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Occupational Injuries Among Workers With Disabilities: Title and subTitle BreakThe National Health Interview Survey, 1985-1994 FREE

Craig Zwerling, MD, PhD, MPH; Paul S. Whitten, MS; Charles S. Davis, PhD; Nancy L. Sprince, MD, MPH
[+] Author Affiliations

Reprints: Craig Zwerling, MD, PhD, MPH, 134 IREH, 100 Oakdale Campus, The University of Iowa, Iowa City, IA 52242-5000 (e-mail: craig-zwerling@uiowa.edu).


JAMA. 1997;278(24):2163-2166. doi:10.1001/jama.1997.03550240053033
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Context.  —As the baby boom generation ages, more people will be working with disabilities, but we have little information regarding how disabilities affect risk for occupational injury.

Objective.  —To test the hypothesis that work-limiting disabilities in general and hearing and visual impairments in particular are risk factors for occupational injuries.

Design-.  —Retrospective cohort study.

Setting.  —The National Health Interview Survey (NHIS), 1985 to 1994.

Participants.  —The 459 827 participants in the NHIS from 1985 to 1994 who listed "working" as their primary activity, who were not farmers, and who were between 18 and 65 years of age.

Main Outcome Measure.  —Occupational injuries in the year preceding the interview causing a residual impairment at the time of interview.

Results.  —After adjusting for occupation, self-employment, and age, occupational injury was associated with preceding work disability (odds ratio [OR], 1.36; 95% confidence interval [CI], 1.19-1.56); blindness (OR, 3.21; 95% CI, 1.32-7.85); deafness (OR, 2.19; 95% CI, 1.17-4.12); hearing impairment (OR,1.55; 95% CI, 1.29-1.87); upper extremity impairment (OR, 1.46; 95% CI, 1.05-2.05); and arthritis (OR, 1.34; 95% CI, 1.07-1.68). Visual impairment was not associated with a significantly increased risk (OR, 1.37; 95% CI, 0.87-2.17).

Conclusions.  —Workers with disabilities, especially sensory impairments, appear to have an elevated risk for occupational injury. Further research in the design and evaluation of improved workplace accommodations for workers with these disabilities is needed.

REFERENCES

Pope AM, Tarlov AR, eds. Disability in America: Toward a National Agenda for Prevention . Washington, DC: National Academy Press; 1991;:48-51.
Fullerton HN.  Another look at the labor force: the American workforce, 1992-2005 . Monthly Labor Rev . 1993;;116:31-44.
Wallhagen MI, Strawbridge WJ, Cohen RD, Kaplan GA.  An increasing prevalence of hearing impairment and associated risk factors over three decades of the Alameda County Study . Am J Public Health . 1997;;87:440-442.
Moll van Charante AW, Mulder PGH.  Perceptual acuity and the risk of industrial accidents . Am J Epidemiol . 1990;;131:652-663.
Zwerling C, Ryan D, Schootman M.  A case-control study of risk factors for industrial low back injury: the utility of preplacement screening in defining high-risk groups . Spine . 1993;;18:1242-1247.
Zwerling C, Sprince NL, Wallace RB, Davis CS, Whitten PS, Heeringa SG.  Risk factors for occupational injuries among older workers: an analysis of the Health and Retirement Study . Am J Public Health . 1996;;86:1306-1309.
Adams PF, Marano MA.  Current estimates from the National Health Interview Survey, 1994 . Vital Health Stat . 1995;;10( (193) ).
Zwerling C, Sprince NL, Wallace RB, Davis DC, Whitten PS, Heeringa SG.  Occupational injuries among agricultural workers 51 to 61 years old: a national study . J Agricultural Safety Health . 1995;;1( (4) ):273-281.
US Dept of Health and Human Services, National Centerfor Health Statistics. National Health Interview Survey, 1989. Washington, DC: US Dept of Health and Human Services; 1989.
National Center for Health Statistics, Centers for Disease Control. Classified Index of Industries and Occupations, 1989. Washington, DC: US Dept of Health and Human Services; 1989.
SAS Institute Inc. SAS Version 6.11 for Windows. Cary, NC: SAS Institute Inc; 1995.
Equal Employment Opportunity Commission. A Technical Assistance Manual on the Employment Provisions (Title 1) of the Americans With Disabilities Act . Washington, DC: Equal Employment Opportunity Commission; 1992;:B-28.
Breslow NE, Day NE. Statistical Methods in Cancer Research, I: The Analysis of Case-control Studies . Lyon, France: International Agency for Research on Cancer; 1980;:74.

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Pope AM, Tarlov AR, eds. Disability in America: Toward a National Agenda for Prevention . Washington, DC: National Academy Press; 1991;:48-51.
Fullerton HN.  Another look at the labor force: the American workforce, 1992-2005 . Monthly Labor Rev . 1993;;116:31-44.
Wallhagen MI, Strawbridge WJ, Cohen RD, Kaplan GA.  An increasing prevalence of hearing impairment and associated risk factors over three decades of the Alameda County Study . Am J Public Health . 1997;;87:440-442.
Moll van Charante AW, Mulder PGH.  Perceptual acuity and the risk of industrial accidents . Am J Epidemiol . 1990;;131:652-663.
Zwerling C, Ryan D, Schootman M.  A case-control study of risk factors for industrial low back injury: the utility of preplacement screening in defining high-risk groups . Spine . 1993;;18:1242-1247.
Zwerling C, Sprince NL, Wallace RB, Davis CS, Whitten PS, Heeringa SG.  Risk factors for occupational injuries among older workers: an analysis of the Health and Retirement Study . Am J Public Health . 1996;;86:1306-1309.
Adams PF, Marano MA.  Current estimates from the National Health Interview Survey, 1994 . Vital Health Stat . 1995;;10( (193) ).
Zwerling C, Sprince NL, Wallace RB, Davis DC, Whitten PS, Heeringa SG.  Occupational injuries among agricultural workers 51 to 61 years old: a national study . J Agricultural Safety Health . 1995;;1( (4) ):273-281.
US Dept of Health and Human Services, National Centerfor Health Statistics. National Health Interview Survey, 1989. Washington, DC: US Dept of Health and Human Services; 1989.
National Center for Health Statistics, Centers for Disease Control. Classified Index of Industries and Occupations, 1989. Washington, DC: US Dept of Health and Human Services; 1989.
SAS Institute Inc. SAS Version 6.11 for Windows. Cary, NC: SAS Institute Inc; 1995.
Equal Employment Opportunity Commission. A Technical Assistance Manual on the Employment Provisions (Title 1) of the Americans With Disabilities Act . Washington, DC: Equal Employment Opportunity Commission; 1992;:B-28.
Breslow NE, Day NE. Statistical Methods in Cancer Research, I: The Analysis of Case-control Studies . Lyon, France: International Agency for Research on Cancer; 1980;:74.
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