Worker populations at risk for work-related injuries across the life course

Descriptive summary of fatal work-related injuries, Western States, 2011-2017

Work-related deaths are a persistent occupational health issue that can be prevented. However, prevention opportunities can be hampered by a lack of adequate public health resources. The Western States Occupational Network (WestON) is a network of federal, state, and local occupational health professionals that includes a 19-state region of the United States. To encourage public health collaboration, WestON partners examined work-related fatalities within the region. Fatality counts (numerators) were obtained from the U.S. Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries restricted-access research files for all workers ages ≥15 years and fatally injured in WestON states from 2011 through 2017. Estimates of full-time equivalent hours worked (FTE) (denominators) were retrieved from the BLS Current Population Survey. Annual average fatality rates were calculated as number of fatalities per 100,000 FTE over the study period. Rates were stratified by state, select demographics, industry sector, and event/exposure types. Pearson chi-squared tests and rate ratios with 95% confidence probability limits were used to assess rate differences. All analyses were conducted using SAS v.9.4. From 2011 through 2017, the annual average overall occupational fatality rate for the WestON region was 3.5 fatalities per 100,000 FTE, comparable to the overall U.S. fatality rate. Male workers had a fatality rate almost 10 times higher than female workers in the region. Fatality rates increased with successive age groups. Alaska and New Mexico had significantly higher fatality rates for all racial/ethnic groups compared to respective regional rates. Wyoming, North Dakota, and Montana had the three highest occupational fatality rates among foreign-born workers. Agriculture/forestry/fishing, mining/oil/gas extraction, and transportation/warehousing/utilities were industry sector groups with the three highest fatality rates regionally. Transportation-related incidents were the most frequent event type associated with occupational fatalities for all 19 states. Work-related fatalities are a crosscutting occupational public health priority. This analysis can be an impetus for collaborative multistate initiatives among a dynamic and varied occupational public health network to better meet the needs of a rapidly changing workforce.

Prevalence, Risk Factors, and Economical Cost of Work-Related Injuries Among Olive Workers in the Achaia Region, Greece

Background Olive gathering involves tree climbing, carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injuries among olive workers. The aim of this study is to evaluate the prevalence and risk factors of occupational injuries among olive workers in a rural Greek area and to assess the financial burden on the health system and insurance funds. Methods A questionnaire was administered to 166 olive workers in the Aigialeia municipality in the Achaia region, Greece. The questionnaire contained detailed information on demographic characteristics, medical history, working environment, protective measures, gathering tools, and type and site of injuries. Moreover, data were recorded about the duration of hospitalization, medical examinations and treatment received, sick leaves, complications, and rate of re-injury. Direct economic costs were calculated for hospitalized and non-hospitalized patients. The associations between olive workers' characteristics, risk factors, and occupational injury within the last year were examined using log-binomial regression models. Results In total, 85 injuries were recorded in 50 workers. The prevalence of one or more injuries in the last year was 30.1%. Factors associated with a higher rate of injury were male gender, age > 50 years, working experience > 24 years, history of arterial hypertension and diabetes mellitus, climbing habits, and non-use of protective gloves. The average cost of agricultural injuries was more than 1400 € per injury. The cost seems to be associated with the severity of the injury, as injuries requiring hospitalization were associated with increased costs, higher cost of medication, as well as more days of sick leave. Losses due to sick leave cause the greatest financial costs. Conclusions Farm-related injuries are quite usual among olive workers in Greece. Injury risk is influenced by gender, age, working experience, medical history, climbing habits, and use of protective gloves. Days off work have the greatest financial cost. These findings can be useful as a starting point to train olive workers to reduce the incidence of farm-related injuries in Greece. Knowledge of risk factors for farm-related injuries and diseases could help the development of proper interventions to minimize the problem.

Sex-Specific Differences in Resolution of Airway Inflammation in Fat-1 Transgenic Mice Following Repetitive Agricultural Dust Exposure

In agriculture industries, workers are at increased risk for developing pulmonary diseases due to inhalation of agricultural dusts, particularly when working in enclosed confinement facilities. Agricultural dusts inhalation leads to unresolved airway inflammation that precedes the development and progression of lung disease. We have previously shown beneficial effects of the omega-3 polyunsaturated fatty acid (ω-3 PUFA) DHA in protecting against the negative inflammatory effects of repetitive dust exposure in the lung. Dietary manipulation of pulmonary disease risk is an attractive and timely approach given the contribution of an increased ω-6 to ω-3 PUFA ratio to low grade inflammation and chronic disease in the Western diet. To prevent any confounding factors that comes with dietary supplementation of ω-3 PUFA (different sources, purity, dose, and duration), we employed a Fat-1 transgenic mouse model that convert ω-6 PUFA to ω-3 PUFA, leading to a tissue ω-6 to ω-3 PUFA ratio of approximately 1:1. Building on our initial findings, we hypothesized that attaining elevated tissue levels of ω-3 PUFA would attenuate agricultural dust-induced lung inflammation and its resolution. To test this hypothesis, we compared wild-type (WT) and Fat-1 transgenic mice in their response to aqueous extracts of agricultural dust (DE). We also used a soluble epoxide hydrolase inhibitor (sEH) to potentiate the effects of ω-3 PUFA, since sEH inhibitors have been shown to stabilize the anti-inflammatory P450 metabolites derived from both ω-3 and ω-6 PUFA and promote generation of specialized pro-resolving lipid mediators from ω-3 PUFA. Over a three-week period, mice were exposed to a total of 15 intranasal instillations of DE obtained from swine confinement buildings in the Midwest. We observed genotype and sex-specific differences between the WT vs. Fat-1 transgenic mice in response to repetitive dust exposure, where three-way ANOVA revealed significant main effects of treatment, genotype, and sex. Also, Fat-1 transgenic mice displayed reduced lymphoid aggregates in the lung following DE exposure as compared to WT animals exposed to DE, suggesting improved resilience to the DE-induced inflammatory effects. Overall, our data implicate a protective role of ω-3 FA in the lung following repetitive dust exposure.

The Assessment of Occupational Injuries of Workers in Pakistan

Background

The prevailing global work scenario and deteriorating health facilities in economies indulge the risk perspective in the labor market model. This is the reason that the risk factor is cautiously attributed to wages and labor market efficiencies specifically in developing and emerging economies. In this respect, Occupational Injuries of Workers (OIW) is considered essential to demonstrate the risk and Occupational Health and Safety (OHS) setups given the constraints of the labor. Intuitively, the prime objective of this study is to make an assessment of the labor market considering the OIW through the indicators of industry division, employment status, occupational distribution, adopted treatment, gender and regionality.

Methods

The assessment strategy of the study has been categorized into trend analysis and Index Value Calculation (IVC) segments employing the data from 2001 to 2018.

Results

The pattern of the selected indicators of the OIW has been observed in the available data while the IVC estimations are considered through time and reference categories. The findings of both exercises revealed absolute and relative heterogeneities at both industry and occupational levels.

Conclusion

The consistency for gender and regional distribution of both assessments points out the need for effective policy initiatives. The study suggests separate analyses of industry and occupations for a better understanding of the OHS setups and up-gradation in Pakistan.

Association between sleep disturbance and occupational injury among Korean employees

Background

Occupational injury has been a serious social problem steadily. Sleep disturbance is a risk factor for occupational injury. However, there were few researches studied on the linking between sleep disturbance and occupational injury in general working population of Korea. Therefore, we explored the association between sleep disturbance and occupational injury among Korean workers.

Methods

This study used data from the 5th Korean Working Conditions Survey. Occupational injury was assessed by asking work related injury for 12 months prior to the point of the survey. Sleep disturbance was assessed using the Minimal Insomnia Symptoms Scale (MISS). To analyze the association between sleep disturbance and occupational injury, multiple logistic regression analysis was conducted.

Results

The odds ratio (OR) of sleep disturbance group for occupational injury was 2.57 (95% confidence interval [CI]: 1.68–3.93) in the fully adjusted model. For the association between MISS score and occupational injury, it showed increasing trend that ORs increase from the 1st to the 4th quartiles. The OR of 2nd quartile was 1.10 (95% CI: 0.60–2.01), the OR of 3rd quartile was 2.27 (95% CI: 1.53–3.38) and the OR of 4th quartile was 2.80 (95% CI: 1.84–4.26).

Conclusions

Sleep disturbance was associated with occupational injury. In addition, increasing trend was observed between MISS score and occupational injury. These findings imply that developing of intervention programs to manage sleep disturbance and fatigue may be necessary to prevent occupational injury.

Evolutionary Process of Promoting Construction Safety Education to Avoid Construction Safety Accidents in China

Construction safety is related to the life and health of construction workers and has always been a hot issue of concern for government and construction units. The government can use “construction safety education” to reduce the probability of safety accidents in the construction process and avoid the loss of life and property of construction workers. To encourage construction units to provide safety education for construction workers before construction starts and promote construction workers to actively participate in safety education. In this paper, a tripartite evolutionary game model of government–construction units–construction workers is established, and the factors affecting each party’s behavior strategy are comprehensively analyzed. Firstly, evolutionary game theory is used to investigate the influence of different behavior strategies among government, construction units, and construction workers on the behavior strategies of the other two parties. Secondly, according to the events in different situations, the influence of critical factors on the evolution process of the model is analyzed. On this basis, combined with the construction experience and construction data of actual construction projects, the established model and preliminary conclusions are verified. Finally, a sensitivity analysis of all parameters is carried out. The results show that: (1) The government’s enhancement of reward and punishment is conducive to promoting the choice of "providing safety education" for construction orders and the choice of “actively participating in safety education” for construction workers, but the excessive reward will lead to the government’s unwillingness of participation; (2) The reasonable reward and punishment mechanism set by the government must meet the condition that the sum of rewards and punishments for all parties is more significant than their speculative gains, to ensure the construction safety under the evolutionary stability; (3) Increasing welfare subsidies for construction workers who choose to participate in safety education actively is an effective way to avoid unwilling participation of construction workers.

Injury inequalities among U.S. construction workers

This study explores racial/ethnic inequalities in work-related injuries among U.S. construction workers. Data from the 2004-2017 National Health Interview Survey were used to estimate work-related injuries by race/ethnicity in construction. Disparities in demographic, socioeconomic, and injury status among construction workers were examined by race/ethnicity. Injury differences were also evaluated in multiple logistic regression analyses controlling for potential confounders. Compared to white, non-Hispanic workers, minority workers were more likely to have lower socioeconomic statuses (e.g., lower educational attainment, lack of health insurance coverage, and family income below the poverty level), which considerably increased the likelihood of work-related injuries. The odds of work-related injuries were 70% higher among racial/ethnic minorities than white, non-Hispanics in construction. Injuries were also more severe among minorities than white, non-Hispanic workers. Among workers with a work-related injury, nearly 85% of Hispanics reported missing at least one workday due to injury, 45.6% higher than the proportion of 57.9% for their white, non-Hispanic counterparts. After adjusting for major demographic and socioeconomic factors, the work-related injury difference between race/ethnicity was no longer statistically significant. However, the odds of work-related injury remained significantly higher among workers who were younger (35-54 years vs. ≥ 55 years: aOR = 2.2, 95% CI: 1.3-3.6); male (aOR = 5.3, 95% CI: 2.9-9.8); not college-educated (aOR = 1.5, 95% CI: 1.0-2.2); had a family income below the poverty threshold (aOR = 1.8, 95% CI: 1.2-2.8); or held a blue-collar occupation (aOR = 2.0, 95% CI: 1.2-3.4). These findings suggest that the injury differences between race/ethnicity were strongly associated with demographics and socioeconomic inequalities in these worker groups. The identified injury disparities should be reduced or eliminated, following the hierarchy of controls paradigm.

Exploring patterns of multiple climates and their effects on safety performance at the department level

INTRODUCTION

This paper represents a first attempt to fill a gap in research about different specific climates and safety outcomes, by empirically identifying patterns of climates and exploring the possible effect of different climates at the department level on some specific safety outcomes. The first objective was to explore how different specific climates (safety, communication, diversity and inclusion) can be associated to each other, considering the department level of analysis. The second objective was to examine the relationships between those patterns of climates with safety performance (compliance and participation behaviors).

METHOD

A total of 429 blue-collar workers in 35 departments answered a questionnaire covering safety, diversity, inclusion, and communication climate measures. Cluster analysis was performed to identify clusters of departments with different climate patterns and their impact on safety compliance and safety participation behaviors. Subsequently, a hierarchical multiple linear regression was conducted at the individual-level to test the effect of climate patterns, by controlling for some sociodemographic variables.

RESULTS

Results showed the existence of four differentiated clusters of departments. Three of those clusters showed homogenous patterns (coherent association among perceptions of low, medium and high climates) and one heterogeneous (low and medium perceptions). The findings also revealed that the higher the climates perceptions, the higher the levels of safety participation and safety compliance, with safety participation being more affected than compliance.

CONCLUSIONS

The present research showed the associated effects of some organizational climate factors, such as fair treatment, inclusion, safety and communication within the organization, which had not been previously studied in their combined relationships, on safety behaviors. Practical applications: Several other organizational climate factors, such as fair treatment, inclusiveness and communication, may play an important role in safety, showing the importance of broadening the focus on safety climate as one of the main predictors of safety behaviors.

Medical Emergencies in Farmers

BACKGROUND

Agricultural work involves hazards that may harm long-term well-being. We evaluated the risk of long-term disability and death for agricultural workers compared to construction workers with similar demographics. We hypothesized that delays to emergency care and subsequent long-term disability following injury might be worse for agricultural workers compared to those injured in construction.

METHODS

We evaluated all adults severely injured on farms or on construction sites in Ontario, Canada, between April 1, 2009, and March 31, 2012, according to the Ontario Trauma Registry. We excluded individuals living outside of the province, those missing a valid health card number, or youth less than 17 years old. Our primary outcome was death or the subsequent application for disability support.

RESULTS

In total, 353 patients were injured on a farm or construction site during the study period. Delays to emergency care exceeding 12 hours were more frequent for agricultural workers compared to construction workers (43% vs 23%, P <.001). After a 5-year follow-up, agricultural workers had a death or disability rate marginally higher than construction workers (23% vs 14%, P = .068), equivalent to a hazard ratio of 1.62 that was marginally statistically significant (95% confidence interval 0.96-2.75, P = .072). The risk of death and disability was greatest for patients who had the longest delays to emergency care.

INTERPRETATION

Agricultural workers experience a substantial delay in receiving emergency care and a marginally higher risk of death or disability in the years following injury compared to construction workers.

Identification of Safety-Related Opinion Leaders among Construction Workers: Evidence from Scaffolders of Metro Construction in Wuhan, China

This study aimed to reveal opinion leaders who could impact their coworkers’ safety-related performance in Chinese construction teams. Questionnaires were distributed to 586 scaffolders in Wuhan to understand their opinions about influencing their coworkers, serving as the foundation for a social network analysis to identify the potential opinion leaders among workers. A further controlled trial with the identified workers was conducted to select real opinion leaders by comparing their influence on others’ safety-related behavior, followed by an association analysis to profile these opinion leaders. Two main sources of opinion leaders were identified: foremen and seasoned workers. Implementing interventions through opinion leaders resulted in better safety-related behavior performance. Furthermore, compared with education level, the association analysis results indicated that one’s practical skills and familiarity with respondents was more important in the formulation of opinion leaders. This research introduces the concept of opinion leaders into construction safety and proposes an approach to identify and validate opinion leaders within a crew, thus providing a tool to improve behavior promotion on sites, as well as a new perspective for viewing interactions among workers.

Workplace Accident Prevalence and Associated Factors among Tobacco Farm in São Lourenço do Sul-RS, Brazil

Agriculture has the highest risk of accidents. In Brazil the reality of this situation is unknown owing to scarcity of studies and underreporting of workplace accidents in rural areas. This article aims to evaluate workplace accident prevalence and associated factors among tobacco farm in Sao Lourenco do Sul-RS, Brazil. Cross-sectional study with 488 tobacco farmers, assessing sociodemographic, behavioural, labour characteristics and association with workplace accidents occurring in their lifetime. The injury prevalence was 24%. Being male (PR 1.62; 95%CI 1.04-2.52), and tenant farmer (PR 1.87; 95%CI 1.29-2.72), bundling tobacco leaves (PR 2.00; 95%CI 1.14-3.52) and having minor psychiatric disorders (PR 1.58; 95%CI 1.06-2.35) were positively associated with accidents. 46% of serious injuries caused superficial lesions and 26% caused fractures. Rural workplace accident prevention policies need to be established, particularly for tobacco farming. Larger studies are needed to understand work process-related aspects that increase the risk of accidents.

Safety climate and safety behaviors in the construction industry: The importance of co-workers commitment to safety

BACKGROUND

There is growing empirical evidence that as safety climate improves work site safety practice improve. Safety climate is often measured by asking workers about their perceptions of management commitment to safety. However, it is less common to include perceptions of their co-workers commitment to safety. While the involvement of management in safety is essential, working with co-workers who value and prioritize safety may be just as important.

OBJECTIVE

To evaluate a concept of safety climate that focuses on top management, supervisors and co-workers commitment to safety, which is relatively new and untested in the United States construction industry.

METHODS

Survey data was collected from a cohort of 300 unionized construction workers in the United States. The significance of direct and indirect (mediation) effects among safety climate and safety behavior factors were evaluated via structural equation modeling.

RESULTS

Results indicated that safety climate was associated with safety behaviors on the job. More specifically, perceptions of co-workers commitment to safety was a mediator between both management commitment to safety climate factors and safety behaviors.

CONCLUSIONS

These results support workplace health and safety interventions that build and sustain safety climate and a commitment to safety amongst work teams.

Prevalence of occupational injury and its contributing factors among rubber tappers in Galle, Sri Lanka

BACKGROUND

Rubber tapping involves carrying heavy loads, navigating rough terrain, and using sharp tools. However, little is known about occupational injury among this vulnerable working population.

OBJECTIVE

To assesses the prevalence, severity, and contributing factors associated with occupational injury among Sri Lankan rubber tappers and to identify possible interventions to improve occupational safety.

METHODS

A questionnaire was administered to 300 Sri Lankan rubber tappers. The associations between tapper characteristics and injury within the last year were examined using log-binomial regression models. Short response answers were analyzed using qualitative content analysis.

RESULTS

300 tappers reported 594 injuries in the previous 12 months, and missed 1,080 days of work. The prevalence of one or more injuries was 49%. Factors associated with injury were being female, working an additional job, tapping with a two-handed approach, and depressive symptomology. Qualitative findings suggest three interventions to address injuries: (1) landscaping, (2) personal protective equipment, and (3) provision of eyeglasses.

CONCLUSIONS

Work-related injuries are common among Sri Lankan rubber tappers. These results highlight the importance of working with and including informal workers in the creation of Sri Lankan occupational health and safety regulations. We believe that the three interventions identified by respondents could help to reduce the risk of occupational injury among rubber tappers.

Prevalence of Injury in Occupation and Industry: Role of Obesity in the National Health Interview Survey 2004 to 2013

OBJECTIVES

The aim of this study was to estimate prevalence of injury by occupation and industry and obesity's role.

METHODS

Self-reported injuries were collected annually for US workers during 2004 to 2013. Prevalence ratios (PRs) and 95% confidence intervals (CIs) were obtained from fitted logistic regression models.

RESULTS

Overall weighted injury prevalence during the previous three months was 77 per 10,000 workers. Age-adjusted injury prevalence was greatest for Construction and Extraction workers (169.7/10,000) followed by Production (160.6) among occupations, while workers in the Construction industry sector (147.9) had the highest injury prevalence followed by the Agriculture/Forestry/Fishing/Mining/Utilities sector (122.1). Overweight and obese workers were 26% to 45% more likely to experience injuries than normal-weight workers.

CONCLUSION

The prevalence of injury, highest for Construction workers, gradually increased as body mass index levels increased in most occupational and industry groups.

Assistive technology use by disability type and race: exploration of a population-based health survey

PURPOSE

To examine the relationships among Assistive Technology (AT) use, race, type of disability and selected other demographic characteristics.

METHOD

Using 2009 National Health Interview Survey, descriptive statistics, statistical interactions and binary logistic regression were performed to identify, contrast and predict the likelihood of using AT based on the type of disability among African Americans (AAs) and European Americans (EAs).

RESULTS

We found that more AAs (10% within group proportion of total AAs) used AT compared to EAs (7.5% within group proportion of total EAs). Physical (p < 0.001), auditory (p = 0.028) and emotional (p = 0.008) impairments were statistically significant predictors of AT use. However, physical impairment as a predictor of AT use was greater among AAs (OR = 222.49, CI: 64.04-773.04, p < 0.001) than EAs (OR = 50.77, CI: 31.78-81.12, p < 0.001). EAs had a greater number of disabling conditions that predict the use of AT than AAs, whereas AAs had more demographic characteristics beyond race that predict AT use than EAs.

CONCLUSIONS

Disparities were observed in AT usage by disability types and demographic characteristics between AAs and EAs. Moreover, the predictive strength of AT usage based on disability types and other demographic variables differed by races. Overall, the findings about the different relationships among race, disability type, and AT use are found. Implications for Rehabilitation The finding may inform the development of initiatives by rehabilitation leaders to encourage the use of AT by AAs and EAs according to their type of impairment. Having identified physical impairment as statistically significant predictor of AT use greater among AAs, rehabilitation leaders should ensure that people living with those types of disability have access to the corresponding type of AT and can use them effectively.

Census-based socioeconomic indicators for monitoring injury causes in the USA: a review

BACKGROUND

Unlike the UK or New Zealand, there is no standard set of census variables in the USA for characterising socioeconomic (SES, socioeconomic status) inequalities in health outcomes, including injury. We systematically reviewed existing US studies to identify conceptual and methodological strengths and limitations of current approaches to determine those most suitable for research and surveillance.

METHODS

We searched seven electronic databases to identify census variables proposed in the peer-reviewed literature to monitor injury risk. Inclusion criteria were that numerator data were derived from hospital, trauma or vital statistics registries and that exposure variables included census SES constructs.

RESULTS

From 33 eligible studies, we identified 70 different census constructs for monitoring injury risk. Of these, fewer than half were replicated by other studies or against other causes, making the majority of studies non-comparable. When evaluated for a statistically significant relationship with a cause of injury, 74% of all constructs were predictive of injury risk when assessed in pairwise comparisons, whereas 98% of all constructs were significant when aggregated into composite indices. Fewer than 30% of studies selected SES constructs based on known associations with injury risk.

CONCLUSIONS

There is heterogeneity in the conceptual and methodological approaches for using census data for monitoring injury risk as well as in the recommendations as to how these constructs can be used for injury prevention. We recommend four priority areas for research to facilitate a more unified approach towards use of the census for monitoring socioeconomic inequalities in injury risk.

Trend of Occupational Injuries/Diseases in Pakistan: Index Value Analysis of Injured Employed Persons from 2001-02 to 2012-13

BACKGROUND

The present study aimed to analyze the index value trends of injured employed persons (IEPs) covered in Pakistan Labour Force Surveys from 2001-02 to 2012-13.

METHODS

The index value method based on reference years and reference groups was used to analyze the IEP trends in terms of different criteria such as gender, area, employment status, industry types, occupational groups, types of injury, injured body parts, and treatment received. The Pearson correlation coefficient analysis was also performed to investigate the inter-relationship of different occupational variables.

RESULTS

The values of IEP increased at the end of the studied year in industry divisions such as agriculture, forestry, hunting, and fishing, followed by in manufacturing and construction industry divisions. People associated with major occupations (such as skilled agricultural and fishery workers) and elementary (unskilled) occupations were found to be at an increasing risk of occupational injuries/diseases with an increasing IEP trend. Types of occupational injuries such as sprain or strain, superficial injury, and dislocation increased during the studied years. Major injured parts of body such as upper limb and lower limb found with increasing trend. Types of treatment received, including hospitalization and no treatment, were found to decrease. Increased IEP can be justified due to inadequate health care facilities, especially in rural areas by increased IEP in terms of gender, areas, received treatment, occupational groups and employment status as results found after Pearson correlation coefficient analysis.

CONCLUSION

The increasing trend in the IEP% of the total employed persons due to agrarian activities shows that there is a need to improve health care setups in rural areas of Pakistan.

Gender differences in occupational injury incidence

OBJECTIVES

To describe the frequency and distribution of workplace injury claims by gender, and quantify the extent to which observed gender differences in injury claim rates are attributable to differential exposure to work-related factors.

METHODS

WorkSafe Victoria (Australia) workers' compensation data (254,704 claims with affliction onset 2004-2011) were analysed. Claim rates were calculated by combining compensation data with state-wide employment data.

RESULTS

Mental disorder claim rates were 1.9 times higher among women; physical injury claim rates were 1.4 times higher among men. Adjusting for occupational group reversed the gender difference in musculoskeletal and tendon injury claim rates, i.e., these were more common in women than men after adjusting for occupational exposure.

CONCLUSIONS

Men had higher rates of physical injury claims than women, but this was mostly attributable to occupational factors. Women had higher rates of mental disorder claims than men; this was not fully explained by industry or occupation.

Linking community partners to increase tetanus immunizations among farmers

Increasing the number of individuals adequately immunized to prevent illness is a goal of community health nursing, but achieving this goal among occupational groups such as farmers remains a challenge. This article shares the process and outcome of a community-based participatory research project designed to provide tetanus immunizations to farmers. Key agricultural partners were identified in south central Kentucky and these individuals coordinated the site selection, advertisement, and recruitment for a tetanus immunization program. A total of 280 farmers or individuals associated with farming were surveyed over a 7-month period. The participants had limited knowledge of tetanus etiology and 84% of the participants either reported no tetanus booster in the past 10 years or did not know their tetanus immunization status. Positive outcomes included increasing the tetanus immunization rate among participating farmers and facilitating partnerships with community agencies and organizations.