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Background Underreporting in the nation's primary source of non-fatal occupational injury and illness data are well documented, but worker-level characteristics of unreported cases have not been fully explored. Methods Bureau of Labor Statistics’ Survey of Occupational Injuries and Illnesses (SOII) data were linked to Washington workers’ compensation claims to identify injury and claim characteristics associated with unreported cases. Workers’ compensation administrative date data were used to characterize timing of disability and SOII case eligibility. Results Based on claim date data, one in five lost time claims with an injury date in the survey year were likely ineligible for SOII case reporting during the survey year. Among SOII-eligible claims, those involving sprains or strains, employer protests, and those not eligible for work disability payments until months after the initial injury were least likely to be reported in SOII. Conclusions SOII case capture is limited both by its cross sectional survey design and employer underreporting. Am. J. Ind. Med. 9999:XX–XX, © 2016 Wiley Periodicals, Inc.

Introduction Despite the size and breadth of OSHA's Outreach Training program for construction, information on its impact on work-related injury rates is limited. Methods In a 9-year dynamic cohort of 17,106 union carpenters in Washington State, the effectiveness of OSHA Outreach Training on workers’ compensation claims rate was explored. Injury rates were calculated by training status overall and by carpenters’ demographic and work characteristics using Poisson regression. Results OSHA Outreach Training resulted in a 13% non-significant reduction in injury claims rates overall. The protective effect was more pronounced for carpenters in their apprenticeship years, drywall installers, and with increasing time since training. Conclusions In line with these observed effects and prior research, it is unrealistic to expect OSHA Outreach Training alone to have large effects on union construction workers’ injury rates. Standard construction industry practice should include hazard awareness and protection training, coupled with more efficient approaches to injury control. Am. J. Ind. Med. 60:45–57, 2017. © 2016 Wiley Periodicals, Inc.

BACKGROUND: For workers engaged in animal care, workplace hazards are common and may outnumber those experienced by human healthcare workers. METHODS: We used accepted Washington State workers' compensation claims for the period from January 1, 2007 and December 31, 2011 to compare injury rates and types of injuries across animal care occupations. RESULTS: Work-related injuries frequently affect veterinary support staff and those working in pet stores, shelters, grooming facilities and kennels. Animal-related injuries were the most commonly reported injury type experienced by all groups, though the animal source of injury appears to differ by work setting. CONCLUSIONS: Workplace related injuries among animal care workers are common and most often caused by physical insults resulting from worker-animal interaction. Am. J. Ind. Med. © 2015 Wiley Periodicals, Inc. Language: en

Introduction The Global Fund and the US President's Emergency Plan for AIDS Relief (PEPFAR) are major donors to HIV services with key populations (KPs) to achieve the UNAIDS 95‐95‐95 epidemic control goals. The programmes they fund are not always well aligned or coordinated, decreasing their effectiveness. Joint assessments are designed and led by LINKAGES, a project funded by PEPFAR and the US Agency for International Development, to improve coordination among donors and on‐the‐ground implementation of KP HIV programmes. Joint assessments help identify barriers that prevent KPs from accessing interventions along the cascade of prevention, diagnosis and treatment services, and provide recommendations to improve and align programmes. Detailed reports from eight assessments in Malawi, Cameroon, Swaziland, Haiti, Angola, Nepal, Côte d'Ivoire and Botswana were analysed for thematic challenges, and recommendations are presented. The purpose of the paper is to identify commonalities across KP HIV programmes that were found through the assessments so others can learn and then strengthen their programmes to become more effective. Discussion The joint cascade assessments offered countries feedback on HIV programme challenges and recommendations for strengthening them at national, subnational and local levels. Shared intervention areas included: (1) robust population size estimates to inform service delivery targets and to budget resources for KP outreach; (2) accessible and KP‐friendly services most relevant to individuals to increase retention in the HIV cascade; (3) decentralized, community‐based services for HIV testing and antiretroviral therapy, and new approaches including self‐testing and PrEP; (4) addressing structural issues of stigma, discrimination and violence against KPs to create a more enabling environment; and (5) more effective and continual tracking of KPs across the cascade, and coordinated, harmonized monitoring tools and reporting systems between donor‐funded and national programmes. Conclusions The assessment teams and country stakeholders viewed the assessments as a best practice for coordinating donor‐funded programmes that may overlap or inefficiently serve KPs. Global and national HIV programmes need investments of time, resources, and commitment from stakeholders to continually course‐correct to align and improve programmes for sustained impact. The type of continued partnership demonstrated by the joint assessments is key to address HIV among KPs globally.

BACKGROUND: Musculoskeletal symptoms and disorders (MSDIs) are common reasons for visits to medical providers in the general population and they are common work-related complaints. Prior reports raise concerns as to whether declines in workers' compensation (WC) rates represent true improvement in occupational health and safety or shifting of care to other payment systems. METHODS: By linking administrative records, we compared patterns of WC claims and private health care utilization for disorders of the upper extremity (UE) and knee among a large cohort of union carpenters over a 20-year period. RESULTS: As WC claim rates declined, private health care utilization increased. The increase was muted somewhat but sustained when adjusting for other patterns of health care utilization. CONCLUSIONS: Findings suggest the decline of WC claim rates do not solely represent improved occupational safety in this population, but also a considerable shifting of care to their private insurance coverage over time. Am. J. Ind. Med. © 2015 Wiley Periodicals, Inc. Language: en

BACKGROUND: Numerous aspects of construction place workers at risk of musculoskeletal disorders and injuries (MSDIs). Work organization and the nature of MSDIs create surveillance challenges. METHODS: By linking union records with workers' compensation claims, we examined 20-year patterns of MSDIs involving the upper extremity (UE) and the knee among a large carpenter cohort. RESULTS: MSDIs were common and accounted for a disproportionate share of paid lost work time (PLT) claims; UE MSDIs were three times more common than those of the knee. Rates declined markedly over time and were most pronounced for MSDIs of the knee with PLT. Patterns of risk varied by extremity, as well as by age, gender, union tenure, and predominant work. Carpenters in drywall installation accounted for the greatest public health burden. CONCLUSIONS: A combination of factors likely account for the patterns observed over time and across worker characteristics. Drywall installers are an intervention priority. Am. J. Ind. Med. © 2015 Wiley Periodicals, Inc. Language: en

BACKGROUND: Falls from height (FFH) are a longstanding, serious problem in construction. METHODS: We report workers' compensation (WC) payments associated with FFH among a cohort (n = 24,830; 1989-2008) of carpenters. Mean/median payments, cost rates, and adjusted rate ratios based on hours worked were calculated using negative-binomial regression. RESULTS: Over the 20-year period FFH accounted for $66.6 million in WC payments or $700 per year for each fulltime equivalent (2,000 hr of work). FFH were responsible for 5.5% of injuries but 15.1% of costs. Cost declines were observed, but not monotonically. Reductions were more pronounced for indemnity than medical care. Mean costs were 2.3 times greater among carpenters over 50 than those under 30; cost rates were only modestly higher. CONCLUSIONS: Significant progress has been made in reducing WC payments associated with FFH in this cohort particularly through 1996; primary gains reflect reduction in frequency of falls. FFH that occur remain costly. Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc. Language: en

BACKGROUND: Acute work-related trauma is a leading cause of death and disability for U.S. workers but it is difficult to obtain information about injured workers not covered by workers' compensation (WC). This study aimed to: (1) describe trends in expected payer and linkage to WC claims, (2) compare characteristics of injured workers who did and did not have a linked WC claim, and (3) describe variation in expected payer and linkage to WC claims by ethnicity and injury severity. METHODS: Data for injuries occurring from 1998 through 2008 were obtained from the Washington State Trauma Registry and linked to WC claims. RESULTS: We found that 27% of work-related traumatic injuries did not have WC listed as a payer, while 37% did not link to a WC claim. Among those with WC listed as a payer, the odds of having a linked WC claim were 57% lower for workers with other non-WC insurance compared with the otherwise uninsured. Latinos were more likely to have a linked WC claim compared with non-Latinos, but there was no significant difference after partially controlling for WC-covered employment and other insurance. CONCLUSIONS: This study demonstrated the importance of considering differential access to other insurance coverage and adaptation by health care settings to financial pressures when assessing trends in occupational injury incidence and reporting, especially when using WC as a proxy for work-relatedness. The addition of occupation, industry, and work status to trauma registries and hospital discharge databases would improve surveillance, research, policy and prevention efforts. Am. J. Ind. Med. © 2013 Wiley Periodicals, Inc. Language: en

Background Evidence regarding the unequal burden of occupational injuries between workers employed by temporary agencies and those in standard employment arrangements is unclear. Studies range from no significant differences in risk to substantial increased risk for temporary workers. The purpose of this study is to compare the workers' compensation experience of a large cohort of temporary agency employed workers with those in standard forms of employment. Methods Washington State Fund workers' compensation data were obtained for claims with injury dates from January 1, 2003 to June 30, 2006, resulting in 342,540 accepted claims. General descriptive statistics, injury rates (per 10,000 FTE), and rate ratios (temp agency/standard employer) were computed by injury type and industry. Results Temporary agency employed workers had higher rates of injury for all injury types, and higher median time loss (40 vs. 27 days) but lower time loss costs (median $1,224 vs. $1,914, P

BACKGROUND: Work-related amputations are infrequent but devastating injuries. Attempts to more accurately estimate the burden of amputations and industries at risk have led the Washington State occupational surveillance program to explore new methods for case identification in Washington State workers' compensation data. METHODS: Two methods were utilized for case identification of work-related amputations. The first method used the ANSI Z16 nature code for amputation. An alternative method utilized medical, hospital, and claim administration coding of medical bills and bill payment systems. After identifying suspected amputation claims, a sample of the medical records associated with different case identification methods were reviewed to verify that an amputation likely occurred. RESULTS: From 1997 to 2005, 2,528 amputations were identified using the ANSI Z16 code for amputation (Nature = 100) and an additional 3,912 amputations were identified using the alternative method. There was an increasing trend of amputation injuries over the time period using the ANSI amputation definition; however, the trend in amputation injuries captured by the alternative method was decreasing. This may indicate a bias in estimating a trend due to misclassification of amputation injuries. The sectors with the highest amputation claims rates were Manufacturing; Construction; Agriculture, Forestry, Fishing and Hunting; Accommodation and Food Services; and Wholesale and Retail Trade. CONCLUSIONS: Current methods to identify work-related amputations in the workers' compensation data system underestimate the burden of amputations in Washington State. By utilizing alternative case identification methods, we estimate that there were about 150% more amputations in Washington State over the time period. Language: en

Globally, overall rates of HIV are on the decline; however, rates among gay men and other men who have sex with men (MSM) and transgender persons are increasing. Meanwhile, there has been exponential growth in access to communication technology over the last decade. More innovative prevention and care technology-based programmes are needed to help address the growing numbers of MSM and transgender persons living with HIV and those at risk for infection. To address this need, a meeting was hosted by the U.S. Agency for International Development (USAID) through the President's Emergency Plan for AIDS Relief (PEPFAR) and co-sponsored by amfAR, The Foundation for AIDS Research and the National Institute of Mental Health (NIMH). The meeting brought together researchers, community implementers, advocates and federal partners to discuss the current landscape of technology-based interventions for MSM and transgender persons and to discuss key considerations. Presentations and discussions focused on the research gaps, facilitators and barriers to programme implementation and public-private partnerships. This article summarizes the meeting proceedings and outlines key considerations for future work in this area.