Young workers and safety: A critical review and future research agenda

Systematic Review of Workplace Interventions to Support Young Workers' Safety, Work Environment and Health

PURPOSE

This systematic review investigates the effectiveness of workplace interventions to support young workers' work environment, safety and health.

METHODS

A systematic search was conducted in bibliographic databases including PubMed, Web of Science Core Collection and PsycInfo for English or Scandinavian articles published from 2007 to 2022. The PICO strategy guided the assessment of study relevance and the bibliographical search for randomized controlled trials (RCTs) and non-RCTs in which (1) participants were young workers (mean age: 15-29), (2) interventions were initiated and/or carried out at the workplace, (3) a comparison group was included, and (4) an outcome measure related to work environment, safety and health was reported. We categorized each included study using the intervention classification framework. The quality assessment and evidence synthesis adhered to the guidelines developed by the Institute for Work & Health (Toronto, Canada).

RESULTS

A total of 33 high and medium quality studies showed a moderate level of evidence for no benefit of 'Mental training' on stress. We found limited evidence of a positive effect of the following intervention types: 'Attitude and belief' on mental health problems, 'Behavior based' on anxiety, and 'Multifaceted' on hand eczema. We found limited evidence for no benefit of the following intervention types: 'Mental training' on mental health problems, and 'Physiological modifications' on musculoskeletal disorders. The remaining intervention types showed mixed or insufficient evidence.

CONCLUSIONS

Except for a moderate level of evidence for no benefit of 'Mental training' on stress, the evidence synthesis recommends, that there is not enough evidence from the scientific literature to guide current practices. The results emphasizes a strong need for high quality interventions specifically aiming at increasing or maintaining young workers' work environment, safety and health. Included studies focused mainly on individual measures, highlighting the need for studies investigating possible preventive measures at the group or organizational level.

Different approaches and their consequences for addressing the occupational health and safety of young workers: A systematic narrative literature review

BackgroundThe last twenty years, studies have examined 'young workers' occupational health and safety (OHS). Depending on the discipline, approach and methodology, they address youth OHS in different ways. This systematic narrative review aims to provide a deeper understanding of this research landscape.ObjectiveThe first objective is to provide a systematic review of the literature on OHS of 'young workers'. It consists of reviewing the literature by disciplines, approaches, methods, data and factors, and of focusing on studies that address the contextual and social aspects of OHS. The second objective is to consider the specific situation of apprentices.MethodsSearches were conducted in five scientific databases, supplemented by three resource platforms. The criteria of literature selection were: OHS of 'young workers' aged from 15-24; explicit link between work and health; publication between 2005 and 2022 in Europe, North America and Australia. Studies have been categorised.Results193 studies were included. The review shows the diversity of the population studied under the same heading and the predominance of medical studies, which favour epidemiological approaches and quantitative data. Other disciplines (e.g., psychology, educational sciences, social sciences), approaches (e.g., organisational, risk perception), data (e.g., interviews, observations) and methods (qualitative, mixed, longitudinal) are marginal. Individual and age-related factors are predominant. The impact of working conditions and social relations on OHS is rarely considered.ConclusionResearch on OHS through organisational context and social relations, particularly employment status, should be encouraged. This provides a deeper understanding of the constraints faced by 'young workers', especially apprentices.

Work-related injuries and illnesses (WRII) presenting to Illinois hospitals, 2017-2021: The importance of emergency department (ED) data

OBJECTIVES

Research characterizing work-related injuries and illnesses (WRII) has predominantly focused on inpatients and deaths, despite evidence that 4% of WRII are admitted as inpatients and deaths are less than 0.2% of acute WRII. Our aim is to determine the usefulness of incorporating emergency department (ED) hospital data into current occupational health surveillance systems.

METHODS

Data on ED and admitted WRII treated in Illinois hospitals from 2017 to 2021 were analyzed. Demographic characteristics, primary diagnosis, procedures undertaken, and unique patient estimates are described. Multivariable logistic regression models were developed to evaluate predictors of treatment in the ED and multivariable median regression models determined associations of total hospital charges.

RESULTS

Between 2017 and 2021 there were 488,033 hospital presentations (95.9% nonadmissions) for WRII in Illinois, equating to a crude annual population rate of 1502.1/100,000. Non-Hispanic Whites (NHW) were disproportionately treated for illnesses, while Hispanic or Latino workers were disproportionately treated for injuries. African-Americans had the highest rate of ED emergent presentations (incident rate ratio [IRR] = 1.3, ref = NHW) and were less likely to be admitted for emergent presentations (IRR = 0.7, ref = NHW). ED presentations were more likely to be female, present with an injury, and at a rural, versus urban, hospital. Radiological investigations compromised the majority of procedures for nonadmitted patients (n = 403,317), and 94.8% were coded for a body region CONCLUSION: Between 2017 and 2021 in Illinois, there were nearly 500,000 hospital visits charged to workers' compensation totaling over US$ four billion. ED data provide additional insights into work-related chronic conditions, health disparities, and the usage of diagnostic and therapeutic procedures for WRII.

Overrepresentation of New Workers in Jobs with Multiple Carcinogen Exposures in Canada

Background. In Canada, understanding the demographic and job-related factors influencing the prevalence of new workers and their exposure to potential carcinogens is crucial for improving workplace safety and guiding policy interventions. Methods. Logistic regression was performed on the 2017 Labour Force Survey (LFS), to estimate the likelihood of being a new worker based on age, industry, occupation, season, and immigration status. Participants were categorized by sector and occupation using the North American Industry Classification System (NAICS) 2017 Version 1.0 and National Occupational Classification (NOC) system 2016 Version 1.0. Finally, an exposures-per-worker metric was used to highlight the hazardous exposures new workers encounter in their jobs and industries. Results. Individuals younger than 25 years had 3.24 times the odds of being new workers compared to those in the 25-39 age group (adjusted odds ratios (OR) = 3.24, 95% confidence interval (95% CI) = 3.18, 3.31). Recent immigrants (less than 10 years in the country) were more likely to be new workers than those with Canadian citizenship (OR 1.36, 95% CI: 1.32, 1.41). The total workforce exposures-per-worker metric using CAREX Canada data was 0.56. By occupation, new workers were the most overrepresented in jobs in natural resources and agriculture (20.5% new workers), where they also experienced a high exposures-per-worker metric (1.57). Conclusions. Younger workers (under 25 years) and recent immigrants who had arrived 10 or fewer years prior were more likely to be new workers, and were overrepresented in jobs with more frequent hazardous exposures (Construction, Agriculture, and Trades).

Occupational inequalities and gender differences: work accidents, Brazil, 2019

OBJECTIVE

To analyze the distribution and association of sociodemographic and occupational factors with self-reported work accidents (WA) in a representative sample of the Brazilian population, with emphasis on occupational class, and to examine gender differences in this distribution.

METHODS

A population-based cross-sectional study, using data from the 2019 National Health Survey (PNS), analyzed the responses of a sample of adults aged 18 or over. Factors associated with WA were investigated using binary logistic regression and hierarchical analysis using blocks (sociodemographic and occupational variables). The final model was adjusted by variables from all blocks, adopting a significance level of 5%. The values of odds ratios (OR) and respective confidence intervals were obtained.

RESULTS

Among the participants, 2.69% reported having suffered a WA, with a higher prevalence in men (3.37%; 95%CI 2.97-3.82%) than in women (1.86%; 95%CI 1.55-2.23%). The analysis identified that age group, night work, working hours, and exposure to occupational risks were associated with WA, with emphasis on gender differences. The class of manual workers, both qualified (ORwomen = 2.87; 95%CI 1.33-6.21 and ORmen = 2.46; 95%CI 1.37-4.40) and unskilled (ORwomen = 2.55; 95%CI 1.44-4.50 and ORmen = 3.70; 95%CI 1.95-7.03), had a higher chance of WA than the class of managers/professionals.

CONCLUSION

Occupational factors contributed significantly to the increase in the probability of WA for men and women, with greater magnitude among those positioned in the lower strata of the occupational structure. The results obtained are clues for working out WA prevention actions.

Development and Cognitive Testing of Occupational Safety and Health Questions for a Youth Survey: Addressing the Research Needs for a Vulnerable Working Population

BACKGROUND

While more than 2.5 million U.S. high students worked in 2020, data to assess how work affects this group are sparse. To facilitate such research, a set of occupational safety and health questions for inclusion on the Youth Risk Behavior Surveillance System (YRBSS) and other youth-focused surveys was developed.

METHODS

Survey questions about occupational experiences of young workers were adapted from other surveys or created de novo. Key audiences were engaged to define priority topic areas and develop draft questions, which were further refined through cognitive interviews with working youth.

RESULTS

Twenty-one resulting questions spanned multiple work-related topics: employment status; health outcomes; psychosocial exposures; and safety climate. Cognitive testing revealed that youth (aged 14-19) had difficulty with temporal concepts. Some difficulties reflected the propensity of youth to engage in multiple, online, and informal jobs. During 3 rounds of interviews, questions were adjusted to better reflect youth employment circumstances and language. Four states added at least 1 work-related question to their 2023 Youth Risk Behavior Survey questionnaire, and the full set of questions has been disseminated to federal agencies and partners.

CONCLUSION

Including tailored questions about employment in surveys of youth will facilitate occupational health surveillance for this group. Analysis of resulting data can help to close knowledge gaps, provide current prevalence data, inform policy, and allow development of focused prevention and intervention strategies to reduce adverse outcomes among young workers.

Occupational Injuries Among Construction Workers by Age and Related Economic Loss: Findings From Ohio Workers' Compensation, USA: 2007-2017

Background

This study examined age-group differences in the rate, severity, and cost of injuries among construction workers to support evidence-based worker safety and health interventions in the construction industry.

Methods

Ohio workers' compensation claims for construction workers were used to estimate claim rates and costs by age group. We analyzed claims data auto-coded into five event/exposure categories: transportation incidents; slips, trips, and falls (STFs); exposure to harmful substances and environments; contact with objects and equipment (COB); overexertion and bodily reaction. American Community Survey data were used to determine the percentage of workers in each age group.

Results

From 2007-2017, among 72,416 accepted injury claims for ∼166,000 construction full-time equivalent (FTE) per year, nearly half were caused by COB, followed by STFs (20%) and overexertion (20%). Claim rates related to COB and exposure to harmful substances and environments were highest among those 18-24 years old, with claim rates of 313.5 and 25.9 per 10,000 FTE, respectively. STFs increased with age, with the highest claim rates for those 55-64 years old (94.2 claims per 10,000 FTE). Overexertion claim rates increased and then declined with age, with the highest claim rate for those 35-44 years old (87.3 per 10,000 FTE). While younger workers had higher injury rates, older workers had higher proportions of lost-time claims and higher costs per claim. The total cost per FTE was highest for those 45-54 years old ($1,122 per FTE).

Conclusion

The variation in rates of injury types by age suggests that age-specific prevention strategies may be useful.

Managers' experience of causes and prevention of sick leave among young employees with Common Mental Disorders (CMDs)-A qualitative interview study with a gender perspective

BACKGROUND

Young adults entering the workforce have an almost 40% greater risk of work-related mental health problems than other working age groups. Common mental disorders (CMDs) constitute the majority of such mental health problems. Managers are crucial in promoting a good psychosocial work environment and preventing sick leave. The study aims to explore managers' experience of 1) causes of sick leave in the personal and work-life of young employees with CMDs, and 2) prevention of such sick leave. A gender perspective is applied to examine managers' experience of causes and prevention of sick leave in relation to male and female employees and male and female-dominated occupations.

MATERIAL AND METHODS

A qualitative design was applied and 23 semi-structured interviews were conducted with Swedish managers experienced in supervising young employees with CMDs. The interviews were analysed with conventional content analysis and the managers' experience of similarities and differences between young female and male employees and occupations were explored through reflective notes.

RESULTS

Four main categories and eight subcategories describe the managers' experience of the causes of sick leave due to CMD among young employees. The main categories are: 1) entering work life when already worn-out, 2) struggling with too high expectations at work, 3) having a challenging personal life, and 4) being unable to manage specific occupational challenges and demands. Gender differences were found in six subcategories regarding, e.g., work demands and problems in personal relationships. One main category and three subcategories describe how this type of sick leave might be prevented, with managers emphasizing the need to ease the transition into work life. Gender differences in the prevention of sick leave were found in one subcategory regarding communication about workers' health and problems at work.

CONCLUSION

Our findings show that gender norms and the expectations of young men and women are factors of importance in managers' experience of the development and prevention of CMDs. These results can inform their preventive work and their supervision and introduction of newly-employed young adults.

How does subjective invulnerability impact young workers' safety voice?

INTRODUCTION

Young workers are at risk of workplace injuries for numerous reasons. One contentious yet untested theory is that subjective invulnerability to danger-a sense of indestructability in the face of physical hazards-can affect some young workers' reactions to workplace hazards. This study contends that subjective invulnerability can affect these reactions in two ways: (a) perceptions of physical hazards at work generate less fear of injury among those who perceive themselves as more invulnerable and/or; (b) fear of injury does not motivate speaking up about safety concerns (safety voice) among those who perceive themselves as more invulnerable.

METHOD

This paper tests a moderated mediation model in which higher perceptions of physical hazards at work are related to higher safety voice intentions via higher fear of injury, but that subjective invulnerability reduces the extent to which: (a) perceptions of physical hazards at work are associated with fear of injury and/or; (b) fear of injury is associated with safety voice. This model is tested in two studies of young workers (Study 1 on-line experiment: N = 114, M age = 20.67, SD = 1.79; range = 18-24 years; Study 2 field study using three waves of data collected at monthly intervals: N = 80, M age = 17.13, SD = 1.08, range = 15-20 years).

RESULTS

Contrary to expectations, the results showed that young workers who feel more invulnerable to danger are more likely to speak up about safety when experiencing higher fear of injury, and that perceptions of physical hazards-safety voice relationship is mediated by fear of injury for those who perceive themselves to be more invulnerable to danger. Conclusions/Practical Applications: Rather than subjective invulnerability silencing safety voice as predicted, the current data suggest that subjective invulnerability may serve to accelerate how fear of injury motivates safety voice.