assembled construction (AC) projects have received extensive attention from Chinese scholars as a future trend, but few studies have explored the interrelationships and potential risks of various stakeholders in depth. This study fills this research gap by proposing a multi-stakeholder AC risk framework. The study surveyed 396 stakeholders, then analyzed the collected data and created a risk framework based on Structural Equation Modelling (SEM) and the CRITIC weighting method. The results revealed that factors like "regular supervision is a formality," "blindly approving the wrong safety measures," and "failure to organize effective safety education and training." are vital risks in AC of China. Finally, the study validates the risk factors and the framework with 180 real-life cases, which shows that the proposed framework is theoretically grounded and realistic. The study also suggests multi-level strategies such as introducing AI-based automated risk monitoring, improving the adaptability of normative provisions to technological advances, and advancing the culture of project communities of interest to ensure AC's safe practices.

Improving Employee Safety Through a Comprehensive Patient Behavioral Program.

BACKGROUND: Health care workers in the United States are facing increasing rates of exposure to aggressive behavior, resulting in an increase in employee injuries related specifically to patient behavioral events. By leveraging interprofessional collaboration and system-level innovation, we aimed to reduce the rate of employee injuries related to patient behavioral events at a children's hospital by 50% over a 3-year period. METHODS: An interdisciplinary quality improvement team comprising physicians, behavior analysts, nursing, and other key stakeholders developed a comprehensive behavior program in our children's hospital. The team developed 5 key pillars: aggression mitigation tools, clinical resources, advanced training, screening and management, and behavior emergency response. The outcome measure was rate of reported employee safety events related to patient behavioral events. This was tracked via prospective time series analysis statistical process control chart using established rules to detect special cause variation. RESULTS: The average rate of employee injuries resulting from patient behavioral events decreased from 0.96 to 0.39 per 1000 adjusted patient-days, with special cause variation observed on a statistical process control U-chart. This improvement has been sustained for 16 months. Staff members who experienced injuries included nurses and patient technicians, with common antecedents to injuries including medical interventions or patient requests that could not be safely met. CONCLUSIONS: A unified and multimodal system aimed to address pediatric patient behavioral events can reduce employee injuries and foster a culture of employee safety in the pediatric inpatient setting.

Establishment-level safety analytics: a scoping review.

The use of data analytics has seen widespread application in fields such as medicine and supply chain management, but their application in occupational safety has only recently become more common. The purpose of this scoping review was to summarize studies that employed analytics within establishments to reveal insights about work-related injuries or fatalities. Over 300 articles were reviewed to survey the objectives, scope and methods used in this emerging field. We conclude that the promise of analytics for providing actionable insights to address occupational safety concerns is still in its infancy. Our review shows that most articles were focused on method development and validation, including studies that tested novel methods or compared the utility of multiple methods. Many of the studies cited various challenges in overcoming barriers caused by inadequate or inefficient technical infrastructures and unsupportive data cultures that threaten the accuracy and quality of insights revealed by the analytics.

The effect of power stretchers on occupational injury rates in an urban emergency medical services system.

BACKGROUND: To examine occupational injury rates in a dual-response emergency medical services (EMS) system before and after implementation of a power-lift stretcher system. METHODS: The seasonally-adjusted occupational injury rate was estimated relative to medical call volume (per 1000 calls) and workers (per 100 FTEs) from 2009 to 2019, and stratified by severity (lost-time, healthcare only), role (EMS, FIRE) and type (patient-handling). Power-lift stretchers were adopted between 2013 and 2015. Preinjury versus postinjury rates were compared using binomial tests. Interrupted time series (ITS) analysis was used to estimate the trend and change in injuries related to patient-handling, with occupational illnesses serving as control. RESULTS: Binomial tests revealed varied results, with reductions in the injury rate per 1000 calls (-14.0%) and increases in the rate per 100 FTEs (+14.1%); rates also differed by EMS role and injury severity. ITS analysis demonstrated substantial reductions in patient-handling injuries following implementation of power-lift stretchers, both in the injury rate per 1000 calls (-50.4%) and per 100 FTEs (-46.6%), specifically among individuals deployed on the ambulance. Injury rates were slightly elevated during the winter months (+0.8 per 100 FTEs) and lower during spring (-0.5 per 100 FTEs). CONCLUSIONS: These results support the implementation of power-lift stretchers for injury prevention in EMS systems and demonstrate advantages of ITS analysis when data span long preintervention and postintervention periods.

Occupational risk perception of construction workers: a cross sectional study.

Introduction: Construction workers are often exposed to significant injury risk. The aim of our study is to assess their occupational hazards and injury risk perception. Methods: We administered 256 questionnaires to construction workers. The survey was aimed at collecting information regarding occupational risk and hazard exposure perception, risk control and behavioral self-assessment. We analyzed the data obtained in order to highlight any associations between injury risk perception and anamnestic, occupational, behavioral or perceptual factors. Results: Participants were prevalently males (92.37%) aged 21-60 years (94%). They showed a job seniority level of 21.3 (11.51) on average and, ranging from a 1 to 10 score, a danger awareness of 6.8 (2.9), a lack of prevention measures 6.0 (3.3), an improper behavior of 7.3 (2.7), an unpredictable fate of 6.0 (2.9). These factors resulted significantly associated with the injury risk perception. Multivariable analysis highlighted that the injury risk perception was associated with the lack of prevention measure and unpredictable fate. On the other hand, we found a negative association with the workers' improper behaviors. Conclusion: Workers' perception showed fairly uniform average values even when occupational risk was demonstrated. Our analysis suggests a positive correlation between injury risk perception and the idea that injuries are due both to fate and to chance; it also shows a negative correlation between injury risk perception and the idea that injuries are due to improper behavior. A lack of fully comparable studies confirms the need for further studies on the injury risk perception of construction workers.

Individual and organizational factors associated with injury history and patient handling behaviors: Results from a nationwide survey of healthcare workers.

With proper compliance, safe patient handling and mobility (SPHM) programs reduce musculoskeletal disorders (MSDs). To better understand individual, environmental, and organizational factors associated with both the adoption of SPHM and prevalence of MSDs, a nationwide online survey was administered. 973 healthcare workers (HCWs) completed the survey, for which 59.6% reported past work-related MSDs or pain. Among those with pain or injury, 33.3% changed roles, 79.7% worked while injured, and only 30.9% reported workers' compensation claims. Less than half of HCWs agreed that SPHM equipment is readily available, and most considered manually handling patients weighing over 91 kg acceptable. Equipment availability, ceiling lift availability, supervisor encouragement, and annual training were associated with increased use of SPHM equipment. Availability of SPHM equipment reduced the likelihood of injured nurses changing roles. Despite overall agreement that SPHM programs are beneficial, common clinical practice remains insufficient to adequately protect HCWs from risk of injury.

Using State Agency Reports to Augment Ohio's Agricultural Injury Surveillance Efforts.

BACKGROUND: Agriculture is a hazardous industry with undocumented injury events. Credible surveillance measures are critical for this industry, especially to guide injury prevention programs with targeted recommendations for specific commodity groups and populations. This multi-phase study explored the feasibility for two state agency databases, the Ohio Bureau of Workers' Compensation (BWC) Program and the Emergency Medical Services Incident Reporting System (EMSIRS), to augment the state's Bureau of Labor Statistics (BLS) annual reports. METHODS: BWC data described injury claims in agricultural workplaces from 1999 to 2008. State EMSIRS data described the types of medical emergencies for which EMS services were requested to Ohio farms in 2013-2014. Descriptive analyses were performed on each distinctive source. RESULTS: Over 14,000 BWC claims were analyzed, with primary nature of injury identified as sprains and strains of bodily extremities; falls were the most common cause of injury. The EMSIRS data provided 1,376 cases, where EMS services were requested to Ohio farms at injury onset. Some cases had possibility to be excluded in CFOI or employment claims data, with 24% patients 65 years and older and 6% children 13 years and younger. The primary cause of injury was falls, and the highest reported injury type was blunt trauma. CONCLUSIONS: Both BWC and EMSIRS databases showed the potential to enhance Ohio's agricultural surveillance data with viable information not found in previously used systems. Each agency database had its own merits to further clarify and quantify morbidity. When used together, these sources enrich surveillance statistics to describe Ohio's agricultural injury incidents.

HOW TO PREVENT HAND INJURIES - REVIEW OF EPIDEMIOLOGICAL DATA IS THE FIRST STEP IN HEALTH CARE MANAGEMENT.

BACKGROUND: Hand injuries are common affecting all ages, genders, and geographic regions. They can result in long term disability and mortality, while they place a significant financial burden in society. Although, hand injuries can be prevented. Preventive strategies can be designed, but knowledge of injuries' epidemiological characteristics is required beforehand. METHODS: We performed a review of the current literature related to hand injuries to identify their incidence, patients' demographics, type, mode, and time of the injury. RESULTS: Hand injuries constitute 6.6% to 28.6% of all injuries presenting to the Emergency Department and 28% of injuries to the musculoskeletal system. They mainly affect young male labourers. Occupational and home accidents are the commonest injury modalities, while traffic road accidents constitute a significant reason for hand injuries as well. Lacerations account for most hand injuries, followed by crush injuries, fractures and amputations. Most occupational injuries occur in the beginning of the week and especially during the morning shift, while there has been identified an increase in the number of hand injuries during the summer months. CONCLUSIONS: Hand injuries are an important health problem with impact on patient's life and on the society. Although they can be prevented. Preventive strategies need to be addressed towards many directions and people's activities, since prevention will have an important impact on people's quality of life and society's well-being.

Fostering Stay at Work After a Period of Disability: A Scoping Review of Occupational Rehabilitation Strategies to Support Workers in the Adoption of Preventive Behaviours.

PURPOSE: Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS: To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS: We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION: The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.

Whether occupational injuries of the industrial workers can be prevented: an analysis from the slums of West Bengal-India?

A lack of research exists concerning the heterogeneity of the occupational injuries of slum dwellers across industries which has a close link with health expenditure and hence livelihood. It necessitates analysing their occupational injuries and associated out-of-pocket health expenditures. Multi-stage random sampling is used to collect the primary data and the logit model is used for data analyses. Permanent non-fatal injuries in the civil-mechanical industries and temporary non-fatal injuries in textile industries are common. The share of health expenditure of the injured workers seeking medical consultations remains 59% of their average monthly income. Average monthly income, parental occupation, types of industry, job security, risk intensity, and salary basis are significant estimates of occupational injuries. The differences in the nature and extent of the occupational injuries of the workers across industries in the light of the socio-demographic and working environment context provide significant insight into the policy implications.

2022 National Occupational Injury Research Symposium (NOIRS): Preventing workplace injuries in a changing world.

About NOIRS: The National Occupational Injury Research Symposium (NOIRS) is the only conference solely dedicated to occupational injury research and prevention. The 8th NOIRS, sponsored by the National Institute for Occupational Safety and Health (NIOSH) and several partners, was held on May 10-12, 2022. NOIRS was held entirely virtually in response to concerns of the COVID-19 pandemic and honoring the symposium theme "Preventing Workplace Injuries in a Changing World." About this Special Issue: The intent of this issue is to highlight the breadth of high-quality presentations at NOIRS, and to make them available to those who did not participate in the conference. This issue includes three short communication articles and nine research articles. Featured research articles in this special issue span a wide variety of methods, data sources, and worker populations. They address leading and emerging causes and contributors to occupational injury in a range of industries and occupations. Concluding Remarks: We hope that this special issue provides readers with a view into some of the research presented at the 2022 NOIRS. We also hope the articles are useful for research and practice, and thinking toward the future.

Does occupational injury research illuminate or obscure occupational safety?

INTRODUCTION: The effectiveness of occupational injury research may, at least in part, depend upon the perspective used in that research. METHOD: This paper presents two perspectives occupational injury research may adopt - the injury-focused and the occupation-focused perspectives. The injury-focused perspective sees injuries as the primary unit of analysis in occupational injury research. It is based on several premises that focus its research on understanding occupational injuries. However, this focus may obscure certain factors of how injuries occur and, ultimately, how to create occupational safety. By contrast, the occupation-focused perspective sees work as the primary unit of analysis of occupational injury research. This perspective may allow researchers to solve what is described in this paper as the 'dark safety' problem (i.e., how even unsafe systems go long periods of time without failure). The paper does not argue that one or the other perspective should be the only perspective. However, a balanced perspective between injury-focused and occupation-focused research is needed to further occupational injury research.

[Storytelling in prevention: the case-study of accidents at work. How the narrative method can enhance the prevention of occupational injuries.] / Narrare per prevenire: il caso degli infortuni sul lavoro.Come il metodo narrativo può valorizzare la prevenzione degli infortuni lavorativi.

OBJECTIVE: This article aims to analyze the elements of the narrative which, applied to investigations of accidents at work, transform them into stories, making the dynamics of accidents clearer, more complete and emotionally engaging and also capable of being transferred to a non-experts audience. METHOD: The theoretical reference identified for the analysis of the accident histories is the work of the Lithuanian semiologist Algirdas Julien Greimas. The title, the dimensions of space and time, the characters (according to the actantial model), the point of view, the structure of the story (following the canonical narrative scheme), and the moral of the tale are the elements of the narration analyzed in this article. RESULTS: This article illustrates how the dynamics of accidents can lend themselves to being told according to the typical categories of narration and textual organization, resulting in them being enriched with important elements for the communication of prevention and the learning of safe behaviour. The accident investigation that becomes history takes on important characteristics also in terms of communication: the contents become clearer, more accessible and more engaging. Unlike traditional surveys, injury stories, through the elements of the narrative and in particular with the addition of indications for prevention, become an efficient learning and sharing tool valid in training contexts, and the contents effectively usable in practice of prevention workers. CONCLUSIONS: The narration applied to accidents at work, allowing for greater attention to the elements of the context, relationships and the emotional sphere of the various actors involved, is able to bring out more clearly the important and various factors that can contribute to causing an accident, becoming thus an effective tool for the transfer of indications for prevention.

Prevalence and factors associated with occupational injuries among building construction workers in the Gambia.

BACKGROUND: Although occupational injuries among building construction workers are a major public health concern, limited studies have focused on the prevalence and factors associated with injuries among building construction workers in sub-Saharan Africa. Accordingly, this study investigates the prevalence and factors associated with occupational injuries among building construction workers in the Gambia. METHOD: Using a cross-sectional design, 504 building construction workers with more than 12 months of work experience in the construction industry and aged ≥18 years were recruited from 22 registered companies in the Kanifing Municipality of the Gambia. Data were collected using a structured questionnaire and an observational checklist. RESULTS: More than 56% of the building construction workers reported sustaining work-related injuries in the past 12 months. Majority of injuries reported were abrasions/lacerations (28.2%), followed by cuts (26.6%), backaches (23.8%) and piercing/punctured wounds (22.8%). Results of the multivariate logistic regression analysis showed that being male worker (adjusted OR (aOR), 3.06; 95% CI 1.31 to 7.19), had <8 hours of work daily (aOR 3.46, 95% CI 1.44 to 7.78), smoke tobacco (aOR 1.97; 95% CI 1.36 to 2.85) and consume alcohol (aOR 0.27; 95% CI 0.08 to 0.95) were significantly associated with injuries from building construction work. CONCLUSION: Our findings show that injuries among building construction workers are prevalent in the Gambia. Male gender, work hours, tobacco use and alcohol consumption were associated with occupational injuries in building construction. Introducing and enforcing workplace safety policies in the building construction industry may help reduce occupational injury among construction workers in the Gambia.

Workers' compensation injury claims among firefighters in Ohio, 2001-2017.

BACKGROUND: Firefighters are at high risk for nonfatal and fatal occupational injuries. While some past research has quantified firefighter injuries using various data sources, Ohio workers' compensation injury claims data largely have not been used. METHODS: Public and private firefighter claims, including volunteer and career firefighters, from Ohio's workers' compensation data for 2001-2017 were identified based on occupational classification codes and manual review of the occupation title and injury description. The task during injury (firefighting, patient care, training, other/unknown, etc.) was manually coded based on the injury description. Injury claim counts and proportions were described across claim type (medical-only or lost-time), worker demographics, task during injury, injury events, and principal diagnoses. RESULTS: 33,069 firefighter claims were identified and included. Most claims were medical-only (66.28%, <8 days away from work) and involved males (93.81%) aged 25-54 years (86.54%). While the task during injury could not be categorized for many narratives (45.96%), the largest percentage that could be categorized occurred during firefighting (20.48%) and patient care (17.60%). The most common injury events were overexertion involving outside sources (31.33%) and struck by objects or equipment (12.68%). The most frequent principal diagnoses were back, lower extremity, and upper extremity sprains (16.02%, 14.46%, and 11.98%, respectively). CONCLUSIONS: This study provides a preliminary basis for the development of focused firefighter injury prevention programming and training. Obtaining denominator data, enabling rate calculation, would strengthen the risk characterization. Based on the current data, prevention efforts focusing on the most frequent injury events and diagnoses may be warranted.

Behind the flexibility: insufficient occupational injury protection of gig workers in China.

Objective: Occupational injury protection is essential to safeguard the basic rights of workers. This article focuses on a group of gig workers who have emerged on a large scale in recent years in China and aims to explore their status of occupational injury protection. Methods: Based on the theory of technology-institution innovation interaction, we adopted the institution analysis to assess the work-related injury protection of gig workers. The comparative study was used to evaluate three cases of occupational injury protection in China for gig workers. Results: Institutional innovation failed to respond to technological innovation and provided insufficient occupational injury protection for gig workers. The work-related injury insurance was inaccessible to gig workers due to they were not treated as employees in China. The work-related injury insurance was not available to gig workers. Although some practices were explored, shortcomings remain. Conclusions: Behind the flexibility of gig work is insufficient occupational injury protection. According to the theory of technology-institution innovation interaction, we believe the reform of work-related injury insurance is increasingly essential for improving the situation of gig workers. This research contributes to expanding understanding of gig workers' situation and may offer a reference to other countries on protecting gig workers against occupational injuries.

Do Clinics in Meat and Poultry Plants Endanger Workers?

Most meatpacking workers are Black, Latinx, and immigrant workers earning low wages and at high risk for occupational injury. Most meat and poultry plants have on-site workplace clinics (OWCs) where workers are required to obtain care for work-related injuries or illnesses before seeking outside clinical assessment or intervention. Although OWCs can help plant managers identify and mitigate hazards, government and other investigations reveal that OWCs in meatpacking plants not only fail to advocate for safer work conditions, but also nurture conditions that exacerbate injury and illness. This article explores ethical challenges for health care professionals in OWCs, including companies' pressure to keep so-called "recordable" injuries low. This article also suggests changes to support OWCs' roles in safety and injury prevention.