title: Contribution of health status and prevalent chronic disease to individual risk for workplace injury in the manufacturing environment.
abstract: OBJECTIVE
  An 'information gap' has been identified regarding the effects of chronic disease on occupational injury risk. We investigated the association of ischaemic heart disease, hypertension, diabetes, depression and asthma with acute occupational injury in a cohort of manufacturing workers from 1 January 1997 through 31 December 2007.
  
  
  METHODS
  We used administrative data on real-time injury, medical claims, workplace characteristics and demographics to examine this association. We employed a piecewise exponential model within an Andersen-Gill framework with a frailty term at the employee level to account for inclusion of multiple injuries for each employee, random effects at the employee level due to correlation among jobs held by an employee, and experience on the job as a covariate.
  
  
  RESULTS
  One-third of employees had at least one of the diseases during the study period. After adjusting for potential confounders, presence of these diseases was associated with increased hazard of injury: heart disease (HR 1.23, 95% CI 1.11 to 1.36), diabetes (HR 1.17, 95% CI 1.08 to 1.27), depression (HR 1.25, 95% CI 1.12 to 1.38) and asthma (HR 1.14, 95% CI 1.02 to 1.287). Hypertension was not significantly associated with hazard of injury. Associations of chronic disease with injury risk were less evident for more serious reportable injuries; only depression and a summary health metric derived from claims remained significantly positive in this subset.
  
  
  CONCLUSIONS
  Our results suggest that chronic heart disease, diabetes and depression confer an increased risk for acute occupational injury.
authors.affiliation: Quantitative Sciences Unit, Stanford University School of Medicine, Stanford, California, USA.
authors.forename: Jessica
authors.initials: J
authors.lastname: Kubo
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Goldstein
authors.forename: Linda F
authors.initials: LF
authors.lastname: Cantley
authors.forename: Baylah
authors.initials: B
authors.lastname: Tessier-Sherman
authors.forename: Deron
authors.initials: D
authors.lastname: Galusha
authors.forename: Martin D
authors.initials: MD
authors.lastname: Slade
authors.forename: Isabella M
authors.initials: IM
authors.lastname: Chu
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
mesh_terms: D000062:Accidents, Occupational / Q000523:psychology; D000328:Adult; D001249:Asthma / Q000150:complications / Q000453:epidemiology; D002908:Chronic Disease / Q000453:epidemiology; D015331:Cohort Studies; D003863:Depression / Q000150:complications / Q000453:epidemiology; D003866:Depressive Disorder / Q000150:complications / Q000453:epidemiology; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000453:epidemiology; D007221:Industry; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000150:complications / Q000453:epidemiology; D060051:Occupational Injuries / Q000209:etiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D014937:Work; D017132:Workplace
keywords: chronic disease; diabetes; heart disease; occupational accidents