Work-Related Exposures and Injuries in the Aging United States Workforce

United States (U.S.) workers aged 55 years and above will comprise 25% of the workforce by the year 2020. Although workers in this age group experience lower rates of non-fatal workplace injuries, compared to their younger counterparts, the impact of such injuries is greater, resulting in more severe outcomes. It is known that an employee’s health and safety behaviors in the workplace are a result of interplay among physical, psychosocial, and organizational work environments. This research effort investigates, longitudinally, the association between work-related exposures including work-related psychosocial exposures and injuries among a cohort of 7,212 working U.S. adults, aged 50 years and above, using data from the Health and Retirement Study (HRS). The HRS which contains a representative of U.S. adults aged 50 years and above, is a biennial study that has been active since 1992. This study specifically uses HRS interview waves from the years 2004-2014 and focuses on the injury experiences of a workgroup that, despite its increasing proportion in the workforce, remains under-researched. In contrast to the current study, the majority of previous research investigating work-related injuries has been cross-sectional and, in many cases, limited to certain occupations and industries.

This study is conducted by Navneet Baidwan, MPH – PhD Candidate.

Transportation-Related Research:
Identification of High-Risk Intersections and Intervention Efficacy

Transportation-related crashes are a major cause of occupational mortality and morbidity. Rural intersections pose significant risks to all road users, including workers and their families. Despite the large number of studies on prediction of intersection-related crash and injury severities, these study results are sometimes prone to common biases. Specifically, the intelligent conflict warning system has received recent attention by transportation agencies and has been deployed to support drivers’ decision-making at rural thru-STOP controlled intersections in many states. However, to date, little is known regarding the effectiveness of this warning sign to promote drivers’ safety performance at these rural intersections. Therefore, the main objectives of this study, conducted by OIP doctoral candidate, Disi Tian, are to identify the magnitude of and risk factors for rural intersection-related crashes and the severity of injuries, as well as to evaluate and improve the current system design through a multidisciplinary assessment framework. The study is expected to identify high-risk intersections that can be prioritized for development and evaluation of intervention efforts, as well as provide insights into the potential benefits and risks for utilizing intelligent transportation system as a safety infrastructure in future practices.

(Figure adapted from google maps: Rural thru-stop intersection of Highway 15 and County Road 15, Nicollet, Minnesota)

Workload, Health and Injury Study among Janitors

Among janitors, an understudied population of workers, the risk of injury- and illness-related days away from work is 2.4 times higher than for all occupations combined. OIP faculty Drs. Gerberich, Kim, McGovern, Albin, and Mr. Ryan and doctoral students, Deirdre Green, MS, PhDc, and Adam Schwartz, MS, PhDc, are partnering with the SEIU Local 26 to conduct a study on the potential associations between ergonomic and workload factors and occupational injury among janitors. Workload is assessed through survey response, on-site ergonomic assessment, and application of FitBit fitness trackers. Because a majority of janitors in SEIU L26 are immigrants (60% Hispanic and 20% Somali), under-reporting of injuries is a primary concern. This study measures janitors’ knowledge about the injury reporting process and their reporting rights, and identifies potential barriers to reporting.

Agricultural Injury Prevention

Agriculture is the most hazardous industry in the United States, with the highest rates of fatal occupational injury. Dr. Marizen Ramirez and her team have been engaged in epidemiologic studies to reduce injuries to farm operators, laborers, and farm children.

Reducing Stress among Traumatized Clinical Health Workers

According to the American Psychological Association, more than a third of US workers feel ”stressed out” during an average workday. (https://www.apa.org/news/press/releases/phwa-survey-summary.pdf). Those employed in the healthcare industry, especially physicians and nurses, have the highest rates of occupational stress (Oglinska-Biluk, 2006). Specific work-related events in healthcare can trigger high stress levels, and these “critical incidents” include experiences with patients (e.g., death or injury, aggressive behaviors, dealing with patient pain, presence of family, providing care to patient who is a relative or friend), non-patient factors (e.g., co-workers, conflict between work and family roles, being physically threatened, witnessing physical threat/assault of co-workers), and organizational factors (e.g., high workload, poor career development, lack of support) (Winefield, 2003).

Dr. Ramirez is collaborating with investigators from the Universities of Iowa and Queensland and with Chaplain Services at the University of Iowa Hospitals and Clinics to conduct a comparative effectiveness study of two early interventions (Response Resiliency Resources, RRR, and Critical Incident Stress Debriefing, CISD). For several years now, the UIHC chaplains have implemented a program of secondary prevention care for hospital workers at UIHC to provide psychosocial support to clinical units. Using a group randomized design, 24-30 groups will be randomized to receive either RRR or CSID from the chaplains. Baseline, 6-week and 3-month follow-up surveys will be completed by participants of group sessions, and stress measures, coping, resiliency and quality of life will be compared between the two modalities of care. This research has promise to advance the evidence base of chaplaincy interventions for healthcare workers, a group at high risk of occupational stress.

Assessing the Impacts of Epidemiologic Biases in World Trade Center (WTC) Health Studies

Principal Investigator: Hyun Kim, ScD
Funding: Centers for Disease Control, National Institute for Occupational Safety and Health

The main goal of this study is to assess the impacts of epidemiologic biases in WTC health studies by identifying the presence of bias and then by quantifying and adjusting for the bias effects. The successful completion of the analysis will assist other researchers to draw plausible inference of WTC health effects and other future disaster studies by adjusting for bias.

Incidence of and Risk Factors for Occupational Injury among Transit Bus Operators

Among a total of 2,095 bus operators, included in this study, designed and conducted by Dr. Chia Wei, former OIP doctoral student, the overall unintentional injury rate with 95% C.I. was 17.8 (16.1-19.7) per 100 FTEs. Multivariable analysis identified increased risks for operators who: were female, compared to male (HR=2.4; 2.0-2.8); worked <7, compared to 7-<12 hours per day (HR=4.6; 3.8-5.5); and drove <7 compared to 7-<12 hours per day (HR=3.2; 2.7-3.8). Operators who worked split, versus straight shifts, demonstrated a suggestive increased risk (HR=1.2; 1.0-1.4). Bus operators also tended to have an increased injury risk when driving limited versus regular bus routes (HR=1.36; 1.0-1.8).

The overall intentional injury rate was 1.4 (1.1-1.7) per 100 FTEs. Operators who commenced working between 3 p.m. and 6 p.m. (HR=2.4; 1.2-5.1) and 12 a.m. and 3 a.m. (HR=5.3; 1.6-18.2), had higher risks of intentional injury, compared to those who commenced work between 9 a.m. and 12 p.m. Moreover, those who worked overtime had 30% higher risks, compared to those who did not.

Reducing the Burden of Injuries On Agricultural Operations

Dr. Gerberich, OIP, and the team of other MCOHS program co-investigators and students, lead major injury prevention studies that are the basis of regional research-to-practice efforts. These include surveillance studies of the incidence and consequences of, and risk factors for, agricultural and other injuries in Minnesota, Wisconsin, North and South Dakota and Nebraska.

The study results and identification of intervention efforts are translated to practice through collaboration with regional Agricultural Extension leaders who work directly with operators and communities. Dissemination has also been accomplished through numerous peer-reviewed publications and presentations in local, national and international arenas.

Preventing Violence Against Teachers

Dr. Gerberich, MCOHS research team colleagues, and students have been providing translation of research data from the Minnesota study of “Violence Against Teachers: Etiology and Consequences,” to practice throughout the school systems, in collaboration with their dedicated advisory board of teachers. Risk factor identification, which serves as a basis for development of relevant interventions, includes consideration of various environmental factors, assault deterrents, violence policies, and school financial resources. To date, results have been disseminated in several peer-reviewed publications and at numerous major professional meetings, nationally and internationally, including audiences involving teachers.

Important factors associated with student perpetrated Physical Assaults (PAs) against a large population of K-12 grade educators were identified through a case-control study. It is important that school administrators recognize the increased risks to less experienced educators with advanced degrees who teach in public schools in elementary grades with small numbers of students, who have disabilities or developmental impairments, and in classes where students are of a different race/ethnicity from the teachers. Based on the strong evidence of an inverse relation between parental involvement and risk of PA to the educator, it appears essential to address this issue rigorously. Moreover, attention to environmental factors, including lighting, accessible exits, school resources, and an environment focused on safety is key. These results provide a basis for development and testing of effective methods for controlling the substantial risk of PA among elementary and secondary school educators that may also benefit others within the school environments.