Marginal structural modelling of associations of occupational injuries with voluntary and involuntary job loss among nursing home workers
Year: 2016
Type: article
Study design: Observational Study
Abstract: 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.
Institutions: Harvard University, Boston University, Portland State University
Language: English
Subfield: Occupational Therapy
Field: Health Professions
Domain: Health Sciences
Open Access status: green
Funders: Harvard University, Harvard Catalyst, National Institutes of Health, National Institute on Aging, National Heart, Lung, and Blood Institute, National Institute for Occupational Safety and Health, National Center for Advancing Translational Sciences, National Institute on Minority Health and Health Disparities, Eunice Kennedy Shriver National Institute of Child Health and Human Development
Awards: G1470284823, G2066364297, G2233451242, Archiving the occupational cohorts in the Work, Family, and Health Network, G2749462338, G2967843719, G3518817918, G5546630224, Flexible Work and Well-Being Center at the University of Minnesota, G5924247454, A Translational Coordinating Center for the Work, Family and Health Network, G73521160, Evaluating cardiometabolic and sleep health benefits of a workplace intervention
OpenAlex ID: W2319684997