By the time they are seniors in high school, only 20% of high school students report never having a paid job. Work provides teenagers with job skills and experiences to help them transition into adulthood; however, the work environment also has numerous injury and illness hazards. Adolescents and young adults (age: 15-24 years) have approximately twice the rate of nonfatal occupational injuries as older workers. The United States has set a goal of reducing the occupational injury incidence rate among adolescents aged 15-19 years by 10% by 2020, from the 2007 rate of 4.9 injuries per 100 full-time equivalent workers. Reducing occupational injuries among adolescent workers first and foremost will require changes by employers. Employers largely control the work environment and how work is done, and they have legal responsibilities for ensuring the safety and well-being of their workers. However, there are others who contribute to adolescent worker safety, including adolescents themselves who have responsibilities for following safe work practices established by their employers; federal and state agencies responsible for establishing and enforcing child labor laws and occupational safety and health standards; public health, trade, and labor organizations who provide occupational safety and health guidance to employers and workers; schools that are often involved in providing work permits, vocational training, and other work-based learning experiences; and parents. Parents have been encouraged to know child labor laws, be aware of their adolescents' rights in the workplace (e.g., the right to report unsafe working conditions and eligibility for workers' compensation benefits if injured at work), and to play an active role in their child's employment, including discussing work tasks, associated equipment and machinery, and training and supervision provided by the employer. The article by Runyan et al in this issue of the Journal of Adolescent Health illustrates the potential, not fully realized, for parents to play a substantive role in fostering safe and healthful employment for their adolescents. The article is the latest in a series reporting on the knowledge, attitudes, and practices of parents of working adolescents based on a national survey. The article in this issue of the Journal reports that more than 70% of the surveyed parents were actively engaged with their adolescents in job seeking and discussions about job tasks and hours. However, less than 50% of the parents helped their children learn about their rights as employees or child labor laws, or discussed questions their children should ask about workplace safety. Additionally, there were no differences between more and less involved parents in the number of workplace hazards reported by their adolescents. Runyan et al acknowledge limitations of their study that preclude generalization to all parents of working adolescents. The parents in their sample were more affluent than the general population, non-English speakers were not included, and the jobs reported by adolescents in their sample were overwhelmingly in the retail and services sectors. Although most adolescents work in the retail and services sectors, sizable numbers work in other industry sectors, such as construction and agriculture, which have greater risks for occupational injury, especially for fatal occupational injury. Nonetheless, the findings from the survey conducted by Runyan et al provide insight into the potential for parents to be more actively engaged in safety considerations for their working adolescents, and the likely barriers in realizing this potential. Parental lack of knowledge and concern about occupational safety and health are likely barriers for increased parental involvement in the safety and health of their working adolescents. Petersen et al conducted research suggesting that parents, including parents of adolescents, are not overly concerned about injuries among their children, and that parents are more likely to teach their children safety skills if they have confidence in their own knowledge and competency, and believe that their actions will be effective. In previous articles, Runyan et al reported that 98% of parents had confidence in their adolescent's ability to keep themselves safe at work and in their knowledge about their employee rights; and, while parents were generally aware of child labor laws, many were not knowledgeable about specific provisions, such as youth aged less than 18 years being prohibited from using forklifts in nonagricultural workplaces. Workshops with parents echo these findings, with some parents reporting lack of knowledge about child labor laws and employee rights. Lack of knowledge may partially explain the finding reported in the article by Runyan et al in this issue of the Journal of discordance between hypothetical and actual responses of parents to concerns about their adolescent's safety at work. There are numerous resources that adolescent health professionals and others can use to raise awareness and knowledge among parents of working adolescents, and research suggesting that such efforts can be efficacious. Numerous public and private organizations have recommendations and guidance tailored specifically for parents, including the federal agencies responsible for enforcing child labor laws and occupational safety and health standards. The National Institute for Occupational Safety and Health has published findings from community- and state-level demonstration projects that provide guidance for reaching out to parents through groups such as parent-teacher associations, and identify resources tailored for parents that could be adopted by others. The potential of such outreach to improve young worker safety has been demonstrated in the agricultural sector, which has especially high injury risks, less government regulation than nonagricultural industries, and unique characteristics in which the child or adolescent is frequently doing work-related tasks for their parents who operate the farm. One study in which guidelines for ageappropriate farm tasks were simply mailed to farm parents suggested that approximately 25% of the parents used the guidelines when assigning farm work to their children, whereas two other studies showed that more intensive activities such as a farm visit or providing personalized child development information and supportive telephone calls had greater impacts, including a reduction in the incidence of child farm injuries in one study. Improving the safety and health of working adolescents will require concerted efforts from employers and others. Parents can play an important role in ensuring the safety of their working adolescents; however, increased efforts are likely needed to provide parents with knowledge about the injury risks for working adolescents and steps that can be taken to address these risks. There are numerous resources that adolescent health professionals and others can use to help increase parents' awareness and feelings of competency.
Dawn N. Castillo, M.P.H., Division of Safety Research, National Institute for Occupational Safety and Health Morgantown, West Virginia