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UNIVERSITY OF CALIFORNIA RIVERSIDE
JUN 09 2008
Morbidity and Mortality Weekly Report GOVERNMENT PUBLICATIONS DEPT. www.cdc.gov/mmwr
ɔrk-Related Injury Deaths Among ispanics are among the fastest-growing segments of the . workforce (1). In 2006, an estimated 19.6 million kers in the United States were Hispanic, 56% of whom foreign born (2). To characterize work-related injury hs among Hispanic workers in the United States, CDC, Bureau of Labor Statistics (BLS), and certain state agenanalyzed data from 1992-2006. This report summaIs the results of that analysis, which indicated that, ing 1992–2006, a total of 11,303 Hispanic workers l from work-related injuries. The death rate for Hisic workers decreased during this period; however, the was consistently higher than the rate for all U.S. workand the proportion of deaths among foreign-born Hisic workers increased over time. During 2003-2006, 5 of Hispanic worker deaths occurred in the construcindustry. Additional efforts are needed to reduce the for death among Hispanic workers because of projected eases in their employment, involvement in work with risk for injury, susceptibility to miscommunication ed by language differences, and other potential risks ciated with culture and economic status.
ne BLS Census of Fatal Occupational Injuries (CFOI) ects data on fatal occupational injuries from multiple ral, state, and local sources, including death certificates, xers' compensation reports, medical examiner reports, police reports. Approximately 95% of cases are verified t least two independent sources (3). To be included in OI, the decedent must have been employed at the time e event, engaged in a legal work activity, or present at e as a job requirement. CFOI excludes deaths that rred during a worker's normal commute to and from
5 not reflect any immigration status.
June 6, 2008 / Vol. 57 / No. 22
United States, 1992-2006
work and deaths related to occupational illnesses. A decedent is classified as Hispanic if documentation is available indicating that the decedent was of Mexican, Puerto Rican, Cuban, or Central or South American descent, or of other Spanish culture or origin, regardless of race. Deaths of undocumented workers are included. In this report, certain data are presented only for the period 2003-2006 because, in 2003, industry coding changed to the 2002 North American Industry Classification System. Death rates were calculated for workers aged ≥16 years, using estimates of employed civilian workers from the BLS Current Population Survey (CPS) (2). CPS is a monthly survey of approximately 60,000 households that uses a combination of in-person and telephone interviews with a single person reporting for all household members. Undocumented persons are included in CPS.
Work-related injury deaths among Hispanic workers during 1992-2006 totaled 11,303 (Figure 1), approximately 13% of all U.S. work-related injury deaths during that period. Median age of Hispanic decedents was 35 years, compared with a median age of 42 years for all workers. Approximately 95% of Hispanic decedents were male. The annual work-related injury death rate for Hispanic workers exceeded the rate for all U.S. workers every year during 1992-2006, with the exception of 1995. In 2006, the work-related injury death rate for Hispanic workers was
: from 2001 exclude fatalities resulting from the September 11 terrorist
DEPARTMENT OF HEALTH AND HUMAN SERVICES
Editorial Note: Although work-related injury death rates declined generally and among Hispanics in the United States from 1992 to 2006, disparities between Hispanics and all workers persisted, with Hispanics consistently experiencing higher rates. In 2006, rates for Hispanics and all workers were above the Healthy People 2010 target for work-related injury deaths of 3.2 deaths per 100,000 workers (objective 20-1) (4). Foreign-born Hispanic workers were at especially high risk, and a large proportion of deaths occurred in the construction industry. Much of the increased risk for Hispanic workers likely can be attributed to holding high-risk jobs (5). However, an analysis of Hispanic work-related injury deaths in the construction industry found that Hispanic workers also had elevated rates when compared with non-Hispanic workers in the same occupations (e.g., laborers or roofers) (6).
In-depth investigations of approximately 200 deaths of Hispanic workers by CDC's National Institute for Occupational Safety and Health and state public health and labor agencies during 1992–2006 suggested characteristics that contributed to higher numbers of work-related injury deaths among Hispanic workers, including inadequate knowledge and control of recognized safety hazards and inadequate training and supervision of workers, often
LE. Number, rate,* birth status, and most common fatal event and industry associated with Hispanic work-related injury deaths, in-elected states United States, 2003-2006
nt coded according to the Bureau of Labor Statistics Occupational Injury and Illness Classification System. stry coded according to the 2002 North American Industry Classification System.
es reporting at least 30 work-related injury deaths of Hispanic workers during 2003-2006.
exacerbated by different languages and literacy levels of workers (CDC, unpublished data, 2008). Preventing work-related injury deaths among Hispanics will require 1) employers to take additional responsibility for providing a safe work environment, 2) safety and health agencies to provide employers of Hispanic workers with safety information and ensure compliance with existing regulations, and 3) researchers and health communication professionals to develop additional materials that are culturally appropriate and effective for workers who speak different languages and have varying levels of literacy. In addition, labor unions, community groups, and workers themselves can contribute to research and prevention measures.
The findings in this report are subject to at least five limitations. First, the number of deaths of Hispanic workers might be undercounted in the CFOI database (6), resulting in an underestimate of the death rate among Hispanics. Second, Hispanic ethnicity might have been misclassified in CFOI, which relies on secondary data sources, and also in CPS, which uses a single reporter for all household members. Third, the number of Hispanic workers might be undercounted in the CPS, which relies on stable residences for sequential interviews and largely collects data via telephone. An undercount of the total population of Hispanic workers would result in overestimate of Hispanic work-related injury death rates (6). Fourth, Hispanic workers are a heterogeneous population, and analyses that aggregate deaths for all Hispanics might mask differences among subpopulations. Finally, the data do not address potential contributors to Hispanic worker risk associated with cultural and social norms or economic status. For example, Hispanic workers, especially those who are foreign born, might be more willing to perform tasks with higher risk and more hesitant to decline such tasks for fear of losing their jobs.
CDC, the Occupational Safety and Health Administration (OSHA), and other agencies have provided additional Spanish-language occupational health and safety materials and training opportunities for employers, supervisors, and workers (7,8). OSHA has worked with employers to publicize best practices for Hispanic worker education and training programs (8). In addition, federally supported research projects are exploring grassroots approaches to improving occupational health and safety among Hispanic and other immigrant workers.** Others agencies can build upon these
¶ Individual case reports of Hispanic worker deaths are available at http:// www2a.cdc.gov/NIOSH-FACE/state.asp?Category=0009&Category2=
**Additional information available at http://www.dph.sf.ca.us/phes/ work_unidos.htm.
projects to develop culturally competent programs th engage Hispanic workers in identifying and addressing th occupational health and safety concerns.
The findings in this report are based, in part, on contributions: B Materna, PhD, California Dept of Public Health; J Zhu, N Pavel AM Gibson, New York State Dept of Health; P Spielholz, PhD, Wa ington State Dept of Labor and Industries; and S Pegula, MS, Bur Labor Statistics, US Dept of Labor.
1. Franklin JC. Employment outlook: 2006-16: An overview of BLS pjections to 2016. Monthly Labor Review, November 2007:3-12. Av able at http://www.bls.gov/opub/mlr/2007/11/art 1 full.pdf.
2. Bureau of Labor Statistics. Current Population Survey, 2006, and force, employment and unemployment from the Current Populat Survey. In: BLS handbook of methods. Washington, DC: US Depar ment of Labor, Bureau of Labor Statistics; 2003. Available at h www.bls.gov/cps/home.htm.
3. Loh K, Richardson S. Foreign-born workers: trends in fatal occupa tional injuries. Monthly Labor Review, June 2004:42–53. Available i http://www.bls.gov/opub/mlr/2004/06/art3full.pdf.
4. US Department of Health and Human Services. Healthy people 201 (conference ed, in 2 vols). Washington, DC: US Department of Healt and Human Services; 2000. Available at http://www.healthypeople go document/html/volume2/20occsh.htm.
5. Richardson S, Ruser J, Suarez P. Hispanic workers in the United States An analysis of employment distributions, fatal occupational injuries. and nonfatal occupational injuries. In: Safety is seguridad: a worke summary. Washington, DC: The National Academies Press; 2003. Avaable at http://books.nap.edu/openbook.php?record_id=10641&page=3 6. Dong X, Platner J. Occupational fatalities of Hispanic constructio workers from 1992 to 2000. Am J Ind Med 2004;45:45–54. 7. National Institute for Occupational Safety and Health. NIOSH -Español. Washington, DC: US Department of Health and Human Se vices, CDC, National Institute for Occupational Safety and Health 2008. Available at http://www.cdc.gov/spanish/niosh.
8. Occupational Health and Safety Administration. OSHA compliant assistance: Hispanic workers and employers. Available at http www.osha.gov/dcsp/compliance_assistance/index_hispanic.html
On July 10, 2004, staff members at a children's hospi in Texas noted that six infants with pertussis diagnosed ri clinical symptoms and confirmed by polymerase chait reaction (PCR) testing had all been born during June → 16 at the same area general hospital. The infants had symp toms consistent with pertussis, including cough, congestion, cyanosis, emesis, or apnea. Infection-control personnel at the general hospital (general hospital A), children's hos tal (children's hospital A), and the county health depart ment investigated and determined that an outbreak of pertussis among 11 newborns at general hospital A had