Hi Ho, Hi Ho -- Its off to work we go: injury and violence implications of teenage employment in the US

Carol W. Runyan, MPH, PhDDirector, UNC Injury Prevention Research Center

Professor, Health Behavior & Health EducationProfessor, Pediatrics

UNC-CH

October 2009U. Of MI

TRUE OR FALSE?

1) MI employer may not employ a teen (<18) without supervision, handling cash after 8 PM

2) A teen under age 16 in MI can work 25 hrs/week during the school year

3) A teen under age 18 can work 10 hours/day

4) Teens under age 18 must obtain a work permit from the employer

5) It is legal for a 17 year old to operate a meat slicer

QUIZ on MI CHILD LABOR LAW

Objectives

To describe public health issue of youth employment

To review selected findings from a line of research on youth employment

To consider research & intervention directions

Short video…

Child labor – early 1900’s in the US

Child labor – internationally today

~ 250 million working children worldwide (age 5-14)www.ilo.org for more information

Background re: teen labor, U.S.Background re: teen labor, U.S.

About 75-80% of teens work before HS graduation

Largest proportion work in service & retail establishments (i.e., restaurants, shops).

Work involvement (% working & number of hours worked) increases by age)

Percent working by grade level, US (Source: NIOSH)

%

Potential benefits of youth labor

Help teens with developmental tasks self-esteem enhancement autonomy from parents learn responsibility skill development

Assist with future employment Develop strong work ethic Money for needs (e.g. college) Reduced delinquency & violence?

Potential risks of youth labor

Foster poor work habits & attitudes Exposure to undesirable role models Money & how it’s used School performance declines with # hrs. Diminished relationships with family Fatigue & stress Exposure to hazards Injury Increased delinquency & violence?

Fatal occupational injuries among youth <18, by industry, U.S., 1992-2002, n=678

Types of events: Transportation 45% Contact w/ objects or equipment 19% Assault 18% Falls 7% All other 12%

Male: 89%

White: 74%

Age: 60% are age 16-17

40% < age 1616%

11%

19%

Source: NIOSH, 2004

43%

Causes of deaths & ED visits, age 14-17, US

Cause Death(2006)

ED visits (2007)

MVC 2,385 208,172

Homicide 1060 190,927

Suicide 837 50,752

Work-related 38 ~52,600

(age 15-17 only, 2006)

Fatality Rates/100,000 Fulltime Equivalents (FTE) by Age Group, United States, 1994-2003

                                                                                    

LEGAL CONTEXT

• Work permits required (age 11-18), issued at schools

- Maximum penalty: $500

Allowable Hours:Age <16:

40/week (school not in session); 18/week (school year); 10 hrs/day

Age 16-17: 48/week (school & work combined); 10 hrs/day

Michigan child labor law

•Illegal to employ an unsupervised person <18 years of age to work alone after sunset or 8 PM doing cash handling

Penalty: $2,000

Michigan child labor law (continued)

Child Labor Policy– basic elements

Federal laws

U.S. Fair Labor Standards Act (1938) Hazardous orders prohibit specific work (agricultural

and non-agricultural) Age restrictions on hours of work

State laws (NC)

Detrimental occupations Additional hour restrictions Work permits required

Hazardous orders -- prohibited tasks for workers age <18 (US)

1. Manufacturing or storing explosives

2. Driving a motor vehicle or work as an outside helper on motor vehicles

3. Coal mining

4. Logging and sawmilling

5. Power-driven woodworking machines

6. Exposure to radioactive substances & ionizing radiation

Hazardous orders -- prohibited tasks for workers age <18 (US)

7. Power-driven hoisting apparatus

8. Power-driven metal-forming, punching & shearing machines

9. Mining, other than coal

10. Power-driven meat-processing machines, slaughtering & meat packing plants

11. Power-driven bakery machines

12. Power-driven paper-products machines

Hazardous orders -- prohibited tasks for workers age <18 (US)

13.Manufacturing of brick, tile and related products

14. Power-driven circular saws, band saws & guillotine shears

15. Wrecking, demolition, & ship-breaking operations

16. Roofing operations

17. Trenching and excavation operations

Agricultural employment of youth -- US

NO restrictions working on parents’ farm

Prohibited for youth age <16 not on parent farm: Operating tractors >20 horsepower Operating corn pickers, cotton pickers, combines, etc. Handling breeding animals (e.g. sows with suckling pigs) Felling, loading, unloading timber >6 inch diameter Using ladders/scaffolds >20 feet Transporting passengers in/on vehicles; being passenger or

outside helper on tractor or other moving apparatus Working inside grain storage silos, manure pits Explosives Specific types of agricultural chemicals

Line of research

Fatality study, NC

Statewideexposure studies NC

US, teens & parents

Jobs & violence prevention

Symposium (synthesis & agenda setting)

NC Teen Construction Workers(Runyan CW, et al., Archives of Pediatric & Adolescent Med., 2007)

Study population, n=187 100% male 85% white Ages

10% age <16 54% age 16 36% age 17

NORTH CAROLINA DEPARTMENT OF LABOR YOUTH EMPLOYMENT CERTIFICATE Please Type or Print Clearly

Name of Youth:

Date of Birth: (mo/da/yr) Age: Sex: Area Code Phone

( )

Complete Mailing Address:

City State Zip Code

Job Description: (Please be as complete as possible)

Company Name: Type of Business: *ABC ON-PREMISES PERMIT? Yes NO

Complete Mailing Address:

City: State: Zip Code Area Code Phone

( )

Teen construction workers’ supervision, NC, 2001, n=187

Percentage of 16-17 year old teen construction workers reporting PROHIBITED tasks, NC, 2001, n-168 (Runyan CW, et al., Archives of Pediatric & Adolescent Med., 2007)

36% Used hand held circular saw

36% Used any other reciprocating saw (besides power table saw or handheld circular saw)

25% Worked as electrician/electrician/s helper

23% Worked in trenches, holes, foundations > 4’ deep

20% Used power nail guns or staple guns

14% Operated forklift

12% Used power table saw

12% Put on shingles or other roofing materials

Number of prohibited tasks reported by 16-17 year old construction workers, NC, 2001 (n=168) (Runyan CW, et al., Archives of Pediatric & Adolescent Med., 2007)

Percentage of 16-17 year old teen construction workers reporting POSSIBLY ILLEGAL TASKS, NC, 2001, n-168 (Runyan CW, et al., Archives of Pediatric & Adolescent Med., 2007)

37% Drove motor vehicle

27% Worked on ladder, scaffold or other structure higher than 6 feet

20% Worked as outside helper on motor vehicle

20% Worked on open floor joists

17% Worked on roofs doing other things (i.e. besides shingles/roofing materials)

14% Operated tractor or other heavy equipment

Conclusions

Teens in this industry are exposed to numerous hazards & risks

Teen labor restrictions are not well enforced in construction industry in NC

Efforts to understand & modify business practices are critical Training of supervisors may be target for change

National (U.S.) Study of Teen Retail & Service Workers & Their Parents

Supported by a grant from the National Institute of Occupational Safety and Health (NIOSH) to

the UNC IPRC

Eligibility criteria

Teen age 14-18 Worked during prior 12 months for at > 2 months Worked while age <18 years English-speaking Continental U.S. (excludes Alaska & Hawaii) Parental consent Teen assent

Teen & parent perceptions of hazards: “Do you Teen & parent perceptions of hazards: “Do you consider any of your (your child’s) job tasks consider any of your (your child’s) job tasks hazardous?” hazardous?” (Runyan, et al., J. of Adolescent Health, 2009)(Runyan, et al., J. of Adolescent Health, 2009)

14% YES17% YES

TEENS PARENTS

86% NO 83% NO

What parents of teens working in retail/service report What parents of teens working in retail/service report they are somewhat or very concerned about re: teen they are somewhat or very concerned about re: teen work, U.S., 2003, n-860 work, U.S., 2003, n-860 (Runyan, et al., J. of Adolescent Health, 2009)(Runyan, et al., J. of Adolescent Health, 2009)

Issues %

Being there during a robbery 48%

Not having safety training 39%

Working alone 37%

Working too late at night 37%

Not getting enough sleep 35%

Getting physically or sexually assaulted 33%

Being rushed on the job 29%

Handling hazardous equipment, chemicals or toxic substances

22%

Parents’ and teens’ knowledge (% correct answers) of selected laws, US, 2003 (Rauscher, et al, under review)

Percent of U.S. teens in retail & service industry by work hours on school nights, 2003, n=866 (Runyan, et al., 2007, Pediatrics)

Percent of US teens working in retail/service reporting Percent of US teens working in retail/service reporting

training & supervision experiences, 2003, n-866training & supervision experiences, 2003, n-866 (Runyan, et al., 2007, Pediatrics)

Percent 16-17 year old retail/service workers reporting exposure to specific hazards, U.S., 2003

(Runyan, et al, Am. J or Industrial Medicine, 2008)

Use of personal protective equipment (PPE) by teen workers, U.S., 2003 (based on presence of hazard)

(Runyan, et al, Am. J or Industrial Medicine, 2008)

Exposure to specific types of equipment, by sex, U.S. teens in groceries & restaurants, 2003, n=395

(Runyan, et al., 2007, Pediatrics)

Percent of US teens in groceries & restaurants reporting ILLEGAL exposure to equipment, by sex, 2003, n=395 (Runyan, et al., 2007, Pediatrics)

Workplace violations reported by U.S. working adolescents, age 14-17, 2003(Rauscher, et al., Am. J. of Public Health 2008)

%

Child labor violations by age group and type, US, 2003 (Rauscher, et al., Am. J. of Public Health 2008)

Child Labor Violations, by sex, US, 2003, (Rauscher, et al., Am. J. of Public Health 2008)

Numbers of violations, US workers, age 14-17, 2003 (Rauscher, et al., Am. J. of Public Health 2008)

Work Permit Status & HO Violations, US workers, 14-17, 2003 (Rauscher, et al., Am. J. of Public Health 2008)

Work Permit Compliance?

YES (62%) NO (38%)

Any Hour Violation 39% 45%

Night work violation 13% 22%

Worked off the clock 13% 14%

Weekly hour violation 2% 3%

Any HO Violation 33% 33%

In summary… Teens perform many different:

dangerous tasks prohibited tasks

Males & older teens perform more risky & illegal tasks than females or younger teens

Laws are not well enforced Supervision is varied Training is limited Teens & parents not very concerned about work

safety Parental involvement is moderate, though safety is

less of a focus than other topics Parent & teen knowledge very limited

What do we know about interventions to reduce injury in young workers?

Almost nothing….

Methodological issues in studying teen work

Definitional issues

What is a job?

What is a teen worker?

What is a hazard?

What is an injury?

Other surveillance & measurement issues

Surveys vs. other methods Sampling strategies Quality of self-report Human subjects issues Contacting employers

Surveillance & routine reporting Denominator issues

How do primary care clinicians interface with this issue?

Very little…

Employment represents a gap in adolescent medicine practice guidelines (Runyan, J. of Adolescent Health, 2007)

INCLUDED: Obesity & eating

disorders Sex & contraception Use of tobacco, alcohol,

other substances Abuse Driving behaviors Sports exposures Weapons exposure

NOT INCLUDED Work experience

Implications for adolescent medicine practice

Advocate with: government, employers, parents, professionals for safer work for teens, enforcement of existing regulations

Educate teens & parents re: child labor laws & risks

Incorporate work history into care of adolescent patients Work hours (total & school nights) Organization type Risks (hazards, equipment, assault) Kinds of training Supervision by whom & how

Unanswered questions re: etiology & prevention– where do we go from here?

Teen worker

Socio-cultural environment

Social-Ecological Model

Institutional & organizational environment

Interpersonal environment (e.g. supervisor, parents,

peers)

Socio-cultural level

Laws/policies about: Work permits Enforcement of labor laws

Norms and values about: Teen work Acceptability of risk Willingness to intervene through policy

Vocational education / apprenticeships Safety design of workplace Safety monitoring at workplace Safety training Supervision practices Training of business leaders Culture of safety at workplace

Institutional & organizational level (e.g. businesses):

Peer influences on worker safety Supervisor practices Parental involvement in job

selection, guidance re: safety

Interpersonal level

Individual level

Training working teens in: safety practices labor laws exercising their rights as

workers

Questions to pursue…

How safe is work in different settings?

How can we make work safer?

What interventions are worthy of dissemination and how do we best disseminate?

Helpful websites for more information:

Federal resources: http://www.dol.gov/dol/topic/youthlab

or/ParentsofYoung.htm

http://www.youthrules.dol.gov/

www.stopchildlabor.org

Discussion?