Surveillance of Work-Related Musculoskeletal Disorders in Health Care Workers: Analysis of Workers Compensation Claims, Nebraska, 2011-2013

Tuesday, June 21, 2016: 4:22 PM
Kahtnu 2, Dena'ina Convention Center
Ketki Patel , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Derry Stover , Nebraska Department of Health and Human Services, Lincoln, NE
Thomas Safranek , Nebraska Department of Health and Human Services, Lincoln, NE
BACKGROUND: The incidence rate of work-related musculoskeletal disorders (MSD) among health care workers in Nebraska, is nearly twice as high as the MSD rate for all industries. MSDs are associated with ergonomic hazards like heavy lifting, pushing/pulling, overexertion and repetitive motion and other industry specific exposures. Yet, there are limited state-level cause-specific MSD data for different subsectors within health care. To address this knowledge gap, the first report of injury (FROI) data in Nebraska’s workers’ compensation (WC) claims database was used to estimate cause-specific work-related MSD rates among workers employed in health care.   

METHODS: WC claims in Nebraska for injuries and illnesses occurring from 2011 to 2013 in health care, excluding social assistance, were selected. To identify MSDs, Workers Compensation Insurance Organization (WCIO) codes for nature and cause of injury in the FROI report were matched with the Bureau of Labor Statistics’ criteria for defining MSD cases. The MSD cases identified using WCIO codes were compared with MSD cases identified using a narrative text auto coder developed by National Institute for Occupational Safety and Health. The number of full-time equivalent (FTE) workers employed in Nebraska’s health care sector were calculated using the American Community Survey for calculating incidence rates. Cause-specific incidence rate ratios (IRRs) were compared to evaluate differences between sub-sectors (ambulatory care services vs. hospitals vs. nursing and residential care facilities).   

RESULTS: The case definition of MSD using WCIO codes was in agreement with the MSD case definition using the narrative text auto coder (kappa=0.614). Of the total 123,233 claims, 15,794 (13%) were among health care workers. The average rate of MSD claims was 158.5 per 10,000 FTE workers in health care and the most frequently reported cause of MSD was lifting (41%). The rate of lifting-related MSDs was 64.6 per 10,000 FTE health care workers. Lifting-related MSDs were significantly higher in nursing and residential care facility workers (IRR=6.6, 95%CI: 5.7-7.7) and hospital workers (IRR=3.0, 95% CI: 2.6-3.5) compared to those in ambulatory care services.  

CONCLUSIONS: Results suggest risks for lifting-related MSDs in nursing and residential care facilities are higher compared to other health care subsectors in Nebraska. Age and cause-specific rates help prioritize and tailor strategies for prevention of MSDs in health care workforce. The concordance between MSD cases identified using WCIO codes and a narrative text auto coder highlights the compatibility between the two coding systems.