Employee assistance programs,drug testing,and workplace injury

IntroductionLittle is known about the effects of employee assistance programs (EAPs) on occupational injuries.Materials and methodsMultivariate regressions probed a unique data set that linked establishment information about workplace anti-drug programs in 1988 with occupational injury rates for 1405 establishments.ResultsEAPs were associated with a significant reduction in both no-lost-work and lost-work injuries, especially in the manufacturing and transportation, communication and public utilities industries (TCPU). Lost-work injuries were more responsive to specific EAP characteristics, with lower rates associated with EAPs staffed by company employees (most likely onsite). Telephone hotline services were associated with reduced rates of lost-work injuries in manufacturing and TCPU. Drug testing was associated with reductions in the rate of minor injuries with no lost work, but had no significant relationship with lost-work injuries.Practical applicationsThis associational study suggests that EAPs, especially ones that are company-staffed and ones that include telephone hotlines, may prevent workplace injuries.     

The need for detailed gender-specific occupational safety analysis

IntroductionThe female work in population is growing in the United States, therefore the occupational health and safety entities must start to analyze gender-specific data related to every industry, especially to nontraditional occupations. Women working in nontraditional jobs are often exposed to extreme workplace hazards. These women have their safety and health threatened because there are no adequate policies to mitigate gender-specific risks such as discrimination and harassment. Employers tend to aggravate this situation because they often fail to provide proper reporting infrastructure and support. According to past studies, women suffered from workplace injuries and illnesses that were less prominent among men. Statistics also confirmed that men and women faced different levels of risks in distinct work environments. For example, the rates of workplace violence and murders by personal acquaintances were significantly higher among women.MethodsIn this paper, the authors analyze prior public data on fatal and nonfatal injuries to understand why we need to differentiate genders when analyzing occupational safety and health issues.ResultsThe analyses confirmed that women dealt with unique workplace hazards compared to men.ConclusionsIt is urgent that public agencies, such as the U.S. Department of Labor, record gender-specific data in details and by occupations and industries.Practical applicationThe reader will become aware of the current lack – and need – of data and knowledge about injuries and illnesses separated by gender and industry. Finally, safety and health researchers are encouraged to investigate the gender-specific data in all industries and occupations, as soon as they become available.     

A framework for evaluating OSH program effectiveness using leading and trailing metrics

Introduction

Many employers and regulators today rely primarily on a few past injury/ illness metrics as criteria for rating the effectiveness of occupational safety and health (OSH) programs. Although such trailing data are necessary to assess program success, they may not be sufficient for developing proactive safety, ergonomic, and medical management plans.

Methods

The goals of this pilot study were to create leading metrics (company self-assessment ratings) and trailing metrics (past loss data) that could be used to evaluate the effectiveness of OSH program elements that range from primary to tertiary prevention. The main hypothesis was that the new metrics would be explanatory variables for three standard future workers compensation (WC) outcomes in 2003 (rates of total cases, lost time cases, and costs) and that the framework for evaluating OSH programs could be justifiably expanded. For leading metrics, surveys were developed to allow respondents to assess OSH exposures and program prevention elements (management leadership/ commitment, employee participation, hazard identification, hazard control, medical management, training, and program evaluation). After pre-testing, surveys were sent to companies covered by the same WC insurer in early 2003. A total of 33 completed surveys were used for final analysis. A series of trailing metrics were developed from 1999-2001 WC data for the surveyed companies. Data were analyzed using a method where each main 2003 WC outcome was dichotomized into high and low loss groups based on the median value of the variable. The mean and standard deviations of survey questions and 1999-2001 WC variables were compared between the dichotomized groups. Hypothesis testing was performed using F-test with a significance level 0.10.

Results/Discussion

Companies that exhibited higher musculoskeletal disorder (MSD) WC case rates from 1999-2001 had higher total WC case rates in 2003. Higher levels of several self-reported OSH program elements (tracking progress in controlling workplace safety hazards, identifying ergonomic hazards, using health promotion programs) were associated with lower rates of WC lost time cases in 2003. Higher reported exposures to noise and projectiles were also associated with higher rates of WC cases and costs in 2003.

Impact on Industry

This research adds to a growing body of preliminary evidence that valid leading and trailing metrics can be developed to evaluate OSH effectiveness. Both the rating of OSH efforts and the regular trending of past loss outcomes are likely useful in developing data-driven improvement plans that are reactive to past exposures and proactive in identifying system deficiencies that drive future losses.     

Workers’ compensation claim counts and rates by injury event/exposure among state-insured private employers in Ohio, 2007–2017

Introduction: This study analyzed workers’ compensation (WC) claims among private employers insured by the Ohio state-based WC carrier to identify high-risk industries by detailed cause of injury. Methods: A machine learning algorithm was used to code each claim by U.S. Bureau of Labor Statistics (BLS) event/exposure. The codes assigned to lost-time (LT) claims with lower algorithm probabilities of accurate classification or those LT claims with high costs were manually reviewed. WC data were linked with the state’s unemployment insurance (UI) data to identify the employer’s industry and number of employees. BLS data on hours worked per employee were used to estimate full-time equivalents (FTE) and calculate rates of WC claims per 100 FTE. Results: 140,780 LT claims and 633,373 medical-only claims were analyzed. Although counts and rates of LT WC claims declined from 2007 to 2017, the shares of leading LT injury event/exposures remained largely unchanged. LT claims due to Overexertion and Bodily Reaction (33.0%) were most common, followed by Falls, Slips, and Trips (31.4%), Contact with Objects and Equipment (22.5%), Transportation Incidents (7.0%), Exposure to Harmful Substances or Environments (2.8%), Violence and Other Injuries by Persons or Animals (2.5%), and Fires and Explosions (0.4%). These findings are consistent with other reported data. The proportions of injury event/exposures varied by industry, and high-risk industries were identified. Conclusions: Injuries have been reduced, but prevention challenges remain in certain industries. Available evidence on intervention effectiveness was summarized and mapped to the analysis results to demonstrate how the results can guide prevention efforts. Practical Applications: Employers, safety/health practitioners, researchers, WC insurers, and bureaus can use these data and machine learning methods to understand industry differences in the level and mix of risks, as well as industry trends, and to tailor safety, health, and disability prevention services and research.     

Foundational workplace safety and health competencies for the emerging workforce

IntroductionYoung workers (aged 15–24) suffer disproportionately from workplace injuries, with a nonfatal injury rate estimated to be two times higher than among workers age 25 or over. These workers make up approximately 9% of the U.S. workforce and studies have shown that nearly 80% of high school students work at some point during high school. Although young worker injuries are a pressing public health problem, the critical knowledge and skills needed to prepare youth for safe and healthy work are missing from most frameworks used to prepare the emerging U.S. workforce.MethodsA framework of foundational workplace safety and health knowledge and skills (the NIOSH 8 Core Competencies) was developed based on the Health Belief Model (HBM).ResultsThe proposed NIOSH Core Competencies utilize the HBM to provide a framework for foundational workplace safety and health knowledge and skills. An examination of how these competencies and the HBM apply to actions that workers take to protect themselves is provided. The social and physical environments that influence these actions are also discussed.ConclusionsThe NIOSH 8 Core Competencies, grounded in one of the most widely used health behavior theories, fill a critical gap in preparing the emerging U.S. workforce to be cognizant of workplace risks.Practical applicationsIntegration of the NIOSH 8 Core Competencies into school curricula is one way to ensure that every young person has the foundational workplace safety and health knowledge and skills to participate in, and benefit from, safe and healthy work.     

The unequal distribution of occupational health and safety risks among immigrants to Canada compared to Canadian-born labour market participants: 1993–2005

ObjectivesTo examine the prevalence of occupational health and safety risk factors among immigrants to Canada compared to Canadian-born labour force participants.MethodsUsing data from Statistic Canada’s Survey of Labour and Income Dynamics, we examined the differential probabilities of six different occupational health and safety risks: non-membership in a union or collective bargaining agreement; employment in physically demanding occupations; employment in a workplace with less than 20 employees; regular shift work; irregular shift work; and having non-permanent employment. Our main independent variables were length of time in Canada, visible minority status, mother tongue, and location where highest level of education was attained. Models were adjusted for age, gender, education, marital status, province of residence, living in an urban or rural location, and industry group.ResultsOf the six occupational health and safety risks examined we found that our main independent variables describing aspects of immigration status were associated with five; the exception being irregular shift work. Adjustment for industry did not attenuate these relationships to a large extent.ConclusionsImmigrants to Canada are faced with many occupational health and safety risks compared to Canadian-born respondents. These risks may be heightened among immigrants as they may not have knowledge of workplace rights and protections or have problems communicating health and safety risks or concerns. The timely provision information on occupational health and safety to immigrants before they start working should be a priority as they integrate into the Canadian labour market.     

The use of state workers' compensation administrative data to identify injury scenarios and quantify costs of work-related traumatic brain injuries

PROBLEM: Traumatic brain injury (TBI) is a public health problem but little is known about the nature of that problem in the working population. METHOD: The author used a national definition to identify cases in Washington State from workers' compensation (WC) hospital billing data, quantified the cost of WC insurance benefits using actuarial cost estimates, and identified high risk industries using ANSI Z16.2 typology. RESULTS: There were 928 cases of TBI with a lifetime claim cost of $159 million from the Washington State Fund (1994-2001). Sixty percent of injuries resulted in death or disability. The highest risks of TBI are concentrated in 16 industrial insurance risk classes and the highest costs in 19 North American Industry Classification codes. Injury scenarios were identified for nine industrial insurance risk classes. CONCLUSIONS: TBI is a disabling and costly workplace injury in the state of Washington, affecting even teenagers and seniors who are not generally considered to be part of the workforce. Injury typology codes provide useful information for improving workplace safety. IMPACT ON INDUSTRY: This research provides industry with quantitative information regarding the cost of work-related traumatic brain injury and the usefulness of using workers' compensation claims data to reduce the burden of workplace injury.     

Facilitators and barriers to occupational health and safety in small and medium-sized enterprises: a descriptive exploratory study in Ontario,Canada

Purpose. The purpose of this particular study was to test a newly created instrument in describing the facilitators and barriers to occupational health and safety in small and medium-sized enterprises (SMEs) in Ontario, Canada. Methods. A cross-sectional design was used to identify the occupational health and safety culture of SMEs in public and private sectors in Ontario. Results. A total of 153 questionnaires were completed. The majority of respondents were female (84%) with a mean age of 49.8 years (SD 10.6). Seventy-four percent were supervisors. Seventy percent of respondents were from the private sector while 30% derived from the public sector including healthcare, community services, and non-profit organizations. Further, conducting regular external safety inspections of the workplace was found to be statistically associated with a safe work environment 2.88 95% CI [1.57, 5.27]. Conclusions. Strategies and training opportunities that focus on how to adapt occupational health and safety legislation to the nature and diversity of SMEs are recommended. Furthermore, employers may use such information to improve safety in their SMEs, while researchers can hopefully use such evidence to develop interventions that are applicable to meeting the occupational health and safety needs of SMEs.     

Why employers spend money on employee health: Interviews with occupational health and safety professionals from British Industry

ObjectivesTo better understand the information that is used in business cases for employee health activities.MethodsInterviews with 18 occupational health and safety professionals at major organisations in the UK were conducted to explore attitudes, motivations, behaviours and information needs about employee health investment.ResultsThe occupational health and safety professionals interviewed for this study have described how employee health issues are discussed in their organisations. Ethical arguments about it being the ‘right thing to do’ are common and are believed to have impact. Unsurprisingly legal compliance is stated to be the driver of most employee health activity. Higher-level activities and resource do require a business case. It is suggested that currently business cases for employee health are often not overly empirical, with more intuitive arguments appealing to people management issues, notions of corporate reputation and alignment with business objectives. Data on benchmarking and some kind of return-on-investment assessment are normally required. Data on cost of illness (mostly expressed via sickness absence), direct health expenditure per employee and insurance premiums are also used. These data are mostly captured by existing sources and procedural systems, although sickness absence data especially is often thought to be unreliable. Data on staff retention and productivity were considered relevant but not currently used or analysed by this sample. There was support for the notion that more robust empirical business cases may help overcome some of the barriers that were identified, for example where costs are more quantifiable than benefits.ConclusionsThere is scope to make significant improvements to the business case for employee health investments in UK organisations through better measurement of impact on productivity and reputation risk and greater business-aligned communication by health professionals. More empirical business cases that meet the needs of decision-makers are more likely to attract investment into employee health activities.     

Under-recording of work-related injuries and illnesses: An OSHA priority

IntroductionA 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States.MethodsOSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses.ResultsOSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses.ConclusionsOSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data.Practical applicationsOccupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses.     

Safety climate at agricultural cooperatives

Introduction: This study identifies determinants of safety climate at agricultural cooperatives. Methods: An extensive survey was designed to build upon past research done in collaboration with DuPont (Risch et al., 2014). In 2014 and 2015, the survey was administered to 1930 employees at 14 different agricultural cooperatives with 154 locations. Injury incidence data were also collected from each location to better understand the overall health and safety environment in this sector. An ordered probit model is used to identify variables that are associated with better safety climates. Results: Safety system components such as discipline programs, inspection programs, modified duty programs, off-the-job safety training programs, and recognition programs are positively related to individual safety climate for both managerial employees and nonmanagerial employees. Variables representing an employee’s agricultural background, distance between their workplace and childhood home, and formal education are not associated with managerial safety climate. However, agricultural background and childhood home distance are associated with nonmanagerial safety climate. Conclusions: Improving occupational health and safety is a priority for many agricultural cooperatives. Lower safety climate emerges as nonmanagerial employees have more experience with production agriculture and work nearer to their home community. Practical applications: Employees of agricultural cooperatives face a host of health and safety challenges that are likely to persist into the future. The safety system components associated with safety climate indicate that continuous feedback is important for improving occupational health and safety. Occupational health and safety programming should also acknowledge that many employees have experiences that influence their attitudes and behaviors.     

Importance of awareness in improving performance of emergency medical services (EMS) systems in enhancing traffic safety: A lesson from India

Objective: India has been slow in implementing a central emergency medical services (EMS) system across the country. “108 services” is one of the most popular services that is functional under the public–private partnership model. Limited available literature shows that despite access to services, many traffic crash victims are transported using private vehicles. The objective of this study is to understand the effectiveness of 108 services from a traffic safety perspective.

Method: A questionnaire survey is conducted to understand the awareness of EMS and their function. Using traffic-related fatalities as the dependent variable, a fixed effect panel data model is developed to analyze the effectiveness of the 108 services in improving the traffic safety.

Results: The results from the survey show that, in general, people are not aware of the 108 services. A majority of the population prefers taking victims to the hospital using their personal vehicles or any other vehicles available compared to calling an ambulance. Results from panel data analysis show that despite having an efficient system, these services failed to make significant improvement in the safety of road users in the states in which their services were subscribed.

Discussion: The lack of awareness of an important safety service is alarming. This could be a major reason for lower utilization of 108 services for transporting victims of traffic crashes. This article shows the importance of having efficient awareness campaigns to improve the efficiency of any similar programs that are aimed to enhance the safety of a region.     

Workplace bullying in risk and safety professionals

IntroductionPrevious research demonstrates that workplace bullying impacts the welfare of victimized employees, with further consequences for the organization and profession. There is, however, a paucity of information relating to the bullying directed at risk and safety professionals. The present study was conducted to address this issue.MethodRisk and safety professionals (N = 420) completed the Negative Acts Questionnaire – Revised and Brief Cope, and reported the extent to which they had been pressured to make or amend a risk or safety based decision.ResultsThose experiencing workplace bullying were more likely to engage in a range of coping behaviors, with exposure to work-related and personal bullying particularly influential. Workplace bullying also predicted pressure to make or change a risk or safety based decision. Work related and physically intimidating bullying were particularly important for this aspect of professional practice.ConclusionsFindings are discussed with regard to current practice and the support available to risk and safety professionals.Practical applicationsRisk and safety professionals require additional support in relation to workplace bullying and specifically guidance to resist pressure to make or change a risk or safety based decision.     

Leader–member exchange: Moderating the health and safety outcomes of job insecurity

IntroductionJob insecurity has been repeatedly linked with poor employee health and safety outcomes. Although research on high quality leader–member exchange (LMX) has demonstrated many beneficial effects, no research to date has examined the extent to which positive LMX might attenuate those adverse health and safety-related consequences of job insecurity. The current study extends research in this area by specifically examining the buffering impact of LMX on the relationship between job insecurity and safety knowledge, reported accidents, and physical health conditions. Furthermore, the study also examines whether positive LMX mitigates the typically seen negative impact of job insecurity on supervisor satisfaction.MethodsThe hypotheses were tested using survey data collected from 212 employees of a mine located in southwestern United States.ResultsAs predicted, job insecurity was related to lower levels of supervisor satisfaction, more health ailments, and more workplace accidents, and was marginally related to lower levels of safety knowledge. Results indicated that LMX significantly attenuated these observed relationships.ConclusionsThe quality of the dyadic relationship between supervisor and subordinate has a significant impact on the extent to which job insecurity is associated with adverse health and safety outcomes.Practical applicationsPractical implications for supervisor behavior and developing high quality LMX are discussed in light of today's pervasive job insecurity.     

A qualitative investigation of factors affecting school district administrators’ decision to adopt a national young worker curriculum

Introduction: Even though the majority of youth in the U.S. work, and workers under the age of 18 are seriously injured on the job at higher rates when compared to adults, most adolescents lack instruction on workplace safety and health. Method: This qualitative study examines the extent to which selected U.S. school districts provide workplace safety and health instruction to students and explores the factors that influence districts’ decision to adopt a free, foundational occupational safety and health (OSH) curriculum. Results: Results from key informant interviews conducted with a purposive sample of 34 school administrators revealed that only a third of the districts have at least 75% of their students receive some instruction on workplace safety and health, while 15% indicated they provide no instruction on this topic. District staff who indicated that they provide OSH instruction stated that it is most often taught through career and technical education (CTE; 65%) and/or health classes (26%). They believed the benefits of providing this instruction include assisting students to get jobs (38%) and helping students learn about safety (32%), while competing demands (44%) and time constraints (41%) were identified as barriers to providing OSH education to students. Conclusions: Given the importance of work to teens and their increased risk of work injury, interested stakeholders—including parents, teachers, employers, and the public health community—should promote the inclusion of workplace safety and health instruction in U.S. secondary schools. Practical Applications: This research fills a gap in current knowledge about the extent to which OSH is currently taught within U.S. secondary schools, enumerates barriers and facilitators to the inclusion of workplace safety and health instruction in schools, presents a free, foundational curriculum in workplace safety and health, and provides directions for future research on the vital role schools can play in preparing the future workforce for safe and healthy employment.     

The direct cost burden of 13 years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index

Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem. Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs. Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd. Practical application: The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States.     

Global bike share: What the data tells us about road safety

IntroductionBike share has emerged as a rapidly growing mode of transport in over 800 cities globally, up from just a handful in the 1990s. Some analysts had forecast a rise in the number of bicycle crashes after the introduction of bike share, but empirical research on bike share safety is rare. The goal of this study is to examine the impact of bike share programs on cycling safety.MethodsThe paper has two substudies. Study 1 was a secondary analysis of longitudinal hospital injury data from the Graves et al. (2014) study. It compared cycling safety in cities that introduced bike share programs with cities that did not. Study 2 combined ridership data with crash data of selected North American and European cities to compare bike share users to other cyclists.ResultsStudy 1 indicated that the introduction of a bike share system was associated with a reduction in cycling injury risk. Study 2 found that bike share users were less likely than other cyclists to sustain fatal or severe injuries.ConclusionsOn a per kilometer basis, bike share is associated with decreased risk of both fatal and non-fatal bicycle crashes when compared to private bike riding.Practical ApplicationsThe results of this study suggest that concerns of decreased levels of cycling safety are unjustified and should not prevent decision makers from introducing public bike share schemes, especially if combined with other safety measures like traffic calming.     

Characteristics of ride share services for older adults in the United States

Introduction: Safe and accessible transportation options are important for older adults’ health, safety, mobility, and independence. Ride share services may promote older adult health and well-being. This is the first study that describes ride share services available to older adults (65+ years) in the United States, including factors that may affect use of services. Methods: We analyzed secondary data from two research and administrative databases provided by ITNAmerica, a national non-profit transportation service for older adults: ITNRides, which tracks information on older adults who used ITN in 29 locations across the United States from 1996 to 2019, and Rides in Sight, the largest national data source on ride share services for older adults. We conducted a literature review, and telephone interviews with nine key informants representing ride share services, referral services, and other organizations. We offer a conceptual framework describing factors that may affect older adults’ use of ride share services. Results: This study identified 917 non-profit ride share services and eleven for-profit ride share services available for older adults in the United States as of August 2018. Services varied by corporate structure, location, use of technology, and business model. The majority of non-profit services served primarily older adults, while the for-profit services served primarily younger adults. Riders from one multi-site non-profit service had a median age of 82. Use of ride share services is affected by individual needs and preferences; social conditions; and business and policy factors. Conclusion: Ride share services may offer a promising alternative to driving for older adults and may help to address negative health consequences associated with driving cessation. Practical applications: These findings may help policy makers, practitioners, and other stakeholders understand older adults’ needs related to use of ride share services in order to offer solutions that prioritize public health and safety.     

A new approach to managing work-related road traffic injury: The development of a health investment framework

Objective: Statistics indicate that employees commuting or traveling as part of their work are overrepresented in workplace injury and death. Despite this, many organizations are unaware of the factors within their organizations that are likely to influence potential reductions in work-related road traffic injury.

Methods: This article presents a multilevel conceptual framework that identifies health investment as the central feature in reducing work-related road traffic injury. Within this framework, we explore factors operating at the individual driver, workgroup supervisor, and organizational senior management levels that create a mutually reinforcing system of safety.

Results: The health investment framework identifies key factors at the senior manager, supervisor, and driver levels to cultivating a safe working environment. These factors are high-performance workplace systems, leader–member exchange and autonomy, trust and empowerment, respectively. The framework demonstrates the important interactions between these factors and how they create a self-sustaining organizational safety system.

Conclusions: The framework aims to provide insight into the future development of interventions that are strategically aligned with the organization and target elements that facilitate and enhance driver safety and ultimately reduce work-related road traffic injury and death.