Secondary Injuries Among U.S. Workers with Disabilities

Details

• Personal Author:
  Bishai D ; Lu B ; Stallones L ; Wilkins J III ; Xiang H
• Description:
  Background: Occupational injury research and safety training for U.S. workers with disabilities is limited, despite the fact that 4.5-8.5 million U.S. adults (ages 16-64 years) with disabilities are employed and this number is expected to increase as the workforce ages. Many workers with disabilities are employed in the most hazardous sectors of the workforce, including agriculture, construction, and services. Because of physical impairments and functional limitations, workers with disabilities may face special occupational safety issues that need to be addressed. It is widely recognized by both researchers and NIOSH that significant gaps still exist in our knowledge about occupational injuries that U.S. workers with disabilities suffer. Methods: This research project investigated nonfatal occupational and non-occupational injuries among U.S. workers with disabilities. We used two national representative survey data: 1997-2011 National Health Interview Survey (NHIS) and 2004-2011 Medical Expenditure Panel Survey (MEPS, Panels 9-15). The NHIS data were used to compare prevelance, odds ratio (OR), and characteristics of nonfatal occupational and non-occupational injuries between workers with and without disabilities (Specific Aim 1 & 2). The MEPS data were used to study medical expenditures of nonfatal occupational injuries and to describe potential differences between workers with and without disabilities in medical utilization and expenditures (Specific Aims 3). We also conducted a systematic meta-analysis to synthesize published studies about association between pre-exiting disability and occupational and non-occupational injuries in adults. Results: Workers with disability were significantly more likely than other workers to suffer occupational injuries (OR=2.39; 95% CI=1.89-3.01) and non-occupational injuries (OR=2.35; 95% CI=2.04-2.71). The 2-year cumulative incidence of occupational injuries was 13.6% (95%CI: 11.6%-15.6%) in workers with persistent disabilities and 7.1% (95%CI: 6.8%-7.4%) in workers without persistent disabilities. Annual rates of occupational and nonoccupational injuries were 6.0 and 16.4 per 100 workers with disabilities and 2.3 and 6.4 per 100 workers without disabilities. Overexertion or strenuous movements and falls accounted for 56.7% of all occupational injuries in workers with disabilities, compared with 45.6% in workers without disability. Workers with disabilities were more frequently injured in the lower extremity (32.3% versus 26.6%) or torso (22.9% versus 16.9%). The average medical expenditure associated with new occupational injuries in the 2-year MEPS reference period was $3778 in workers with disabilities, $2212 in workers without disabilities after adjusting for sociodemographics and medical insurance coverage status (in 2011 U.S. dollars, P=0.0004). Of the total expenditures for occupational injuries, Workers' Compensation paid 54.6% for workers with disabilities and 58.9% for workers without disabilities. There were no significant differences in the expenditures across types of medical services sought by the two groups of workers. Meta-analysis of 11 published studies indicates that workers with disabilities had a significantly elevated OR of occupational injuries (OR=1.62; 95% CI=1.24-2.13). Conclusions: Workers with disabilities are at significently elevated risk of occupational injuries. These injuries are more sever and average medical care expenditure is significantly higher than injuries suffered by workers with disabilities. Our systematic literature review found limited injury prevantion efforts in the U.S. that target workers with disablities. [Description provided by NIOSH]
• Subjects:
  Delivery Of Health Care Morbidity Mortality Occupational Health Safety
• Keywords:
  Disabled Workers Fatalities Injuries Injury Prevention Medical Care Morbidity Rates Mortality Data Occupational Safety Physical Capacity Safety Education
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Final Grant Report
• Place as Subject:
  Ohio ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-41
• NIOSHTIC Number:
  nn:20053998
• NTIS Accession Number:
  PB2019-100398
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, R01-OH-009585, 2014 Aug; :1-41
• Contact Point Address:
  Huiyun Xiang, MD, MPH, PhD, Center for Injury Research and Policy, The Research Institute at Nationwide Children's Hospital, The Ohio State University College of Medicine. 700 Children's Drive, Columbus, Ohio 43205, USA
• Email:
  Xiang.30@osu.edu
• Federal Fiscal Year:
  2014
• Performing Organization:
  Research Institute Nationwide Children's Hospital, Columbus, Ohio
• Peer Reviewed:
  False
• Start Date:
  20100901
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20140831
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d74209f2dfa1846febf11e3c1fb2cbcb4c48ca5bb07dcbd33c1e55825febd7e7c0a6b4160ed458c4100943bcdaf8474c2204860fb5670ed7910025c1345b7d79
• Download URL:
  https://stacks.cdc.gov/view/cdc/218791/cdc_218791_DS1.pdf
• File Type:
  [PDF - 763.92 KB ]