20-year injury trends in drywall injury rates: How much do these changes reflect real progress in work-related injury prevention?

Introduction
Compared to their construction industry counterparts in the U.S., drywall installers are at high risk of work-related injury. These workers are challenging to study from an epidemiologic perspective; research specific to this group is limited.

Methods
Using data from the Carpenters Trusts of Western Washington, we defined a cohort of 5066 union drywall carpenters who accumulated 37 million work hours in Washington State from 1989 through 2008. Outcomes of interest were identified using health utilization claims filed through union-provided insurance and reported workers’ compensation claims provided by Washington State. Data were linked on an individual basis using a blind identifier. Rates of reported work-related injury and health care utilization were calculated. Stratified analyses and regression models examined trends over time.

Results
Forty-two percent of the drywall carpenters (n=2127) experienced 6066 work-related injuries, for an overall rate of 33.1 per 200,000 hours worked. Common injury mechanisms were struck by/against (36%), overexertion/bodily reaction (33%), and falls (12%). Reported work-related injury rates declined from a high of 59.0 per 200,000 hours in 1990 to a low of 15.6 per 200,000 hours in 2008. A similar pattern of decline was observed for the 22% of injuries with paid day(s) away. However, the mean amount of paid lost time per injury with day(s) away increased over time. These trends were observed for acute and overexertion injuries.

Discussion
Among this large cohort of union drywall carpenters, although rates of overall and time loss work-related acute and overexertion injuries declined over the past two decades, the proportion of injuries defined as severe increased over time. Private health care utilization patterns for some diagnoses suggest the decline in injury rates may reflect, in part, the shifting of care from workers’ compensation to union-provided private health insurance. Innovative methods are needed to comprehensively measure the health of construction workers.