Targeting prevention programs for young and new healthcare workers: what is the association of age and job tenure with occupational injury in healthcare?

BACKGROUND: previous evidence suggests young and new workers experience an increased risk of occupational injury. We sought to confirm this observation for healthcare workers. METHODS: a retrospective cohort of 42,771 healthcare workers (88.2% women) was constructed from an active injury surveillance database. Over 2 years, incidence rates and crude and adjusted relative risks for occupational injury were compared between age groups and job tenures. RESULTS: there were opposite trends in the two main types of injuries which cancelled each other: new workers and young workers had a decreased (not increased) risk of musculoskeletal sprain and strain injuries (adjusted RR [95% CI] for new hires was 0.60 [0.48, 0.73], and 0.85 [0.73, 0.98] for workers <25 years old); but an increased risk of cut and puncture injuries (1.25 [1.07, 1.45] for new hires, 1.28 [0.99, 1.67] for workers <25 years old). CONCLUSIONS: contrary to studies of other sectors, younger age and shorter tenure were not universal risk factors for occupational injuries in the female dominated healthcare sector. Young and new workers had increased risk of cuts and punctures, but a decreased risk of musculoskeletal injuries.

Trends and costs of overtime among nurses in Canada.

OBJECTIVE: To examine the regular and overtime working hours of Registered Nurses in acute care and their associated costs by employment status (full time, part time, casual) and department over a 4-year period. METHODS: Data were extracted for 2005-2008 from one health region's payroll database for Registered Nurses in acute care in British Columbia, Canada. Regular and overtime hours by employment status and department were plotted over time and tested using simple linear regression. Regular and overtime wage costs were calculated at the individual level using the employee's wage rate and stratified by year, gender, age, employment status and department. RESULTS: Full time Registered Nurses are working an increasing amount of overtime hours each year. Full time nurses in Emergency, Intensive Care and General Medical departments are working the highest proportion of overtime hours per total hours and consequently, contributing the highest proportion of overtime costs. CONCLUSIONS: Efforts to lighten the burden of overtime should be focused at the department level. Creating more full time positions out of overtime hours may be one solution to alleviate this burden of overtime and to assuage the nursing shortage in Canada.

Near miss and minor occupational injury: Does it share a common causal pathway with major injury?

BACKGROUND: An essential assumption of injury prevention programs is the common cause hypothesis that the causal pathways of near misses and minor injuries are similar to those of major injuries. METHODS: The rates of near miss, minor injury and major injury of all reported incidents and musculoskeletal incidents (MSIs) were calculated for three health regions using information from a surveillance database and productive hours from payroll data. The relative distribution of individual causes and activities involved in near miss, minor injury and major injury were then compared. RESULTS: For all reported incidents, there were significant differences in the relative distribution of causes for near miss, minor, and major injury. However, the relative distribution of causes and activities involved in minor and major MSIs were similar. The top causes and activities involved were the same across near miss, minor, and major injury. CONCLUSIONS: Finding from this study support the use of near miss and minor injury data as potential outcome measures for injury prevention programs.

Potential allergy and irritation incidents among health care workers.

This study describes the types, causes, and outcomes of potential irritation and allergy incidents among workers in British Columbia's health care industry. Data on occupation-induced allergy and irritation incidents were extracted from a standardized database using the number of productive hours obtained from payroll data as a denominator during a 1-year period from three British Columbia health regions. Younger workers, female workers, facility support service workers, laboratory assistants and technicians, and maintenance and acute care workers were found to be at higher risk for allergy and irritation incidents. Major causes of allergy and irritation incidents included chemicals, blood and body fluids, food and objects, communicable diseases, air quality, and latex. A larger proportion of chemically induced incidents resulted in first aid care only, whereas non-chemical incidents required more emergency room visits.

Occupational injury among full-time, part-time and casual health care workers.

BACKGROUND: Previous epidemiological studies have conflicting suggestions on the association of occupational injury risks with employment category across industries. This specific issue has not been examined for direct patient care occupations in the health care sector. AIMS: To investigate whether work-related injury rates differ by employment category (part time, full time or casual) for registered nurses (RNs) in acute care and care aides (CAs) in long-term facilities. METHODS: Incidents of occupational injury resulting in compensated time loss from work, over a 1-year period within three health regions in British Columbia (BC), Canada, were extracted from a standardized operational database. Detailed analysis was conducted using Poisson regression modeling. RESULTS: Among 8640 RNs in acute care, 37% worked full time, 24% part time and 25% casual. The overall rates of injuries were 7.4, 5.3 and 5.5 per 100 person-years, respectively. Among the 2967 CAs in long-term care, 30% worked full time, 20% part time and 40% casual. The overall rates of injuries were 25.8, 22.9 and 18.1 per 100 person-years, respectively. In multivariate models, having adjusted for age, gender, facility and health region, full-time RNs had significantly higher risk of sustaining injuries compared to part-time and casual workers. For CAs, full-time workers had significantly higher risk of sustaining injuries compared to casual workers. CONCLUSIONS: Full-time direct patient care occupations have greater risk of injury compared to part-time and casual workers within the health care sector.