title: Organisational and occupational risk factors associated with work related injuries among public hospital employees in Costa Rica.
abstract: OBJECTIVE
  To explore the relation between occupational and organisational factors and work related injuries (WRI) among public hospital employees in Costa Rica.
  
  
  METHODS
  A cross-sectional survey was conducted among a stratified random sample of 1000 employees from 10 of the 29 public hospitals in Costa Rica. A previously validated, self-administered questionnaire which included occupational and organisational factors and sociodemographic variables was used. From the final eligible sample (n = 859), a total of 842 (response rate 98%) questionnaires were returned; 475 workers were analysed after excluding not-at-risk workers and incomplete questionnaires. WRI were computed for the past six months.
  
  
  RESULTS
  Workers exposed to chemicals (RR = 1.36) and physical hazards (RR = 1.26) had higher WRI rate ratios than non-exposed workers. Employees reporting job tasks that interfered with safety practices (RR = 1.46), and a lack of safety training (RR = 1.41) had higher WRI rate ratios than their counterparts. Low levels of safety climate (RR = 1.51) and safety practices (RR = 1.27) were individually associated with an increased risk of WRI. Also, when evaluated jointly, low levels of both safety climate and safety practices showed the highest association with WRI (RR = 1.92).
  
  
  CONCLUSIONS
  When evaluated independently, most of the occupational exposures and organisational factors investigated were significantly correlated with an increased injury risk. As expected, some of these associations disappeared when evaluated jointly. Exposure to chemical and physical hazards, lack of safety training, and low levels of safety climate and safety practices remained significant risk factors for WRI. These results will be important to consider in developing future prevention interventions in this setting.
authors.affiliation: Southwest Center for Occupational and Environmental Health, The University of Texas School of Public Health, PO Box 20186, Houston, Texas 77225-0186, USA.
authors.forename: D
authors.initials: D
authors.lastname: Gimeno
authors.forename: S
authors.initials: S
authors.lastname: Felknor
authors.forename: K D
authors.initials: KD
authors.lastname: Burau
authors.forename: G L
authors.initials: GL
authors.lastname: Delclos
mesh_terms: D000328:Adult; D003364:Costa Rica / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004865:Equipment and Supplies, Hospital / Q000009:adverse effects; D005260:Female; D015386:Hazardous Substances / Q000009:adverse effects; D006779:Hospitals, Public / Q000458:organization & administration; D006801:Humans; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology* / Q000209:etiology; D016273:Occupational Exposure / Q000009:adverse effects; D010564:Personnel, Hospital / Q000193:education / Q000706:statistics & numerical data*; D011159:Population Surveillance / Q000379:methods; D015995:Prevalence; D011369:Professional-Patient Relations; D012307:Risk Factors; D012449:Safety / Q000592:standards; D014947:Wounds and Injuries / Q000453:epidemiology* / Q000209:etiology
chemical_list: D015386:Hazardous Substances