Patient handling and musculoskeletal disorders among hospital workers: Analysis of 7 years of institutional workers' compensation claims data

2012 ◽  
Vol 55 (8) ◽  
pp. 683-690 ◽  
Author(s):  
Hyun Kim ◽  
Jonathan Dropkin ◽  
Kenneth Spaeth ◽  
Francine Smith ◽  
Jacqueline Moline
2021 ◽  
Author(s):  
Tyler J Lane

Abstract Purpose Workers’ compensation claims consist of occupational injuries severe enough to meet a compensability threshold. Theoretically, systems with higher thresholds should have fewer claims but greater average severity. For research that relies on claims data, particularly cross-jurisdictional comparisons of compensation systems, this results in collider bias that can lead to spurious associations and confound analyses. In this study, I use real and simulated claims data to demonstrate collider bias and problems with methods used to account for it. Methods Using Australian claims data, I used a linear regression to test the association between claim rate and mean disability durations across Statistical Areas. Analyses were repeated with nesting by state/territory to account for variations in compensability thresholds across compensation systems. Both analyses are repeated on left-censored data. Simulated claims data are analysed with Cox survival analyses to illustrate how left-censoring can reverse effects.Results The claim rate within a Statistical Area was inversely associated with disability duration. However, this reversed when Statistical Areas were nested by state/territory. Left-censoring resulted in an attenuation of the unnested association to non-significance, while the nested association remained significantly positive. Cox regressions on simulated data showed left-censoring can also reverse effects. Conclusions Collider bias can seriously confound work disability research, particularly cross-jurisdictional comparisons. Work disability researchers must grapple with this challenge by using appropriate study designs and analytical approaches, and considering how collider bias affects interpretation of results.


2016 ◽  
Vol 59 (8) ◽  
pp. 656-664 ◽  
Author(s):  
Samuel C. Yamin ◽  
Anca Bejan ◽  
David L. Parker ◽  
Min Xi ◽  
Lisa M. Brosseau

Author(s):  
Laura Punnett

Inadequate application of ergonomic principles to the design of workplaces and individual jobs has adverse consequences for worker health and safety, especially in terms of strains, sprains, and other musculoskeletal disorders. In addition to the human pain and suffering, other losses are externalized to workers, with adverse financial and psychosocial impacts. There are also costs to employers through workers' compensation claims, scrap, and decreased production quality, medical insurance premiums, labor turnover, and adverse impacts on labor relations, although many of these are not linked by traditional accounting methods to ergonomic problems per se. Data collected in five plants of two major U.S. automotive manufacturing companies in the last decade have been used to estimate some of the costs associated with work-related musculoskeletal disorders (MSDs), only some of which resulted in workers' compensation claims. In one plant in 1984–85, the payroll cost of all back and shoulder disorders was at least $320 per year per worker, not including workers' compensation premiums or claims paid. A large proportion of these costs were accrued by “unreported” cases, that is, cases that either had never been reported to the plant clinic or had been reported in the past and were considered administratively to have recovered. In the other four plants, annual costs associated with in-plant medical visits for MSDs in 1989–93 were almost as high as those resulting from compensation claims. At least one-half of these disorders were estimated to be attributable to physical ergonomic exposures in the workplace and thus preventable. These data are consistent with estimates by others that the real costs to employers are at least two to three times the amount paid in workers' compensation cases, and that at least 50 percent of all work-related musculoskeletal disorders among the working population could be prevented by appropriate ergonomic job design. Furthermore, recent experience with ergonomics programs in various manufacturing and service settings shows that they are cost-effective in reducing morbidity, work absenteeism, and workers' compensation claims; payback periods for workplace modifications can be as short as a few months. Further investigations should explore the reasons that monetary costs and other impacts on profitability do not always motivate employers to improve working conditions.


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