Disability ranking of US workers employed in 206 occupations: The National Health Interview Survey (NHIS) 1986-1994 DJ Lee, LE Fleming, W LeBlanc, O Gómez-Marín, AJ Caban, T Pitman (University of Miami School of Medicine, Miami, FL, 33136) Funding provided in part by NIOSH Grant number R01 0H03915; http://www.rsmas.miami.edu/groups/niehs/niosh/ INTRODUCTION Studies examining the disability status of selected worker groups such as nurses and postal workers have been published, but a study comparing the disability status of the major working groups in the US has never been undertaken. METHODS The National Health Interview Survey (NHIS) is a multipurpose household survey of the US civilian non-institutionalized population conducted yearly since 1957. Between 1986 and 1994, over 450,000 US workers, age > 18 years, participated in the NHIS. 1 A series of multivariate logistic regression analyses controlling for survey design, age, gender, race, ethnicity, and educational status compared workers in each occupational group to the remaining employed workforce on the following dichotomous dependent variables: < 4 vs. >= 4 days of restricted activity in the previous two weeks; 0 vs. >= 1 days of bed rest in the previous two weeks; 0 vs. >= 1 days of missed work in the previous 2 weeks due to illness or injury; < 4 vs. >= 4 doctor visits in the previous 12 months; 0 vs. >= 1 days spent in a hospital in the previous 12 months; 0 vs. >= 1 reported health conditions; and excellent, very good or good vs. fair or poor reported health status. A disability summary score was created by taking a weighted average of the survey-adjusted multivariate odds ratios for these seven measures. 2, 3 RESULTS The 15 occupational groups reporting the greatest disability included social workers, inspectors, postal clerks, psychologists, grinding machine operators (Table 1). The 15 occupational groups reporting the least disability included dentists, pilots, physicians, pharmacists, and dieticians (Table 2). Conclusions These findings aid in the identification of worker groups that require increased attention for disability research and prevention by the occupational health community. Some of these occupations, such as the nursing professions, have been studied fairly extensively with respect to job-specific tasks thought to increase the risk of disability (e.g., back strain due to lifting). Social workers and psychologists occupied the #1 and #4 rankings, respectively. Since these are both sedentary jobs, research into potential occupational stress-related factors influencing the health of these professions is needed. 4-7 The “low-risk” occupations identified in the present analysis, may have been identified as such due, in part, to a healthy worker effect (e.g., pilots). Nevertheless, study of selected professions, may identify job or worker characteristics which may be protective and which could be adopted for use in high-risk worker groups. 8 References 1. Massey J. Design and estimation for the NHIS 1985-94. Vital & Health Statistics Series #2 . 1989 2. RTI. Software for survey data analysis (SUDDAN) release 8.0.0. 2001 3. Botman SL, Jack SS. Combining national health interview survey datasets: Issues and approaches. Stat Med . 1995;14:669-677 4. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol . 2001;52:397-422 5. Lonne RL. Social workers and human service providers. In: Dollard MF, Winefield T, Winefield HR, eds. Occupational stress in the service professions . London: CRC Press; 2003:281-309. 6. Griffiths SP. Stress in psychological work. In: Dollard MF, Winefield T, Winefield HR, eds. Occupational stress in the service professions . London: CRC Press; 2003:359-388. 7. Lloyd C, King R, Chenoweth L. Social work, stress and burnout: A review. Journal of Mental Health . 2002;11:255-265 8. Nelson DL, Simmons BL. Health psychology and work stress: A more positive approach. In: Quick JC, Tetrick LE, eds. Handbook of occupational health psychology . Washington, D.C.: APA Books; 2003:97-119. AFD1 = 0 vs = 1 Restricted Activity Days in Prior 2 Wks AFD2 = 0 vs = 1 Bed Days in Prior 2 Wks AFD3 = 0 vs = 1 Lost Work Days in Prior 2 Wks CFD1 = 0-3 vs = 4 Doctor Visits in Prior 12 months CFD2 = 0 vs = 1 Hospitalizations in Prior 12 months HS1 = 0 if Health Self-rated Excellent or Good vs = 1 if Health Self-rated Fair or Poor HS2 = 0 vs = 1 Health Condition reported 1.12 1.16 1.78 1.06 1.83 1.69 1.47 1.19 Bill and account collectors 378 15 1.21 1.36 1.25 1.35 1.02 1.01 1.02 1.19 Guards and police, except public service 426 14 1.19 1.12 0.84 1.35 1.11 1.23 1.27 1.20 Actors and directors 187 13 1.25 0.81 1.10 1.30 1.56 1.17 1.34 1.21 Mail carriers, postal service 355 12 1.23 0.99 1.46 1.31 1.31 1.07 1.13 1.21 Punching and stamping press machine operators 706 11 1.22 1.31 1.58 0.99 1.58 1.41 1.32 1.22 Licensed practical nurses 207 10 1.13 1.04 1.31 1.26 1.49 1.15 1.45 1.22 Correctional institution officers 424 9 1.16 0.99 1.30 1.32 1.41 1.27 1.26 1.23 Inspectors/compliance officers, except construction 36 8 1.20 1.40 1.15 1.17 1.38 1.32 1.26 1.23 Specified mechanics and repairers 547 7 1.25 1.46 1.39 1.07 1.57 1.39 1.47 1.28 Nursing aides, orderlies, and attendants 447 6 1.22 1.39 1.42 1.34 1.38 1.05 1.34 1.28 Grinding/abrading/buffing/polishing machine operators 709 5 1.37 0.99 1.24 1.62 1.11 1.14 1.18 1.30 Psychologists 167 4 1.30 1.11 0.92 1.48 1.66 1.62 1.44 1.32 Postal clerks, except mail carriers 354 3 1.26 1.49 1.16 1.57 1.43 1.49 1.51 1.39 Inspectors, testers, and graders 689 2 1.42 1.40 1.28 1.44 1.53 1.46 1.40 1.42 Social workers 174 1 HS2 OR HS1 OR CFD2 OR CFD1 OR AFD3 OR AFD2 OR AFD1 OR Weighted Sum of the Odds Ratios Occupation Census Occupational Code Ranking The 15 Occupations with the Greatest Reported Disability Following Adjustment for Age, Gender, Race/Ethnicity, and Educational Status: the 1986-1994 National Health Interview Survey AFD1 = 0 vs = 1 Restricted Activity Days in Prior 2 Wks AFD2 = 0 vs = 1 Bed Days in Prior 2 Wks AFD3 = 0 vs = 1 Lost Work Days in Prior 2 Wks CFD1 = 0-3 vs = 4 Doctor Visits in Prior 12 months CFD2 = 0 vs = 1 Hospitalizations in Prior 12 months HS1 = 0 if Health Self-rated Excellent or Good vs = 1 if Health Self-rated Fair or Poor HS2 = 0 vs = 1 Health Condition reported 0.65 0.35 0.73 0.58 0.35 0.35 0.39 0.53 Dentists 85 206 0.65 0.37 0.44 0.63 0.74 0.54 0.73 0.61 Airplane pilots and navigators 226 205 0.77 0.64 0.93 0.57 0.56 0.57 0.70 0.68 Physicians 84 204 0.78 1.02 0.69 0.58 0.71 0.78 0.80 0.72 Pharmacists 96 203 0.72 0.60 0.46 0.95 0.69 0.73 0.84 0.74 Dietitians 97 202 0.83 1.13 1.20 0.83 0.46 0.44 0.67 0.74 Driver-sales workers 806 201 0.80 1.16 0.98 0.67 0.68 0.63 0.67 0.75 Farm workers 479 200 0.76 0.87 0.70 0.73 0.79 0.97 0.83 0.77 Sales workers, apparel 264 199 0.75 0.86 0.80 0.76 0.75 0.87 0.79 0.77 Sales counter clerks 275 198 0.91 0.68 1.08 1.09 0.55 0.48 0.61 0.78 Tool and die makers 634 197 0.77 0.73 0.82 0.80 0.94 0.75 0.80 0.79 Sales workers, parts 269 196 0.74 0.64 0.89 0.85 0.88 0.88 0.84 0.79 Bank tellers 383 195 0.83 1.11 0.57 0.64 1.08 0.92 1.00 0.79 Drywall installers 573 194 0.78 1.03 0.93 0.68 0.90 1.04 0.96 0.81 Automobile body and related repairers 514 193 0.79 1.11 0.97 0.83 0.80 0.70 0.79 0.82 Textile sewing machine operators 744 192 HS2 OR HS1 OR CFD2 OR CFD1 OR AFD3 OR AFD2 OR AFD1 OR Weighted Sum of the Odds Ratios Occupation Census Occupational Code Ranking The 15 Occupations with the Least Reported Disability Following Adjustment for Age, Gender, Race/Ethnicity, and Educational Status: the 1986-1994 National Health Interview Survey