suffered permanent disabilities; younger teens (14-and 15-year-olds) were more likely than older teens (16-and 17-year-olds) to be permanently disabled (Belville et al., 1993). Parker et al. (1994a) found that sprains and strains were the most common causes of severe injury, with strains to the back accounting for 73 percent of all strain injuries. Back injuries were more common in smaller workers and were positively associated with the amount of weight lifted at work. Back sprains and strains made up 15 percent of all young workers' compensated injuries in Massachusetts (Brooks and Davis, 1996). Back pain is unusual among adolescents. Because a history of back pain has been identified as a risk factor for new back injuries (Mitchell et al., 1994; Venning et al., 1987), back strains among adolescent workers may have consequences for their long-term health.

It has been estimated that work-related injuries for all workers in 1993 cost $121 billion in medical care, lost productivity, and wages (National Safety Council, 1995). In 1993–1994, hospital emergency department visits by 15-to 17-year-olds for injuries identified as occurring at work resulted in medical costs of $522 million (in 1993 dollars) (H.B. Weiss et al., 1997). There is no information on the long-term human and economic burden of occupational injuries suffered by young workers. The effects of these injuries on their future health and employment status and the costs incurred by the workers, their families, employers, and society at large remain to be documented.

Work Settings and Injuries

From a prevention standpoint, information about the types of work settings and circumstances in which working children and adolescents are injured is crucial. Not surprisingly, most injuries occur in those industries in which the majority of young workers are employed. Without exception, in studies of nonfatal injuries, half of the injuries occurred among youth employed in retail trades, predominantly in restaurants and food stores (Banco et al., 1992; Belville et al., 1993; Brooks et al., 1993; Brooks and Davis, 1996; Layne et al., 1994; Miller, 1995; Schober et al., 1988). Nationally, nearly 40 percent of work-related injuries suffered by youngsters occur in restaurants, and between 8 percent and 14 percent occur in food stores. Other industries that experience relatively high numbers of such



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