Effect of Child Labor Violations on Reported Injuries among Working Youth Janet Abboud Dal Santo J.Michael Bowling Thomas A. Harris 327 teens (20%) reported putting shingles or other materials for roofing, an illegal task. Funding from: The National Institute of Occupational Safety and Health R01-OH03530-02

Presenter Disclosures Janet Abboud Dal Santo (1) The following personal financial relationships with commercial interests relevant to this presentation existed during the past 12 months: < If you have no disclosures to make, type and center within in this text box “No relationships to disclose” (Use at least 24 point type.) > No relationships to disclose < If you have disclosures to make, type within this text box, flush with left margin. Include the Category of Relationship as provided in slide instructions and follow with the name of each commercial interest (company) disclosed. Use at least 18 point type.> < Use separate paragraphs with bullets for each Category of Relationship.> < Continue on a second slide if needed. >

Introduction Over six million adolescent workers in the US. About 80% of adolescents work during high school years. Each year about 160,000 youth under 18 years of age are injured on the job. One third suffer serious injuries that require emergency room treatment. Young workers are at increased risk of injury than adult workers. Injury burden. Negative impact on physical, mental and psychological development Lower school attendance and achievement High economic cost of medical care, disability, and loss of wages and productivity

Objectives Examine associations between sociodemographic variables, child labor violations (Hazardous Order Violations and hour violations) and reported injuries among adolescents Implications for policies aimed at increased compliance with and enforcement of child labor regulations Implications for youth safety interventions and for targeting sub-populations of adolescents at high risk of injuries.

Methods School-based surveys Conducted in 32 randomly selected high schools in North Carolina and South Carolina (Oct–Dec 2008) Teens who had worked in any paid job outside the home during the last two years completed the entire questionnaire Excludes: domestic and agricultural employment Anonymous 15–20 minute questionnaire Non-working students provided only sociodemographic information

Survey Response Using CASRO definition response rate is 73.8–86.6% for North Carolina survey and 82.2–91.1% for South Carolina A total of 1655 working teens completed the whole questionnaire and 2089 non-working students completed socio-demographic section only

Selected Characteristics of the Sample Working Teens % Frequency Urban 41.9 695 Race   White 58.3 942 Black/African American 30.6 495 Other 10.6  171 Male 48.0 785 Age at Survey (≥16) 86.8 1399 Age when started working (≥16) 61.2 918 Grades 11 and 12 78.9 1291 Mother education above high school 60.7 966 Father education above high school 50.6 812 Employed mother 79.1 1248 Employed father 79.7 1190

Characteristics of Working Teens Worked in multiple jobs 41.4% 685 Worked during the school year 79.4% 1307 Still working at the time of 56.7% 928 survey Family ownership of business 10.8% 176 Type of jobs: Services 59.2% 903 Cashiers and sales 23.8% 363 Managers/professionals/admin 5.8% 89 Laborers 10.0% 153 Same as national figures, work during the school year is 80%, here it is 79.4%..

Distribution of Employed Youth by Occupation Managerial, professional, and technical work Precision production, operations, transportation, laborers Food preparation, food services Administrative Support Sales occupations Similar to CPS 1996-1998 in DOL report of 2000. Cashiers Other services 9

Sociodemographic Variables Unadjusted Associations Between Sociodemographic Variables and Reported Injuries Sociodemographic Variables OR 95% Confidence Limit P value Age<16 when started work 1.44 (0.89,2.32) 0.141 Rural 1.52 (0.96,2.42) 0.076 Hispanic origin (0.64,3.61) 0.344 Race White vs black Others vs black 1.30 1.87 (0.73,2.30) 0.86,4.08 0.369 0.115 Gender Male vs female 1.73 (1.07,2.79) 0.024 Business owned by family 3.00 (1.74,5.19) <0.001 Worked more than 3 months 2.27 (0.98, 5.27) 0.056

Unadjusted Associations Between Hazardous Order Violations and Reported Injuries Type of Violation OR 95% Confidence Limit P value Operated power tools or appliances 2.88 (1.72, 4.82) < 0.001 Used a power Slicer or Grinder 1.19 (0.31,4.56) 0.803 Used a power Saw 5.44 (3.07,9.66) Worked in a demolition crew 7.41 (2.32,23.76) 0.001 Used a forklift 3.49 (1.64,7.44) Used power nail guns or staple guns 3.32 (1.83,5.99) <0.001 Worked with a power dough 1.01 (0.22, 4.66) 0.992 Worked with a box crusher 1.29 (0.57, 2.92) 0.538

Unadjusted Associations Between Work Hour Violations and Reported Injuries (<16 years) OR 95% Confidence Limit P value Worked more than 8 hours on a weekend day 2.15 (0.86, 5.34) 0.010 Worked after 7PM on a school night 1.84 (0.78,4.30) 0.161 Worked more than 40 hours during a non-school week 4.43 (2.02,9.72) < 0.001 Worked more than 18 hours per week during a school week 7.41 (2.32,23.76) Worked after 11Pm (<18 years) 1.97 (1.11,3.49) 0.020

Discussion Results suggest that the majority of Hazardous Order violations and hour violations are associated with reported injuries. Results are consistent with findings of previous studies that number of hours worked per week, small businesses and gender are associated with injuries Age was not associated with injuries. Family owned businesses and businesses in rural counties should specifically be targeted for inspections and for educational and other injury prevention interventions.

Limitations Surveys did not employ state-wide random sampling procedures; results may not be generalizeable. Self report by working teens. Recall bias. Teens who worked in domestic employment or in agriculture were excluded from the study. School-based survey so school drop-outs not represented .

Recommendations Stricter enforcement of labor laws by regulatory agencies . Implement new laws for increased penalties for child labor violations. Address failure of most state work permit systems to screen for work hour restrictions by adding a requirement to list the proposed number of daily and weekly work hours and daily end time of work to prevent hour violations. Parents and schools should monitor number of hours worked. Employers should provide adequate safety training, supervision and use of personal protective devices in the workplace. Injury prevention strategies should be tailored to the cognitive, social, and physical development needs of young workers. Health and safety training and education on labor laws and legal rights should be provided to parents, schools, employers, as well as teens to ensure compliance with regulations and safety procedures.