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Author: Dembe, Allard E.
Resulting in 10 citations.
1. Dembe, Allard E.
Delbos, Rachel G.
Erickson, J. Bianca
Estimates of Injury Risks for Healthcare Personnel Working Night Shifts and Long Hours
Quality and Safety in Health Care 18,5 (October 2009): 336-340.
Also: http://qshc.bmj.com/content/18/5/336.abstract
Cohort(s): NLSY79
Publisher: BMJ Publishing Group, Ltd. - British Medical Journal Publishing Group
Keyword(s): Health Care; Injuries, Workplace; Shift Workers; Work Hours/Schedule; Work, Atypical

Permission to reprint the abstract has not been received from the publisher.

BACKGROUND: Evidence suggests that working long hours or unconventional shifts (night, evening and rotating shifts) can induce fatigue and stress in healthcare employees that might jeopardise quality of care and patient safety. METHODS: This study is based on a retrospective analysis of 13 years of occupational data from the National Longitudinal Survey of Youth, covering nearly 11,000 American workers. During the study period, 545 injuries were reported by employees in healthcare professions. Cox proportional hazard analyses were used to calculate adjusted hazard ratios comparing the risk of a job-related injury among healthcare workers in various types of demanding schedules to employees working conventional schedules. The analyses were stratified to estimate risks within different occupational classifications and care settings. RESULTS: The greatest injury risks to healthcare workers were in schedules involving overtime or at least 60 h per week. Interestingly, an elevated risk of injury was not observed for healthcare employees working 12 or more hours per day or for those in night, evening or rotating shifts. Among employees working overtime and long-hour (>60 h per week) schedules, those at medical provider offices had a significantly higher risk of injury (HR 2.86) than at hospitals, rehabilitation clinics or long-term care facilities. Support personnel, including aids, attendants, technicians, therapists and dieticians, faced a higher risk of injury than did physicians and nurses. CONCLUSION: Healthcare managers responsible for quality improvement and patient safety programmes should be aware of the possibility for worker fatigue and injury in particular scheduling arrangements.
Bibliography Citation
Dembe, Allard E., Rachel G. Delbos and J. Bianca Erickson. "Estimates of Injury Risks for Healthcare Personnel Working Night Shifts and Long Hours." Quality and Safety in Health Care 18,5 (October 2009): 336-340.
2. Dembe, Allard E.
Delbos, Rachel G.
Erickson, J. Bianca
Banks, Steven M.
Associations Between Employees' Work Schedules and the Vocational Consequences of Workplace Injuries
Journal of Occupational Rehabilitation 17,4 (December 2007): 641-651
Cohort(s): NLSY79
Publisher: Springer
Keyword(s): Accidents; Gender Differences; Injuries, Workplace; Occupations; Shift Workers; Variables, Independent - Covariate; Vocational Rehabilitation; Work Hours/Schedule

Permission to reprint the abstract has not been received from the publisher.

INTRODUCTION: This study examines the effect of long-hour work schedules and nonstandard shift work (e.g., night and evening shifts) on the ability of injured workers to maintain productive employment following a workplace injury. METHODS: Analyses were based on 13 years of data from the National Longitudinal Survey of Youth. Multivariate logistic regression analyses were performed with one of ten nonstandard schedules as the independent variable and a particular vocational consequences as the dependent variable. Vocational consequences included being unable to perform normal job duties, temporary job reassignment, working less than full time, filing a workers' compensation claim, and quitting or being fired because of the injury. Covariates in the regression model included age, gender, occupation, industry, and region. RESULTS: The most prominent effects of working a nonstandard schedule were a increased risk of being fired (OR = 1.81; 1.15-2.90 CI 95%), quitting (OR = 1.68; 1.20-2.36 CI 95%), or being unable to work full time (OR = 1.33; 1.08-1.64 CI 95%) following an injury, compared to injured workers in conventional schedules. Schedules involving overtime and long working hours generally had a greater impact on vocational consequences following a workplace injury than did schedules involving night, evening, and other nonstandard shift work. CONCLUSIONS: Occupational rehabilitation professionals need to consider the specific type of work schedule when developing effective return-to-work plans for injured workers. Special precautions need to be taken for workers returning to schedules that involve more than 12 h per day, 60 h per week, and long commutes.
Bibliography Citation
Dembe, Allard E., Rachel G. Delbos, J. Bianca Erickson and Steven M. Banks. "Associations Between Employees' Work Schedules and the Vocational Consequences of Workplace Injuries." Journal of Occupational Rehabilitation 17,4 (December 2007): 641-651 .
3. Dembe, Allard E.
Erickson, J. Bianca
Relationships Between Stressful Work Schedules and Occupational Injuries: New Findings from the National Longitudinal Survey of Youth
Presented: Philadelphia, PA, American Public Health Association. 130th Annual Meeting, November 2002.
Also: http://apha.confex.com/apha/130am/techprogram/paper_41298.htm
Cohort(s): NLSY79
Publisher: American Public Health Association
Keyword(s): Disability; Injuries; Occupations

Permission to reprint the abstract has not been received from the publisher.

Background: Most outcome studies of occupational injuries and illnesses have tended to focus on direct economic costs and duration of work disability. Rarely have the broader social consequences of work-related disorders or their impacts on injured workers' families, coworkers, and community been investigated. This paper examines a wide range of social consequences including workers' psychological and behavioral responses, vocational function, and family and community relationships

Methods: Literature review and development of conceptual framework

Results: Complex and multifactorial relationships are described whereby occupational injuries and illnesses produce a variety of social consequences involving filing and administration of workers' compensation insurance claims, medical care experiences, domestic function and activities of daily living, psychological and behavioral responses, stress, vocational function, rehabilitation and return to work, and equity and social justice

Conclusion: A research agenda is proposed for guiding future investigations in this field.

Bibliography Citation
Dembe, Allard E. and J. Bianca Erickson. "Relationships Between Stressful Work Schedules and Occupational Injuries: New Findings from the National Longitudinal Survey of Youth." Presented: Philadelphia, PA, American Public Health Association. 130th Annual Meeting, November 2002.
4. Dembe, Allard E.
Erickson, J. Bianca
Delbos, Rachel G.
Predictors of Work-Related Injuries and Illnesses: National Survey Findings
Journal of Occupational and Environmental Hygiene 1,8 (August 2004): 542-550
Cohort(s): NLSY79
Publisher: Taylor & Francis
Keyword(s): Family Income; Injuries; Job Characteristics; Job Hazards; Job Satisfaction; Occupations; Rural Areas; Shift Workers; Variables, Independent - Covariate; Working Conditions

This study used national survey data of working adults (aged 33-41) to identify factors associated with the occurrence of occupational injuries and illnesses. Data from the National Longitudinal Survey of Youth were used to compare selected employment and personal characteristics for respondents who reported experiencing a work-related injury or illness with those who did not. Multivariate analyses were performed to calculate nationally representative odds ratios reflecting the likelihood for specific individual attributes and job characteristics to be associated with the reporting of a work-related injury or illness, while controlling for relevant covariates. In this study the incidence of occupational injuries was related to several demographic factors, including low family income and rural residence, and several job characteristics, including working in a high-hazard occupation, job dissatisfaction, and exposure to six specific hazardous job activities: (1)performing lots of physical effort on the job, (2) lifting or carrying more than 10 lbs, (3) using stairs and inclines, (4) kneeling or crouching, (5) reaching, and (6) hearing special sounds. These results suggest targeted prevention strategies for decreasing the incidence of work-related injuries and illnesses, such as worker self-assessment of the total physical effort demanded by a job and periodic monitoring of workforce job satisfaction. [ABSTRACT FROM AUTHOR]
Bibliography Citation
Dembe, Allard E., J. Bianca Erickson and Rachel G. Delbos. "Predictors of Work-Related Injuries and Illnesses: National Survey Findings." Journal of Occupational and Environmental Hygiene 1,8 (August 2004): 542-550.
5. Dembe, Allard E.
Erickson, J. Bianca
Delbos, Rachel G.
Banks, Steven M.
Nonstandard Shift Schedules and the Risk of Job-Related Injuries
Scandinavian Journal of Work, Environment and Health 32,3 (June 2006): 232-340.
Also: http://www.sjweh.fi/show_abstract.php?abstract_id=1004
Cohort(s): NLSY79
Publisher: Finnish Institute of Occupational Health, Finland
Keyword(s): Injuries; Job Characteristics; Job Hazards; Job Satisfaction; Occupations; Shift Workers; Variables, Independent - Covariate; Working Conditions

Permission to reprint the abstract has not been received from the publisher.

OBJECTIVES: This study assessed the extent to which working various types of nonstandard shift schedules (e.g., night and evening shifts) is associated with the risk of occupational injuries or illnesses.

METHODS: Multivariate analyses were conducted using data from 13 years (1987 to 2000) of the National Longitudinal Survey of Youth (NLSY) encompassing 110 236 job records and over 82 000 person-years of work experience. Cox proportional hazard regression techniques were used to derive hazard ratios comparing the relative risk of suffering a work-related injury among people working night, evening, rotating, split, and irregular shifts to the risks for those working conventional day shifts, after adjustment for age, gender, occupation, industry, and region. Incidence rates were normalized using a common denominator of 100 person-years of "at-risk time" to obtain valid comparisons.

RESULTS: All of the nonstandard shift schedules, except split shifts, were found to have a higher risk for occupational injuries and illnesses than conventional day shifts. After control for the selected covariates, the calculated hazard ratios were 1.43 for evening shifts [95% confidence interval (95% CI) 1.26-1.62], 1.36 for rotating shifts (95% CI 1.17-1.58), 1.30 for night shifts (95% CI 1.12-1.52), 1.15 for irregular shifts (1.03-1.30), and 1.06 for split shifts (0.71-1.58).

CONCLUSIONS: These findings suggest that nonstandard shifts are not more risky merely because of the concentration of hazardous jobs in those types of schedules or because of underlying differences in the characteristics of employees working nonstandard shifts. The results point to the need to extend targeted injury prevention programs not only to people working night shifts, but also to those who work evenings.

Bibliography Citation
Dembe, Allard E., J. Bianca Erickson, Rachel G. Delbos and Steven M. Banks. "Nonstandard Shift Schedules and the Risk of Job-Related Injuries." Scandinavian Journal of Work, Environment and Health 32,3 (June 2006): 232-340.
6. Dembe, Allard E.
Erickson, J. Bianca
Delbos, Rachel G.
Banks, Steven M.
The Impact of Overtime and Long Work Hours on Occupational Injuries and Illnesses: New Evidence from the United States
Occuptional and Environmental Medicine 62 (2005):588–597.
Also: http://oem.bmjjournals.com/cgi/content/full/62/9/588
Cohort(s): NLSY79
Publisher: BMJ Publishing Group, Ltd. - British Medical Journal Publishing Group
Keyword(s): Commuting/Type, Time, Method; Health/Health Status/SF-12 Scale; Injuries; Work Histories; Work Hours/Schedule

Permission to reprint the abstract has not been received from the publisher.

Aims: To analyse the impact of overtime and extended working hours on the risk of occupational injuries and illnesses among a nationally representative sample of working adults from the United States.

Methods: Responses from 10 793 Americans participating in the National Longitudinal Survey of Youth (NLSY) were used to evaluate workers' job histories, work schedules, and occurrence of occupational injury and illness between 1987 and 2000. A total of 110 236 job records were analysed, encompassing 89 729 person-years of accumulated working time. Aggregated incidence rates in each of five exposure categories were calculated for each NLSY survey period. Multivariate analytical techniques were used to estimate the relative risk of long working hours per day, extended hours per week, long commute times, and overtime schedules on reporting a work related injury or illness, after adjusting for age, gender, occupation, industry, and region.

Results/: After adjusting for those factors, working in jobs with overtime schedules was associated with a 61% higher injury hazard rate compared to jobs without overtime. Working at least 12 hours per day was associated with a 37% increased hazard rate and working at least 60 hours per week was associated with a 23% increased hazard rate. A strong dose-response effect was observed, with the injury rate (per 100 accumulated worker-years in a particular schedule) increasing in correspondence to the number of hours per day (or per week) in the workers' customary schedule.

Conclusions: Results suggest that job schedules with long working hours are not more risky merely because they are concentrated in inherently hazardous industries or occupations, or because people working long hours spend more total time "at risk" for a work injury. Strategies to prevent work injuries should consider changes in scheduling practices, job redesign, and health protection programmes for people working in jo bs involving overtime and extended hours.

Bibliography Citation
Dembe, Allard E., J. Bianca Erickson, Rachel G. Delbos and Steven M. Banks. "The Impact of Overtime and Long Work Hours on Occupational Injuries and Illnesses: New Evidence from the United States." Occuptional and Environmental Medicine 62 (2005):588–597. A.
7. Dembe, Allard E.
Savageau, Judith A.
Erickson, J. Bianca
Banks, Steven M.
Social Inequalities in Occupational Health Care
Presented: Washington, DC, AcademyHealth Annual Research Meeting, "Disparities in Health and Health Care: Race, Ethnicity & Patients' Experiences with Health Care", June 2002
Cohort(s): NLSY97
Publisher: AcademyHealth
Keyword(s): Benefits, Disability; Benefits, Insurance; Educational Attainment; Ethnic Differences; Family Income; Health Care; Hispanics; Injuries; Occupations; Racial Differences; Socioeconomic Status (SES)

Permission to reprint the abstract has not been received from the publisher.

Research Objective: This study is aimed at determining whether there are disparities in the incidence of occupational injuries and illnesses and in medical care for those disorders, based on workers' race, ethnicity, and socioeconomic status (SES). Few previous studies have investigated social inequalities in occupational health. Based on existing fragmentary evidence, we hypothesize that Blacks, Hispanics, and workers with low SES have a disproportionately high incidence of occupational injuries and illnesses, receive inferior medical care, suffer more severe disability, return to work more slowly, and are less likely to receive compensation benefits than are whites and those with high SES .

Study Design: Retrospective cross-sectional analysis of two existing national population-based surveys: the National Ambulatory Medical Care Survey (NAMCS) and National Longitudinal Survey of Youth (NLSY). Pilot studies by us have demonstrated the usefulness of these databases in providing new information about occupational health care. This study will result in descriptive analyses of work-related cases from each database, including stratified sub-analyses comparing patient experiences among racial, ethnic, and socioeconomic patient groups, and selected multivariate analyses to assess the interactive effect of patient sociodemographic characteristics with employment experiences, medical services, and vocational outcomes.

Population Studied: The NAMCS covers physician-reported data for a nationally representative sample of 46,875 ambulatory medical care visits made in 1997-1998. 1,179 of those visits (2.5%) were for diagnosis and treatment of work-related conditions. Our analysis of the NLSY covers the experiences of 7,508 persons aged 33-4 who were interviewed in 1 998, of which 563 (7.5%) self-reported experiencing an occupational injury or illnesses in the 2-year period preceding the interview.

Principal Findings: Both analyses suggest that there are significant disparities among the social groups studied. In the NAMCS, Hispanics with work-related conditions required insurer authorization for care 57% more often than non-Hispanics, and Blacks 1 4% more often than whites. On average, Blacks saw a physician during their visit 6% less often than whites, and Hispanics 5% less often than non-Hispanics. Blacks had blood pressure measured at the visit 32% less often than whites, and Hispanics 11 % less often than non-Hispanics. The NLSY analysis indicated that following a work-related condition, Blacks were 1 6% more likely to miss work, had 28% more missed work days, and were 18% more likely to lose wages than non-Blacks. Similar patterns were observed among Hispanics compared to non-Hispanics, and low-SES (as indicated by educational attainment and family income) compared to high-SES workers.

Conclusions: Preliminary data from two national health care surveys indicates disparities in occupational health and health care for work-related conditions based on patients' race, ethnicity, and SES. These studies have demonstrated the usefulness of national survey databases as a novel source for collecting information about the health and vocational experiences of injured workers.

Implications for Policy, Delivery or Practice: This study helps demonstrate the barriers that Black, Hispanic, and low-SES workers face in accessing occupational health care, and their susceptibility to more severe vocational impacts following a work-related injury. These findings will help alert policymakers and public health advocates to the need to devise specific strategies for protecting the health and earning capacity of minority and low-wage workers.

Bibliography Citation
Dembe, Allard E., Judith A. Savageau, J. Bianca Erickson and Steven M. Banks. "Social Inequalities in Occupational Health Care." Presented: Washington, DC, AcademyHealth Annual Research Meeting, "Disparities in Health and Health Care: Race, Ethnicity & Patients' Experiences with Health Care", June 2002.
8. Dembe, Allard E.
Yao, Xiaoxi
Chronic Disease Risks From Exposure to Long-Hour Work Schedules Over a 32-Year Period
Journal of Occupational and Environmental Medicine 58,9 (September 2016): 861-867.
Also: http://journals.lww.com/joem/Citation/2016/09000/Chronic_Disease_Risks_From_Exposure_to_Long_Hour.2.aspx
Cohort(s): NLSY79
Publisher: American College of Occupational and Environmental Medicine
Keyword(s): Gender Differences; Health, Chronic Conditions; Health, Mental/Psychological; Health/Health Status/SF-12 Scale; Work Hours/Schedule

Permission to reprint the abstract has not been received from the publisher.

Objectives: This study aims at evaluating the chronic disease risk related to prolonged work in long-hour schedules for eight major chronic diseases: heart disease, non-skin cancer, arthritis, diabetes, chronic lung disease, asthma, chronic depression, and hypertension.

Methods: The study used data from the National Longitudinal Survey of Youth, 1979 covering 32 years of job history (1978 to 2009) for 7492 respondents. Logistic regression analyses were performed to test the relationship between average weekly work hours, and the reported prevalence of those conditions for each individual.

Results: Regularly working long hours over 32 years was significantly associated with elevated risks of heart disease, non-skin cancer, arthritis, and diabetes. The observed risk was much larger among women than among men.

Conclusions: Working long-hour schedules over many years increases the risk for some specific chronic diseases, especially for women.

Copyright (C) 2016 by the American College of Occupational and Environmental Medicine

Bibliography Citation
Dembe, Allard E. and Xiaoxi Yao. "Chronic Disease Risks From Exposure to Long-Hour Work Schedules Over a 32-Year Period." Journal of Occupational and Environmental Medicine 58,9 (September 2016): 861-867.
9. Dembe, Allard E.
Yao, Xiaoxi
Wickizer, Thomas
Shoben, Abigail
Dong, Xiuwen Sue
A Novel Method for Estimating the Effects of Job Conditions on Asthma and Chronic Lung Disease
Journal of Asthma 51,8 (2014) 799-807.
Also: https://www.tandfonline.com/doi/full/10.3109/02770903.2014.917183
Cohort(s): NLSY79
Publisher: Taylor & Francis Group
Keyword(s): Asthma; Health, Chronic Conditions; Job Hazards; Occupational Information Network (O*NET); Working Conditions

Permission to reprint the abstract has not been received from the publisher.

Objective: This study uses 32 years of longitudinal job history to analyze the long-term effect of exposure to specific workplace conditions on the risk of contracting asthma or chronic lung disease later in life. Our approach allows for the estimation of occupational respiratory risks even in the absence of direct environmental monitoring.

Methods: We employ a novel methodology utilizing data from the National Longitudinal Survey of Youth 1979 (NLSY79), and ratings of job exposures from the Occupational Information Network (O*NET), which are based on 70 years of empirical data compiled by the U.S. Department of Labor. A series of multivariable logistic regression analyses are performed to determine how long-term exposure to a particular occupational O*NET indicator (e.g., working in an extremely hot or cold environment) is related to asthma and COPD risk.

Results: The risk of contracting COPD was significantly associated with long-term work in very hot or cold temperatures (OR = 1.50, CI: 1.07-2.10), performing physically demanding activities (OR = 1.65, CI:1.20-2.28), working outdoors exposed to weather (OR = 1.45, CI:1.06-1.99), and workplace exposure to contaminants (OR = 1.42, CI:1.05-1.96). In general, the effects of exposure were greater for COPD than for asthma. With respect to contracting asthma, only exposure to work in very hot or cold temperatures (OR = 1.35, CI:1.08-1.70) and performing physically demanding activities (OR = 1.23, CI:1.00-1.52) were statistically significant.

Conclusions: Use of O*NET job descriptors as surrogate measures of workplace exposures can provide a useful way of analyzing the risk of occupationally-related respiratory disease in situations where direct exposure measurement is not feasible.

Bibliography Citation
Dembe, Allard E., Xiaoxi Yao, Thomas Wickizer, Abigail Shoben and Xiuwen Sue Dong. "A Novel Method for Estimating the Effects of Job Conditions on Asthma and Chronic Lung Disease." Journal of Asthma 51,8 (2014) 799-807.
10. Dembe, Allard E.
Yao, Xiaoxi
Wickizer, Thomas
Shoben, Abigail
Dong, Xiuwen Sue
Using O*NET to Estimate the Association Between Work Exposures and Chronic Diseases
American Journal of Industrial Medicine 57,9 (September 2014): 1022-1031.
Also: http://onlinelibrary.wiley.com/doi/10.1002/ajim.22342/abstract
Cohort(s): NLSY79
Publisher: Wiley Online
Keyword(s): Health, Chronic Conditions; Occupational Information Network (O*NET); Occupations; Working Conditions

Permission to reprint the abstract has not been received from the publisher.

Background: A standardized process using data from the Occupational Information Network (O*NET) is applied to estimate the association between long-term aggregated occupational exposure and the risk of contracting chronic diseases later in life. We demonstrate this process by analyzing relationships between O*NET physical work demand ratings and arthritis onset over a 32-year period.

Methods: The National Longitudinal Survey of Youth provided job histories and chronic disease data. Five O*NET job descriptors were used as surrogate measures of physical work demands. Logistic regression measured the association between those demands and arthritis occurrence.

Results: The risk of arthritis was significantly associated with handling and moving objects, kneeling, crouching, and crawling, bending and twisting, working in a cramped or awkward posture, and performing general physical activities.

Conclusion: This study demonstrates the utility of using O*NET job descriptors to estimate the aggregated long-term risks for osteoarthritis and other chronic diseases when no actual exposure data is available.
Am. J. Ind. Med. © 2014 Wiley Periodicals, Inc.

Bibliography Citation
Dembe, Allard E., Xiaoxi Yao, Thomas Wickizer, Abigail Shoben and Xiuwen Sue Dong. "Using O*NET to Estimate the Association Between Work Exposures and Chronic Diseases." American Journal of Industrial Medicine 57,9 (September 2014): 1022-1031.