摘要：Objectives. We examined medically treated injuries among US workers with disability. Methods. Using 2006–2010 National Health Interview Survey data, we compared 3-month rates of nonoccupational and occupational injuries to workers with disability (n = 7729) and without disability (n = 175 947). We fitted multivariable logistic regression models to calculate odds ratios and 95% confidence intervals of injuries by disability status, controlling for sociodemographic variables. We also compared leading causes of injuries by disability status. Results. In the 3-month period prior to the survey, workers with disability were more likely than other workers to have nonoccupational injuries (odds ratio [OR] = 2.35; 95% confidence interval [CI] = 2.04, 2.71) and occupational injuries (OR = 2.39; 95% CI = 1.89, 3.01). For both groups, the leading cause was falls. Conclusions. Disability status was strongly associated with risk of nonoccupational and occupational injuries among US workers. The safety issues facing US workers with disability in the workplace warrant future research. Federal agencies with an interest in the employment of workers with disability and their safety in the workplace should take a lead in further assessing injury risk and in promoting a safe working environment for workers with disability. In the United States, persons with disabilities constitute 12.0% of the population. 1 Both the World Health Organization and the US surgeon general have released reports addressing disparities in the health of persons with disabilities. 2,3 These reports identify community participation and health promotion as societal priorities. According to the 2008 American Community Survey, about 4.6 million adults (aged 16–64 years) with disabilities are employed in the United States, and the number of workers with disabilities is expected to increase in the coming years as the workforce ages. 4 A public health concern is that workers with disabilities may be at high risk of occupational injuries. 5–8 Reducing the proportion of individuals with disabilities who report nonfatal injuries is among the objectives of US Healthy People 2020 . 9 A number of studies have shown that adults with disabilities are more vulnerable to injuries than nondisabled adults. 10–14 Studies using nationally representative data sets have found that the odds of injury increased with increasing severity of disability 10,12 and with the number of disabilities. 13 The settings and external causes of these injuries differed between individuals with and without disabilities. 11,12 Falls, for example, were a leading mechanism of injury reported more frequently among those with disabilities. 10–12 Occupational injuries among workers with disabilities have also been previously studied. 5,15–19 A number of studies from the 1990s showed an elevated risk of injury among workers with disabilities. 5,15–17,19 However, much of the prior research examined only those with specific types of disabilities. 15–19 For example, older workers with poor hearing and poor vision were shown to have an elevated risk for occupational injuries. 17 By contrast, recent research based on workers’ compensation insurance claims found that workers with cognitive disabilities sustained fewer injuries and experienced fewer absences due to injury than workers without cognitive disabilities. 18 Previous work has also been critiqued because of the conceptualization and definition of disability 5 and because environmental factors or work accommodations for workers with disability could not be taken into account. 20,21 Zwerling et al. found that approximately 12% of workers with impairments reported receiving some type of workplace accommodation. 22 Recent work by Leff et al. explored the role of environmental factors (e.g., societal attitudes, the natural environment, and policies) in the functioning and societal participation of people with disabilities. 14 Environmental factors were found to be independently associated with injury regardless of disability status; however, disability status remained a risk factor for injury, although environmental factors attenuated the association. One current conceptualization of disability, the World Health Organization’s International Classification of Functioning, Disability and Health (ICF), emphasizes environmental factors and has been used in recent studies to evaluate injury risks of persons with disabilities. 10,12,23 The ICF defines disability as physical impairments, activity limitations, and participation restrictions that affect one’s interaction with the physical and social environment. 24 However, the impact of this refined definition on the number of injuries to workers with disabilities has yet to be determined. Given the significant number of US workers with disabilities and the advancements in disability and injury definitions, 25 we compared medically attended nonoccupational and occupational injuries among workers with and without disabilities, using data from the 2006–2010 National Health Interview Survey (NHIS). Our current study improves on previous studies by our team and other researchers by examining both nonoccupational and occupational injuries to workers with disabilities using a single data source and a newer definition of disability based on the ICF.
