Evaluation of a Workers' Compensation Electronic Database for Tracking Work-Related Musculoskeletal Disorders (MSDs) Among Hotel Housekeepers--California, 2006-2009

BACKGROUND:   Hotel room cleaners are at high risk for painful and disabling work-related musculoskeletal disorders (MSDs).  Conducting surveillance of work-related MSDs is challenging due to underreporting, the lack of a single comprehensive work-related injury data source, and no consistent definition of an MSD.  In 2012, UNITE HERE, the union representing hotel room cleaners, petitioned the California Occupational Safety and Health Standards Board (OSHSB) to promulgate a standard requiring the hotel industry to follow safe housekeeping practices.  To inform the rulemaking process, the California Department of Public Health sought to evaluate the usefulness of the California Workers’ Compensation Information System (WCIS) database in describing MSDs among hotel room cleaners.  WCIS includes data from both First Reports of Occupational Injury (FROI) and medical billing which can both potentially be used to determine measures of frequency, severity, disparities, and costs of MSDs. 

METHODS:   MSD cases were classified by nature of injury, cause of injury, and body part reported in FROIs, as well as ICD-9 and procedure codes found in medical billing data to match the National Institute for Occupational Safety and Health (NIOSH) definition of an MSD.  NIOSH defines an MSD as any injury or disorder of the muscles, nerves, tendons, joints, cartilage, or supporting structures of the limbs, neck, and back that is caused, precipitated or exacerbated by sudden exertion or prolonged exposure to repetition, force, vibration, or awkward posture.  The American Community Survey was used to calculate the numbers of full-time equivalent persons employed in both the hotel industry and as hotel room cleaners, which were used as denominators when calculating MSD rates.  Industry-specific incidence rates and incidence rate ratios (IRRs) were used to compare hotel room cleaners with other occupations. 

RESULTS:   From 2006-2009, there were more than 2.4 million claims in California's WCIS database; 867,650 (33%) met the criteria for an MSD based on the nature of injury, cause of injury, and body part.  Of these claims, 16,900 were within the hotel industry and 7,643 were among hotel room cleaners. The average rate of MSD claims was 174 per 10,000 full-time equivalent hotel room cleaners.

CONCLUSIONS:   This study will evaluate whether California's WCIS database is useful for describing MSDs in hotel room cleaners and will determine if rates in California room cleaners are higher than in other occupations.