Home health services represent one of the fastest-growing segments of the US economy. Home health workers (HHWs) may have a high incidence and increased severity of injury because of inherent difficulty in control over the work environment. This study describes the types of occupational injuries in HHWs and the resulting costs and morbidity. Using the 1995-1996 West Virginia Workers' Compensation database, information on 386 injuries occurring in the home health care field was extracted. The incidence, frequency, and types of injuries were calculated, using hospital-based nursing personnel for comparison. An incidence of 52 injuries per 1000 workers per year was calculated; the incidence of lost-time (43/1000) and indemnified (>3 days lost-time) injuries (29/1000) were significantly increased over those occurring in hospital-based nursing personnel (P < 0.001). Injuries to the lower back accounted for 35.7% of the total. The mean number of days lost from work by home health workers was 44 (14 in hospital nursing workers, P < 0.001). The mean indemnity payment was $1523 and medical costs were $1276 per injury. Permanent partial disability awards were made to 19 (4.9%) of the injured workers. Overexertion injuries and falls accounted for 63% of injuries in this group of workers, while 13.5% of injuries and 1 fatality occurred as a result of motor vehicle accidents. These data indicate that injuries to HHWs occur more frequently than those in their hospital-based counterparts and result in greater lost time from work and accompanying costs. Characteristics of the work, including increased intensity and speed of work; adverse working conditions, including lack of assistive devices for lifting; and the necessity of motor vehicle transportation may contribute to injury in HHWs. Prompt access to appropriate medical services may also play a role in the reduction of morbidity and costs.
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