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B1.1 Special Populations at Risk: Who are They? What are Their Injury Research Needs?-Frumkin H
Occupational hazards are known to be distributed differently. Workers with specific biologic, social, and/or economic characteristics may sustain increased risks of work-related diseases and injuries. This discussion will identify various such special working populations. These include populations defined by age (both young workers and old workers); by ethnicity, educational attainment, or geographic location; by socioeconomic status; by gender; by disability status or by a disease or genetic predisposition; or by some combination of these. Some special populations seem to be defined by purely biological attributes, and others by social categories, but in nearly every case social policies and practices are superimposed on biological features to define populations as "special"; in this sense. Recognizing special populations is worthwhile for at least three reasons. First, since special populations may sustain increased risks, recognizing them identifies opportunities for high-yield interventions. Second, since specific approaches may be required by special populations, recognizing and better understanding them permits the design and delivery of more appropriate services. Third, since special populations have in some cases suffered employment discrimination, including being underserved by occupational health programs, recognizing them permits more just and equitable service delivery.
B1.2 Work Injuries and Age: Is the News all Bad?-Wegman DH
Broad reviews of age and injuries at work suggest that injury frequency decreases while injury severity and fatal occupational injuries increase with age. Reduced injury frequency with age probably relates to job experience and familiarity with tasks, but increased severity (generally measured as time-off-job) is less easily explained. Greater injury severity could result from aging of the neurologic and musculoskeletal systems, but other possibilities include that older workers may be less likely to report minor accidents or be advised to take more time before returning to work. More specifically, injury type and source are reported to vary by age with back injuries higher in older workers and eye/hand injuries higher in younger workers. Agents of injury also differ by age, for example, hand tools are a more common cause in younger workers and working surfaces are a more important cause in older workers. Studies of injury experience within occupations reveal a less clear pattern in part because both age-related injury risk and employment vary by specific job. When jobs are classified according to the relative importance of physical capacity and experience requirements, age-related injury risk patterns can be seen. Jobs "enhanced" by age show a negative relationship between injury and age while those "impaired" by age show a positive relationship. Longitudinal studies of worker and workplace characteristics suggest that when work teams accommodate age of workers better injury experience results. Other studies provide indirect evidence for the importance of organizational factors showing job dissatisfaction positively related to disability retirements and good supervisor support negatively associated. The presentation will review published evidence on age-related work injury risk and make recommendations for further study to better understand and guide prevention efforts for these risks.
B1.3 Injury and Employment Patterns Among Hispanic Construction Workers-Hunting KL, Anderson JTL, Welch LS
Medical record data were analyzed to compare injury patterns among 3,290 injured Hispanic, black, and white construction workers treated at the George Washington University emergency department from 1990 to 1998. Initially, we observed that Hispanics had a higher proportion of serious injuries and hospitalizations than blacks and whites. However, injured Hispanic workers were disproportionately employed as laborers and in other less-skilled trades.
Construction tasks and injury risk factors vary considerably between trades. Since trade and ethnicity are strongly linked, any evaluation of ethnicity's role in work-related injury must therefore try to separate the risk associated with trade. Laborers and carpenters had enough injuries for within-trade comparison of injured whites, blacks, and Hispanics. Differences between ethnic groups in diagnoses, circumstances, hospitalization, and recommended time off and light duty largely disappeared after controlling for trade.
Interviews conducted several weeks post-injury indicated that a smaller proportion of injured Hispanic workers belonged to a union and reported that anything could have been done to prevent their injury, as compared to black and white workers. Interviews conducted one year post-injury revealed that a larger proportion of injured Hispanic workers took time off work and that the duration of the time off was three to four times longer than for other injured workers. Also, the physical, financial, and emotional consequences were more apparent one year later for injured Hispanics, even after controlling for trade.
These observations suggest that minority status is a predictor of trade, and trade is a predictor of injury risk. Once injured, Hispanic workers may be disadvantaged in terms of health and employment options; further research is needed to explain these findings. In addition to reducing injury hazards, interventions should address the limited employment, union membership, and training options that are available to minority workers.
B1.4 Workers With Disabilities-Pransky GS, Blanck P
Individuals with disabilities constitute a sizeable portion of the workforce and represent the majority of working-age persons who are unable to work. Historically, barriers to employment have included attitudinal discrimination by employers, lack of workplace accommodations, and inadequate job training. The disability rights movement has achieved considerable success in promoting legislation to remove these barriers and uphold equal employment. Research suggests that many employers actively attempt to incorporate persons with disabilities into the workforce and gain substantial economic benefit from their participation, without incurring burdensome expenses. Occupational health providers are asked by employers and others to provide input on feasibility and safety, a difficult task given the lack of scientific study on the occupational abilities and risks associated with specific disabilities. The limited amount of data available suggests that an excess risk for persons with disabilities cannot be predicted with any degree of certainty for most jobs. Thus, more research is needed to understand the actual nature and magnitude of risks due to disabilities, effectiveness and costs of accommodations, and persistence of discrimination.
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