标题：Occupational Injury and Absence From Work Among African American, Hispanic, and Non-Hispanic White Workers in the National Longitudinal Survey of Youth
摘要：Objectives . We examined how race and ethnicity influence injury and illness risk and number of days of work missed as a result of injury or illness. Methods . We fit logistic regression and negative binomial regression models using generalized estimating equations with data from 1988 to 2000 on currently employed African American, Hispanic, and non-Hispanic White participants in the National Longitudinal Survey of Youth. Results . Occupational factors—having a blue-collar occupation, working full-time, having longer tenure, working 1 job versus 2, and working the late shift—were associated with increased odds of an occupational injury or illness. Although racial/ethnic minority workers were no more likely than Whites to report an occupational injury or illness, they reported missing more days of work. African American and Hispanic men missed significantly more days of work than non-Hispanic White men, and African American women missed significantly more days of work than non-Hispanic White women. Conclusions . Factors associated with occupational health are multifaceted and complex. Our findings suggest that race/ethnicity influences the duration of work absence owing to injury or illness both indirectly (by influencing workers’ occupational characteristics) and directly (by acting independently of occupational factors). Occupational injuries and illnesses represent a significant source of morbidity and mortality in the United States. The Bureau of Labor Statistics reported more than 5 million work-related injuries and illnesses in private industry workplaces in 2001, resulting in an annual rate of 5.7 cases per 100 full-time workers. 1 Historically, racial/ethnic minority workers have exhibited higher rates of work-related morbidity than have non-Hispanic White workers. 2 – 4 The extent to which such inequalities persist today is less clear. Over time, notable trends such as improved workplace safety, decreased rates of fatal and nonfatal occupational injuries and illnesses, the expansion of affirmative action, and an increasingly diversified workforce are likely to have influenced both the types of occupations held by individuals of different races and ethnicities and occupational injury rates. 1 , 5 The studies investigating this topic have yielded inconsistent findings; some suggest that minority workers are at greater risk of occupational injuries than their non-Hispanic White counterparts, 4 , 6 , 7 whereas others have found comparable rates of occupational injuries between these groups. 8 – 10 Racial and ethnic differences in occupational injury and illness rates are often attributed to the greater likelihood of minority workers being employed in more hazardous occupations. 3 , 11 , 12 Minority workers, in turn, are employed in hazardous occupations largely because of lower educational attainment, greater difficulty finding work, and higher rates of poverty compared with non-Hispanic Whites, as well the effects of lingering racism. 2 , 3 , 13 The occupational categories in which the greatest proportion of African American and Hispanic men are employed include machine operators, fabricators, and laborers, whereas the greatest proportion of non-Hispanic White male workers are found in the managerial and professional specialties. 14 The extent to which factors other than occupation may also contribute to racial/ethnic differences in work-related injuries and illnesses has not been adequately explored in the public health literature. Myriad factors in addition to occupation are believed to influence the risk of occupational injury, among them education, age, work experience, gender, shift worked, and union membership. 9 , 15 – 17 A number of methodological issues limits the conclusions of previous studies examining the relationship between race/ethnicity and risk of occupational injury and illness. First, the use of multiple data sources in some studies prevented linking demographic, occupational, and injury data at the individual level, 4 , 7 , 10 limiting the inferences that can be drawn. Second, previous studies obtained data from state workers’ compensation claims systems, 4 , 7 emergency department hospital records, 10 , 12 and employer records, 6 all of which depend upon injured workers having sought medical care or filed for workers’ compensation. As occupational injuries and illnesses are highly underreported, 2 data drawn from these sources may not be fully representative of all injured workers. Third, the majority of studies have examined differences between African American and White populations without distinguishing or including Hispanics. 4 , 8 , 18 Finally, few studies have utilized data from the past 15 years; injury rates and job opportunities have changed since the late 1980s, so it is important to reexamine this issue in a current context. Additionally, few studies have considered the outcomes of occupational injuries and illnesses, such as the duration of absence from work, a variable likely influenced by a number of factors. Increased absence from work is costly to both society and the injured worker and is associated with the worker’s reduced future participation in the workforce. 19 , 20 Examining this outcome may prove useful in further elucidating the relationship between occupational health and race/ethnicity. We used data from a nationally representative sample to (1) describe the occupational characteristics of non-Hispanic White, African American, and Hispanic workers; (2) examine the relationship between race/ethnicity and self-reported injuries and illnesses that caused respondents to miss work; and (3) assess the relationship between race/ethnicity and the number of workdays missed owing to the injury or illness.
