Search

BACKGROUND: Occupational eye injuries are a significant source of injury in the workplace. Little population-based research in the area has been conducted, and is necessary for developing and prioritizing effective interventions. METHODS: Workers' compensation data from the state of Kentucky for the years 1994-2003 were analysed by demographics, injury nature and cause, cost, and occupational and industrial characteristics. The US Bureau of Labor Statistics' Current Population Survey was utilised to compute injury rates for demographic and occupational groups. RESULTS: There were 10,545 claims of ocular injury, representing 6.29 claims per 10,000 workers on average annually. A substantial drop in the claim rate was found after the state passed monetary penalties for injuries caused by employer negligence or OSHA violations. Claims by men were over three times more likely than those by women to have associated claim costs (OR 0.52; 95% CI 0.32 to 0.85; p = 0.009). The highest eye injury rates per 10,000 of 13.46 (95% CI 12.86 to 14.07) were found for the helpers/labourers occupation, and of 19.95 (95% CI 18.73 to 21.17) for the construction industry. The total cost of claim payments over the period was over $3,480,000, and average cost per claim approximated $331. CONCLUSIONS: Eye injuries remain a significant risk to worker health, especially among men in jobs requiring intensive manual labour. Evidence showed that increased legislative regulation led to a decline in eye injuries, which was consistent with other recent findings in the area. Additionally, targeting groups most at risk, increasing worker training, providing effective eye protection equipment, and developing workplace safety cultures may together reduce occupational eye injuries. [ABSTRACT FROM AUTHOR]

PURPOSE: Injuries to adolescents from occupational activities has been recognized as a significant public health concern. The objective of this study was to quantify adolescent injury rates, analyze risk factors, and measure the severity of injuries sustained using Oregon workers' compensation data. METHODS: From 1990-1997, a total of 8060 workers' compensation claims, submitted by claimants 16-19 years old, were accepted by Oregon and used in these analyses. Data from the Bureau of Labor Statistics were used to derive injury rates. RESULTS: An overall estimated claim rate of 134.2 (95% confidence interval [CI] 124.9-143.6) per 10,000 adolescent workers was found, with males having over twice the rate of females. The total average annual claim cost was $3,168,457, representing $3145 per claim. The average total temporary disability period per claim was 22.3 days. Precision production workers had the highest claim rate of 296.2 (95% CI 178.9-413.4) and highest associated costs ($8266) for all occupations, whereas those in the farming/fishing/forestry occupation had the longest average periods of indemnification with 31.6 days. Day shift workers had the highest claim rates and most severe injuries relative to other shifts. CONCLUSION: The injury rates found among adolescent workers demonstrates that continued safety interventions and increased training are needed. Because of high claim rate and injury severity, particular attention should be focused on adolescents in food service, manufacturing, and agricultural occupations. Understanding the differences of adolescent circadian rhythm patterns in establishing work schedules and supervisory practices could also prove valuable for decreasing injury risk. [ABSTRACT FROM AUTHOR]

OBJECTIVE.: To analyze workplace assault by rate, injury severity, and trends using Rhode Island workers' compensation claim data. METHOD.: A total of 6402 workers' compensation assault claims from Rhode Island for the period of 1998 through 2002 was analyzed. Data from the U.S. Department of Labor was used to derive estimates of injury rates. RESULTS.: An average rate of 27.7 assaults per 10,000 workers was found and varied only marginally across years. Females filed 75% of all assault claims, though injuries to males resulted in longer periods of indemnification. The total cost of workplace assaults was $7,025,997, averaging $1097 per claim, and average indemnification duration was 16.8 days per claim. While the assault rate was relatively stable, a notable decline in both cost and indemnification periods over time was discovered. CONCLUSION.: The assault rate found was among the highest reported to date, demonstrating that workplace violence remains a significant threat to employee safety. While a decline in incident severity was discovered over time, many outcomes were still serious. Preventive interventions to reduce incidents of workplace assaults among groups at the highest risk should be given highest priority. Copyright © 2006 by Elsevier Inc. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We sought to examine occupational injuries sustained by adolescent workers during a 5-year period. METHODS: Workers' compensation claims from Rhode Island were used to assess injuries of 15- to 19-year-old employees (n = 8321) from 1998 to 2002. Baseline employee population estimates were derived using the Current Population Survey. RESULTS: The annual estimated adolescent claim rate was 6.6 per 100 workers (95% confidence interval = 6.1-7.1), with annual average costs of $614,182. Injury rates increased with employee age, hours worked, and for day and nightshift employees relative to evening shift workers. The highest proportion of claims by industry was in eating establishments, and the average indemnification duration was 13.0 days. CONCLUSIONS: Specific emphasis should be placed on increasing safety training and preventative interventions for teenagers in hazardous occupations and for those working longer hours. [ABSTRACT FROM AUTHOR]

This study estimated injury and illness rates, risk factors, and costs associated with construction work in Oregon from 1990-1997 using all accepted workers' compensation claims by Oregon construction employees (N = 20,680). Claim rates and risk estimates were estimated using a baseline calculated from Current Population Survey data of the Oregon work force. The average annual rate of lost-time claims was 3.5 per 100 workers. More than 50% of claims were by workers under 35 years and with less than 1 year of tenure. The majority of claimants (96.1%) were male. There were 52 total fatalities reported over the period examined, representing an average annual death rate of 8.5 per 100,000 construction workers. Average claim cost was $10,084 and mean indemnity time was 57.3 days. Structural metalworkers had the highest average days of indemnity of all workers (72.1), highest average costs per claim ($16,472), and highest odds ratio of injury of all occupations examined. Sprains were the most frequently reported injury type, constituting 46.4% of all claims. The greatest accident risk occurred during the third hour of work. Training interventions should be extensively utilized for inexperienced workers, and prework exercises could potentially reduce injury frequency and severity. [ABSTRACT FROM AUTHOR]

This study examined all accepted Oregon workers' compensation claims for occupational burn injuries during the period of 1990 to 1997 (N = 3,158). The Current Population Survey was used to derive employee population baselines for establishing rate estimates. It was estimated that the average occupational burn claim rate was 2.89 per 10,000 workers (95% confidence interval [CI] 2.76, 3.02). The majority of claimants (71.7%) were males, the largest proportion (32.6%) was aged 25 years or less, and almost half (48.7%) had less than 1 year of job tenure. The most frequent burn type cited was heat/scald burns (78.9%) followed by chemical burns (19.3%). Costs averaged over 1.6 million dollars annually. The average indemnity period was 16 days. Higher relative risks were found for evening workers (2.97, 95% CI 2.96, 2.98) and night workers (2.13, 95% CI 2.12, 2.13) compared with dayshift workers. Kitchen workers had the highest burn rate of all occupations, with 62.5 claims per 10,000 workers. [ABSTRACT FROM AUTHOR]

Allergic reaction experienced by health care workers from latex glove use has increasingly become the focus of researchers evaluating occupational sources of injury in health care settings. Many studies have attempted to estimate the prevalence of latex sensitization among health care workers by using various methods, but the findings have been inconsistent and do not predict reactivity. This study used workers' compensation data from Minnesota from 1988 to 1997 to assess allergic reactivity rates, injury severity, and costs associated with latex allergic reactions. The average reactivity rate was 7.1 claims per 100,000 health care workers, and total cost associated with the claims averaged $0.295 per health care employee. Using empirical cost data from another study, it was found that it is not cost-beneficial for health care institutions to globally adopt latex glove-free policies solely on the basis of workers' compensation costs. [ABSTRACT FROM AUTHOR]

OBJECTIVES: We used Bronfenbrenner's ecological systems theory to identify factors that predicted never or sometimes using condoms in a multiethnic cohort of adolescent mothers. METHODS: We interviewed adolescent mothers within 48 hours of delivery and surveyed them 6 and 12 months after delivery (n = 636). We used multinomial logistic regression to identify individual-, dyad-, family-, and peer and community-level factors associated with never or sometimes using versus always using condoms during intercourse at 12 months postpartum. RESULTS: Pregnancy status, partner refusal to use condoms, intimate partner violence, and race/ethnicity predicted both never and sometimes using condoms. Condom use 6 months earlier and church attendance also predicted never using condoms, whereas maternal monitoring was an additional predictor for sometimes using condoms. CONCLUSIONS: Overlapping yet distinct risk profiles predicted never or sometimes using versus always using condoms. Factors from multiple levels of influence affected the condom use behaviors of adolescent mothers indicating that multilevel interventions are needed to promote safer sexual practices among these young women. [ABSTRACT FROM AUTHOR]

Purpose The purpose of this paper is to investigate the relationship between patient safety culture and two attitudinal constructs: affective organizational commitment and structural empowerment. In doing so, the main and interaction effects of the two constructs on the perception of patient safety culture were assessed using a cohort of physicians. Design/methodology/approach Affective commitment was measured with the Organizational Commitment Questionnaire, whereas structural empowerment was assessed with the Conditions of Work Effectiveness Questionnaire-II. The abbreviated versions of these surveys were administered to a cohort of 71 post-doctoral medical residents. For the data analysis, hierarchical regression analyses were performed for the main and interaction effects of affective commitment and structural empowerment on the perception of patient safety culture. Findings A total of 63 surveys were analyzed. The results revealed that both affective commitment and structural empowerment were positively related to patient safety culture. A potential interaction effect of the two attitudinal constructs on patient safety culture was tested but no such effect was detected. Research limitations/implications This study suggests that there are potential benefits of promoting affective commitment and structural empowerment for patient safety culture in health care organizations. By identifying the positive associations between the two constructs and patient safety culture, this study provides additional empirical support for Kanter's theoretical tenet that structural and organizational support together helps to shape the perceptions of patient safety culture. Originality/value Despite the wide recognition of employee empowerment and commitment in organizational research, there has still been a paucity of empirical studies specifically assessing their effects on patient safety culture in health care organizations. To the authors' knowledge, this study is the first empirical study to examine the relationship between structural empowerment as proposed by Kanter and the culture of patient safety using physicians.

Background: This study uses the NEO-Five Factor Personality Inventory (NEO) to assess its value in identifying resident educational needs., Methods: A cohort of surgical residents (n = 65) were administered the NEO. Statistical analysis compared the results between previously determined national norms and between varying resident demographics., Results: The resident scores of Extroversion, Openness, and Conscientiousness were significantly higher than those of the US population and Agreeableness was significantly lower. By gender, only Agreeableness was statistically higher for female residents. The mean Extroversion score for residents who were postgraduate years (PGYs) 3 to 5 was significantly higher than that of PGYs 1 to 2. Further subanalyses were conducted on each primary component., Conclusions: The NEO was valuable for identifying areas where training could be especially useful to augment Accreditation Council for Graduate Medical Education (ACGME) core competencies. The use of this test on resident populations could be of significant value for tailoring comprehensive surgical leadership education programs., (Copyright © 2011. Published by Elsevier Inc.)

Previous research has demonstrated that communication failure and interpersonal conflicts are significant impediments among health-care teams to assess complex information and engage in the meaningful collaboration necessary for optimizing patient care. Despite the prolific research on the role of effective teamwork in accomplishing complex tasks, such findings have been traditionally applied to business organizations and not medical contexts. This chapter, therefore, reviews and applies four theories from the fields of organizational behavior (OB) and organization development (OD) as potential means for improving team interaction in health-care contexts. This study is unique in its approach as it addresses the long-standing problems that exist in team communication and cooperation in health-care teams by applying well-established theories from the organizational literature. The utilization and application of the theoretical constructs discussed in this work offer valuable means by which the efficacy of team work can be greatly improved in health-care organizations.

Introduction: As in any area of medicine, clinical trials are crucial to the advancement of trauma care and the establishment of evidence-based guidelines. This work identifies consent regulations that impede advances in trauma resuscitation research and examines several ethical issues underlying current policies in the United States which regulate how clinical trials are conducted in an emergency setting. Trauma is a leading cause of mortality in the U.S. Minorities and those in low socioeconomic groups are subject to a disproportional amount of traumatic injuries and have worse treatment outcomes than non-minority individuals. Current regulations guiding consent requirements in emergency research were enacted to protect such vulnerable populations from exploitation. Ironically, these same regulations also serve as barriers to clinical trials in trauma research, thus depriving these same vulnerable groups from the benefits of advances in trauma care., Methods: A literature review was conducted on areas affecting emergency medical research including: informed consent, socioeconomic and racial disparities, federal regulations in trauma research and biomedical ethics., Results: In the ten year period following the passage of the FDA's Common Rule (21 CFR 50.24) in 1995, 21 published emergency research studies were conducted under the waiver of informed consent. Misconceptions regarding federal regulations and cumbersome internal review board approval processes are frequently cited as significant barriers to conducting prospective randomized trials in the emergency setting., Conclusions: Given the history of past abuses in medical research, the principle of maintaining autonomy of choice is of paramount importance. However, trauma resuscitation is unique in that patients are either unconscious or of limited mental capacity at the time treatment is required, and thus the standard of informed consent is unable to be achieved as in other areas of medicine. While this paradox was recognized by the FDA in 1995 with the creation of an exception to the requirement for informed consent in emergency research (the "Common Rule"), the wording of this exception is ambiguous, and has consequently deterred trauma investigators from pursuing valuable research endeavors. In particular, the language requiring "community consultation" and demonstration that existing treatments are "unproven or unsatisfactory" have been identified as the most problematic terms to satisfactorily address by those aiming to conduct trauma research. It is imperative that the current exemptions to the Common Rule be more thoroughly operationalized, so that greater advancement in emergency medicine research can be promulgated, while concurrently maintaining a high standard of protection for the rights of trauma patients.

Introduction: The need for leadership training has become recognized as being highly important to improving medical care, and should be included in surgical resident education curriculums., Materials and Methods: Surgical residents (n = 65) completed the 5x-short version of the Multifactor Leadership Questionnaire as a means of identifying leadership areas most in need of training among medical residents. The leadership styles of the residents were measured on 12 leadership scales. Comparisons between gender and postgraduate year (PGY) and comparisons to national norms were conducted., Results: Of 12 leadership scales, the residents as a whole had significantly higher management by exception active and passive scores than those of the national norm (t = 6.6, P < 0.01, t = 2.8, P < 0.01, respectively), and significantly lower individualized consideration scores than the norm (t = 2.7, P < 0.01). Only one score, management by exception active was statistically different and higher among males than females (t = 2.12, P < 0.05). PGY3-5 had significantly lower laissez-faire scores than PGY1-2 (t = 2.20, P < 0.05). Principal component analysis revealed two leadership factors with eigenvalues over 1.0. Hierarchical regression found evidence of an augmentation effect for transformational leadership., Conclusion: Areas of resident leadership strengths and weaknesses were identified. The Multifactor Leadership Questionnaire was demonstrated to be a valuable tool for identifying specific areas where leadership training would be most beneficial in the educational curriculum. The future use of this instrument could prove valuable to surgical education training programs.

Objective: This study examines workers' compensation burn claims from Virginia to assess risk factors and costs associated with occupational burn injuries., Methods: Virginia workers' compensation burn claims for the period of 1999 to 2002 were analyzed. Claim rates were determined by using the Bureau of Labor Statistics' Current Population Survey for the working population of Virginia., Results: There were 5810 burn claims reported for the 4-year period examined, with the average burn rate estimated to be 4.3 per 10,000 workers. The total cost of claims was found to average $11,705,939 per year and $8059 per claim. There was over a sixfold increase for burn rates on weekends relative to weekdays., Conclusion: Burns are a common injury experienced by workers and are often severe. Assessing personnel issues affecting weekend employees may lead to valuable preventive interventions to reduce burn risk.

Objective: STK15 is a serine threonine kinase which assists chromosomal separation and mitotic spindle stability through interaction with the centrosome during mitosis. We hypothesized that STK15 polymorphisms might modulate the risk of uterine cancer., Methods: We used a hospital-based case-control study to assess the association between STK15 polymorphisms and risk of uterine cancer. Cases and controls were matched on age, race, and smoking status. Two common STK15 single nucleotide polymorphisms (SNPs), F31I (T/A), and V57I (G/A), were genotyped. Odds ratios (OR) and 95% confidence intervals (CI) were obtained using unconditional logistic regression analysis., Results: A total of 193 women with uterine cancer and 218 controls were genotyped for both SNPs. After adjustment for age, race, and smoking status for the F31I SNP, the homozygous variant genotype (AA) was associated with a significantly increased uterine cancer risk (OR 10.2; 95% CI 2.23-46.5). Individuals with the heterozygous genotype (TA) and a history of tobacco use also exhibited an increased risk for uterine cancer (OR 2.63; 95% CI 1.20-5.76). For the V57I SNP, neither the homozygous (AA) nor the heterozygous (GA) variant genotypes were associated with significantly altered risk for uterine cancer (OR 0.76; 95% CI 0.18-3.25 and OR 0.88; 95% CI 0.52-1.49)., Conclusion: Our study demonstrates that STK15 F31I SNP is associated with an increased risk for uterine cancer. Confirmation of this pilot study is needed in a larger case-control population to evaluate this genetic variant with other known risk factors for uterine cancer.

Background: Interpersonal and communication skills are 1 of the 6 core competencies articulated as essential to resident education by the Accreditation Council for Graduate Medical Education. The current study assessed verbal and nonverbal communication skills among surgical residents., Methods: The communication skills of surgical residents (n = 64) were assessed using the Social Skills Inventory., Results: The majority of surgical residents demonstrated strong verbal and nonverbal skills, although the equilibrium index scores demonstrated an imbalance in the social skill profile for a minority (17.2%) of residents. Post graduate year was positively related to social expressivity (r = .31, P < .01) and social control (r = .27, P < .01) skills. In some cases, being proficient in one social skill was actually negatively related to another., Conclusions: The Social Skills Inventory was found to be a useful instrument for the multidimensional assessment of resident communication skills. Areas of strengths and weaknesses were identified and could be used for targeting areas for future educational interventions.

Extended criteria donor (ECD) liver allografts are often allocated to less severely ill liver transplant (LT) candidates who are at a relatively lower risk of pretransplant mortality, but it is not clear that the use of ECD allografts will decrease center waitlist mortality (WLM). Individual patient data from the UNOS OPTN database (2002-2005) were aggregated to obtain center-specific data. Deceased donor allografts with any of the following characteristics were defined as ECDs: from a donor with any of the criteria described by the New York State Department of Health Workgroup; or 12+ h of cold ischemia. Multivariate regression was used to examine the relationship between WLM and ECD, non-ECD and LDLT use after adjusting for candidate severity of illness. A total of 3555 ECD transplants, 11,660 standard criteria donor (SCD) transplants, and 717 LDLTs were performed at 100 centers during this period. The model demonstrated that SCD and ECD LTs were inversely correlated with a center's WLM (beta=-0.242 and -0.221, respectively; p

Background: Assessments of the impact of occupational amputations with outcomes of pain, disfigurement, and often an inability to return to the same job, are limited. The present study examines and quantifies the rates, risk factors, and costs of occupational amputations in the workplace in the State of Kentucky., Methods: Worker's compensation data from 1994 through 2003 from Kentucky was used to investigate job-related amputations (n = 2,297). The US Department of Labor's Current Population Survey (CPS) was used to estimate injury rates., Results: The average amputation claim rate for all Kentucky workers was 1.37 per 10,000, with an average per-claim indemnity cost of $8,822. A declining trend was found in the rate over the last 7 years studied. Accidents resulting in amputations occurred at twice the rate on weekends than on weekdays. Amputations affecting the hand constituted 94.6% of all injuries. Workers in the mining industry had the highest estimated claim rate of 5.92 (95% CI 5.23-6.66), and machine operators and assemblers had the highest rate of all occupations with 3.35 (95% CI 3.23-3.47)., Conclusions: Workplace amputations remain a significant workplace concern and represent a particular hazard for those in the mining and manufacturing industries. Future research should examine causes of the weekend effect to develop human resource and safety interventions for risk reduction.

Background: Occupational eye injuries have been recognized as a serious health risk to workers and are in need of further investigation to develop effective interventions., Methods: Rhode Island workers' compensation claims of ocular injury between 1998 through 2002 (n=8,877) were examined. The Current Population Survey was used to estimate occupational employment levels as a baseline for rate calculations., Results: The estimated ocular injury claim rate was 32.9 per 10,000 workers (95% CI=32.3-33.6), with the cost of claims totaling $1,514,666 and averaging $171 per claim. The highest estimated claim rate of all occupations was found for construction laborers of 373.7 per 10,000 workers (95% CI=267.1-480.3). Relative to the durable manufacturing industry, the highest risk of injury resulting in disability indemnification was the wholesale trade industry (OR=2.18, 95% CI=1.19-4.01, P<0.05)., Conclusions: Many of the eye injuries reported were likely preventable. Greater diligence, training, and safety precautions are needed to reduce the risk of eye injury to employees., (Am. J. Ind. Med. 49:45-53, 2006. (c) 2005 Wiley-Liss, Inc.)

Occupational burns have been determined to be a serious public health concern. The analysis of workplace risks and risk factors associated with burns are critical to developing effective interventions in the future. In this study, we examined accepted Rhode Island workers' compensation claims (n = 5619) from 1998 to 2002 to assess the rates and risks of occupational burns. We used employment data from the Department of Labor's Current Population Survey (CPS) to estimate claim rates and shift analyses. The overall burn rate was estimated to be 24.3 per 10,000 workers. The claim rate for workers younger than 25 years of age was almost double that for all other age groups. The average per-claim disability duration for claims requiring indemnity was 167.9 days, and average annual total cost of claims was dollar 1,010,166. The highest claim rate identified was for workers in food service occupations and an increased risk was found for chemical burns among evening and night-shift workers. Increased interventions are needed to reduce occupational burns in work settings. Particular diligence should be should address occupational burn hazards in restaurant establishments, and preventative should be measures aimed at young employees and late-shift workers.

This study used workers' compensation data from Oregon from 1990 to 1997 to examine workers' compensation claims from vehicular accidents by truck drivers, and to calculate claim rate estimates using baseline data derived from the US Bureau of Census' Current Population Surveys. During this period, 1168 valid injury claims due to vehicular accidents were filed representing an accident claim rate of 50.3 (95% CI: 45.1-55.5) per 10,000 truck drivers annually. There were 19 work-related vehicular accident fatalities recorded in the data over the 8-year period. Of all claimants, males constituted the majority (80.7%), most were 35 years of age or younger (51.4%) and had less than 1 year of job tenure (51.0%). Truck driver claim rates due to vehicular accidents were lowest during the 6 a.m. to 12 p.m. period. The average amount of compensable lost work days per injury claim was 57.8 days (S.D.=124.7) and the median claim time was 16.0 days with the inter-quartile range being 53.5 days. The amount of lost work reported increased with the claimant's age. A total of US$ 11,642,635 was paid in claims for vehicular accidents of truck drivers in Oregon over the time examined, which averaged US$ 9966 per claim, with a median claim amount of US$ 2590 and inter-quartile range of US$ 7670. Claims citing sprains were the most frequently recorded injury experienced from vehicular accidents.

Unlabelled: Objectives To extend and update past research on occupational dermatitis by examining recent workers' compensation claims data., Design: Retrospective analysis of workers' compensation claims from Oregon (1990-1997)., Setting: All dermatitis-related workers' compensation claims were merged with US census data to estimate rates of dermatitis by age, sex, occupation, and industry. Associated claim costs and disability times were also calculated from these data., Participants: All individuals with accepted dermatitis claims (N = 611) were included in the analyses., Main Outcome Measures: The overall claim rates of individuals by age, sex, industry, and occupation were estimated. Total costs and average disability time were computed. Monthly patterns of dermatitis claims were examined., Results: The average claim rate of occupational dermatitis was estimated to be 5.73 per 100 000 workers (95% confidence interval, 5.66-5.80). Statistically significant differences (P<.001) in claim rates by age, sex, industry, and occupation were found. More than 47% of all claimants had 1 year of job tenure or less. Employees in the farming, forestry, and fishing occupations and industries had significantly higher claim rates compared with employees in other occupations. The average cost per claim was $3552, and the average disability time was 23.9 days. Some temporal trends in claim rates were observed., Conclusions: Occupational dermatitis remains a significant problem in workplace settings. In addition, certain types of occupations and industries seem to be particularly affected by occupational dermatitis. Interventions may be particularly valuable for workers with little job tenure.

Background: While past research on health care workers has found that shift work can lead to negative physiological and psychological consequences, few studies have assessed the extent to which it increases the risk of specific work-related injuries, nor quantified and compared associated types, severity and costs., Aims: This study aimed to derive and compare the rates, typologies, costs and disability time of injuries for various hospital worker occupations by day, evening and night shift., Methods: This study used Oregon workers' compensation claim data from 1990 to 1997 to examine the differences in hospital employee claims (n = 7717) by shift and occupation. Oregon hospital employee claim data, hospital employment data from Oregon's Labor Market Information System and shift proportion estimates derived from the Current Population Survey (CPS) were used to calculate injury rate estimates., Results: The injury rate for day shift per 10,000 employees was estimated to be 176 (95% CI 172-180), as compared with injury rate estimates of 324 (95% CI 311-337) for evening shift and 279 (95% CI 257-302), night shift workers. The average number of days taken off for injury disability was longer for injured night shift workers (46) than for day (38) or evening (39) shift workers., Conclusion: Evening and night shift hospital employees were found to be at greater risk of sustaining an occupational injury than day shift workers, with those on the night shift reporting injuries of the greatest severity as measured by disability leave. Staffing levels and task differences between shifts may also affect injury risk.

Background: Hearing loss from occupational exposures is a serious and widespread problem. This study measured the outcomes that increased enforcement of regulations and legislative interventions had on hearing loss workers' compensation claims., Methods: Workers' compensation claim data from Oregon was analyzed for the period of 1984-1998 to examine trends and severity of hearing loss claims. In 1987 and 1990, Oregon enacted legislative reforms to improve enforcement and promulgation of safety standards in the state. This study examined hearing loss claims between the periods of pre- and post-legislative reforms., Results: It was found that hearing loss claims decreased significantly following the legislative reforms, although the average cost per claim increased. Age and tenure effects, and evidence of moral hazard were also discovered., Conclusions: Increased enforcement of regulations and legislative interventions by Oregon improved working conditions leading to occupational hearing loss. Nevertheless, hearing loss remains problematic, and continued efforts are required to improve worker safety., (Copyright 2004 Wiley-Liss, Inc.)

One of the most serious occupational problems in the workplace is the occurrence of violent assaults. This study examined 2028 workers' compensation claims of workplace violence from Oregon between 1990 and 1997, and used Current Population Survey data for risk analysis. The rate of workplace violence was 1.86 per 10,000 employees annually (95% confidence interval, 1.78-1.94), with females and workers under 35 years of age experiencing the most violence. The average claim resulted in approximately 40 days of indemnity and $6200 in costs. Workers on evening and night shifts had significantly higher rates of being victims of violence, as did those working on weekends. Preventative interventions should be targeted at younger workers and those with less tenure. Special measures should be focused on ensuring the safety of evening/night-shift workers and weekend employees.

Objectives: This study explored whether the prevalence of latex-related health conditions has increased among individuals employed in medical occupations relative to those employed in nonmedical occupations since the issuance of universal precautions in 1987., Methods: Data derived from the 1983 to 1994 versions of the National Health Interview Survey were used to obtain odds ratios comparing prevalence rates of latex-related symptoms over time., Results: No statistical evidence was found that the universal precautions resulted in increased prevalence rates of latex-related health conditions among medical workers relative to those employed in nonmedical occupations., Conclusions: Increased use of latex gloves among health care personnel subsequent to the implementation of universal precautions appears to have had no effect on latex allergic reactions experienced by these workers.

Background: Occupational reaction to natural rubber latex (NRL) glove use by healthcare employees has been an area of increasing concern. Unfortunately, there is little data demonstrating the prevalence and severity of actual reactivity to NRL., Method: Occupational reaction to NRL was estimated using workers' compensation claims filed by healthcare employees in Oregon for the period of 1987-1998. For the first ten years, these claims were estimated by source and conditions consistent with NRL glove reactions, while in the last two years a specific code developed in 1997 for NRL glove reactions was also employed., Results: The claim rate was on average 0.58 per 10,000 healthcare workers annually, which constituted 0.29% of all workers' compensation claims. The most common condition experienced was dermatitis (80%) and most common body part affected was the hands (55.4%). The majority of claimants, 45 (69.2%), reported taking less than a month off work, suggesting most reactions were minor in nature, although one fatality was reported. The average NRL claim cost was $8,309.48. Overall the average cost per insured healthcare worker was approximately $0.50 per year. The occupational groups with the highest number of claims were nurses (30.8% of claimants) and nursing aides and orderlies (24.6% of claimants)., Conclusions: In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.25% of the total was potentially related to NRL gloves. The rare incidence of respiratory and ocular claims is inconsistent with the hypothesis that asthmatic or conjunctival reactions to NRL gloves are common.

Occupational reaction to natural rubber latex experienced by healthcare employees was examined using data of all workers' compensation claims filed by state-insured healthcare employees in Washington State for the period 1991-1999 (n = 65,703). As latex reaction is not a condition for which there are specific identification codes, these claims were estimated by coupling source and nature of injury records that were consistent with reactions to latex. It was found that the claim rate was on average 2.66 per 10,000 state-insured healthcare workers annually. The most common condition experienced was dermal (84.3%), and most common body part affected was the hand (70.0%). Because few claims cited respiratory or conjunctivitis as reaction experienced, little evidence was discovered to support that glove powder acted as a widespread latex allergen transmitter in healthcare environments. Most cases did not require indemnity payment for lost work time (81.2%), suggesting most reactions were minor. The average cost per natural rubber latex claim was $2,759.10, compared to $3,178.18 for the average healthcare worker claim for all causes. Overall, the average cost per state-insured healthcare worker employed during this time was under $0.74 per year. Nursing aides/orderlies were the most frequent healthcare occupation filing a claim (33.2%). The majority of claimants were female (87.9%), and unmarried workers (52.0%) filed slightly more claims than married workers (48.0%). In comparison with other workers' compensation claims filed by healthcare workers during this period, 0.34 percent of the total was potentially related to natural rubber latex, with other common healthcare workplace items cited more frequently as source of occupational injury.

Latex allergies among health care workers have garnered considerable attention from medical researchers and practitioners. However, the majority of research on natural rubber latex allergy has focused on clinical methodologies and emphasized the quantification of employee sensitization rates as opposed to actual incidents of reactivity. Workers' compensation data provide information on the number and impact of reactions to latex use. This article presents an analysis of health care workers' compensation data from North Dakota to estimate the prevalence, costs, and nature of claims associated with latex allergic reaction. The results show an annual average claim rate of 1.52 per 10,000 health care workers employed in the state, and annual costs averaging about $.08 per health care worker. Skin disorders were the most commonly reported condition. These findings are compared with previous studies of Minnesota and Rhode Island and demonstrate similar results.