title: Comparison of musculoskeletal disorder health claims between construction floor layers and a general working population.
abstract: OBJECTIVE
  Compare rates of medical insurance claims for musculoskeletal disorders (MSD) between workers in a construction trade and a general worker population to determine if higher physical exposures in construction lead to higher rates of claims on personal medical insurance.
  
  
  METHODS
  Health insurance claims between 2006 and 2010 from floor layers were frequency matched by age, gender, eligibility time and geographic location to claims from insured workers in general industry obtained from MarketScan. We extracted MSD claims and dates of service from six regions of the body: neck, low back, knee, lower extremity, shoulder and distal arm, and evaluated differences in claim rates.
  
  
  RESULTS
  Fifty-one per cent of floor layers (n=1475) experienced musculoskeletal claims compared with 39% of MarketScan members (p<0.001). Claim rates were higher for floor layers across all body regions with nearly double the rate ratios for the knee and neck regions (RR 2.10 and 2.07). The excess risk was greatest for the neck and low back regions; younger workers had disproportionately higher rates in the knee, neck, low back and distal arm. A larger proportion of floor layers (22%) filed MSD claims in more than one body region compared with general workers (10%; p<0.001).
  
  
  CONCLUSIONS
  Floor layers have markedly higher rates of MSD claims compared with a general worker population, suggesting a shifting of medical costs for work-related MSD to personal health insurance. The occurrence of disorders in multiple body regions and among the youngest workers highlights the need for improved work methods and tools for construction workers.
authors.affiliation: Division of General Medical Sciences Department, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA.
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Dale
authors.affiliation: Department of Medical Social Sciences, Northwestern University, Feinberg School of Medicine, Chicago, Illinois, USA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Ryan
authors.affiliation: The Center for Construction Research and Training CPWR, Silver Spring, Maryland, USA.
authors.forename: Laura
authors.initials: L
authors.lastname: Welch
authors.affiliation: Divisions of Infectious Diseases and Public Health Sciences, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA.
authors.forename: Margaret A
authors.initials: MA
authors.lastname: Olsen
authors.affiliation: Work Environment Department, University of Massachusetts Lowell, Lowell, Massachusetts, USA.
authors.forename: Bryan
authors.initials: B
authors.lastname: Buchholz
authors.affiliation: Division of General Medical Sciences Department, Washington University School of Medicine in St. Louis, Saint Louis, Missouri, USA.
authors.forename: Bradley
authors.initials: B
authors.lastname: Evanoff
mesh_terms: D000293:Adolescent; D000328:Adult; D001132:Arm; D060389:Construction Industry; D005430:Floors and Floorcoverings; D006801:Humans; D007348:Insurance, Health / Q000706:statistics & numerical data; D007717:Knee; D008161:Lumbosacral Region; D008297:Male; D008875:Middle Aged; D009140:Musculoskeletal Diseases / Q000453:epidemiology*; D009333:Neck; D009784:Occupational Diseases / Q000453:epidemiology*; D012782:Shoulder; D014481:United States / Q000453:epidemiology; D055815:Young Adult