Since 1980, the Bureau of Labor
and Statistics (BLS), has taken injury and illness readings in
nursing homes and hospitals, the two largest employers of health
service workers. Over the last five years, the nursing home industry
has seen a decrease in lost workday cases incident rates1.
In Oregon, the 1993 incidence rate of 9.2 in the nursing
care facilities industry decreased 13.3 percent to 8.0 in 1997.
In the hospital industry, the 1993 incident rate of 4.0 decreased
slightly to 3.9 in 1997. This difference between the two industries
reflects, for the most part, how caregivers carry out daily duties
in the various health care settings.
Within nursing homes, for example, many patients
require around-the-clock assistance with the basic activities
of daily living, such as getting in and out of bed or bathing.
Such physically demanding assistance, often carried out by nursing
aides and orderlies, is less evident in hospitals which typically
provide acute care rather than long-term care.
This report presents data about Oregons
work-related injuries, illnesses, and fatalities to health care
workers. It evaluates accepted disabling workers compensation
claims during the years 1993-1997. Information on claims for
all workers of all occupations can be found in the yearly publication
entitled Oregon Workers Compensation Claims Characteristics.
In Oregon, a disabling claim involves more
than three days of time loss, permanent disability, or inpatient
hospitalization. An accepted claim means that a workers
compensation insurer has determined that the condition is work-related
and compensable. The claims that are not severe enough to be
defined as disabling are not reported to the Workers Compensation
Division (WCD). Therefore, this report includes only the most
From 1993-1997, a total of 8,202 disabling
claims were accepted for health careworkers; eight of these
claims were work-related fatalities.
WCD received notification of 1,913
claims for health care workers in 1993. This number declined
at an average rate of 124 claims per year to 1,417 claims in
Fifty-five percent of health care workers
injured were nursing aides; 18 percent were registered nurses.
Sprains, strains, and tears accounted
for 73 percent of injuries to health care workers. Fifty-nine
percent of the sprains and strains were to nursing aides.
Back, the most common body part injured by health care workers,
accounted for 41 percent of injuries.
Overexertion caused 55 percent of injuries
to health care workers.
Other people, including health care
patients, were the sources of injury to health care workers 52
percent of the time.
Analysis of Industrial
Injuries and Illnesses
number of health care workers suffering occupational injuries
and illnesses has declined an average of 124 claims per year
since 1993, when WCD received notification of 1,913 accepted
disabling claims for health care workers. Compensable claims
averaged 1,640 per year during the five-year period from 1993-1997.
Fatalities averaged 1.6 per year (Table 1).
Table 1 shows health care occupations with
the number of accepted disabling claims received by the Workers
Compensation Division (WCD). Injuries to nursing aides have steadily
decreased at an average of 95 claims a year with 1993 showing
the highest amount of claims (1,103) during the five-year period
from 1993-1997. Nursing aides accounted for 55 percent (4,471
claims) and registered nurses accounted for 18 percent (1,448
claims) of the 8,202 accepted claims during 1993-1997.
Hospitals in the health services industry accounted for 40 percent
(3,300 claims) of the accepted disabling claims to health care
workers (see Table 2). Eighty-six percent of the injured health
care workers employed at nursing and personal care facilities
were nursing aides, as were 37 percent of those employed at hospitals
and 77 percent of those employed in residential care. For all
health care injuries, 84 percent of the workers were in the private
sector and 16 percent in the public sector.
Overexertion was the most common event for most
health care occupations. In hospitals, 61 percent of the injuries
to registered nurses and 43 percent to health technicians were
due to overexertion. Sixty-nine percent of the injuries to nursing
aides in nursing and personal care facilities were overexertion
injuries; these figures were 55 percent in hospitals, and 60
percent in residential care. Most of the overexertion injuries
were caused by lifting, pushing/pulling, or holding/carrying
Overexertion resulted in the greatest number
of claims for health care workers (4,544) during the five-year
period from 1993-1997 (Table 3). Nursing aides suffered 54 percent
of overexertion claims involving other people, including health
care patients. Falls resulted in the second greatest number of
job-related injuries to health care workers (1,040 claims), followed
by violent acts and assaults (524 claims). Almost half of the
falls occurred when nursing aides fell down stairs or fell to
the same level, mostly to the floor, walkway, or ground surface.
Seventy-one percent of the assaults were to nursing aides.
Nature of injury
Sprains, strains, and tears were the leading
cause of job-related injuries to health care workers (5,977 claims)
during 1993-1997 (Table 4). Of sprains, strains, and tears, nursing
aides suffered 59 percent and registered nurses suffered 17 percent.
Bruises and contusions resulted in the second greatest number
of claims (371), followed by fractures (287 claims). Almost 70
percent of sprains, strains, and tears were caused by overexertion,
followed by bodily reaction (9 percent). Twenty-six percent of
the bruises and contusions and 11 percent of the fractures resulted
when the worker was either struck by or against an object.
Part of body
Backs were the most common body part injured by health care workers
(3,330 claims) during the five-year period 1993-1997 (Figure
1). Nursing aides suffered 58 percent of back injuries and registered
nurses suffered 19 percent. The trunk, except the back, was the
second most frequently injured body part (1,125 claims), followed
by multiple body parts (1,098 claims). Overexertion was the leading
cause of back injuries (79 percent). Injuries to the trunk, except
the back, were also caused by overexertion (66 percent). Injuries
to multiple body parts were caused by overexertion 45 percent
of the time.
Source of injury
People, including health care patients, were
the leading source of injury to health care workers (4,293 claims)
during the five-year period from 1993-1997 (Table 5).
People, including health care patients, were
the source of injury 65 percent of the time for nursing aides,
and 51 percent for registered nurses. The bodily
motion of the injured worker was the source in 13 percent of
Gender and tenure
Eighty-five percent of injured health care workers were female,
compared to 15 percent male. Male health care workers with higher
number of claims than females were physicians, dentists, pharmacists,
and physicians assistants.
Thirty-five percent of work-related injuries
to health care workers occurred during the first year of employment
(2,880 claims). There were considerably fewer claims during the
second and third year of employment with an average of 820 claims
per year during 1993-1997.
Nursing aides accounted for 75 percent of the
injuries during the first year of employment.
From 1993 to 1997, the Workers Compensation Division of
the Department of Consumer & Business Services recorded the
acceptance of eight claims for fatally injured health care workers.
Two of these fatal accidents were caused by a violent act: a
health aide was stabbed and a nursing aide was shot. Of the eight
fatalities, two were male. Table 6 lists the occupation of the
worker and the description of the event that caused the fatality.
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