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Falls from heights are a leading cause of morbidity and mortality among construction workers, especially inexperienced workers and those performing residential construction. This research reports changes in fall prevention behaviors following revision of fall prevention training in a union-based carpenters' apprenticeship program. We used a comprehensive needs assessment to identify gaps in apprentice carpenters' preparation to work at heights, used these results to guide a school-based fall prevention curriculum to fill these gaps, and measured the effects of the revised curriculum on knowledge, beliefs, and fall prevention behaviors.

OBJECTIVE To examine possible predictors of lost workdays among nurses and nurses' aides who sought treatment for work-related back pain. PARTICIPANTS Nursing staff employed at a tertiary care medical center over a 13-year time period (1994 through 2006). METHODS We used existing data from clinic surveys administered to nursing personnel during their initial treatment visit to the hospital's occupational health clinic. Predictors of losing ≤ 7 and ≥ 8 workdays was examined. RESULTS 589 of 708 (83%) nursing personnel with complaints of work-related back pain completed the survey, with 31% resulting in lost workdays. Experiencing sudden onset of pain (RR:1.9; 95% CI: 1.1, 3.1), a combination of severe pain with numbness and tingling in the back/legs (RR: 7.4; 95% CI: 2.9, 18.6), severe pain only (RR: 4.4; 95% CI: 1.8, 11.1), numbness and tingling in the back/legs only (RR: 3.5; 95% CI: 1.0, 12.2), and working < 5 years at the hospital (RR: 2.3; 95% CI: 1.2, 4.7) were predictive of losing ≥ 8 workdays. Job title, work demands, work conflicts, and most psychosocial factors were not predictive. CONCLUSIONS Severe pain, neurologic symptoms and sudden onset of pain were predictive of delayed return-to-work; however, these symptoms alone should not be considered indicators of poor outcomes given that most workers who reported these symptoms returned to work in less than 8~days. Among these health care workers, lost workdays appear to be related to more severe pathology rather than workplace characteristics.

Hospital workers are known to be at risk of physical assault. The objective of this study is to characterize injuries resulting from physical assault among hospital nursing staff and to identify associated risk factors. Workers' compensation reports linked to human resources data were used to identify a cohort of aides and nurses employed in acute care units at a major healthcare system from 1997 to 2004 and their reported physical assault events. Poisson regression methods were used to estimate rates and rate ratios (RR) by occupation, gender, race, age, tenure, and hospital unit. During the study period 220 assaults were reported; the overall incidence rate was 1.65 (95% CI: 1.45-1.89) per 100 full-time-equivalent employees (FTEs). Assault risk was higher among those with shorter tenure (< 5 years vs. 15 or more) (RR=1.35, 95% CI: 0.83-2.19) and younger workers (under age 30 vs. 50 or older) (RR=1.30, 95%CI: 0.78-2.19), and lower among Black workers (vs. non-Blacks) (RR=0.63, 95% CI: 0.45-0.90). Incidence rates were highest in Psychiatry (12.65, 95% CI: 8.90-17.99), Neurology (4.43, 95% CI: 3.17-6.20) and Rehabilitation (3.63, 95% CI: 1.51-8.71) units. Interventions targeting Psychiatry, Neurology, and Rehabilitation units, and younger and newly hired staff are warranted. More detailed data are needed to develop targeted interventions.

The aim of this cross-sectional study was to explore the association of worker characteristics and work organization factors with prevalence of patient-handling injury among nursing personnel in an acute-care inpatient setting. Self-administered questionnaires (n = 585) captured worker characteristics and patient-handling injuries within the previous 6 months. Karasek's Job Content Questionnaire measured work organization factors, including job strain (high psychological demand, low decision latitude). We created a novel measure (job strain(PHYSICAL)) reflecting high physical demand and low decision latitude, providing a more direct physiologic link to our outcome. Log-binomial regression was used to calculate prevalence ratios (PR) and 95% confidence intervals (CI). Patient-handling injuries were prevalent (35%), and incident reports were filed infrequently for injuries receiving medical care. Prevalence of injury was higher among aides compared to nurses [adjusted PR 1.4, 95%CI (1.1-1.8)] as well as among those with high [adjusted PR 1.6, 95%CI (1.2-2.4)] or mid [adjusted PR 1.9, 95%CI (1.4-2.7)] levels of job dissatisfaction. The novel definition of job strain (job strain(PHYSICAL): high physical demand, low decision latitude) was more strongly associated with patient-handling injury than the traditional definition of job strain (high psychological demand, low decision latitude). These findings add to a growing body of literature on the highly contextual nature of work organization factors.