Fact Sheet: Health Care Service – 2013
Non-Fatal Work-Related Injuries to Massachusetts Teens
Teens at Work: Injury Surveillance and Prevention Project
Occupational Health Surveillance Program
Massachusetts Department of Public Health
Background
While work can provide benefits to youth, it can also pose safety risks. The Massachusetts Department of Public Health’s Teens at Work: Injury Surveillance and Prevention Project (TAW) collects data on work-related injuries to minors, and uses the information to help plan prevention activities throughout the state. 

The findings presented here are based on data collected by TAW during the calendar years 2005-2010 using information from workers’ compensation (WC) lost wage claims, for injuries resulting in five or more lost work days, and reports from a sample of hospital emergency departments (ED).

For a detailed description of the project, please see our “Overview Fact Sheet.” All of our materials are available online: www.mass.gov/dph/teensatwork. 
Overview
Healthcare is the largest industry in Massachusetts, and has grown nationwide over the past decade. While only 4% of working MA15- to 17-year-olds worked in health care from 2005-2010, this proportion is also likely to grow. 

Despite the small percentage of MA teens working in health care, 175 (12%) of the 1,666 work-related injuries identified by the TAW Project from 2005 through 2010 (for which industry was known) occurred in this industry. 59% of these injuries were identified through WC lost wage claims, and 41% through hospital ED reports.

This fact sheet provides a closer look at these non-fatal injuries to teens working in health care service.

47% of injured teens interviewed said they received no safety training prior to their health care injury. 

Source: Teens at Work: Injury Surveillance System, 2000-2010, MDPH.

Injuries by Gender
Unlike most other industries, the majority of teen workers in health care services were female. It is not surprising, then, that far more female workers were injured in health care facilities than males. This was reflected in both data sources (Figure 1).

Source: Teens at Work: Injury Surveillance System, MDPH.
Injuries by Age
Nearly all injuries occurred among 16- and 17-year-olds—92% in WC data, and 99% in ED data. There were very few injuries to younger teens (Figure 2).

Persons under 14 may not work. View our “Child Labor Laws in Massachusetts” poster online: www.mass.gov/dph/teensatwork. Click on ‘Educational Materials’ then ‘Working Teen Pamplets.’

Note: Note: Cases where either age was missing or teens were <16 were not included in the calculations. 
Source: Teens at Work: Injury Surveillance System, MDPH.

Injuries by Establishment Type
Of the 175 injuries identified, 137 (79%) occurred in “nursing and residential care facilities,” accounting for the vast majority of injuries to teens working in health care facilities. 

Injuries also occurred in “hospitals” (n=25) and “ambulatory health care services” (n=13) establishments, but were far fewer in number (Figure 3).

Source: Teens at Work: Injury Surveillance System, MDPH.
Injury Type
Injury Type by Data Source
“Open wounds” (including cuts) accounted for about a third of all injuries identified in ED data. “Sprains, strains and tears” accounted for more than half of all injuries identified through WC data (Figure 4).

20

*

* Counts not shown for categories with less than four cases.
Note: Cases where injury type was unknown were not included in the calculations.
Source: Teens at Work: Injury Surveillance System, MDPH.

Sprains, Strains and Tears by Body Part Affected
Among “sprains, strains and tears” to teens working in health care facilities, backs were affected more than all other body parts combined, accounting for 38 of the cases 
(Figure 5).

Nearly half of the 39 “sprain” injuries for which source was known involved contact with a health care patient. Among the 42 cases for which event type was known, 18 were due to overexertion (as opposed to another event type, such as a slip or a twisting).

Source: Teens at Work: Injury Surveillance System, MDPH.

Open Wounds by Body Part Affected
The majority of “open wounds”sustained by teen workers in health care, including cuts, lacerations and punctures, were to their fingers (Figure 6). Due to the small numbers, little information was available about the source or event involved in these injuries however, several indicated involvement in food preparation.

Note: Cases where body part was missing were not included in the calculations.
Source: Teens at Work: Injury Surveillance System, MDPH.

Injury Type by Gender
“Sprains, strains and tears” were the most common type of injury among female teen workers, accounting for nearly half of all injuries identified (Figure 7). For male teen workers, “open wounds” (including cuts) were most common, making up 38% of injuries, but “sprains” still accounted for a quarter of all male injuries. 

* Counts not shown for categories with less than four cases.
Note: Cases where gender was known but injury type was unknown were not included in the calculations.
Source: Teens at Work: Injury Surveillance System, MDPH.

What Injured Teens Have to Say 
From 2000 through 2010, TAW staff completed interviews with 58 teens health care who were injured on the job. While the information from these interviews does not necessarily represent all young workers who have been injured, it provides important insights about the impact of injuries on teens, and safety gaps that need to be addressed.

Nearly half (47%) of all interviewed teens reported that they had received no training on how to perform their job safely prior to their injury; over half (57%) thought their injury could have been prevented in some way; and over a quarter (28%) of interviewed teens said they did not have a work permit for their job at the time they were injured (Figure 8).

Massachusetts child labor laws require minors to have work permits, which may be obtained through the school district in which the teen lives or goes to school.
Source: Teens at Work: Injury Surveillance System, MDPH.

Young Worker Voices 
“A co-worker and I were lifting a patient to help her sit up in bed….there weren't enough people helping. I pulled my lower back and strained my ligaments.” — 17-year-old female CNA, nursing home

“I was at the sink cleaning a large knife. I got distracted and the knife slipped and the blade cut my finger.” — 16-year-old male cook, hospital

“I was lifting a water cooler above me and I felt my right wrist snap. I did this while cleaning up after lunch was served. I drove myself to the doctor….he X-rayed my arm/wrist and gave me exercises to do. He told me not to lift or play softball until further notice.” 
— 17-year-old dietary aide, nursing home

If you have questions about the information presented here, contact Project Coordinator Beatriz Pazos Vautin: 617-624-5632 or Beatriz.Pazos@state.ma.us. 
Acknowledgements
This fact sheet was prepared by the Massachusetts Department of Public Health’s Teens at Work: Injury Surveillance and Prevention Project, and supported by cooperative agreement # 2U60OH008490-06 from CDC-NIOSH. Its contents are solely the responsibility of the authors and do not necessarily represent the official views of CDC-NIOSH.

Teens at Work Fact Sheet: Health Care | www.mass.gov/dph/teensatwork | 617-624-5632