Last data update: Dec 09, 2024. (Total: 48320 publications since 2009)
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Suicides and overdoses at work: Census of fatal occupational injuries, 2011-2022
Tiesman HM , Hendricks S . Am J Prev Med 2024 INTRODUCTION: The worsening life expectancy of middle-aged white Americans due to suicides and substance overdoses has been hypothesized to be caused by various societal conditions. Work is a social determinant of health, but its role in this demographic shift has not been examined. This article describes the characteristics and trends of suicides and overdose fatalities occurring in U.S. workplaces among all workers between 2011 and 2022. METHODS: Data originated from the Census of Fatal Occupational Injury database. Fatality rates were calculated using the Current Population Survey. Fatality rates were calculated and compared among demographic and occupational groups. Annual rates were modeled with a first order auto-regressive linear regression to account for serial correlation. Analyses were conducted in 2023-2024. RESULTS: Between 2011 and 2022, the rate of workplace overdose fatality rates increased from 0.05 per 100,000 workers to 0.33 - an increase of 560%. Workplace suicide rates were relatively stable (0.19 per 100,000 to 0.17). Most industries and occupations experienced significant increases in workplace overdose rates and non-significant decreases in workplace suicide rates. The largest workplace overdose rates occurred in the Transportation & Warehousing industry (0.47, 95% CI=0.27-0.67) and Farming, Fishing, & Forestry occupations (0.68, 95% CI=0.27-1.08). CONCLUSIONS: Fatal workplace suicides and substance overdoses have different trends and impact industries, occupations, and demographic groups differently. The rise in workplace overdoses deserve immediate attention. |
An urgent call to address work-related psychosocial hazards and improve worker well-being
Schulte PA , Sauter SL , Pandalai SP , Tiesman HM , Chosewood LC , Cunningham TR , Wurzelbacher SJ , Pana-Cryan R , Swanson NG , Chang CC , Nigam JAS , Reissman DB , Ray TK , Howard J . Am J Ind Med 2024 Work-related psychosocial hazards are on the verge of surpassing many other occupational hazards in their contribution to ill-health, injury, disability, direct and indirect costs, and impact on business and national productivity. The risks associated with exposure to psychosocial hazards at work are compounded by the increasing background prevalence of mental health disorders in the working-age population. The extensive and cumulative impacts of these exposures represent an alarming public health problem that merits immediate, increased attention. In this paper, we review the linkage between work-related psychosocial hazards and adverse effects, their economic burden, and interventions to prevent and control these hazards. We identify six crucial societal actions: (1) increase awareness of this critical issue through a comprehensive public campaign; (2) increase etiologic, intervention, and implementation research; (3) initiate or augment surveillance efforts; (4) increase translation of research findings into guidance for employers and workers; (5) increase the number and diversity of professionals skilled in preventing and addressing psychosocial hazards; and (6) develop a national regulatory or consensus standard to prevent and control work-related psychosocial hazards. |
Trends in workplace homicides in the U.S., 1994-2021: An end to years of decline
Hendricks SA , Hendricks KJ , Tiesman HM , Gomes HL , Collins JW , Hartley D . Am J Ind Med 2024 Workplace and non-workplace homicides in the United States (U.S.) have declined for over 30 years until recently. This study was conducted to address the change in trends for both workplace and non-workplace homicides and to evaluate the homogeneity of the change in workplace homicides by specified categories. Joinpoint and autoregressive models were used to assess trends of U.S. workplace and non-workplace homicides utilizing surveillance data collected by the Bureau of Labor Statistics and the Federal Bureau of Investigation from 1994 through 2021. Both workplace and non-workplace homicides decreased significantly from 1994 through 2014. Workplace homicides showed no significant trend from 2014 through 2021 (p = 0.79), while non-workplace homicides showed a significant average annual increase of 4.1% from 2014 through 2020 (p = 0.0013). The large decreases in the trend of workplace homicides occurring during a criminal act, such as robbery, leveled off and started to increase by the end of the study period (p < 0.0001). Declines in workplace homicides due to shootings also leveled off and started to increase by the end of the study period (p < 0.0001). U.S. workplace and non-workplace homicide rates declined from the 1990s until around 2014. Trends in workplace homicides varied by the types of the homicide committed and by the type of employee that was the victim. Criminal-intent-related events, such as robbery, appear to be the largest contributor to changes in workplace homicides. Researchers and industry leaders could develop and evaluate interventions that further address criminal-intent-related workplace homicides. |
Occupational injuries and illnesses among law enforcement officers, 2001-2019: Findings from the Ohio Bureau of Workers'Compensation
Tiesman HM , Konda S , Wurzelbacher SJ , Naber SJ , Attwood WR . Am J Ind Med 2023 66 (12) 1079-1089 BACKGROUND: Occupational injuries are common among law enforcement officers (LEOs) and can impact an agency's ability to serve communities. Workers' compensation (WC) data are an underutilized source for occupational injury surveillance in the law enforcement field. METHODS: LEOs WC claims from the Ohio Bureau of Workers' Compensation (OHBWC) from 2001 to 2019 were identified based on manual review of the occupation title and injury description. Worker, employer, incident, and injury characteristics were described by claim type-medical-only (MO) and lost-time (8 or more days away from work). Data are presented using injury claim counts. RESULTS: From 2001 to 2019, 50,793 WC claims were identified among Ohio LEOs. Of these, 68% were MO claims (n = 34,622). WC claims significantly decreased over the 19-year period (p < 0.001). Seventy-five percent of WC claims were from a LEO with more than one claim and of these, 34% were from a LEO with five or more claims during the study period. Male officers and those aged 25-54 years incurred the highest proportion of total claims (87.8% & 91.8%, respectively). Violence (n = 17,247; 34%), falls/slips/trips (n = 9079; 17.9%), and transportation events (n = 7977; 15.7%) were the leading events. Among the 50,793 claims, there were 79,637 unique clinical diagnosis groups. The most common injury diagnoses were sprains (n = 32,796; 41.2%) followed by contusions (n = 13,529; 17%). CONCLUSIONS: Results can guide the development or improvement of workplace injury prevention strategies for LEOs. Efforts should be focused on better understanding and preventing violent injury events and sprains among LEOs, as well as preventing multiple injury events. |
An analysis of suicides among first responders ─ Findings from the National Violent Death Reporting System, 2015–2017
Carson LM , Marsh SM , Brown MM , Elkins KL , Tiesman HM . J Safety Res 2023 85 361-370 Introduction: First responders, including law enforcement officers (LEOs), firefighters, emergency medical services (EMS) clinicians, and public safety telecommunicators, face unique occupational stressors and may be at elevated risk for suicide. This study characterized suicides among first responders and identifies potential opportunities for additional data collection. Methods: Using suicides identified from the three most recent years of National Violent Death Reporting System data with industry and occupation codes from the NIOSH Industry and Occupation Computerized Coding System (2015–2017), decedents were categorized as first responders or non-first responders based on usual occupation. Chi-square tests were used to evaluate differences in sociodemographic and suicide circumstances between first and non-first responders. Results: First responder decedents made up 1% of all suicides. Over half of first responders (58%) were LEOs, 21% were firefighters, 18% were EMS clinicians, and 2% were public safety telecommunicators. Compared to non-first responder decedents, more first responders served in the military (23% vs. 11%) and used a firearm as the method of injury (69% vs. 44%). Among first responder decedents for whom circumstances were known, intimate partner problems, job problems, and physical health problems were most frequent. Some common risk factors for suicide (history of suicidal thoughts, previous suicide attempt, alcohol/substance abuse problem) were significantly lower among first responders. Selected sociodemographics and characteristics were compared across first responder occupations. Compared to firefighters and EMS clinicians, LEO decedents had slightly lower percentages of depressed mood, mental health problems, history of suicidal thoughts, and history of suicide attempts. Conclusions: While this analysis provides a small glimpse into some of these stressors, more detailed research may help inform future suicide prevention efforts and interventions. Practical application: Understanding stressors and their relation to suicide and suicidal behaviors can facilitate suicide prevention among this critical workforce. © 2023 |
An analysis of suicides among first responders Findings from the National Violent Death Reporting System, 20152017
Carson LM , Marsh SM , Brown MM , Elkins KL , Tiesman HM . J Saf Res 2023 Introduction: First responders, including law enforcement officers (LEOs), firefighters, emergency medical services (EMS) clinicians, and public safety telecommunicators, face unique occupational stressors and may be at elevated risk for suicide. This study characterized suicides among first responders and identifies potential opportunities for additional data collection. Methods: Using suicides identified from the three most recent years of National Violent Death Reporting System data with industry and occupation codes from the NIOSH Industry and Occupation Computerized Coding System (20152017), decedents were categorized as first responders or non-first responders based on usual occupation. Chi-square tests were used to evaluate differences in sociodemographic and suicide circumstances between first and non-first responders. Results: First responder decedents made up 1% of all suicides. Over half of first responders (58%) were LEOs, 21% were firefighters, 18% were EMS clinicians, and 2% were public safety telecommunicators. Compared to non-first responder decedents, more first responders served in the military (23% vs. 11%) and used a firearm as the method of injury (69% vs. 44%). Among first responder decedents for whom circumstances were known, intimate partner problems, job problems, and physical health problems were most frequent. Some common risk factors for suicide (history of suicidal thoughts, previous suicide attempt, alcohol/substance abuse problem) were significantly lower among first responders. Selected sociodemographics and characteristics were compared across first responder occupations. Compared to firefighters and EMS clinicians, LEO decedents had slightly lower percentages of depressed mood, mental health problems, history of suicidal thoughts, and history of suicide attempts. Conclusions: While this analysis provides a small glimpse into some of these stressors, more detailed research may help inform future suicide prevention efforts and interventions. Practical application: Understanding stressors and their relation to suicide and suicidal behaviors can facilitate suicide prevention among this critical workforce. 2023 |
Workplace Violence and the Mental Health of Public Health Workers During COVID-19.
Tiesman HM , Hendricks SA , Wiegand DM , Lopes-Cardozo B , Rao CY , Horter L , Rose CE , Byrkit R . Am J Prev Med 2022 64 (3) 315-325 INTRODUCTION: During the COVID-19 pandemic, public health workers were at an increased risk for violence and harassment due to their public health work and experienced adverse mental health conditions. This article quantifies the prevalence of job-related threats, harassment, and discrimination against public health workers and measures the association of these incidents with mental health symptoms during the COVID-19 pandemic. METHODS: A nonprobability convenience sample of state, local, and tribal public health workers completed a self-administered, online survey in April 2021. The survey link was emailed to members of national public health associations and included questions on workplace violence, demographics, workplace factors, and mental health symptoms. Mental health symptoms were measured using standardized, validated tools to assess depression, anxiety, post-traumatic stress disorder, and suicidal ideation. Multivariable Poisson models calculated adjusted prevalence ratios of mental health symptoms, with workplace violence as the primary risk factor. Analyses were conducted in 2021-2022. RESULTS: Experiencing any type or combination of workplace violence was significantly associated with an increased likelihood of reporting depression symptoms (prevalence ratio=1.21, 95% CI=1.15, 1.27), anxiety (prevalence ratio=1.21, 95% CI=1.15, 1.27), post-traumatic stress disorder (prevalence ratio=1.31, 95% CI=1.25, 1.37), and suicidal ideation (prevalence ratio=1.26, 95% CI=1.14, 1.38), after adjusting for confounders. A dose‒response relationship was found between the number of workplace violence events experienced by a public health worker and the likelihood of reporting mental health symptoms. CONCLUSIONS: Violence targeted at the public health workforce is detrimental to workers and their communities. Ongoing training, workplace support, and increased communication after a workplace violence incident may be helpful. Efforts to strengthen public health capacities and support the public health workforce are also needed. |
Occurrences of Workplace Violence Related to the COVID-19 Pandemic, United States, March 2020 to August 2021.
Marsh SM , Rocheleau CM , Carbone EG , Hartley D , Reichard AA , Tiesman HM . Int J Environ Res Public Health 2022 19 (21) As businesses dealt with an increasingly anxious public during the COVID-19 pandemic and were frequently tasked with enforcing various COVID-19 prevention policies such as mask mandates, workplace violence and harassment (WPV) emerged as an increasing important issue affecting worker safety and health. Publicly available media reports were searched for WPV events related to the COVID-19 pandemic that occurred during 1 March 2020, and 31 August 2021, using Google News aggregator services scans with data abstraction and verification. The search found 408 unique WPV events related to COVID-19. Almost two-thirds involved mask disputes. Over half (57%) of the 408 events occurred in retail (38%) and food service (19%). We also conducted a comparison of events identified in this search to a similar study of media reports between March 2020 to October 2020 that used multiple search engines to identify WPV events. Despite similar conclusions, a one-to-one comparison of relevant data from these studies found only modest overlap in the incidents identified, suggesting the need to make improvements to future efforts to extract data from media reports. Prevention resources such as training and education for workers may help industries de-escalate or prevent similar WPV events in the future. |
Working hours, sleep, and fatigue in the public safety sector: A scoping review of the research
Allison P , Tiesman HM , Wong IS , Bernzweig D , James L , James SM , Navarro KM , Patterson PD . Am J Ind Med 2022 65 (11) 878-897 BACKGROUND: The public safety sector includes law enforcement officers (LEO), corrections officers (CO), firefighter service (FF), wildland firefighting (WFF), and emergency medical services (EMS), as defined in the National Occupational Research Agenda (NORA) of the National Institute for Occupational Safety and Health (NIOSH). Across these occupations, shiftwork, long-duration shifts, and excessive overtime are common. Our objective was to identify research gaps related to working hours, sleep, and fatigue among these workers. METHODS: We used a scoping review study design that included searches of MEDLINE, Embase, CAB Abstracts, Global Health, PsychInfo, CINAHL, Scopus, Academic Search Complete, Agricultural and Environmental Science Collection, ProQuest Central, Cochrane Library, Safety Lit, Homeland Security Digital Library, and Sociological Abstracts using a range of occupational search terms and terms related to working hours, sleep, and fatigue. RESULTS: Out of 3415 articles returned from our database search, 202 met all inclusion criteria. Six common outcomes related to working hours, sleep, and fatigue emerged: sleep, fatigue, work performance, injury, psychosocial stress, and chronic disease. Nearly two-thirds (59%, n = 120) of the studies were observational, of which 64% (n = 77) were cross sectional and 9% were (n = 11) longitudinal; 14% (n = 30) of the studies were reviews; and 19% (n = 39) were experimental or quasi-experimental studies. Only 25 of the 202 articles described mitigation strategies or interventions. FFs, LEOs, EMS, and WFFs were the most studied, followed by COs. CONCLUSIONS: In general, more longitudinal and experimental studies are needed to enrich the knowledge base on the consequences of long working hours, poor sleep, and fatigue in the public safety sector. Few experimental studies have tested novel approaches to fatigue mitigation in diverse sectors of public safety. This gap in research limits the decisions that may be made by employers to address fatigue as a threat to public-safety worker health and safety. |
Resistance-related injuries among law enforcement officers: Addressing the empirical gap
Tiesman HM , Konda S , Grieco J , Gwilliam M , Rojek J , Montgomery B . Am J Prev Med 2020 59 (6) e231-e238 INTRODUCTION: Officers can be unintentionally injured during officer-suspect interactions, and these injuries are often not coded as assaults. This article defines and enumerates injuries that officers sustain while chasing, detaining, arresting, or pursuing suspects. These are termed resistance-related injuries. METHODS: Data on law enforcement officer injuries treated in U.S. emergency departments were obtained from the National Electronic Injury Surveillance System-Occupational Supplement from 2012 to 2017. Resistance-related injuries were defined using the Bureau of Labor Statistics Occupational Injury and Illness Classification System, version 2.01. Injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2019. RESULTS: Between 2012 and 2017, an estimated 303,500 officers were treated in U.S. emergency departments for nonfatal injuries for an overall injury rate of 568 per 10,000 full-time equivalents. Emergency department-treated injuries significantly decreased by 3.8% annually during this time period (p<0.0001). The leading causes of injury were assaults and violent acts (48%), transportation incidents (11%), and falls (11%). Of the total injuries, more than half were resistance-related (53%). A total of 88% of violence-related injuries, nearly 50% of falls, and 31% of overexertion injuries were considered resistance related. CONCLUSIONS: More than half of officers' nonfatal injuries occurred when they were interacting, detaining, or pursuing a suspect. This highlights the need to code nonfatal injuries in a consistent and meaningful way that informs police policy and practice. |
Nonphysical workplace violence in a state-based cohort of education workers
Konda S , Tiesman HM , Hendricks S , Grubb PL . J Sch Health 2020 90 (6) 482-491 BACKGROUND: The purpose of this study was to estimate the prevalence, identify risk factors, and assess the impact of nonphysical workplace violence (WPV) events among education workers (teachers, professionals, and support personnel). METHODS: A cross-sectional survey was mailed to a random sample of 6450 education workers, stratified by sex, occupation, and school location in Pennsylvania. Multivariable logistic regression was performed to assess risk factors. RESULTS: Of the 2514 participants, 859 (34%) reported experiencing at least one nonphysical WPV event during the 2009-2010 school year. Coworkers were the most common source of bullying. Most education workers responded that they did not receive an adequate response from their administration after reporting a nonphysical WPV event. Risks of nonphysical assaults increased for education workers who were female, those working in an urban school, and those in their first 3 years of working in their current school. Those assaulted were significantly likely to have low job satisfaction, find work more stressful, and have poor mental health compared to those were not assaulted. CONCLUSIONS: Administration support for specific prevention efforts and post-event responses that address the risk factors for nonphysical WPV are essential for creating a positive, safe work environment in schools. |
Workers' compensation claims for traumatic brain injuries among private employers-Ohio, 2001-2011
Konda S , Al-Tarawneh IS , Reichard AA , Tiesman HM , Wurzelbacher SJ , Pinkerton LE , Meyers AR , Hendricks SA , Tseng CY , Lampl MP , Robins DC . Am J Ind Med 2019 63 (2) 156-169 BACKGROUND: The purpose of this analysis was to identify and prioritize high-risk industry groups for traumatic brain injury (TBI) prevention efforts. METHODS: Workers with TBI from 2001 to 2011 were identified from the Ohio Bureau of Workers' Compensation data. To prioritize industry groups by claim type (lost-time (>/=8 days away from work) and total claims) and injury event categories, we used a prevention index (PI) that averaged TBI counts and rate ranks (PI = (count rank + rate rank)/2). TBI rates per 10 000 estimated full-time equivalent (FTE = 2000 h/y) workers were calculated. RESULTS: From 2001 to 2011, 12 891 TBIs were identified among private employers, resulting in a rate of 5.1 TBIs per 10 000 FTEs. Of these, 40% (n = 5171) were lost-time TBIs, at a rate of 2.0 per 10 000 FTEs. Spectator Sports had the highest lost-time TBI rate (13.5 per 10 000 FTEs), whereas General Freight Trucking had the greatest number of lost-time TBIs (n = 293). Based on PIs, General Freight Trucking ranked first for lost-time TBIs for all injury events combined. Several industry groups within Construction, General and Specialized Freight Trucking, Services to Building and Dwellings, Employment Services, and Restaurants and Other Eating Places ranked high across multiple injury event categories for lost-time TBIs. CONCLUSIONS: The high-ranking industry groups identified from our study can be used to effectively direct occupational TBI prevention efforts. |
The impact of a crash prevention program in a large law enforcement agency
Tiesman HM , Gwilliam M , Rojek J , Hendricks S , Montgomery B , Alpert G . Am J Ind Med 2019 62 (10) 847-858 BACKGROUND: Motor vehicle crashes (MVCs) remain a leading cause of death for US law enforcement officers. One large agency implemented a crash prevention program with standard operating policy changes, increased training, and a marketing campaign. This was a scientific evaluation of that crash prevention program. METHODS: MVC and motor vehicle injury (MVI) data for law enforcement officers were compared using an autoregressive integrated moving average (ARIMA) model. Two law enforcement agencies who had not implemented a crash prevention program were controls. RESULTS: After program implementation, overall, MVC rates significantly decreased 14% from 2.2 MVCs per 100 000 miles driven to 1.9 (P = .008). MVC rates did not decrease in the control agencies. Overall, MVI rates significantly decreased 31% from 3.4 per 100 officers to 2.1 (P = .0002). MVC rates did not decrease in the control agencies. MVC rates for patrol officers significantly decreased 21% from 3.1 per 100 000 miles to 2.4. MVI rates for patrol officers significantly decreased 48% from 3.2 per 100 officers to 1.6 (P < .0001). CONCLUSIONS: Crash and injury rates can be reduced after implementation of a crash prevention program and the largest impacts were seen in patrol officers. |
Drug overdose deaths at work, 2011-2016
Tiesman HM , Konda S , Cimineri L , Castillo DN . Inj Prev 2019 25 (6) 577-580 Drug overdose fatalities have risen sharply and the impact on US workplaces has not been described. This paper describes US workplace overdose deaths between 2011 and 2016. Drug overdose deaths were identified from the Census of Fatal Occupational Injuries and fatality rates calculated using denominators from the Current Population Survey. Fatality rates were compared among demographic groups and industries. Negative binomial regression was used to analyse trends. Between 2011 and 2016, 760 workplace drug overdoses occurred for a fatality rate of 0.9 per 1 000 000 full-time equivalents (FTEs). Workplace overdose fatality rates significantly increased 24% annually. Workplace overdose fatality rates were highest in transportation and mining industries (3.0 and 2.6 per 1 000 000 FTEs, respectively). One-third of workplace overdose fatalities occurred in workplaces with fewer than 10 employees. Heroin was the single most frequent drug documented in workplace overdose deaths (17%). Workplace overdose deaths were low, but increased considerably over the six-year period. Workplaces are impacted by the national opioid overdose epidemic. |
Suicide rates by major occupational group - 17 states, 2012 and 2015
Peterson C , Stone DM , Marsh SM , Schumacher PK , Tiesman HM , McIntosh WL , Lokey CN , Trudeau AT , Bartholow B , Luo F . MMWR Morb Mortal Wkly Rep 2018 67 (45) 1253-1260 During 2000-2016, the suicide rate among the U.S. working age population (persons aged 16-64 years) increased 34%, from 12.9 per 100,000 population to 17.3 (https://www.cdc.gov/injury/wisqars). To better understand suicide among different occupational groups and inform suicide prevention efforts, CDC analyzed suicide deaths by Standard Occupational Classification (SOC) major groups for decedents aged 16-64 years from the 17 states participating in both the 2012 and 2015 National Violent Death Reporting System (NVDRS) (https://www.cdc.gov/violenceprevention/nvdrs). The occupational group with the highest male suicide rate in 2012 and 2015 was Construction and Extraction (43.6 and 53.2 per 100,000 civilian noninstitutionalized working persons, respectively), whereas the group with the highest female suicide rate was Arts, Design, Entertainment, Sports, and Media (11.7 [2012] and 15.6 [2015]). The largest suicide rate increase among males from 2012 to 2015 (47%) occurred in the Arts, Design, Entertainment, Sports, and Media occupational group (26.9 to 39.7) and among females, in the Food Preparation and Serving Related group, from 6.1 to 9.4 (54%). CDC's technical package of strategies to prevent suicide is a resource for communities, including workplace settings (1). |
Nonfatal injuries to firefighters treated in U.S. emergency departments, 2003-2014
Marsh SM , Gwilliam M , Konda S , Tiesman HM , Fahy R . Am J Prev Med 2018 55 (3) 353-360 INTRODUCTION: Several studies of nonfatal firefighter injuries have been conducted but are limited by the inclusion criteria used and coverage. The aim of this study was to enhance current knowledge by providing national estimates of nonfatal injuries to firefighters treated in U.S. emergency departments. METHODS: Nonfatal injuries from 2003 through 2014 were extracted from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work). NEISS-Work captures nonfatal occupational injuries, illnesses, and exposures treated in a sample of U.S. emergency departments. Nonfatal injury rates were calculated based on NEISS-Work counts (numerator) and counts from the National Fire Protection Association (denominator). Data were analyzed from 2016 through 2017. RESULTS: Between 2003 and 2014, an estimated 351,800 firefighters were treated in emergency departments for nonfatal injuries. The overall rate was 260 injuries per 10,000 firefighters. Career firefighters had an annual rate of 699 injuries per 10,000 firefighters; volunteers had a rate of 39 injuries per 10,000 firefighters. Leading injury events were fires and explosions (36%) and overexertion and bodily reactions (20%). A majority (38%) of injuries occurred during firefighting activities, 7% occurred during training, and 7% occurred during patient care. Sprains and strains accounted for the largest proportion of injuries in all three of these activities: 28% firefighting activities, 32% training, and 36% patient care. CONCLUSIONS: The results demonstrate that nonfatal injuries for firefighters remained high throughout the study period. The predominance of sprains and strains in all firefighting activities suggests the need for additional research and prevention needs in areas of improved fitness, safer body postures and movements, and situational awareness. |
Nonfatal injuries to law enforcement officers: A rise in assaults
Tiesman HM , Gwilliam M , Konda S , Rojek J , Marsh S . Am J Prev Med 2018 54 (4) 503-509 INTRODUCTION: Limited studies exist that describe nonfatal work-related injuries to law enforcement officers. The aim of this study is to provide national estimates and trends of nonfatal injuries to law enforcement officers from 2003 through 2014. METHODS: Nonfatal injuries were obtained from the National Electronic Injury Surveillance System-Occupational Supplement. Data were obtained for injuries treated in U.S. emergency departments from 2003 to 2014. Nonfatal injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2016-2017. RESULTS: Between 2003 and 2014, an estimated 669,100 law enforcement officers were treated in U.S. emergency departments for nonfatal injuries. The overall rate of 635 per 10,000 full-time equivalents was three times higher than all other U.S. workers rate (213 per 10,000 full-time equivalents). The three leading injury events were assaults and violent acts (35%), bodily reactions and exertion (15%), and transportation incidents (14%). Injury rates were highest for the youngest officers, aged 21-24 years. Male and female law enforcement officers had similar nonfatal injury rates. Rates for most injuries remained stable; however, rates for assault-related injuries grew among law enforcement officers between 2003 and 2011. CONCLUSIONS: National Electronic Injury Surveillance System-Occupational Supplement data demonstrate a significant upward trend in assault injuries among U.S. law enforcement officers and this warrants further investigation. Police-citizen interactions are dynamic social encounters and evidence-based policing is vital to the health and safety of both police and civilians. The law enforcement community should energize efforts toward the study of how policing tactics impact both officer and citizen injuries. |
Fatal traumatic brain injuries in the construction industry, 2003-2010
Konda S , Tiesman HM , Reichard AA . Am J Ind Med 2016 59 (3) 212-20 BACKGROUND: Research on fatal work-related traumatic brain injuries (TBIs) is limited. This study describes fatal TBIs in the US construction industry. METHODS: Fatal TBIs were extracted from the Bureau of Labor Statistics Census of Fatal Occupational Injuries. RESULTS: From 2003 to 2010, 2,210 fatal TBIs occurred in construction at a rate of 2.6 per 100,000 full-time equivalent (FTE) workers. Workers aged 65 years and older had the highest fatal TBI rates among all workers (7.9 per 100,000 FTE workers). Falls were the most frequent injury event (n = 1,269, 57%). Structural iron and steel workers and roofers had the highest fatal TBI rate per 100,000 FTE workers (13.7 and 11.2, respectively). Fall-related TBIs were the leading cause of death in these occupations. CONCLUSIONS: A large percentage of TBIs in the construction industry were due to falls. Emphasis on safety interventions is needed to reduce these fall-related TBIs, especially among vulnerable workers. |
Research in brief: Motor vehicle safety for law enforcement officers - still a priority
Tiesman HM , Heick R . Police Chief 2015 82 (4) 22-23 The IACP Research Advisory Committee is proud to offer the monthly Research in Brief column. This column features evidence-based research summaries that highlight actionable recommendations for Police Chief magazine readers to consider within their own agencies. The goal of the column is to feature research that is innovative, credible, and relevant to a diverse law enforcement audience. |
Law enforcement officers’ risk perceptions toward on-duty motor-vehicle events
Tiesman HM , Heick RJ , Konda S , Hendricks S . Policing 2015 38 (3) 563-577 PURPOSE: Motor-vehicle related events (MVEs) are the leading cause of on-duty death for law enforcement officers, yet little is known about how officers view this significant job hazard. This paper explores officers’ motor-vehicle risk perception and examines how prior on-duty MVEs and the death or injury of a fellow officer influences this perception. DESIGN/METHODOLOGY/APPROACH: A state-wide random sample of 136 law enforcement agencies was drawn using publically accessible databases, stratified on type and size of agency. Sixty agencies agreed to participate and a cross-sectional questionnaire was distributed to 1,466 officers. Using 6-point Likert scales, composite scores for motor-vehicle and intentional violence risk perception were derived. A linear regression multivariable model was used to examine factors affecting motor-vehicle risk perception. FINDINGS: Motor-vehicle risk perception scores were significantly higher than intentional violence scores. A prior on-duty motor-vehicle crash, prior roadside incident, or knowledge of fellow officer’s injury or death from a MVE significantly increased motor-vehicle risk perception scores. After controlling for potential confounders though, only prior on-duty crashes and roadside incidents impacted motor-vehicle risk perception. RESEARCH LIMITATIONS/IMPLICATIONS: The study comprised primarily small, rural agencies and generalizability may be limited. Also, although the data were collected anonymously, reporting and response biases may affect these findings. ORIGINALITY/VALUE: This study involved a large and diverse cohort of officers and explored motor-vehicle risk perception. A better understanding of officers’ risk perceptions will assist in the development and implementation of occupational injury prevention programs, training, and policy. |
Characteristics of officer-involved vehicle collisions in California
Wolfe S , Rojek jJ , Alpert GP , Tiesman HM , James S . Policing 2015 38 (3) 458-477 PURPOSE: The purpose of this paper is to examine the situational and individual officer characteristics of officer-involved vehicle collisions that result in fatality, injury, and non-injury outcomes. DESIGN/METHODOLOGY/APPROACH: Data on 35,840 vehicle collisions involving law enforcement officers in California occurring between January 2000 and December 2009 are examined. A descriptive analysis of collision characteristics is presented. FINDINGS: There were 39 officers killed by collisions over this study period and 7,684 officers who received some type injury. Incidents involving officers on motorcycles represented 39% of officer fatalities and 39% of severe injuries. In the case of fatalities, 33% of officers were reported as wearing seatbelts, 38% were not wearing a seatbelt, and seatbelt use was not stated in 29% of car fatalities. RESEARCH LIMITATIONS/IMPLICATIONS: The findings only represent one state and the analysis is based on an estimated 86% of collisions that occurred during the study period due to missing data. Nonetheless, the results are based on a robust sample and address key limitations in the existing literature. PRACTICAL IMPLICATIONS: During the study period in California the estimated financial impact of collisions reached into the hundreds of millions of dollars when considering related fatality, injury, and vehicle damage costs combined. These impacts highlight the need for the law enforcement community to give greater attention to this issue. ORIGINALITY/VALUE: At the time of this writing there was no published independent research that compares the situational and officer characteristics across fatality, injury, and non-injury outcomes in these events. The findings reported here will help inform emerging interest in this issue within the law enforcement, academic, and policy-making communities. |
Suicide in U.S workplaces, 2003-2010: a comparison with non-workplace suicides
Tiesman HM , Konda S , Hartley D , Menendez CC , Ridenour M , Hendricks S . Am J Prev Med 2015 48 (6) 674-82 INTRODUCTION: Suicide rates have risen considerably in recent years. National workplace suicide trends have not been well documented. The aim of this study is to describe suicides occurring in U.S. workplaces and compare them to suicides occurring outside of the workplace between 2003 and 2010. METHODS: Suicide data originated from the Census of Fatal Occupational Injury database and the Web-Based Injury Statistics Query and Reporting System. Suicide rates were calculated using denominators from the 2013 Current Population Survey and 2000 U.S. population census. Suicide rates were compared among demographic groups with rate ratios and 95% CIs. Suicide rates were calculated and compared among occupations. Linear regression, adjusting for serial correlation, was used to analyze temporal trends. Analyses were conducted in 2013-2014. RESULTS: Between 2003 and 2010, a total of 1,719 people died by suicide in the workplace. Workplace suicide rates generally decreased until 2007 and then sharply increased (p=0.035). This is in contrast with non-workplace suicides, which increased over the study period (p=0.025). Workplace suicide rates were highest for men (2.7 per 1,000,000); workers aged 65-74 years (2.4 per 1,000,000); those in protective service occupations (5.3 per 1,000,000); and those in farming, fishing, and forestry (5.1 per 1,000,000). CONCLUSIONS: The upward trend of suicides in the workplace underscores the need for additional research to understand occupation-specific risk factors and develop evidence-based programs that can be implemented in the workplace. |
Non-fatal work-related traumatic brain injuries treated in US hospital emergency departments, 1998-2007
Konda S , Reichard A , Tiesman HM , Hendricks S . Inj Prev 2014 21 (2) 115-20 PURPOSE: Little is known about work-related traumatic brain injuries (WRTBI). This study describes non-fatal WRTBIs treated in US emergency departments (ED) from 1998 through 2007. METHODS: Non-fatal WRTBIs were identified from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work) using the diagnoses of concussion, internal organ injury to the head and skull fracture. WRTBI rates and rate ratios were calculated, and the trend in rates was assessed. RESULTS: An estimated 586 600 (95% CI=+/-150 000) WRTBIs were reported during the 10-year period at a rate of 4.3 (CI=+/-1.1) per 10 000 full-time equivalent (FTE) workers (1 FTE=2000 h per year). From 1998 through 2007, the rate of WRTBIs increased at an average of 0.21 per 10 000 FTE per year (p<0.0001) and the rate of fall-related WRTBIs increased at an average of 0.10 per 10 000 FTE (p<0.0001). During the same period, the annual rate of WRTBIs resulting in hospitalisation increased 0.04 per 10 000 FTE (p<0.0001). Ten percent of WRTBIs were hospitalised, compared with hospitalisation of 2% all NEISS-Work injuries. Also, workers with highest fall-related TBI rates per 10 000 FTE were the youngest (2.4; CI=+/-1.4) and oldest (55 and older) workers (1.9; CI=+/-0.8). CONCLUSIONS: Non-fatal WRTBIs are one of the most serious workplace injuries among ED-treated work-related injuries. Non-fatal WRTBIs are much more likely to result in hospitalisation compared with other types of injuries. The upward trend of WRTBI rates from 1998 through 2007 underscore the need for more directed effective prevention methods to reduce WRTBI injuries. |
Physical assaults among education workers: findings from a statewide study
Tiesman HM , Hendricks S , Konda S , Hartley D . J Occup Environ Med 2014 56 (6) 621-7 OBJECTIVE: Enumerate and describe physical assaults occurring to Pennsylvania education workers. METHODS: A cross-sectional survey was mailed to a random sample of 6450 workers, stratified on gender, occupation, and region. Logistic regression was used to examine risk factors for physical assault. RESULTS: During the 2009-2010 school year, 309 of 2514 workers were assaulted 597 times. Special education teachers, urban workers, and those in their first 3 years of employment were at an increased risk. Most assaults did not lead to medical care or time away from work; however, those assaulted were significantly more likely to find work stressful, have low job satisfaction, and consider leaving the education field (adjusted odds ratio [AOR] = 2.5 [95% CI = 1.5 to 4.1]; AOR = 2.4 [95% CI = 1.5 to 3.9]; AOR = 10.7 [95% CI = 4.1 to 28.1]). CONCLUSIONS: Although education workers experienced few serious physical assaults, the impact of this violence was considerable. |
Non-robbery-related occupational homicides in the retail industry, 2003-2008
Konda S , Tiesman HM , Hendricks S , Gurka KK . Am J Ind Med 2013 57 (2) 245-53 BACKGROUND: The purpose of this study was to examine non-robbery-related occupational homicides in the retail industry from 2003 to 2008. METHODS: Data were abstracted from the Census of Fatal Occupational Injuries. Motive (robbery- or non-robbery-related) and workplace violence (WPV) typology (Type I-IV) were assigned using narrative text fields. Non-robbery-related homicide rates were calculated and compared among WPV types, demographic characteristics, and occupation. RESULTS: Twenty-eight percent of homicides that occurred in the retail industry were non-robbery-related. The leading event associated with non-robbery-related homicides was Type II (perpetrated by customers) (34%), followed by Type IV (perpetrated by personal relationship) (31%). The majority of homicides were due to arguments (50%). Security guards and workers in drinking establishments had the highest homicide rates per 100,000 workers (14.3 and 6.0, respectively). CONCLUSIONS: Non-robbery-related homicides comprised a meaningful proportion of workplace homicides in the retail industry. Research is needed to develop strategies to prevent non-robbery-related homicides specifically. |
Fatal occupational injuries among U.S. law enforcement officers: a comparison of national surveillance systems
Tiesman HM , Swedler DI , Konda S , Pollack KM . Am J Ind Med 2013 56 (6) 693-700 BACKGROUND: This study describes and compares the three surveillance systems used to record occupational injury fatalities among U.S. law enforcement officers (LEOs). METHODS: The Census of Fatal Occupational Injuries (CFOI), National Law Enforcement Officer Memorial Fund database (NLEOMF), and Law Enforcement Officers Killed and Assaulted reports (LEOKA) were examined for LEO deaths between 2003 and 2009. Fatality rates per 100,000 workers were calculated and compared. RESULTS: Between 2003 and 2009, the NLEOMF reported 1,050 fatalities (rate of 16.4 per 100,000 workers), the CFOI reported 968 fatalities (15.1 per 100,000), and the LEOKA recorded 853 fatalities (13.3 per 100,000). The LEOKA under-counted the number of fatalities compared to the NLEOMF and CFOI. Discrepancies were found between the LEOKA, NLEOMF, and CFOI regarding age, race, and Hispanic origin. Similar patterns for cause of fatality were found; however, the NLEOMF recorded a higher number of "other" fatalities compared to the other two systems. CONCLUSIONS: This study fills a critical knowledge gap by providing an overview of the three surveillance systems used to enumerate LEO occupational deaths. Understanding the differences across the systems is critical when utilizing them for surveillance research. (Am. J. Ind. Med. Published 2013. This article is a U.S. Government work and is in the public domain in the USA.) |
Public health impact of heat-related illness among migrant farmworkers
Fleischer NL , Tiesman HM , Sumitani J , Mize T , Amarnath KK , Bayakly AR , Murphy MW . Am J Prev Med 2013 44 (3) 199-206 BACKGROUND: Migrant farmworkers are at risk for heat-related illness (HRI) at work. PURPOSE: The purpose of this study was to determine which risk factors could potentially reduce the prevalence of HRI symptoms among migrant farmworkers in Georgia. METHODS: Trained interviewers conducted in-person interviews of adults who attended the South Georgia Farmworker Health Project clinics in June 2011. The analysis was conducted in 2011-2012. Population intervention models were used to assess where the greatest potential impact could be made to reduce the prevalence of HRI symptoms. RESULTS: In total, 405 farmworkers participated. One third of participants had experienced three or more HRI symptoms in the preceding week. Migrant farmworkers faced barriers to preventing HRI at work, including lack of prevention training (77%) and no access to regular breaks (34%); shade (27%); or medical attention (26%). The models showed that the prevalence of three or more HRI symptoms (n=361, 34.3%) potentially could be reduced by increasing breaks in the shade (-9.2%); increasing access to medical attention (-7.3%); reducing soda intake (-6.7%); or increasing access to regular breaks (-6.0%). CONCLUSIONS: Migrant farmworkers experienced high levels of HRI symptoms and faced substantial barriers to preventing these symptoms. Although data are cross-sectional, results suggest that heat-related illness may be reduced through appropriate training of workers on HRI prevention, as well as regular breaks in shaded areas. |
Workplace homicides among U.S. women: the role of intimate partner violence
Tiesman HM , Gurka KK , Konda S , Coben JH , Amandus HE . Ann Epidemiol 2012 22 (4) 277-84 PURPOSE: Intimate partner violence (IPV) is an important public health issue with serious consequences for the workplace. Workplace homicides occurring to U.S. women over a 6-year period, including those perpetrated by an intimate partner, are described. METHODS: Workplace homicides among U.S. women from 2003 to 2008 were categorized into type I (criminal intent), type II (customer/client), type III (co-worker), or type IV (personal relations) events using the Census of Fatal Occupational Injuries. Fatality rates were calculated and compared among workplace violence (WPV) types, occupations, and characteristics including location of homicide, type of workplace, time of day, and weapon used. RESULTS: Between 2003 and 2008, 648 women were feloniously killed on the job. The leading cause of workplace homicide for U.S. women was criminal intent, such as robbing a store (n = 212; 39%), followed by homicides perpetrated by a personal relation (n = 181; 33%). The majority of these personal relations were intimate partners (n = 142; 78%). Over half of workplace homicides perpetrated by intimate partners occurred in parking lots and public buildings (n = 91; 51%). CONCLUSIONS: A large percentage of homicides occurring to women at work are perpetrated by intimate partners. WPV prevention programs should incorporate strategies to prevent and respond to IPV. |
Occupational injuries, illnesses, and fatalities among workers in the services sector industries: 2003 to 2007
Utterback DF , Charles LE , Schnorr TM , Tiesman HM , Storey E , Vossenas P . J Occup Environ Med 2011 54 (1) 31-41 OBJECTIVE: Provide descriptive statistics and discuss priorities for injury and fatality risks among services sector workers. METHODS: Bureau of Labor Statistics Survey of Occupational Injuries and Illnesses and Census of Fatal Occupational Injuries data for 2003 to 2007 were analyzed to identify occupational injury and fatality risks for services sector industry groups. RESULTS: Many services sector industry groups experienced, on average, greater than one occupational fatality per week, and survey of occupational injuries and illnesses days-away-from-work rates in excess of those for all US workers. Overall, transportation incidents and homicides are leading factors contributing to fatalities. CONCLUSIONS: These results indicate the need for adoption of safety and health prevention practices in numerous industry groups. For groups that experience elevated injury and fatality rates, priorities for research and intervention can be identified through these data. |
The epidemiology of fatal occupational traumatic brain injury in the U.S.
Tiesman HM , Konda S , Bell JL . Am J Prev Med 2011 41 (1) 61-7 BACKGROUND: Although traumatic brain injury (TBI) is one of the leading causes of death and disability in the U.S., work-related TBI has not been well documented. PURPOSE: The aim of this study was to describe the epidemiologic characteristics and temporal trends of fatal occupational TBI in the U.S between 2003 and 2008. METHODS: A cross-sectional analysis of the Census of Fatal Occupational Injury database was performed. Both the Occupational Injury and Illness Classification System nature of injury codes and body part codes were used to define TBIs. Fatality rates were calculated using denominators derived from the Current Population Survey. Fatality rates were compared among industries, cause of death, and demographics with rate ratios (RRs) and 95% CIs. Poisson regression was used to assess trends in fatality rates. Data were analyzed in 2009-2010. RESULTS: Nearly 7300 occupational TBI deaths occurred between 2003 and 2008, for an average fatality rate of 0.8 per 100,000 workers per year. The leading causes of occupational TBI death were as follows: motor vehicle (31%); falls (29%); assaults and violent acts (20%); and contact with objects/equipment (18%). Fatality rates were 15 times higher in men compared with women (RR=15, 95% CI=13.7, 16.3). Workers aged ≥65 years experienced the highest TBI fatality rate of all age groups (2.5 per 100,000 per year). Construction, transportation, and agriculture/forestry/fishing industries recorded nearly half of all TBI fatalities (n=1828, n=825, n=761, respectively). Occupational TBI death rates declined 23% over the 6-year period (p<0.0001). CONCLUSIONS: This study provides the first national profile of fatal TBIs occurring in the U.S. workplace. Prevention efforts should be directed at those industries with the highest frequency and/or highest risk. The construction industry had the highest number of TBIs, and the agriculture, forestry, and fishing industry had the highest rates. Additionally, workers aged >65 years in all industries would be a good target for future prevention efforts. |
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