Educating workers at risk for occupational injuries

Low-wage workers are at an elevated risk for workplace injuries, yet for many, their employers provide little or no education or training on workplace safety and health.

According to an article by University of Illinois at Chicago researchers, reaching these workers with health and safety information at community health centers may help lower their risk of injury and improve their knowledge of workers’ compensation.

About 39 million U.S. workers, close to 1 in 3, had low incomes in 2009-2010, and between 2.5 and 5.7 million workers were considered temporary or contingent workers in 2005, according to the research published in the American Journal of Industrial Medicine. While these low-wage workers were more likely to experience injuries while working, they also had difficulty accessing health and safety information in their workplaces.

“With the growth of the low-wage workforce, their elevated risk for injury on the job, and their reliance on community health centers, we wanted to see how work-related injuries were detected in these centers and how familiar health care workers are with workers’ compensation,” said Dr. Linda Forst, professor of environmental and occupational health sciences in the UIC School of Public Health and corresponding author on the paper.

Workers’ compensation insurance provides medical benefits and wage replacement to workers injured on the job, and employers are required to purchase workers’ compensation insurance in most states. Community health centers serve low-income populations at reduced rates using government subsidies.

Under-recognition of work-related illnesses and injuries by health care providers is one of the major factors leading to the underuse of workers’ compensation. Undocumented workers are ineligible for health care coverage under the Affordable Care Act but are eligible for workers’ compensation in Illinois and other states. It is estimated that 25 to 55 percent of costs for occupational illness and injury are shifted away from workers’ compensation, with the costs falling on community health centers.

The researchers interviewed 51 low-wage workers waiting for their doctor appointments in two community health center waiting rooms in the Chicago area. Interviewees were employed in a variety of areas including the manufacturing, agriculture and service sectors. The reasons for their visits to community health centers included workplace strains and sprains from repetitive work, lacerations from handling tools or machinery and falls.

The interviewees reported understanding that their employer was responsible for covering health care for work-related injuries, but many could not name workers’ compensation as the entity that would cover those costs, suggesting that they were not adequately informed about their state-mandated rights.

The most common barrier to reporting an occupational injury among interviewees was fear of job loss and economic ruin. Several interviewees also cited concern about becoming stigmatized by their employers and their co-workers if they were to report an injury.

Many cited a desire to learn more about their rights related to health and safety and employment, and expressed a desire that their employers provide this education. They believed more knowledge would improve their health and safety on the job. However, many employers of temporary or at-risk workers do not provide this kind of education, and because of the precarious nature of employment for many low-wage workers, fear of being fired prevents them from asking for such training.

“Because many low-wage workers who have been injured on the job visit community health centers for their care, we believe the centers could provide a good alternative venue for providing health and safety education and training,” Forst explained.

Liza Topete, Joseph Zanoni and Lee Friedman, of the University of Illinois at Chicago School of Public Health, are co-authors on the paper.

This research was funded by grant U60OH010905 from the National Institute for Occupational Safety and Health.