Enhanced surveillance of work-related injuries to youths.
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, U01-OH-007301, 2005 Oct; :1-27
Each year in the United States, an estimated 230,000 youths are injured on the job and close to 70 are killed. Teens have been recognized as a priority worker population with special concerns and unique opportunities for intervention through schools and communities as well as the workplace. Surveillance of work-related injuries to youths is essential to guide educational and regulatory interventions as well as the development of new control technologies. State surveillance data are needed to inform state prevention priorities, and states are in an optimal position to actively link surveillance findings with intervention efforts at the worksite and in the community. State-based surveillance that includes follow-up activities can also fill significant gaps in surveillance of occupational injuries to teens at the national level. In 1993, work-related injuries to individuals less than 18 years of age became reportable in Massachusetts. Since that time, with support from NIOSH, the Massachusetts Department of Public Health's (MDPH) Occupational Health Surveillance Program (OHSP) has worked to establish a model statewide surveillance and intervention system for occupational injuries to youths. The surveillance system is designed both to identify sentinel cases for case specific follow-up and to generate representative summary data that can be used to inform broad-based prevention activities. This Cooperative Agreement enabled OHSP to continue and enhance surveillance and related intervention activities during 2000-2004. Multiple data sources predominantly workers' compensation records and emergency department reports were used to identify over 1,700 teen occupational injury cases, follow-up interviews with 173 injured teens were completed, and surveillance findings were used to target worksite interventions and a promote a range of broad-based prevention activities. Between 1993 and 2003 there were 5,530 teen injury cases reported to OHSP. Fifty-six percent of these injuries occurred in four industries: restaurants (32%), grocery stores (14%), nursing homes (6%), and department stores (5%). The highest rates (based on injuries to 16- and 17-year-olds for which workers' compensation claims were filed) were observed among teens employed in the transportation and warehousing industry. The nature of injury varied by data source. The most frequent injuries captured by workers' compensation were strains and sprains of which half involved the back. Cuts and lacerations predominated among injuries identified through emergency department records reported by a convenience sample of 9 hospitals actively participating in the surveillance system. Ten teens died as a result of work-related injuries during the 10-year surveillance period. Information from interviews with injured teens, while not necessarily representative, underscored critical problems to be addressed. Almost half (47%) of 758 injured teens interviewed since 1993 reported they had received no health and safety training from their employers; only 61% had employment permits, and 14% were working with no supervisors on site at the time of injury. Close to 55% of the injured teens interviewed reported anticipating permanent effects as a result of their injuries. Of these, 20% expected permanent loss of sensation, impaired movement, or feeling and an additional 20% expected persistent pain as a result of their injuries. Interviews also revealed the need for improved first aid and emergency response procedures in workplaces where teens are employed. OHSP's efforts to enhance the surveillance system under this Cooperative Agreement yielded new insights about surveillance methods: statewide emergency department data are an important new population-based data source for work-related injuries to teens, complimenting sentinel case data provided by the sample of hospitals actively participating in the surveillance system; mailed surveys of injured teens appear to be a viable and less resource intensive alternative to telephone interviews; and research oriented worksite investigations of non-fatal serious injuries are feasible whereas investigations of less serious injuries prove challenging and are best conceived of as worksite assessments rather than incident investigations. OHSP had numerous successes in linking surveillance to practice. Surveillance findings were successfully used to promote a technological intervention to reduce burn injuries in the retail bakery industry, an industry comprised of small establishments. A bilingual sticker developed by OHSP for use on forklifts warning that teens cannot operate these machines was well received by local industry, and over 100,000 copies have subsequently been disseminated by the US Department of Labor nationwide. An ongoing interagency team to coordinate government efforts to promote safe and healthful work for teens in Massachusetts was established and worked to revise the state system for obtaining work permits. Collaborations facilitated by the project have led to OSHA training for vocational educators who are in turn providing OSHA 10-hour training to vocational education students. OHSP also completed a manual on how to conduct surveillance of work-related injuries to teens which has been disseminated to other states and serves as a prototype for sharing surveillance methods.
Injuries; Injury-prevention; Adolescents; Surveillance-programs; Employee-health; Occupations; Work-operations; Work-practices; Information-systems; Recording-systems; Health-surveys; Health-care; Emergency-treatment; Food-services; Service-industries; Grocery-stores; Nursing; Department-stores; Transportation; Transportation-workers; Warehousing; Back-injuries; Cutting-tools; Mortality-data; Training; Supervisory-personnel; Safety-education; First-aid; Emergency-care; Emergency-response; Burns; Communication-systems; Machine-operation; Warning-signs; Education
Letitia Davis, ScD, Director, Occupational Health Surveillance Program, Massachusetts Department of Public Health, 250 Washington Street, Boston, MA 02108
Final Cooperative Agreement Report
NTIS Accession No.
National Institute for Occupational Safety and Health
Massachusetts State Department of Public Health - Boston