Disabled workers face increased injury risk
OH staff best positioned to reduce injuries
Workers who are disabled are much more likely than other workers to be injured on the job, finds a disturbing new study. The author of the report tells Occupational Health Management that the study should be a strong warning to occupational health providers that disabled workers need special attention.
The report explains that workers who are hearing-impaired, blind, or have disabilities such as arthritis are at a 36% increased risk of injury.1 That result comes from an analysis of 459,827 participants in the National Health Interview Survey, conducted from 1985 to 1994 by Craig Zwerling, MD, MPH, PhD, an occupational health researcher at the University of Iowa in Iowa City.
To test the hypothesis that disabled workers are more at risk than others, Zwerling and his colleagues used data from the survey, which is an ongoing nationwide survey of households implemented by the Census Bureau for the National Center for Health Statistics. Of the total number of workers surveyed, 226 were disabled with work limitations.
What they found was surprising and unsettling. It was no shock that disabled workers are at increased risk for injuries, but Zwerling tells OHM that he and his colleagues did not anticipate the degree to which the risk of injury increases with some disabilities. Overall, having a disability increased the chance of workplace injury by 36%, but the increase was even higher for some specific disabilities.
Sensory impairments were associated with a particularly higher risk of injury. Blindness tripled the risk for injury, deafness more than doubled the risk, hearing impairments increased the risk for injury by 55%, and arthritis increased the risk by 34%. Upper extremity impairments increased the risk by 46%, but there was no statistically significant increase in risk associated with lower extremity or back impairments.
Except for arthritis, there appeared to be no relationship with age and the increased risk of injury. Self-employed workers with disabilities had a lower risk of injury, which the researchers suggest is because they have more control over their surroundings and working conditions.
Zwerling says the study shows that occupational health providers have not done enough to accommodate disabled workers. "We’re going to see more disabled workers in the workplace in the next decades, as the baby boomers get up into their 50s and 60s, where you see more disabilities," he says. "Plus, the Americans with Disabilities Act will continue to increase the number of disabled workers in the workplace."
Zwerling notes there has been little research into what type of workplace accommodations can help the disabled worker, how effective those accommodations are, and how much they cost.
"There is some anecdotal evidence that those accommodations are relatively cheap, certainly in comparison to the cost of a workplace injury," he says. "Most of them are small things that nobody ever thought of doing, like modifying the person’s chair or changing the work schedule so that they have more frequent breaks."
Door was major hazard for quadriplegic
As an example, Zwerling tells the story of a disabled worker in his own department. The man is quadriplegic, confined to a wheelchair, and unable to open doors on his own. Although The University of Iowa facility was equipped already with an automatic door opener on a door that the man had to use frequently during the day, the opener was designed for people with lesser disabilities. As a result, the door did not stay open long enough for the man to get through. Nearly every time he had to use the door, he would get halfway through and then the doors would close, hitting him on the shoulder because he was unable to protect himself.
"It was a cheap accommodation. We had the maintenance guy come and spend 15 minutes adjusting the timer," Zwerling explains. "We spent maybe 10 bucks on the maintenance guy’s time. That’s pretty typical of the kind of change that can make the difference between a disabled worker being able to work safely or going home with an injury."
Other accommodations may involve safety systems. If a blind person enters the workplace, visual safety warnings such as flashing lights will be inadequate to warn of fires or other emergencies, so an audible alarm would have to be added. And if a deaf person takes a job at the facility, visual warnings will have to supplement any audible warnings.
The occupational health provider is in the best position to facilitate these changes, Zwerling says. To determine what changes are needed and effective, he suggests talking directly with the disabled workers’ supervisors, who may have noticed incidents suggesting the need for improvements.
"And you absolutely need to ask the worker," Zwerling says. "The disabled worker is the person most likely to know what he or she needs to do the job safely. The worker may be reluctant to come forward and ask for those accommodations upfront. But if you ask, chances are very good that he or she knows exactly what sort of change would eliminate the hazard."
Reference
1. Zwerling C, Whitten PS, Davis CS, et al. Occupational injuries among workers with disabilities. JAMA 1997; 278:2,163-2,166.
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