Documents Lipscomb, Hester J. 14 results

"Objective Using an observational research design and robust surveillance data, we evaluated rates of musculoskeletal (MS) injuries, days away from work, and restricted work days among patient care staff at a medical center and community hospital in the United States over 13 years, during which time a “minimal manual lift” policy and mechanical lift equipment were implemented. Methods Workers' compensation claims data were linked to human resources data to define outcomes of interest and person-time at risk to calculate rates. Poisson and negative binomial regression with lagging were used to compare outcome rates in different windows of time surrounding the intervention. Patterns of MS injuries associated with patient-handling were contrasted to patterns of other MS injuries that would not be affected by the use of mechanical lift equipment. Results At the medical center, no change in the patient-handling MS injury rate followed the intervention. A 44% decrease was observed at the community hospital. At both hospitals, the rate of days away declined immediately – before it was reasonable for the intervention to have been adopted. Conclusions Institutional-level changes at the time of the intervention likely influenced observed results with findings only partially consistent with an intervention effect. Observational studies can be useful in assessing effectiveness of safety interventions in complex work environments. Such studies should consider the process of intervention implementation, the time needed for intervention adoption, and the dynamic nature of work environments."

"In 1989, North Carolina Occupational Safety and Health Administration (OSHA) inspectors cited two poultry processing plants in northeastern North Carolina for serious repetitive motion problems. In 1990, investigators from the National Institute for Occupational Safety and Health confirmed significant upper extremity musculoskeletal symptoms and disorders among workers. We now report on analyses of baseline data collected from a cohort of women employed in one of these plants. The plant, which is the largest employer of women in the area, is located in a sparsely populated area with a black majority where nearly one-third of the population lives below the poverty level. Conditions we report suggest failure of existing health and safety systems, both regulatory and consultative, to prevent morbidity among vulnerable women in this industry, as well as social and economic conditions that influence availability of work and use of benefits to which they are entitled."

"Background Poultry processing is characterized by rapid line speed and extreme division of labor. Morbidity associated with this work has been reported by scientists, journalists and workers in this fast growing industry. Methods Cross-sectional data from baseline measures of a cohort of black women employed in poultry processing (n = 291) and a community comparison group (n = 299) in rural North Carolina were used to evaluate musculoskeletal symptom reports and to explore factors associated with those reports. Recruitment of participants and collection of data were performed by women in the community circumventing the need to involve employers. Results Significant differences in musculoskeletal symptom prevalence were observed between women employed in poultry processing and those of similar economic status employed elsewhere in the same area of rural northeastern North Carolina. After adjusting for other factors independently associated with symptoms among these women including age, depression, and perceived isometric load at work, the prevalence of upper extremity and neck symptoms was 2.4 (95% CI 1.7, 3.2) times higher among women working in poultry processing. Conclusions The findings add to the documentation of occupational health concerns among vulnerable workers employed in poultry processing in our state; in this economically depressed area of rural northeastern North Carolina poultry processing is the largest single employer of women. On a larger scale, the potential magnitude of upper extremity morbidity among women employed in poultry processing should be viewed with the knowledge that poultry processing is a growing industry in the U.S. with work done largely by blacks and immigrants. Am. J. Ind. Med. 50:327-338, 2007. © 2007 Wiley-Liss, Inc. "

"Background There is limited information on occupational back pain specific to carpenters despite their known exposures to recognized occupational risk factors and limited opportunities for modified work due to the predominantly heavy nature of their work. Methods By combining union records with worker's compensation claims, we describe work-related back injuries, including associated medical diagnoses, among a well-defined cohort of union carpenters between 1989 and 2003. High risk subgroups were explored based on age, gender, union tenure, and predominant type of work. Paid lost time claims were contrasted to less serious events, and injuries sustained from overexertion activities were contrasted with those sustained through more acute trauma. Results Back injuries occurred at an overall rate of 6.2/200,000 hours worked. Most injuries were coded in the compensation records as sprains, but there was little agreement between these nature of injury codes and ICD9 diagnosis codes. Injury rates declined most significantly over time for injuries secondary to overexertion. In multivariate analyses, we observed similar patterns of risk for the types of claims evaluated despite disparate mechanisms and severity. Those who worked predominantly in residential carpentry or drywall installation were consistently at greatest risk. Conclusions Overexertion injuries from manual materials handling activities are responsible for the largest burden of back injuries among these carpenters, but a growing proportion of injuries result from acute traumatic events. Interventions are called for which specifically address risk among residential carpenters and drywall installers. These data provide additional evidence that Bureau of Labor Statistics data underestimate work-related injuries. "

"Background The purpose of the present study was to identify associations between a work posture with elevated arm position, duration of active playing time, and neck-shoulder pain among orchestra musicians. Methods In this study, with a cross-sectional study design, a total of 235 subjects from 12 Swedish orchestras were categorized into four exposure groups according to arm position and duration of active playing time. Logistic regression analysis was used to calculate odds ratios (OR) for neck-shoulder pain in the four exposure groups. Results A higher prevalence of neck-shoulder pain were found in the groups elevated arm position, <2 hr per workday [OR 4.15 (1.30-13.22)], and elevated arm position, >3 hr per workday [OR 5.35 (1.96-14.62)] compared to the group neutral arm position, <2 hr per workday. Conclusions Musicians working in an elevated arm position (e.g., violinists, violists, flutists, and trumpet players) had a higher prevalence of neck-shoulder pain than those working in a more neutral position. Am. J. Ind. Med. 50:370-376, 2007. © 2007 Wiley-Liss, Inc"

"Methods Union administrative records identified 20,642 union carpenters who worked in Washington State from 1989 to 2003. The Department of Labor and Industries provided records of workers' compensation claims and associated medical care. Work-related back claims (n = 4,241) were identified by ANSI codes (back, trunk, or neck/back) or ICD-9 codes relevant to medical care consistent with a back injury. Cases (n = 738) were defined as back injury claims with >90 days of paid lost time; controls (n = 699) resulted in return to work within 30 days. Logistic regression models estimated odds ratios and 95% confidence intervals (OR, 95% CI) of delayed return to work (DRTW). Results Thirty percent of case claims and 8% of control claims were identified by an ICD-9 code. DRTW after back injury was associated with being female (2.7, 95% CI: 1.3-5.5), age 30-44 (1.2, 95% CI: 0.9-1.7) and age over 45 (1.6, 95% CI: 1.1-2.3), four or more years union experience (1.4, 95% CI: 1.1-1.8), previous paid time loss back claim (1.8, 95% CI: 1.3-2.5), and 30-day delay to medical care (3.6, 95% CI: 2.1, 6.1). Evidence of more acute trauma was also associated with DRTW. Conclusions Use of ICD-9 codes identified claims with multiple injuries that would otherwise not be captured by ANSI codes alone. Though carpenters of younger age and inexperience were at increased risk for a paid lost time back injury claim, older carpenters and more experienced workers, once injured, were more likely to have DRTW as were those who experienced acute events."

Background: The purpose of this study was to evaluate musculoskeletal injuries and disorders resulting from patient handling prior to the implementation of a minimal manual lift policy at a large tertiary care medical center. We sought to define the circumstances surrounding patient handling injuries and to identify potential preventive measures. Methods: Human resources data were used to define the cohort and their time at work. Workers' compensation records (1997-2003) were utilized to identify work-related musculoskeletal claims, while the workers' description of injury was used to identify those that resulted from patient handling. Adjusted rate ratios were generated using Poisson regression. Results: One-third (n = 876) of all musculoskeletal injuries resulted from patient handling activities. Most (83%) of the injury burden was incurred by inpatient nurses, nurses' aides and radiology technicians, while injury rates were highest for nurses' aides (8.8/100 full-time equivalent, FTEs) and smaller workgroups including emergency medical technicians (10.3/100 FTEs), patient transporters (4.3/100 FTEs), operating room technicians (3.1/100 FTEs), and morgue technicians (2.2/100 FTEs). Forty percent of injuries due to lifting/transferring patients may have been prevented through the use of mechanical lift equipment, while 32% of injuries resulting from repositioning/turning patients, pulling patients up in bed, or catching falling patients may not have been prevented by the use of lift equipment. Conclusions:The use of mechanical lift equipment could significantly reduce the risk of some patient handling injuries but additional interventions need to be considered that address other patient handling tasks. Smaller high-risk workgroups should not be neglected in prevention efforts."

"BackgroundLung cancer is the leading cause of cancer death in US women, accounting for 72,130 deaths in 2006. In addition to smoking cessation, further reduction of the burden of lung cancer mortality can be made by preventing exposure to occupational lung carcinogens. Data for occupational exposures and health outcomes of US working women are limited.MethodsPopulation-based mortality data for 4,570,711 women who died between 1984 and 1998 in 27 US States were used to evaluate lung cancer proportionate mortality over time by the usual occupation and industry reported on death certificates. Lung cancer proportionate mortality ratios were adjusted for smoking, using data from the National Health Interview Survey (NHIS) and the American Cancer Society's Cancer Prevention Study II.ResultsAnalyses revealed that 194,382 white, 18,225 Black and 1,515 Hispanic women died 1984-1998 with lung cancer reported as the underlying cause of death. Following adjustment for smoking, significant excess proportionate lung cancer mortality was observed among US women working in the US manufacturing; transportation; retail trade; agriculture, forestry, and fishing; and nursing/personal care industries. Women employed in precision production, technical, managerial, professional specialty, and administrative occupations experienced some of the highest significantly excess proportionate lung cancer mortality during 1984-1998.ConclusionsThe results of our study point to significantly elevated risks for lung cancer after adjustment for smoking among women in several occupations and industries. Because 6-17% of lung cancer in US males is attributable to known exposures to occupational carcinogens, and since synergistic interactions between cigarette smoke and other occupational lung carcinogens have been noted, it is important to continue research into the effects of occupational exposures on working men and women."

"Perspectives on nail gun safety were sought from residential contractors as part of an injury surveillance and prevention effort (2005-2008). Anonymous surveys inquired about tool use, training, injury risk, and awareness of the 2003 American National Standards Institute (ANSI) standard calling for shipment of pneumatic nail guns used in wood framing with sequential actuation. Despite some awareness of inexperience, lack of training, speed and tool design in injury causation, 55 percent consistently reported injuries resulted from worker carelessness. Contractors reported safety experiences of their employees were considerably better than those of other residential contractors. After five years, only 16 percent reported any awareness of the voluntary standard. These findings raise questions as to what gains can realistically be expected from passage of voluntary standards such as the one described here. Given that the epidemiology of acute injuries from pneumatic nail guns is now well-described, the safer sequential trigger should be required to protect workers."