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Nursing Health, & Environment: Strengthening the Relationship to Improve the Public's Health
seafood taken from local waterways and by explaining appropriate measures for rinsing pesticide residues from fruits and vegetables.
THE WORKPLACE ENVIRONMENT
The workplace is an important setting to consider when studying environmentally related illness; environmental hazards and exposures can be substantial in occupational settings. At present, workplace injuries and fatalities are the most well-documented indices of adverse effects of the environment on health. More than 2.25 million work-related illnesses and injuries were reported to the U.S. Department of Labor in 1993 (BLS, April 26, 1995). Three primary occupations with at least 100,000 cases involving work absences2—truck drivers, nonconstruction laborers (except farm), and nursing aides and orderlies—had larger shares of the injury and illness case total for 1993 than their share of the total workforce (BLS, May 15, 1995). Sprains and strains were by far the leading type of injury, and the parts of the body most often affected were the back, shoulder, and other areas of the upper trunk. The three most common injuries or illnesses in terms of number of lost work days were carpal tunnel syndrome (median = 30 lost days), amputation (median = 22 lost days), and fractures (median = 20 lost days). Men accounted for a larger share (two-thirds) of the survey-wide total absences due to injuries and illnesses than their share (55 percent) of total employment. Women injured on the job accounted for a larger share of repetitive motion disorders (64 percent) and injuries from violent acts (57 percent) than their share of total employment (45 percent).
The costs to employers and society of these injuries are high and can be measured in lost work days: 20 percent of injured people were absent from work for 31 days or more. There were 117,000 absences in 1993 from work due to work-related illnesses, including carpal tunnel syndrome and long-term latent diseases, such as skin cancer following exposure to arsenic or ionizing radiation. The incidence of occupational diseases is believed to be understated in the survey because of: (1) the difficulty in relating these illnesses to the workplace, and (2) the failure of health care providers to recognize and report such conditions as being work related (BLS, April 26, 1995).
A total of 6,271 fatal work injuries were reported to the BLS in 1993—highway traffic incidents were the most common cause of death (20 percent),
An "absence" is defined as one or more work days lost due to a single episode of occupational injury or illness. Thus, five lost work days due to a sprained ankle equals one absence.