Boyer Jon, Galizzi Monica, Cifuentes Manuel, d'Errico Angelo, Gore Rebecca, Punnett Laura, Slatin Craig
Department of Work Environment, University of Massachusetts Lowell, Lowell, Massachusetts 01854, USA.
Am J Ind Med. 2009 Jul;52(7):551-62. doi: 10.1002/ajim.20702.
Hospital workers are a diverse population with high rates of musculoskeletal disorders (MSDs). The risk of MSD leading to workers' compensation (WC) claims is likely to show a gradient by socioeconomic status (SES) that may be partly explained by working conditions.
A single community hospital provided workforce demographics and WC claim records for 2003-2005. An ergonomic job exposure matrix (JEM) was developed for these healthcare jobs from direct observation of physical workload and extraction of physical and psychosocial job requirements from the ONET online database. Occupational exposures and SES categories were assigned to workers through their ONET job titles. Univariate and multivariate Poisson regression analyses were performed to estimate the propensity to file an injury claim in relation to individual factors, occupational exposures, and SES.
The jobs with the highest injury rates were nurses, semi-professionals, and semi-skilled. Increased physical work and psychological demands along with low job tenure were associated with an increase in risk, while risk decreased with psychosocial rewards and supervisor support. Both occupational and individual factors mediated the relationship between SES and rate of injury claims.
Physical and organizational features of these hospital jobs along with low job tenure predicted WC injury claim risk and explained a substantial proportion of the effects of SES. Further studies that include lifestyle risk factors and control for prior injuries and co-morbidities are warranted to strengthen the current study findings.
医院工作人员构成多样,肌肉骨骼疾病(MSD)发生率较高。MSD导致工伤赔偿(WC)索赔的风险可能因社会经济地位(SES)呈现梯度变化,这可能部分归因于工作条件。
一家社区医院提供了2003 - 2005年的劳动力人口统计数据和WC索赔记录。通过直接观察体力工作量,并从ONET在线数据库中提取身体和心理社会工作要求,为这些医疗工作制定了一个人体工程学工作暴露矩阵(JEM)。根据工作人员的ONET工作头衔为其分配职业暴露和SES类别。进行单变量和多变量泊松回归分析,以估计与个人因素、职业暴露和SES相关的提出伤害索赔的倾向。
受伤率最高的工作岗位是护士、半专业人员和半熟练工人。体力工作和心理需求增加以及工作任期短与风险增加相关,而风险随着心理社会奖励和上级支持而降低。职业因素和个人因素都介导了SES与伤害索赔率之间的关系。
这些医院工作的身体和组织特征以及低工作任期预测了WC伤害索赔风险,并解释了SES影响的很大一部分。有必要进行进一步的研究,纳入生活方式风险因素,并对既往损伤和合并症进行控制,以加强当前的研究结果。