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Declining rates of work-related overexertion back injuries among union drywall installers in Washington State, 1989-2008: improved work safety or shifting of care?

Schoenfisch AL; Lipscomb HJ; Marshall SW; Casteel C; Richardson DB; Brookhart MA; Cameron W
Am J Ind Med 2014 Feb; 57(2):184-194
Introduction: Construction workers are at high risk of work-related musculoskeletal back disorders, and research suggests medical care and costs associated with these conditions may be covered by sources other than workers' compensation (WC). Little is known about the back injury experience and care seeking behavior among drywall installers, a high-risk workgroup regularly exposed to repetitive activities, awkward postures, and handling heavy building materials. Methods: Among a cohort of 24,830 Washington State union carpenters (1989-2008), including 5,073 drywall installers, we identified WC claims, visits for health care covered through union-provided health insurance and time at risk. Rates of work-related overexertion back injuries (defined using WC claims data) and health care utilization for musculoskeletal back disorders covered by private health insurance were examined and contrasted over time and by worker characteristics, stratified by type of work (drywall installation, other carpentry). Results: Drywall installers' work-related overexertion back injury rates exceeded those of other carpenters (adjusted IRR 1.63, 95% CI 1.48-1.78). For both carpentry groups, rates declined significantly over time. In contrast, rates of private healthcare utilization for musculoskeletal back disorders were similar for drywall installers compared to other carpenters; they increased over time (after the mid-1990s), with increasing years in the union, and with increasing numbers of work-related overexertion back injuries. Conclusions: Observed declines over time in the rate of work-related overexertion back injury, as based on WC claims data, is encouraging. However, results add to the growing literature suggesting care for work-related conditions may be being sought outside of the WC system.
Construction; Construction-industry; Construction-workers; Musculoskeletal-system-disorders; Back-injuries; Health-care; Medical-treatment; Injuries; Behavior; Group-behavior; Repetitive-work; Overloading; Manual-materials-handling; Author Keywords: drywall installers; back; musculoskeletal; workers' compensation; private health insurance
Ashley L. Schoenfisch, PhD, Division of Occupational and Environmental Medicine, Department of Community and Family Medicine, Duke University Medical Center, 2200 West Main Street, Suite 400, Durham, NC 27705
Publication Date
Document Type
Journal Article
Email Address
Funding Type
Cooperative Agreement; Construction
Fiscal Year
Identifying No.
Cooperative-Agreement-Number-U60-OH-009761; M122013
Issue of Publication
Priority Area
Source Name
American Journal of Industrial Medicine
Performing Organization
Virginia Polytechnic Institute and State University
Page last reviewed: January 29, 2021
Content source: National Institute for Occupational Safety and Health Education and Information Division