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INTRODUCTION: Workers' compensation injuries entail burdensome financial and social costs. This study's objective was to describe cost and frequency of workplace injuries in aviation manufacturing in the state of Kansas using workers' compensation data. Manufacturing incurs more workers' compensation claims in Kansas than any other industry, and aviation contributes more of those claims than any other sub sector. METHOD: Workers' compensation insurance and reporting are required in the state of Kansas. Data were provided by the Kansas Department of Labor (KDOL) and included all closed workers' compensation claims entailing indemnity and medical costs filed in the state from 2014 to 2022. Cost of claim data were normalized to 2022 U.S. dollars and data were analyzed as a function of percentage and claim cost by body part, type of injury, cause of injury, specific musculoskeletal disorder type, and as a function of age and gender injury rates. RESULTS: Aviation claims entailed a median total cost of $26,941 and represented 8% of all closed claims filed in the state from 2014 to 2022. The grand total direct cost over the nine-year period was $75,404,147. Medical costs comprised 48.6% of all costs, indemnity 45.0%, and legal 6.4%. The most frequently injured body part was the hand/wrist (35.9%) followed by the shoulder (20.6%), and the most expensive body parts were related to the back. Overexertion (38.6%) was the most common cause followed by repetitive motion (22.8%). Work-related musculoskeletal disorders were the most common type accounting for 67.4% of all claims. Men and workers aged 55-64 incurred slightly higher claim rates than average. A sharp decrease in number of claims closed in 2021 coincided with production shutdowns the previous year related to the Covid-19 pandemic and design issues. CONCLUSIONS: Aviation manufacturing is a key industry in Kansas and this study is the first known to describe costs and frequencies of workplace injuries in the sector using workers' compensation data. PRACTICAL APPLICATIONS: This guide to the most problematic and costly injuries in aviation manufacturing helps practitioners prioritize prevention strategies to most effectively reduce workplace injury and helps safety and health practitioners in prioritizing prevention efforts to reduce the most severe and costly aviation manufacturing injuries and illnesses. It also brings attention to some special considerations when working with safety data from 2020 to 2022 related to the Covid-19 pandemic.
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Traumatismos Ocupacionales , Indemnización para Trabajadores , Humanos , Indemnización para Trabajadores/estadística & datos numéricos , Indemnización para Trabajadores/economía , Kansas/epidemiología , Masculino , Adulto , Femenino , Persona de Mediana Edad , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/economía , Aviación/estadística & datos numéricos , Adulto Joven , Adolescente , Accidentes de Trabajo/estadística & datos numéricos , Accidentes de Trabajo/economíaRESUMEN
BACKGROUND: Diseases and conditions related to the respiratory system contribute to work-related morbidity, mortality, and disability. Details on the causes and nature of work-related respiratory disease and the specific industries in which they occur are limited. This study identifies respiratory-related claims in the Ohio Bureau of Workers' Compensation (OHBWC) system and describes claim and worker characteristics to inform public health surveillance. METHODS: We developed a list of respiratory-related International Classification of Diseases Clinical Modification (ICD-CM) diagnosis codes and searched over 2 million claims filed between 2001 and 2018 in the OHBWC system for at least one of these codes. The claim characteristics, rates of claims by employer industry classification, and causes of claims from narrative text were determined for these respiratory-related claims. RESULTS: Among the 23,015 respiratory-related claims (5.8 per 10,000 full-time equivalents [FTE]), 54.6% had at least one ICD-CM code for Allergic Reactions and 30.6% had at least one code for Toxic Effects of Substances Chiefly Non-medicinal as to Source. Claim causes from narrative text included Chemical Exposure (30.3%), Activity Suggesting Exposure (24.4%), and Vapors, Gases, Dusts, or Fumes (VGDF) Exposure (19.3%). The highest overall rates of respiratory-related claims among private employers were for the agriculture, forestry & fishing (11.4 per 10,000), public safety (ambulance services) (11.3), and manufacturing (10.7) industry sectors. CONCLUSIONS: Respiratory-related claims in the OHBWC system were often acute in nature and included allergic reactions. Narratives from these claims provide insight into the work-related exposures and events causing claims or the disease and symptom factors surrounding claims.
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Indemnización para Trabajadores , Humanos , Indemnización para Trabajadores/estadística & datos numéricos , Ohio/epidemiología , Masculino , Adulto , Femenino , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Enfermedades Respiratorias/epidemiología , Adulto Joven , Adolescente , Clasificación Internacional de EnfermedadesRESUMEN
OBJECTIVES: To describe and compare the incidence and trends of workers' compensation (WC) claims for psychological injury: (1) between health and social care (HSC) industry and other industries; (2) among specific occupations in the HSC industry; and (3) to determine if psychological injury claim rates differ by age and gender in the HSC industry and among specific occupations. METHODS: A retrospective cohort study was conducted using data from the New South Wales WC system. Workers with accepted psychological injury claims between July 2012 and June 2021 were included. Negative binomial regression models were employed to estimate incidence rate ratios and 95% CIs. RESULTS: The HSC industry had a higher incidence (2.4 per 1000 workers) than all other industries combined (1.1 per 1000 workers). In the HSC industry, the incidence increased from 1.8 in 2013-2015 to 3.4 in 2019-2021. Ambulance officers had the highest incidence (24.9 per 1000 workers) and the highest growth rate. Nurses and midwives, and aged and disability care workers also had fast-growing incidence over the 9 years. Risk of psychological injury claims was highest among female workers and older adults. CONCLUSIONS: The increasing incidence and trend of psychological injury claims among HSC workers in New South Wales signify a growing public health issue. Greater efforts are needed to prevent work-related psychological injury in the HSC industry and support affected workers. The different patterns of psychological injury claims across occupations suggest that interventions should be tailored to each occupational group.
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Personal de Salud , Indemnización para Trabajadores , Humanos , Indemnización para Trabajadores/estadística & datos numéricos , Nueva Gales del Sur/epidemiología , Femenino , Estudios Retrospectivos , Masculino , Incidencia , Adulto , Persona de Mediana Edad , Personal de Salud/psicología , Personal de Salud/estadística & datos numéricos , Trabajadores Sociales/psicología , Factores de Riesgo , Anciano , Adulto Joven , Traumatismos Ocupacionales/epidemiología , Traumatismos Ocupacionales/psicologíaRESUMEN
OBJECTIVES: To examine the association between precarious employment and risk of occupational injury or illness in Ontario, Canada. METHODS: We combined accepted lost-time compensation claims from the Workplace Safety and Insurance Board with labour force statistics to estimate injury and illness rates between January 2016 and December 2019. Precarious employment was imputed using a job exposure matrix and operationalised in terms of temporary employment, low wages, irregular hours, involuntary part-time employment and a multidimensional measure of 'low', 'medium', 'high' and 'very high' probabilities of exposure to precarious employment. Negative binomial regression models examined exposure to precarious employment in relation to risk of occupational injury or illness. RESULTS: After adjusting for age, sex and year, all indicators of precarious employment were associated with increased risk of injury or illness. Workers with 'high' and 'very' high' exposure to precarious employment presented a nearly threefold risk of injury or illness (rate ratio (RR): 2.81, 95% CI 2.73 to 2.89; RR: 2.82, 95% CI 2.74 to 2.90). Further adjustment for physical demands and workplace hazards attenuated associations, though a statistically and substantively significant exposure-outcome relationship persisted for workers with 'high' and 'very high' exposures to precarious employment (RR: 1.65, 95% CI 1.58 to 1.72; RR: 2.00, 95% CI 1.92 to 2.08). CONCLUSIONS: Workers exposed to precarious employment are more likely to sustain a lost-time injury or illness in Ontario, Canada. Workplace health and safety strategies should consider the role of precarious employment as an occupational hazard and a marker of work injury risk.
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Empleo , Enfermedades Profesionales , Traumatismos Ocupacionales , Humanos , Ontario/epidemiología , Femenino , Masculino , Empleo/estadística & datos numéricos , Adulto , Persona de Mediana Edad , Enfermedades Profesionales/epidemiología , Traumatismos Ocupacionales/epidemiología , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Indemnización para Trabajadores/estadística & datos numéricos , Factores de Riesgo , Seguridad del EmpleoRESUMEN
Occupational motor vehicle (OMV) crashes are a leading cause of occupation-related injury and fatality in the United States. Statewide crash databases provide a good source for identifying crashes involving large commercial vehicles but are less optimal for identifying OMV crashes involving light or medium vehicles. This has led to an underestimation of OMV crash counts across states and an incomplete picture of the magnitude of the problem. The goal of this study was to develop and pilot a systematic process for identifying OMV crashes in light and medium vehicles using both state crash and health-related surveillance databases. A two-fold process was developed that included: 1) a machine learning approach for mining crash narratives and 2) a deterministic data linkage effort with crash state data and workers compensation (WC) claims records and emergency medical service (EMS) data, independently. Overall, the combined process identified 5,302 OMV crashes in light and medium vehicles within one year's worth of crash data. Findings suggest the inclusion of multi-method approaches and multiple data sources can be implemented and used to improve OMV crash surveillance in the United States.
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Accidentes de Trabajo , Accidentes de Tránsito , Minería de Datos , Humanos , Accidentes de Tránsito/estadística & datos numéricos , Accidentes de Tránsito/mortalidad , Kentucky/epidemiología , Accidentes de Trabajo/estadística & datos numéricos , Vehículos a Motor/estadística & datos numéricos , Aprendizaje Automático , Bases de Datos Factuales , Indemnización para Trabajadores/estadística & datos numéricos , Proyectos Piloto , Almacenamiento y Recuperación de la Información , Servicios Médicos de Urgencia/estadística & datos numéricosRESUMEN
OBJECTIVES: Approximately 81% of traumatic brain injury cases are considered to be mild (mTBI), but few studies have reviewed mTBI caused by workplace violence (WPV). This study aimed to (1) determine the incidence of mTBI secondary to WPV in a statewide workers' compensation system using International Classification of Disease codes and (2) analyse and compare factors associated with return-to-work outcomes between WPV mTBI cases versus other mechanisms. METHODS: Using a retrospective cohort of claims data from the California Workers' Compensation Information System during 2015-2019, cases with a return-to-work date were classified as WPV if the injury description contained keywords such as assault, gunpoint, harassed, intimidated, punch, threat, robbery, violent or verbal abuse. RESULTS: Of the 14 089 mTBI claims analysed in this study, 11.2% were caused by WPV. When comparing WPV to non-WPV claims, the variables with statistically significant (p≤0.001) differences were age, income, industry and job class. There were no significant differences between groups for leave duration. In a linear mixed model, the variable of interest (WPV) was not associated with recovery duration after adjusting for other factors. CONCLUSION: To our knowledge, this is the first study to examine WPV mTBI claims in the USA. The findings suggest that the public administration, education and healthcare and social services industries are at higher risk for WPV mTBI. WPV and job class were the only modifiable factors in the model and therefore should be the focus of additional research.
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Conmoción Encefálica , Reinserción al Trabajo , Indemnización para Trabajadores , Violencia Laboral , Humanos , Indemnización para Trabajadores/estadística & datos numéricos , Adulto , Masculino , Violencia Laboral/estadística & datos numéricos , Femenino , Estudios Retrospectivos , Persona de Mediana Edad , Reinserción al Trabajo/estadística & datos numéricos , California/epidemiología , Conmoción Encefálica/epidemiología , Incidencia , Adulto Joven , Traumatismos Ocupacionales/epidemiologíaRESUMEN
We conducted a comprehensive review of state workers' compensation laws in the United States to evaluate the extent to which they support first responders with mental injury. Most state workers' compensation systems divide mental injuries into categories based on their presumed etiology: physical-mental, mental-physical, and mental-mental. Major differences exist among states as to which workers are eligible. Proving workplace causation can be difficult where no traumatic physical injuries exist. Latency periods, time limits, preexisting health conditions, restrictions as to types of condition covered, and complex chains of causation may make this burden, which falls on the claimant, even more challenging. Only nine (9) states enacted presumption of causation laws for mental health conditions to ease claimants' burden of proof. This contrasts starkly with presumption laws for chronic and infectious diseases. State decision-makers should create presumptions that mental health conditions in first responders are caused or significantly exacerbated by their stressful workplaces.
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Trastornos Mentales , Indemnización para Trabajadores , Humanos , Estados Unidos , Indemnización para Trabajadores/legislación & jurisprudencia , Salud Mental/legislación & jurisprudencia , Gobierno EstatalRESUMEN
INTRODUCTION: Questions concerning under-reporting of occupational diseases (OD) linked to asbestos exposure are regularly voiced in France. Monitoring of the French multicenter Asbestos-Related Disease Cohort (ARDCO), which ensures post-occupational medical surveillance of subjects having been exposed to asbestos, provides information on (1) the medico-legal steps taken following screening by computed tomography (CT) for benign thoracic diseases, and (2) recognition of OD as a causal factor in malignant diseases. METHODS: OD recognition - and possible compensation - was analyzed in July 2021 among 13,289 volunteers in the cohort recruited between 2003 and 2005. RESULTS: Fifteen percent of the subjects in the cohort were found to have at least one recognized asbestos-related OD (78.2% benign pleural disease, 10.3% asbestosis, 14.2% lung cancer, and 6.0% mesothelioma). Only 58% of pleural plaques reported by the radiologist who performed the CT resulted in their recognition as ODs. On a parallel track, 88.7% of the mesotheliomas identified based on French National health insurance data and 46.9% of lung cancers were recognized as ODs. CONCLUSIONS: This study confirms the feasibility of a system designed to facilitate recognition, leading to possible compensation, of asbestos-related occupational diseases. The system could be improved by better training of the medical actors involved.
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Amianto , Asbestosis , Neoplasias Pulmonares , Enfermedades Profesionales , Exposición Profesional , Indemnización para Trabajadores , Humanos , Francia/epidemiología , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/diagnóstico , Enfermedades Profesionales/etiología , Masculino , Persona de Mediana Edad , Femenino , Exposición Profesional/efectos adversos , Exposición Profesional/estadística & datos numéricos , Anciano , Asbestosis/epidemiología , Asbestosis/diagnóstico , Estudios de Cohortes , Neoplasias Pulmonares/epidemiología , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/etiología , Indemnización para Trabajadores/estadística & datos numéricos , Amianto/efectos adversos , Adulto , Anciano de 80 o más Años , Tomografía Computarizada por Rayos X/estadística & datos numéricos , Mesotelioma/epidemiología , Mesotelioma/diagnóstico , Mesotelioma/etiologíaRESUMEN
OBJECTIVES: Prior analyses of the Occupational Disease Surveillance System (ODSS) have compared cancer rates using internal referent groups. As an exploratory analysis, we sought to estimate cancer risk using general population reference rates to evaluate the impact that the comparison population has on findings from our surveillance program. METHODS: A cohort of approximately 2.3 million workers in Ontario, Canada with an accepted lost-time workers' compensation claim were followed for all cancer diagnoses between 1983 and 2018. Standardized incidence ratios (SIRs) and 95% confidence intervals were calculated for workers in specific occupational groups using (1) all other workers in the ODSS cohort, and (2) the general population of Ontario. RESULTS: SIRs using the general population reference group were generally equal to or modestly lower compared to SIRs using the internal reference group. Within occupation groups, SIRs had a discordant direction of association (increased rate in the internal comparison and decreased in the external comparison) for some cancer sites including urinary, prostate, and colorectal. CONCLUSIONS: Findings emphasize the importance of the choice of reference group when evaluating cancer risks in large occupational surveillance cohorts. Importantly, the magnitude of confounding and the healthy worker hire bias may depend on the occupation group and cancer site of interest.
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Neoplasias , Enfermedades Profesionales , Vigilancia de la Población , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios de Cohortes , Incidencia , Neoplasias/epidemiología , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Ocupaciones/estadística & datos numéricos , Ontario/epidemiología , Indemnización para Trabajadores/estadística & datos numéricos , Diversidad de la Fuerza Laboral , Anciano de 80 o más AñosRESUMEN
This is a summary of the results of a research work, born from a collaboration between multiple Italian bodies and published by the Italian Workers' Compensation Authority (Inail) in March 2024: Second report on maritime workers. Activities and risk factors of sea workers.To disseminate the contents, the work offers a global overview of safety and health in the sector: with an analysis of accidents in the sector (which also involves some remarks on the event reporting form), workers' risk perception is examined and occupational diseases monitored through the MalProf system, managed by the Inail Research Sector and the local health authorities. Finally, an in-depth study is dedicated to exposure to asbestos on ships.
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Enfermedades Profesionales , Exposición Profesional , Humanos , Italia/epidemiología , Factores de Riesgo , Enfermedades Profesionales/epidemiología , Exposición Profesional/efectos adversos , Navíos , Accidentes de Trabajo/estadística & datos numéricos , Amianto/efectos adversos , Indemnización para Trabajadores , Salud LaboralRESUMEN
ABSTRACT: Clinical practices that provide workers' compensation care and other services related to managing work-related illnesses and injuries have long been challenged in receiving appropriate payment for their professional work. The American College of Occupational and Environmental Medicine (ACOEM) has provided excellent guidelines for coding and billing via its various documents that have been provided over the years. However, despite these guidelines, payors have been slow to adopt occupational specific coding guidelines to justify higher professional payment. With the move to a Centers for Medicare & Medicaid Services (CMS)-sponsored time-based coding option in 2011, the occupational and environmental medicine (OEM) clinics have been able to finally not only document but recoup the value of those services that go beyond the simple patient interface, being able to capture those activities that truly provide high value in the management of workers' medical issues.
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Codificación Clínica , Indemnización para Trabajadores , Indemnización para Trabajadores/economía , Humanos , Estados Unidos , Codificación Clínica/normas , Medicina del Trabajo , Guías de Práctica Clínica como Asunto , Documentación/normas , Enfermedades Profesionales/terapia , Enfermedades Profesionales/economía , Centers for Medicare and Medicaid Services, U.S. , Traumatismos Ocupacionales/terapia , Traumatismos Ocupacionales/economíaRESUMEN
PURPOSE: To investigate the patient reported outcomes (PROs) of patients undergoing hip arthroscopy (HA) for femeroacetabular impingement syndrome (FAIS), a condition where irregular bone growth in the hip joint leads to friction and pain during movement, who have worker's compensation (WC) or no-fault insurance (NF) versus commercial insurance (CI) at both 2 year and 5 year follow-up. METHODS: This was a single center, single surgeon, retrospective analysis performed between August 2007 and May 2023 of consecutive patients that underwent HA, a minimally invasive surgical procedure used to diagnose and treat problems inside the hip joint through small incisions, for FAIS. Patients were divided into two cohorts-those with WC/NF and those with commercial insurance (CI). Patient reported outcomes (PROs), which included modified Harris Hip Score (mHHS) and Non-Arthritic Hip Score (NAHS), were collected preoperatively, as well as at least 2-year postoperatively. Additionally, other clinically relevant outcomes variables including prevalence of revision surgery and conversion to total hip arthroplasty were recorded. RESULTS: Three hundred and forty three patients met inclusion criteria. There were 32 patients in the WC/NF cohort and 311 patients in the commercial cohort. When controlling for age, sex, and Body Mass Index (BMI), WC/NF status was associated with lower mHHS at both 2 year (ß = - 8.190, p < 0.01, R2 = 0.092) and 5 year follow-up (ß = - 16.60, p < 0.01, R2 = 0.179) and NAHS at 5 year follow up (ß = - 13.462, p = 0.03, R2 = 0.148). The WC/NF cohort had a lower rate of achieving Substantial Clinical Benefit (SCB) for mHHS at 2-years follow-up (66.7% vs. 84.1%, p = 0.02).The rate of revision hip arthroscopy was significantly higher in the worker's compensation/no fault cohort than the commercial insurance cohort (15.6% vs. 3.5%, p < 0.01). The rate of conversion to total hip arthroplasty (THA) in the WC/NF cohort was not significantly different than the rate of conversion to THA in the commercial insurance cohort (0.0% vs. 3.2%, p = 0.30). CONCLUSION: Patients with WC/NF insurance may expect a significant improvement from baseline mHHS and NAHS following HA for FAIS at short-term follow-up. However, this improvement may not be as durable as those experienced by patients with CI. Additionally, WC/NF patients should be counseled that they have a higher risk of undergoing revision hip arthroscopy than similar CI patients. LEVEL OF EVIDENCE: III, Retrospective Comparative Prognostic Investigation.
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Artroscopía , Pinzamiento Femoroacetabular , Medición de Resultados Informados por el Paciente , Reoperación , Indemnización para Trabajadores , Humanos , Pinzamiento Femoroacetabular/cirugía , Artroscopía/métodos , Masculino , Femenino , Reoperación/estadística & datos numéricos , Estudios Retrospectivos , Adulto , Persona de Mediana Edad , Estudios de Seguimiento , Indemnización para Trabajadores/estadística & datos numéricos , Articulación de la Cadera/cirugíaRESUMEN
Work-related musculoskeletal disorders (WRMSD) pose a significant occupational health challenge in Europe. The digitization of the economy substantially reshaped the nature and organization of work. The proliferation of hybrid working, characterized by a combination of office-based and remote work, has been accelerated by the COVID-19 pandemic. This review covers hybrid forms of work, their impact on WRMSDs, and the potential implications for WRMSD compensation. Approximately 30-40% of the European workforce could potentially transition to hybrid forms of work. Hybrid work arrangements can result in prolonged static postures of the trunk, neck, and upper limbs without adequate breaks, thereby increasing the risk of neck and lower back pain. As teleworking and hybrid working become more prevalent, an increase in non-specific WRMSDs is anticipated among the working population. In many countries, claims for WRMSDs necessitate a formal diagnosis by a healthcare professional. However, cases of non-specific WRMSDs, such as cervicalgia or chronic shoulder pain, - commonly observed in sedentary workers engaged in predominantly low-intensity, prolonged static work amid visually and cognitively demanding tasks - often do not meet the criteria for compensation as occupational diseases. The compensation system and/or the criteria for compensation must be adapted to accommodate the rise of telework, necessitating evolving criteria for compensation that address both medical and risk exposure considerations.
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COVID-19 , Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Indemnización para Trabajadores , Humanos , Indemnización para Trabajadores/economía , Europa (Continente) , TeletrabajoRESUMEN
OBJECTIVE: To analyze the temporal trend and magnitude of national indicators of previdenciary benefits for workplace accidents issued and granted by the Social Security of Brazil. METHODS: Secondary data from Social Security from 2008 to 2019 were used. The trend and percentage variation of the indicators were estimated through Prais-Winsten generalized linear regression. RESULTS: A total of 9,220,372 previdenciary benefits for workplace accidents were issued by the Social Security of Brazil in the period, costing approximately R$ 8.4 billion and representing about 2.0% of the net value of all benefits paid. None of the categories of previdenciary benefits for workplace accidents showed an increasing trend. The highest variation in the benefits granted and issued for workplace accidents occurred in temporary disability benefit (B91), with an annual percentage variation of -54.00% and -29.29%, respectively. CONCLUSION: A reduction in magnitude and an overall decreasing trend were observed in the historical series of national indicators of benefits granted and benefits issued related to workplace accidents in Brazil from 2008 to 2019.
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Accidentes de Trabajo , Brasil/epidemiología , Humanos , Accidentes de Trabajo/estadística & datos numéricos , Accidentes de Trabajo/prevención & control , Factores de Tiempo , Seguridad Social/estadística & datos numéricos , Indemnización para Trabajadores/estadística & datos numéricos , Lugar de TrabajoRESUMEN
BACKGROUND: Previous studies have suggested that firefighters, police officers and civil servants in the education sector, particularly in Western countries, are vulnerable to mental stress and disorders; however, evidence for this association in South Korea is lacking. AIMS: This study aimed to identify whether firefighters, police officers and teachers are at a higher risk for occupational mental health disorders. METHODS: We used workers' compensation claims from civil servants (2009-18). Our target population comprised 46â 209 civil servants (9009 civil servants in administrative and technical positions, 23 107 police officers, 4417 firefighters and 8676 civil servants in the educational sector). Occupational and environmental medicine physicians and medical doctors defined and confirmed mental disorders. We conducted Cox proportional hazards regression analyses to evaluate civil servants' risk of occupational mental health disorders. RESULTS: Compared with the civil servants in administrative and technical positions, civil servants in the education sector (hazard ratio [HR]â =â 2.16; 95% confidence interval [CI]:1.65-2.84) showed a statistically significant increased risk of mental disorders; conversely, firefighters did not (HRâ =â 0.80; 95% CI 0.51-1.27). Police officers had a significantly decreased mental disorder risk compared with civil servants in administrative and technical positions (HRâ =â 0.17; 95% CI 0.11-0.25). CONCLUSIONS: The risk of occupational mental health disorders was higher in civil servants in the education sector but lower in police officers and firefighters than civil servants in administrative and technical positions. Further studies on civil servants' mental health awareness are required to confirm our results.
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Bomberos , Trastornos Mentales , Enfermedades Profesionales , Policia , Indemnización para Trabajadores , Humanos , República de Corea/epidemiología , Trastornos Mentales/epidemiología , Masculino , Adulto , Femenino , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/psicología , Bomberos/estadística & datos numéricos , Bomberos/psicología , Persona de Mediana Edad , Policia/estadística & datos numéricos , Indemnización para Trabajadores/estadística & datos numéricos , Factores de Riesgo , Modelos de Riesgos ProporcionalesRESUMEN
INTRODUCTION: Community health worker (CHW) incentives and remuneration are core issues affecting the performance of CHWs and health programs. There is limited documentation on the implementation details of CHW financial compensation schemes used in sub-Saharan African countries, including their mechanisms of delivery and effectiveness. We aimed to document CHW financial compensation schemes and understand CHW, government, and other stakeholder perceptions of their effectiveness. METHODS: A total of 68 semistructured interviews were conducted with a range of purposefully selected key informants in 7 countries: Benin, Burkina Faso, Ghana, Malawi, Mali, Niger, and Zambia. Thematic analysis of coded interview data was conducted, and relevant country documentation was reviewed, including any documents referenced by key informants, to provide contextual background for qualitative interpretation. RESULTS: Key informants described compensation schemes as effective when payments are regular, distributions are consistent, and amounts are sufficient to support health worker performance and continuity of service delivery. CHW compensation schemes associated with an employed worker status and government payroll mechanisms were most often perceived as effective by stakeholders. Compensation schemes associated with a volunteer status were found to vary widely in their delivery mechanisms (e.g., cash or mobile phone distribution) and were perceived as less effective. Lessons learned in implementing CHW compensation schemes involved the need for government leadership, ministerial coordination, community engagement, partner harmonization, and realistic transitional financing plans. CONCLUSION: Policymakers should consider these findings in designing compensation schemes for CHWs engaged in routine, continuous health service delivery within the context of their country's health service delivery model. Systematic documentation of the tasks and time commitment of volunteer status CHWs could support more recognition of their health system contributions and better determination of commensurate compensation as recommended by the 2018 World Health Organization Guidelines on Health Policy and System Support to Optimize Community Health Worker Programs.
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Agentes Comunitarios de Salud , Investigación Cualitativa , Humanos , África del Sur del Sahara , Indemnización para Trabajadores , Salarios y Beneficios , Documentación , MotivaciónRESUMEN
OBJECTIVE: We estimated associations of a rest break ordinance, implemented for construction workers in Dallas, Texas in 2016, with workplace injuries and illnesses. METHODS: We used workers' compensation claims data to compare changes in rates of injuries and illnesses among Dallas County, Texas construction (ie, "treated") workers with changes in untreated workers, before (2013-2015) and after (2016-2018) a rest break ordinance was implemented. RESULTS: Immediately after the ordinance was implemented, rates of injuries/illnesses among treated workers were modestly lower than in comparison workers (rate ratio comparing postmandate vs premandate rates, treated vs comparison workers: 0.89, 95% confidence interval: 0.72-1.11). Postordinance versus preordinance slope trends were similar in the treated versus the comparison group. CONCLUSIONS: Ten-minute rest breaks were associated with modestly lower rates of workplace injury/illnesses. More comprehensive standards may be needed for protection.
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Industria de la Construcción , Análisis de Series de Tiempo Interrumpido , Enfermedades Profesionales , Traumatismos Ocupacionales , Descanso , Indemnización para Trabajadores , Humanos , Texas/epidemiología , Traumatismos Ocupacionales/epidemiología , Indemnización para Trabajadores/estadística & datos numéricos , Indemnización para Trabajadores/legislación & jurisprudencia , Adulto , Masculino , Industria de la Construcción/legislación & jurisprudencia , Industria de la Construcción/estadística & datos numéricos , Enfermedades Profesionales/epidemiología , Femenino , Persona de Mediana EdadRESUMEN
Workers' compensation systems aim to financially support injured workers. However, seeking compensation often leads to poorer physical and mental health outcomes. This review examines previous studies to investigate the relationship between workers' compensation and mental health and self-harm outcomes. A three-tiered search strategy across five databases identified studies that examined workers' compensation claims as an exposure or risk factor, with outcomes related to mental health, self-harm and suicidality. Nine full-text studies were included; however, heterogeneity limited generalizability. Most studies supported an association between pursuing compensation and poorer mental health and self-harm outcomes. Some studies attributed this to specific aspects of the system such as justice perception and navigation of the claims system. Findings suggest an association between workers' compensation and mental health or self-harm outcomes. Inconclusive findings highlight the need for further research. Understanding the psychiatric impacts of pursuing compensation is crucial to help formulate a more accessible compensation system.
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Salud Mental , Conducta Autodestructiva , Indemnización para Trabajadores , Lugar de Trabajo , Humanos , Indemnización para Trabajadores/estadística & datos numéricos , Conducta Autodestructiva/psicología , Conducta Autodestructiva/epidemiología , Salud Mental/estadística & datos numéricos , Lugar de Trabajo/psicología , Traumatismos Ocupacionales/psicología , Traumatismos Ocupacionales/epidemiología , Trastornos Mentales/epidemiología , Factores de RiesgoRESUMEN
The objective of this study was to determine if preoperative patient characteristics have an effect on pain and function after primary arthroscopic rotator cuff repair. Seventy-five arthroscopic primary rotator cuff repairs with at least 2 years of follow-up were identified. Studied variables were preoperative tobacco, opioid, and alcohol use; obesity; mood disorders; disability claim; and Workers' Compensation status. Outcome measures included visual analog pain scores, American Shoulder and Elbow Surgeons (ASES) scores, Single Assessment Numeric Evaluation (SANE) scores, range of motion, and strength. Preoperative smoking was significantly associated with worse pain (p = 0.009), ASES (p = 0.004), and SANE (p = 0.011) scores. Opioid use showed no statistically significant difference in pain or functional scores. Alcohol use did predict improved ASES scores at long-term follow-up (p = 0.046). The other variables were not associated with inferior outcomes. Smoking and preoperative opioid use represent modifiable risk factors that can be corrected before surgery to optimize outcomes. (Journal of Surgical Orthopaedic Advances 33(1):005-009, 2024).