TY - JOUR
T1 - Marginal structural modelling of associations of occupational injuries with voluntary and involuntary job loss among nursing home workers
AU - Okechukwu, Cassandra Adiba
AU - Bacic, Janine
AU - Velasquez, Esther
AU - Hammer, Leslie B.
N1 - Funding Information:
Murray Mittleman, MD, DrPH consulted on methods used in the paper with support from Harvard Catalyst The Harvard Clinical and Translational Science Center (National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health Award UL1 TR001102) and financial contributions from Harvard University and its affiliated academic healthcare centres. The content is solely the responsibility of the authors and does not necessarily represent the official views of Harvard Catalyst, Harvard University and its affiliated academic healthcare centres, or the National Institutes of Health. National Institute for Occupational Safety and Health; Administration for Children and Families; Alfred P Sloan Foundation; William T Grant Foundation; National Institute on Aging; National Institute of Child Health and Human Development. Data collection was funded by cooperative agreement involving National Institute on Aging (U01AG027669), National Institute of Child Health and Human Development (U01HD051217, U01HD051218, U01HD051256, U01HD051276), National Heart, Lung and Blood Institute (R01HL107240), Office of Behavioral and Social Sciences Research, and National Institute for Occupational Safety and Health (U01OH008788, U01HD059773); and by the Administration for Children and Families, Alfred P Sloan Foundation, and William T Grant Foundation. CAO, JC and EV were funded by Harvard Chan School Career Incubator Award.
PY - 2016/3
Y1 - 2016/3
N2 - Objectives Qualitative studies have highlighted the possibility of job loss following occupational injuries for some workers, but prospective investigations are scant. We used a sample of nursing home workers from the Work, Family and Health Network to prospectively investigate association between occupational injuries and job loss. Methods We merged data on 1331 workers assessed 4 times over an 18-month period with administrative data that include job loss from employers and publicly available data on their workplaces. Workers self-reported occupational injuries in surveys. Multivariable logistic regression models estimated risk ratios for the impact of occupational injuries on overall job loss, whereas multinomial models were used to estimate OR of voluntary and involuntary job loss. Use of marginal structural models allowed for adjustments of multilevel lists of confounders that may be time varying and/or on the causal pathway. Results By 12 months, 30.3% of workers experienced occupational injury, whereas 24.2% experienced job loss by 18 months. Comparing workers who reported occupational injuries to those reporting no injuries, risk ratio of overall job loss within the subsequent 6 months was 1.31 (95% CI 0.93 to 1.86). Comparing the same groups, injured workers had higher odds of experiencing involuntary job loss (OR 2.19; 95% CI 1.27 to 3.77). Also, compared with uninjured workers, those injured more than once had higher odds of voluntary job loss (OR 1.95; 95% CI 1.03 to 3.67), while those injured once had higher odds of involuntary job loss (OR 2.19; 95% CI 1.18 to 4.05). Conclusions Despite regulatory protections, occupational injuries were associated with increased risk of voluntary and involuntary job loss for nursing home workers.
AB - Objectives Qualitative studies have highlighted the possibility of job loss following occupational injuries for some workers, but prospective investigations are scant. We used a sample of nursing home workers from the Work, Family and Health Network to prospectively investigate association between occupational injuries and job loss. Methods We merged data on 1331 workers assessed 4 times over an 18-month period with administrative data that include job loss from employers and publicly available data on their workplaces. Workers self-reported occupational injuries in surveys. Multivariable logistic regression models estimated risk ratios for the impact of occupational injuries on overall job loss, whereas multinomial models were used to estimate OR of voluntary and involuntary job loss. Use of marginal structural models allowed for adjustments of multilevel lists of confounders that may be time varying and/or on the causal pathway. Results By 12 months, 30.3% of workers experienced occupational injury, whereas 24.2% experienced job loss by 18 months. Comparing workers who reported occupational injuries to those reporting no injuries, risk ratio of overall job loss within the subsequent 6 months was 1.31 (95% CI 0.93 to 1.86). Comparing the same groups, injured workers had higher odds of experiencing involuntary job loss (OR 2.19; 95% CI 1.27 to 3.77). Also, compared with uninjured workers, those injured more than once had higher odds of voluntary job loss (OR 1.95; 95% CI 1.03 to 3.67), while those injured once had higher odds of involuntary job loss (OR 2.19; 95% CI 1.18 to 4.05). Conclusions Despite regulatory protections, occupational injuries were associated with increased risk of voluntary and involuntary job loss for nursing home workers.
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U2 - 10.1136/oemed-2015-103067
DO - 10.1136/oemed-2015-103067
M3 - Article
C2 - 26786757
AN - SCOPUS:84958747787
SN - 1351-0711
VL - 73
SP - 175
EP - 182
JO - Occupational and Environmental Medicine
JF - Occupational and Environmental Medicine
IS - 3
ER -