29 Jan 2015

Occupational Injury Patterns of U.S. Workers With Physical or Mental Disabilities

Roger Rabb, J.D., Special Correspondent for the LexisNexis Workers’ Compensation eNewsletter

Past studies have shown that workers with disabilities in the U.S. are more likely to sustain an occupational injury than workers without disabilities, with one study published in 2012 concluding that “U.S. workers with disabilities have a 2.39 times higher odds of occupational injury than workers without disabilities.” However, there has been little research comparing the types and causes of injuries sustained by the two groups. A new study, “Characteristics of Nonfatal Occupational Injuries Among U.S. Workers With and Without Disabilities,” published in the American Journal of Industrial Medicine, attempts to remedy that deficiency.

The Study Data

Analyzing self-reported survey data compiled between 1997 and 2011 by the National Center for Health Statistics, the new study sought to compare occupational injury patterns between workers with and without disabilities, focusing on the cause and place of injury, activity being performed at the time of injury, type and severity of injury, and body part injured. Data was not provided on fatal injuries.

Placement into the “worker with disability” group was made based on an affirmative survey response to the question of whether the person had “activity limitations because of a physical, mental, or emotional problem,” and if the reported limitations were from a chronic condition, defined as a condition that is not cured once acquired or is otherwise present for 3 months or longer. For purposes of this study, an activity limitation included personal care needs, routine needs, working, walking, remembering, or any other activities. The study excluded persons who reported limitations when it was not known if the limitations were caused by a chronic condition. Persons who reported no limitations were placed into the “worker without disability” group.

The study identified 633,710 workers who were 18 years or older and otherwise met the study’s criteria for inclusion. Of these workers, 29,576 were placed into the “worker with disability” category.

The Study’s Findings

Of the workers from both categories, 4,105 reported at least one occupational injury during the study period, with 4,203 injuries reported in total. Of those, 3,757 medically-treated occupational injuries were reported by the workers without disability, with a “3-month incidence” of 0.62 injuries per 100 workers. By comparison, 446 such occupational injuries were reported by the workers with disability, or a 3-month incidence of 1.51 injuries per 100 workers. While the prevalence of occupational injuries declined for both groups in the later years of the study compared to the earlier years, evaluation of that decline was beyond the scope of the study.

Most of the reported occupational injuries were minor, with hospitalization required for only about 2% of the injuries. However, in general, injuries sustained by workers with disabilities appeared to be more severe than the injuries sustained by workers without disabilities and resulted in more days missed from work.

Workers with disabilities were more likely to be older than those without disabilities, as 31.5% of the workers with disabilities were 55 or older, compared to only 15.3% for workers without disabilities. While male workers sustained more than half the injuries reported for both groups, females sustained 43.3% of the injuries among workers with disabilities and only 31.4% of the injuries in the group without disabilities.

The study found that workers with disabilities were more likely to be in service occupations, with smaller proportions in managerial or professional occupations, and were more likely to be poorer. Workers with disabilities were more likely to sustain injuries at a shopping center, restaurant, store, bank, gas station, or other place of business, or at a health care facility, and less likely than workers without disabilities to be injured in industrial or construction areas. However, the data used in the study did not provide complete occupation information, making it difficult to determine whether a higher percentage of employment in specific occupations in the workers with disabilities, or among certain subgroups such as older workers or female workers, might be the cause of some of the differences found.

As to cause of injury, the two leading causes of occupational injury for both groups were overexertion/strenuous movements and falls. However, these two causes accounted for 56.7% of the injuries among the workers with disabilities, compared to only 45.6% among workers without disabilities. While the greater incidence of injuries caused by overexertion/strenuous movement among workers with disabilities was not apparent, as noted by the authors of the study, “one possible explanation could be that workers with physical disabilities might have greater difficulty performing some physically demanding job tasks and thus were more likely to be injured by overexertion.”

For workers with disabilities, the three most common types of injuries by body region injured and nature of injury were “sprains and strains of the back and buttock (9.9%), open wounds of the wrist/hand/fingers (8.8%), and unspecified injuries of the trunk (6.5).” Conversely, for workers without disabilities, the three most common injuries were “open wounds to the wrist/hand/fingers (15.6%), sprains and strains of the back and buttock (9.5%), and lower leg or ankle sprains and strains (6.0%).” While sprains and strains grouped together were the leading injury type, coming in around 37 to 38% for both groups, workers with disabilities reported fewer open wound injuries, 15.7% compared with 24.2%. The authors speculated that perhaps “due to activity limitations, workers with disabilities were less likely to engage in or be assigned to high-risk jobs that may potentially result in fractures or open wounds.”

A higher proportion of workers with disabilities reported injuries to the lower extremities than their counterparts without disabilities, 32.3% to 26.6%, as well as torso injuries, 22.9% to 16.9%.

Conclusion

While the results of this study appear to reaffirm that workers with disabilities sustain a higher incidence of occupational injuries than workers without disabilities, the data used in the study did not include injuries resulting in death, contained only limited information about worker occupations, and was subject to the same limitations as any self-reported data, including recall bias. Nonetheless, the authors of the study have at the very least taken a step forward in providing some evidence on the specific characteristics of occupational injuries sustained by workers with disabilities, hoping to “provide evidence for developing targeted work safety programs to reduce occupational injuries among U.S. workers with disabilities.”