Are injury admissions on weekends and weeknights different from weekday admissions?

PURPOSE: To examine whether hours of a day and days of a week influence injury pattern, means of evacuation, and hospital resource utilization. METHODS: A study based on the Israeli National Trauma Registry of patients hospitalized due to injury between 2008 and 2015. RESULTS: Of 293,077 subjects included; 32.8% were admitted on weekends (weekend-days 16.7% and weekend-nights 16.1%), 20.0% on weeknights and 47.2% on weekdays. Compared with weekday admissions, weekend and weeknight admissions had higher risk of hospitalization from violence and fall-related injuries, but lower risk from road traffic injuries (RTI) except for weekend-day admissions adjusted for age, gender, and ethnicity. Hospitalization due to burn injuries was greater on weekends, particularly on weekend-days. Hospitalization for violence and burn injuries was greater on weekend-nights vs weeknights, while injuries from other unintentional causes were greater on weeknights than weekend-nights. Furthermore, patients admitted on weekends and weeknights were more likely to have severe and critical injuries, greater utilization of intensive care unit and to be referred for rehabilitation, but were less likely to receive prehospital emergency medical service. In stratified analyses, RTI-related hospitalization was greater on weekends among youth and adults aged 15-64 years, males and Arabs, while burn injuries were more likely among weekend admissions for children aged 0-14 years, female and Jews. CONCLUSIONS: Injury pattern and resource utilization are related to time. Therefore, injury prevention and intervention efforts should account for hours of a day and days of a week, particularly in relation with age, gender, and ethnicity.

Prohibition on Changing Workplaces and Fatal Occupational Injuries among Chinese Migrant Workers in South Korea.

We assessed the risk of fatal occupational injuries among migrant workers with two different types of employment permits in South Korea. This observational study used national data from January 2007 to September 2018 and analyzed 42,089 cases of occupationally injured migrant workers of Chinese nationality. Fatality rates were analyzed according to year, sex, age, occupation, industry, and type of employment permit. Chinese workers were permitted to work for one employer and prohibited from changing employers, whereas Korean-Chinese workers were permitted to change their employer. The adjusted fatality rate of occupational injuries of Chinese migrant workers was significantly higher (1.80-fold, 95% confidence interval 1.31-2.46) than that of Korean-Chinese migrant workers. The prohibition on changing workplaces; male sex; age ≥ 45 years; machine operator; construction industry; and agriculture, livestock, and fisheries industry were risk factors for fatal occupational injuries. The results imply a need for revision of the migrant-worker employment permit systems and implementation of occupational safety and health policies for all workers to promote health equity.

Migrant Workers from the Eastern-Mediterranean Region and Occupational Injuries: A Retrospective Database-Based Analysis from North-Eastern Italy.

The month of Ramadan is the ninth month of the Islamic lunar calendar, and, according to the Islamic tradition, it coincides with the month when the Noble Koran/Qur'an began to be revealed. In recent years, concerns about the potentially negative health effects of Ramadan fasting and the risks of work-related injuries have increased in Western European (EURO) countries. In the present study, we performed a retrospective database-based analysis assessing the impact of Ramadan fasting on occupational injuries (OIs) in North-Eastern Italy among migrant workers from the Eastern-Mediterranean Region (EMRO). Our results suggest that EMRO workers exhibit a significantly increased risk for OIs during Ramadan in periods characterized by heat-waves, while their frequency was somehow reduced for days associated with Ramadan characterized by increased but not extreme temperatures. However, these results may be attributable to an explanatory causation in the specific differences between EMRO and EURO workers in the job tasks performed at the workplace. Not coincidentally, no significant differences were found regarding industrial settings, mechanisms of OIs and final prognosis. Despite the obvious practical implications for health decision- and policy-makers, due to the limitations of the present investigation, further studies are warranted.

System Failure: Work Organization and Injury Outcomes among Latino Forest Workers.

OBJECTIVES: Forestry services is a hazardous industry with high job-related injury, illness, and fatality rates. The Northwest workforce is largely Spanish-speaking, Latino, and immigrant, working in poor conditions with insufficient attention paid to safety and health. Institutional racism fundamentally shapes the structural vulnerability of Latino immigrant workers. Given this context, we sought to understand how workplace organizational factors and safety climate affect job-related injuries in this industry. METHODS: We developed 23 case studies from personal interviews after selecting from an initial participant survey pool of 99 Latino forest workers in southern Oregon who had been injured at work in the previous 2 years. Workers were recruited through snowball sampling and door-to-door canvassing. Questions spanned work conditions, tasks, employer safety practices, injury experience, medical treatment, and workers' compensation benefits. RESULTS: Workers reported broken bones, chainsaw lacerations, back pain, heat and pesticide illnesses, and other occupational injuries. One-third of the cases fell into a Systems Functional category in which they reported their injuries to their supervisors and received medical treatment and workers' compensation benefits. The remaining two-thirds experienced System Failures with difficulties in receiving medical treatment and/or workers' compensation benefits, employer direction to not report, being fired, or seeking alternative home remedies. CONCLUSION: Workers employed by companies with more indicators of safety climate were more likely to obtain adequate treatment for their injuries and fully recover. Workers for whom interpretation at medical exams was provided by someone unaffiliated with their employers also reported better treatment and recovery outcomes.

Occupational medicine clinical practice data reveal increased injury rates among Hispanic workers.

BACKGROUND: Minnesota has an ethnically diverse labor force, with the largest number of refugees per capita in the United States. In recent years, Minnesota has been and continues to be a major site for immigrant and refugee resettlement in the United States, with a large population of both immigrant and native born Hmong, Hispanic, and East Africans. This study seeks to evaluate the injury risk among the evolving minority workforce in the Minnesota Twin Cities region. METHODS: A retrospective cohort study identifying work-related injuries following pre-employment examinations was performed using electronic health records from a large multi-clinic occupational medicine practice. Preplacement examinations and subsequent work-related injuries were pulled from the electronic health record using representative ICD-10 codes for surveillance examinations and injuries. This study included patient records collected over a 2-year period from January 1, 2015, through December, 2016. The patients in this cohort worked in a wide-array of occupations including production, assembly, construction, law enforcement, among others. RESULTS: Hispanic minority workers were twice as likely to be injured at work compared with White workers. Hispanics were 2.89 times more likely to develop back injuries compared with non-Hispanic workers, and 1.86 times more likely to develop upper extremity injuries involving the hand, wrist, or elbow. CONCLUSION: Clinical practice data shows that Hispanic workers are at increased risk for work-related injuries in Minnesota. They were especially susceptible to back and upper extremity injuries. Lower injury rates in non-Hispanic minority workers, may be the result of injury underreporting and require further investigation.

Trends in occupational injuries and diseases among Saudi and non-Saudi insured workers.

BACKGROUND: The ongoing industrial and infrastructural development in Saudi Arabia carries a high risk of occupational injuries/diseases. AIMS: To compare trends in occupational injuries and diseases among Saudi and non-Saudi insured workers. METHODS: We used the index values method and slope (S) calculation to analyse the occupational injuries/diseases trends from data in the annual statistical reports published by the General Organization for Social Insurance between 2004 and 2014. Data for 10 565 993 (18.5%) Saudi insured workers (SIWs) and 46 402 079 (81.5%) non-Saudi insured workers (NSIWs) and 896 627 occupational injuries/diseases were analysed. RESULTS: The distribution of incidences of occupational injuries/diseases among NSIWs (93.5%) was 14 times higher than that of SIWs (6.5%). Occupational injuries/diseases were more likely to increase among NSIWs than SIWs, particularly in the construction, trade, financing and real estate economic activities, and engineering, technicians and service workers occupations. There was a general decreasing trend in occupational injuries/diseases until 2013. CONCLUSIONS: Non-Saudi insured workers were at high risk of occupational injuries/diseases, therefore, implementation of an effective injury prevention programme is required.

Associations of Work Stress, Supervisor Unfairness, and Supervisor Inability to Speak Spanish with Occupational Injury among Latino Farmworkers.

Little is known about how psychosocial work factors such as work stress, supervisor fairness, and language barriers affect risk of occupational injury among Latino farmworkers. This study attempts to address these questions. Surveys were administered via interviews to 225 Latino thoroughbred farmworkers. Multivariable logistic regression analyses were performed to calculate odds ratios (OR) and 95% confidence intervals (CI) of occupational injury in the past year in relation to occupational characteristics. Work stress (OR 6.70, 95% CI 1.84-24.31), supervisor unfairness (OR 3.34, 95% CI 1.14-9.73), longer tenure at farm (OR 2.67, 95% CI 1.13-6.34), and supervisor inability to speak Spanish (OR 2.29, 95% CI 1.05-5.00) were significantly associated with increased odds of occupational injury. Due to the associations between work stress, supervisor unfairness, supervisor inability to speak Spanish and injury, supervisor training to improve Spanish language ability and equitable management practices is merited. Future research is needed to understand the antecedents of work stress for Latino farmworkers.

Characterization of Foreign-Born vs. Native-Born Worker Fatalities in Kentucky, 2001-2014.

Information on foreign-born worker (FBW) and native-born worker (NBW) fatal injuries is scarce. The Kentucky Fatality Assessment and Control Evaluation program analyzed 2001-2014 worker fatality data. The Kentucky FBW fatality rate was double the US FBW and NBW rates, and 50% higher than the Kentucky NBW fatality rate. FBW average age at death was 38 years; NBW age was 47 years. FBW deaths occurred in construction (26%) and services (22%) industries, and transportation [28% (54% due to semi truck crashes)] and construction [26%(48% due to roofing, scaffolding, and ladder-related falls)] occupations; in contrast, NBW deaths occurred in services (22%), and transportation (18%) industries, and transportation (25%) and management (20%) occupations, and were due to exposures to inanimate mechanical forces (38%), and transport accidents (30%). Enhanced FBW cultural competent interventions and policies are needed to prevent FBW occupational injuries, and improve FBW workplace safety and health.

Occupational Exposures and Health Outcomes Among Immigrants in the USA.

PURPOSE OF REVIEW: Immigrants experience higher rates of occupational injury and fatality than their native-born counterparts. This review summarizes the current data related to occupational/environmental exposures and explores potential reasons for the disparities. RECENT FINDINGS: Immigrant workers are employed in sectors that expose them to dangerous working conditions. They experience increased risk for exposure to heat, pesticides, hazardous chemicals, and cleaning agents, as well as physical hazards such as falls. Immigrant workers are at increased risk for occupational injury and fatality due to the nature of the work they traditionally perform, a lack of enforced safety regulations, and limited access to health care or worker's compensation benefits.

Gambling with life: Masculinity, risk, and danger in the lives of unauthorized migrant roofers.

BACKGROUND: This paper examines the occupational experiences of unauthorized immigrants employed in one of the most dangerous occupations in the United States: roofing. METHODS: We draw on 40 in-depth interviews with return migrants in Guanajuato, Mexico, to examine how the adoption of masculinity, dangerous working conditions, the labor market structure, and absence of legal status exacerbates injuries for unauthorized roofers. FINDINGS: Undocumented men return to Mexico injured with chronic pain, health complications, and trauma. We find that men "do gender" that is adopt masculine beliefs, when they skirt safety practices, police each other's behaviors, withhold their emotions, experience heightened stress, and engage in poor health behaviors. It is a combination of dangerous working conditions, economic insecurity, and men seeking to fulfill their masculine roles that all combine to create unsafe working conditions and lead to injuries.

The Relationship Between BMI and Work-Related Musculoskeletal (MSK) Injury Rates is Modified by Job-Associated Level of MSK Injury Risk.

OBJECTIVE: The aim of this study was to examine the relationship between body mass index (BMI) and occupational musculoskeletal (MSK) injury rates, and the statistical interaction between BMI and occupational exposure to MSK hazards (measured by level of MSK injury risk based on job category). METHODS: Using 17 years of data from 38,214 university and health system employees, multivariate Poisson regression modeled the interaction between BMI and MSK injury risk on injury rates. RESULTS: A significant interaction between BMI and MSK injury risk was observed. Although the effect of BMI was strongest for 'low' MSK injury risk occupations, absolute MSK injury rates for 'mid'/'high' MSK injury risk occupations remained larger. CONCLUSIONS: To address the occupational MSK injury burden, initiatives focused on optimal measures of workers' BMI are important but should not be prioritized over (or used in lieu of) interventions targeting job-specific MSK injury hazards.

Characteristics and circumstances of injuries vary with ethnicity of different population groups living in the same country.

OBJECTIVE: To examine whether characteristics and circumstances of injuries are related to ethnicity. DESIGN: The study was based on the Israeli National Trauma Registry data for patients hospitalized between 2008 and 2011. Data included demographics, injury, hospital resource utilization characteristics and outcome at discharge. Univariate analysis followed by logistic regression models were undertaken to examine the relationship between injury and ethnicity. RESULTS: The study included 116,946 subjects; 1% were Ethiopian Born Israelis (EBI), 11% Israelis born in the Former Soviet Union (FSUBI) and 88% the remaining Israelis (RI). EBI were injured more on street or at work place and had higher rates of penetrating and severe injuries. However, FSUBI were mostly injured at home, and had higher rates of fall injuries and hip fracture. Adjusted analysis showed that EBI and FSUBI were more likely to be hospitalized because of violence-related injuries compared with RI but less likely because of road traffic injuries. Undergoing surgery and referral for rehabilitation were greater among FSUBI, while admission to intensive care unit was greater among EBI. CONCLUSION: Targeted intervention programmes need to be developed for immigrants of different countries of origin in accordance with the identified characteristics.

Obscured by administrative data? Racial disparities in occupational injury.

Objectives Underreporting of occupational injuries is well documented, but underreporting patterns may vary by worker characteristics, obscuring disparities. We tested for racial and ethnic differences in injury reporting patterns by comparing injuries reported via research survey and administrative injury database in the same group of healthcare workers in the US. Methods We used data from a cohort of 1568 hospital patient-care workers who were asked via survey whether they had been injured at work during the year prior (self-reported injury; N=244). Using the hospital's injury database, we determined whether the same workers had reported injuries to the hospital's occupational health service during that year (administratively reported injury; N=126). We compared data sources to test for racial and ethnic differences in injury reporting practices. Results In logistic regression models adjusted for demographic and occupational characteristics, black workers' odds of injury as measured by self-report data were 1.91 [95% confidence interval (95% CI) 1.04-3.49] compared with white workers. The same black workers' odds of injury as measured by administrative data were 1.22 (95% CI 0.54-2.77) compared with white workers. Conclusions The undercount of occupational injuries in administrative versus self-report data may be greater among black compared to white workers, leading to underestimates of racial disparities in workplace injury.

Construction accidents: identification of the main associations between causes, mechanisms and stages of the construction process.

OBJECTIVE: To identify the most frequent causes of accidents in the construction sector in order to help safety practitioners in the task of prioritizing preventive actions depending on the stage of construction. METHODS: Official accident investigation reports are analysed. A causation pattern is identified with the proportion of causes in each of the different possible groups of causes. RESULTS: Significant associations of the types of causes with accident mechanisms and construction stages have been identified. CONCLUSIONS: Significant differences have been found in accident causation depending on the mechanism of the accident and the construction stage ongoing. These results should be used to prioritize preventive actions to combat the most likely causes for each accident mechanism and construction stage.

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

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

Occupational fatalities among young workers in the United States: 2001-2012.

BACKGROUND: While adolescent workers in the United States (US) are protected by child labor laws, they continue to suffer fatal occupational injuries. This study was designed to provide a comprehensive profile of occupational fatalities among this sub-population of US workers. METHODS: Using Census of Fatal Occupational Injuries data between 2001 and 2012, we calculated descriptive statistics and rates to examine the magnitude and nature of fatalities among workers under age 18. RESULTS: During the study period, there were 406 fatalities among young workers which translated into 24,790 years of potential life lost; 12,241 of which were in agriculture alone. Rates declined since 2001 yet Hispanics, foreign-born workers, males, and those working in agriculture continued to suffer a disproportionate fatality burden. CONCLUSIONS: Efforts to reduce young worker fatalities should focus on male Hispanics, particularly those who are foreign-born, as well as agricultural workers as these groups have the greatest fatality risks. Am. J. Ind. Med. 59:445-452, 2016. © 2016 Wiley Periodicals, Inc.

From the Horse Worker's Mouth: A Detailed Account of Injuries Experienced by Latino Horse Workers.

Horse breeding farms are hazardous. Yet, little is known about the injuries of Latino horse workers. This study assesses Latino horse workers' injury prevalence, describes their injuries, and analyzes differences between injuries receiving medical versus those receiving first aid care. Data were gathered from 225 Latino thoroughbred workers via a community-based purposive sampling strategy. Questions included injury experiences in the past year and details about each person's two most severe injuries. Univariate and bivariate analyses were conducted. Nearly half of workers experienced an injury in the past year, often involving a horse. Bruises and sprains/strains were most common, as were injuries to upper/lower appendages. Head/face injuries more often resulted in medical care. The injury burden in this Latino worker population is high. Personal protective equipment (PPE) and training is advised due to the high prevalence of horse-related injuries. Future research should investigate aspects of the work environment that may influence injury risk.

Are immigrants in Canada over-represented in riskier jobs relative to Canadian-born labor market participants?

BACKGROUND: This paper uses new data to examine the gap in injury and fatality rates between immigrant men and women and their Canadian-born counterparts. METHODS: Data from the 2011 National Household Survey and the Association of Workers' Compensation Boards of Canada were used to determine the difference in occupational and industry injury and fatality rates between various arrival cohorts of immigrants and those Canadian born. RESULTS: For both men and women, there is no significant difference in occupational injury and fatality rates between various arrival cohorts of immigrants and Canadian-born workers. However, industry injury and fatality rates are lower for the most recent arrival cohorts of immigrants relative to Canadian-born workers. CONCLUSIONS: Although immigrants face many hurdles and challenges in their resettlement process in Canada, given the evidence from the paper, they are not likely to be at higher risk for work-related injuries relative to those Canadian-born.

Repatriation rates in Filipino seafarers: a five-year study of 6,759 cases.

BACKGROUND: Studies on medical repatriation of seafarers due to illnesses and injuries have been limited. The aim of the study was to describe the epidemiology of medical repatriation among Filipino seafarers. MATERIALS AND METHODS: We performed a retrospective analysis of records from January 2010 to December 2014 of medical repatriations of Filipino seafarers from the claims and legal departments of different manning agencies in Manila, Philippines. RESULTS: We analysed data from a total of 6,759 medical repatriation cases in a 5-year period, representing 174 shipping companies and 2,256 vessels. The total number of seafarers deployed from the manning agencies where we obtained data was 388,963 with the rate of medical repatriations calculated at 1.7%. We used the 10th revision of the International Statistical Classification of Diseases and Related Health Problems (ICD-10) to determine the most common causes of repatriation. We found that these were injuries (trauma), musculoskeletal disorders, gastrointestinal problems, and genitourinary illnesses. We also conducted an analysis of the most common clinical problems per organ system. CONCLUSIONS: Filipinos represent the most numerous group of seafarers in the world. Profiling their health issues may help in optimising current protocols, implementing health surveillance programs, and formulating health policies for seafaring personnel. In addition, our study results may help physicians performing pre-employment medical examinations to identify and manage conditions that are at a high risk of medical repatriation.