Nonfatal Injuries Among Skilled Nursing and Residential Care Facility Workers Treated in U.S. Emergency Departments, 2015-2022
Am J Prev Med. 2025 May 6:107645. doi: 10.1016/j.amepre.2025.107645. Online ahead of print.
ABSTRACT
INTRODUCTION: Skilled nursing and residential care facilities (SNRCFs) report among the highest nonfatal occupational injury rates compared to the overall working population. This cross-sectional study reports nonfatal emergency department (ED)-treated injury national estimates among U.S. SNRCF workers.
METHODS: Nonfatal ED-treated occupational injury data were analyzed (2015-2022) from the National Electronic Injury Surveillance System, Occupational Supplement, a national probability sample of approximately 67 U.S. EDs. Occupational injuries in SNRCFs were selected using relevant U.S. Census Bureau industry codes. National estimates and rates per 10,000 worker full-time equivalents (FTEs) were calculated using the U.S. Current Population Survey. Piecewise linear regression models examined temporal trends in biannual injury rates.
RESULTS: An estimated 569,800 (95% confidence interval 420,400-719,200) injuries occurred from 2015 to 2022, a rate of 302 (223-382) per 10,000 FTEs. Most injuries occurred among females (81%). The most prevalent injury events were overexertion and bodily reaction [38%; 116 (85-147) per 10,000 FTEs], violence [24%; 73 (46-100) per 10,000 FTEs], and falls, slips, and trips [16%; 49 (35-63) per 10,000 FTEs]. SNRCF injury rates were higher than the rest of the healthcare industry and all industries. SNRCF injury rates declined from 2015-2021 [average biannual change -9.6% (-13.3%, -5.9%), p <.001]. Following a 2021 trend change, there was a non-significant increase in injury rates.
CONCLUSIONS: Among the working population, SNRCF workers experience a high rate of nonfatal ED-treated occupational injuries. Future research should confirm trends and study effectiveness and uptake of evidence-based injury prevention interventions across settings.
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