Musculoskeletal Injury amongst Illinois Hospital Workers: Incidence, Severity and Staffing, 2018-2023

Introduction: Hospital workers experience musculoskeletal disorders (WMSDs) at rates substantially higher than workers in most other industries, yet regulatory approaches have largely focused on patient-handling hazards and Registered Nurses, with limited attention to other occupational groups or staffing as a structural determinant of risk. This study examines the incidence and severity of WMSDs among Illinois hospital workers and evaluates whether nurse staffing levels are associated with injury rates. Methods: This retrospective observational study analyzed Illinois Workers’ Compensation First Report of Injury (FROI) data for hospital workers from 2018–2023. Musculoskeletal injuries were identified using standardized nature and cause codes aligned with Bureau of Labor Statistics definitions. Injury incidence rates were estimated using negative binomial regression with employment denominators derived from the American Community Survey. Injury severity was examined using logistic regression. For general hospitals with medical-surgical units, hospital-wide nursing WMSD rates were compared by staffing levels using Nursing Hours per Patient Day (NHPPD) and Registered Nurse Hours per Patient Day (RNHPPD). Results: A total of 5,656 hospital worker WMSDs were identified. Nursing assistive personnel and service, maintenance, skilled trades, and security workers experienced the highest injury incidence across all regions. Injury rates were significantly higher in Chicago and Suburban Cook County than in other parts of Illinois. Among injured workers, Registered Nurses and service workers had the highest odds of severe injury. Hospitals in the Chicago metropolitan area showed significantly greater odds of severe injuries. In years with available staffing data, hospitals with higher musculoskeletal injury rates had significantly lower medical-surgical staffing levels, particularly nursing support hours per patient day. Discussion: WMSDs among hospital workers are patterned by occupation, geography, and staffing conditions. Findings suggest that patient-handling programs alone are insufficient without addressing workload and staffing adequacy, particularly for nursing assistive personnel and service workers. Strengthening staffing standards and expanding ergonomic regulation beyond patient lifting may reduce injury risk and improve workforce sustainability in Illinois hospitals. Word count: 319

Author dc:creator

• Ronald E Neimark (24400019)

• Hospital Workers
• Occupational Health

Statement dc:rights

• In Copyright
• Open Access after 2028-05-01

DOI dc:identifier

https://doi.org/10.25417/uic.32995094.v1

OAI identifier oai:identifier

oai:figshare.com:article/32995094