Abstract
Introduction
Every nine minutes in the United States, a young worker is injured on the job [1]. Although child labor laws were enacted to prevent mistreatment and to protect minors from work that is damaging to their health and safety, young workers are still twice as likely as adult workers to be injured [2]. Each year in the United States, 70–90 teens are fatally injured, hundreds are hospitalized, and tens of thousands require treatment in emergency rooms for injuries sustained at work. The true number of non-fatal injuries is potentially much greater as the National Institute for Occupational Safety and Health (NIOSH) estimates only one-third of work-related injuries and illnesses are treated in hospital emergency departments [3, 4]. In population-based studies of young workers, between 15 and 41% report having sustained an injury on the job [5–13]. Estimates of those who were “severely injured,” defined as injuries requiring medical treatment, time off from work, or otherwise interfering with daily activities for more than three days, range from 8% to 33% of all working teens [5, 8, 10–12, 5, 8, 10–12].
Workplace injury can have lasting repercussions on health and may be especially dangerous for adolescents during this formative time in their lives. Parker et al. [14, 15] found that 15 to 26% of injured teen workers reported permanent health conditions such as chronic pain, scarring, sensory loss, and loss of range of motion [14, 15]. Based on findings among adult workers, which show a relationship between supervision and safety behaviors and injury reduction, researchers and labor institutions have suggested supervision as a potential mitigating factor for injuries among working youth.
Studies in adult workers have found that a positive perception of supervisors is associated with improved safety behaviors and climate, better communication, and reduced injury [16–22]. Dunbar [16] found in a study of adult workers that the perception that a supervisor cared about one’s safety was associated with a lower rate of injury [16]. Michael et al. [21] reported that employees who had a strong relationship with their supervisors were less likely to be injured or have a near miss incident [21]. Regarding communication, Hofman and Morgeson [17] found that workers who had a higher quality relationship with their supervisors were more likely to feel comfortable voicing safety concerns [17]. In a study assessing influence on construction worker’s attitudes towards safety, Dingsdag et al. [22] found that compared to co-workers, supervisors had a stronger influence on workers’ attitudes towards safety [22].
While there is much research on supervision in adult workers, limited research exists on the quantity and quality of supervision and how supervision impacts safety and health among young workers. Two studies assessed the quantity of supervision and both found many teens work without adult supervision. Runyan et al. [23] found 20% of teens in retail and service jobs worked at least one day without any adult supervision [23]. Lewko et al. [24] found 38% of Canadian teenagers reported working unsupervised for at least part of their shift, and a surprisingly high percent of teenagers worked completely alone, both during the day and at night (14% and 17% respectively) [24]. No additional characteristics about the quality of the relationship or the communication between teen worker and supervisor wereevaluated.
The impact of supervision on risk-taking behaviors and injury has been assessed in two studies. Westaby and Lowe [25] found young workers took fewer risks when their supervisors directly voiced opposition against risk-taking behaviors [25]. Frone [26] found that those teens who perceived their supervisors monitoring them more often were not significantly less likely to get injured [26]. This finding, while surprising, reveals the complexity of this issue and may indicate injury may be related to quality and not just amount of supervision.
Although adult supervision is recommended for working teens, no research has characterized the supervisor-teen worker relationship nor investigated its potential influence on safety and health. Utilizing focus groups and interviews with working teens, the objectives of this study were to: (a) explore teens’ perceptions of supervision and supervisors (b) characterize teen-supervisor communication, and (c) investigate the role of communication in injury and workplace safety.
Methods
Interviews and focus groups were conducted with forty-two working teenagers. All study procedures were approved by the Institutional Review Board of the University of Louisville and the Data Management, Planning, and Program Evaluation Department of the Jefferson County Public Schools.
Recruitment of students
Teens were recruited from two public magnet high schools in Louisville, Kentucky. Each school provides opportunities in career training along with a traditional education. One school is an inner-city school with approximately 88% minority students and offers nine magnet programs, including nursing, business, and pre-law. The second school is a working-class suburban school with approximately 70% white students that offers magnet programs in fine arts, media, and communications.
Teens were recruited during lunch periods. In order to take part in the study, teens had to be 15 years or older, currently employed for pay, and willing to meet afterschool for approximately 2 hours. For teens who met the criteria, we explained the purpose of the study, the amount of time it would take, the compensation for participating, and the consent form. We provided each teen with a reminder card of the focus group/interview day and gave each the consent form to bring home. Most returned the signed consent form on one of the following days while the study team was still in the school recruiting. A study team member called to remind those teens who signed up to participate but who did not return the consent form while we were in the school recruiting to bring the consent form for the focus group/interview. All participants in the study received a phone call reminder the evening before their interview or focus group.
Data collection procedures
Overall, five focus groups and seven interviews were conducted. The discussions were held immediately afterschool in a conference room. Snacks were provided and an ice-breaker was used to relax the teens. All teens younger than 18 years old were assented. A semi-structured guide containing questions that focused on the teens’ jobs, their safety training and supervision at work, and injuries they sustained on the job was utilized. Some prompts were used to obtain additional detail from the teens, but in most cases the teens spoke freely about their experiences. The individual interviews lasted approximately one hour and the focus groups lasted between 1.5 and 2 hours. All discussions were tape recorded and one study team member took notes. The teens were allowed to ask the study team questions about their research when the focus groups and interviews were over. Each teen was provided a $25 gift card for time.
Data analysis
Immediately following a focus group or interview, the recording was downloaded onto the PI’s computer. The recordings were transcribed verbatim by two members of the research team. Once the transcriptions were complete, the data was analyzed using inductive thematic analysis [27, 28]. This method allows themes to emerge from the data, rather than finding examples of preconceived themes in the data. In this method, three research team members read each transcript multiple times and coded the data according to the ideas that emerged from the interviews and focus groups. The research team then met together and agreed upon themes to use in the final analysis. Afterwards the research team re-read the transcripts further analyzing them based on the defined themes.
Results
Forty-two teens aged 15–19 years old participated in the study. The study sample was 57% female and included 69% African-American, 26% white, and 5% Hispanic students. The mean age was 17.1 years old (SD = 1.00). The teens worked a variety of jobs; however, 56% worked in either restaurants/food services or other retail jobs. Of the forty-two teens, 45% (n = 19) had been working at the current job for less than 6 months and 29% (n = 12) had been working at the current job for 7 months to 1 year. Half of the teens (52%, n = 22) reported sustaining an injury at the current job and 48% (n = 20) said they worry about getting hurt at work. Injuries that the teens reported included burns, cuts, sprains, jammed fingers, bruises, and a foot run over bya vehicle.
From the discussions with the teens, three major themes relating to workplace supervision emerged: (a) emphasis on productivity and lack of care, (b) communication breakdown, meaning lack of communication, and (c) a strong sense of self-blame.
Productivity and lack of care
When asked to define supervision, the majority of teenagers interviewed emphasized productivity and doing the job over safety. Almost all the teenagers commented on “being watched” or “stared at” to make sure you are “doing it right” or “staying on task”. As one 17-year old male student who worked for a parcel delivery service stated: “Well, the supervision is highly enforced in the work area. Supervisor’s always watching you, and comin’ back and forth, make sure you doin’ your job and not, not stayin’ off task.” Similarly, a 17-year old female who worked at a skate rink defined her supervisor as “Somebody who watches you to make sure you’re doingit right.”
The teenagers did not mention monitoring safety and safe work practices as part of a supervisor’s job. The teens perceived that productivity was more important than safety. Furthermore, a lack of caring about safety was stressed by many teens. As a 19-year-old female who worked at a superstore explained, “some of them don’t care at all… That’s how I feel. I mean they are not nice, asking me, ‘Oh, how am I doing?’ and stuff like that. They are more like, do your job and you get to go home after.” A 16-year-old female working at a skate rink, described a perceived insincerity in her supervisor’s concern for health and safety: “If [a customer] was to get hurt he’d be the first person there, but if it’s somebody that’s working for him and he’s paying, it’s just like, ‘Oh, they are fine.”’ An 18-year-old female who worked at a parcel delivery service explained that, despite the fact that her supervisors were around often, “I don’t know if they really care or not.”
In some situations, this perceived lack of care from the supervisors is coupled with reported inaction when injuries occurred and/or a reported ignoring and dismissal of safety concerns. As a 15-year-old female working at a pizza restaurant, explained, “a lot of people had been getting burned but they didn’t talk about that in our meeting. They just talked about how to push sales. It’s like they just push it under the rug, they don’t really choose to pay attention to anything but just making the business run good.”
Communication breakdown
i. Don’t want to bother the boss
Communication problems were frequently highlighted by the teenagers. Most of the teens highlighted that they did not talk to supervisors because they did not want to bother them and they feared job loss or retaliation if they tried to discuss health and safety concerns. Most teens stated that instead of talking with supervisors, they would seek answers from co-workers. A 17-year old male summed up his general communication with his supervisor as being too rushed and less friendly than other co-workers: “I probably wouldn’t really have the time ‘cause my supervisor’s just always busy and I just felt more concern talking to the people at customer service ‘cause they more friendly than talking to the supervisor.” Several teens confirmed the practice of seeking answers from co-workers as opposed to supervisors. They additionally highlighted that their supervisors may be unhappy for bothering them with questions or concerns. As a 19-year old female who was working in a superstore stated: “It’s kind of a pain to call up your supervisor and ask them how to do it and sometimes they’re not too happy about having to come over and show you, so it’s easier to ask someone right next to you.” One 17-year old female summed up many of the teens’ behaviors regarding communication “I don’t want to bother the manager with a simple question, so I just ask someone else who’s up there with me who’s been there longer thanI have.”
ii. Ignoring safety concerns and injuries
Some teens reported that they had dismissed or would dismiss their own safety concerns to carry out tasks for their supervisors, rather than voicing these concerns because they feared retaliation. One female who worked at a drive-in restaurant, gave an example where she felt uncomfortable, but when asked if she said something to her supervisor she explained, “I wanted to, but I didn’t. Because at [specific restaurant] you keep all your money that you make in an apron and since you have to go outside, anyone could easily just come through and rob you, but I never said anything about it because they not going to probably change the whole thing just for me. [… ] I think they’re the type who would probably tell me I could find another job.” A 15-year old female working in a pizza restaurant stated that her supervisor “would take it as an insult that I questioned him,” regarding unsafe work tasks or conditions. Teens like these young females not only feel like their supervisors don’t care about their wellbeing, but they also feel unimportant and dispensable. A 17-year-old male working at a carwash echoed the sentiment from the females. He said if he were asked to do something that he felt uncomfortable doing, he would still do it. When asked if he would be concerned about the ramifications of saying no, he answered that, “ … If they are paying me to do a job and if you tell them no, they could easily go find someone else who would do it.”
Several teenagers even dismissed their owninjuries as not serious or worth reporting to their supervisors. One 15-year old female who suffered severe burns working in a pizza parlor highlighted the lack of communication between teen workers and supervisors.
Teen: “I get burned all of the time from hotpans because they are not put up pro-perly or there are too many that youcannot work around.”
Interviewer: What do you do when you get hurt?
Teen: Go to the doctor and put stuff on myburn.
Interviewer: So you don’t tell like your boss or asupervisor.
Teen: They don’t care.
Similarly, many other teens reported never speaking to a supervisor regarding their injuries. A 17-year-old male working at a fast food restaurant said his injuries are “nothing serious. I’ve been burned before at work… It can be serious, but all I do is go to the first aid kit and get some burn cream and then go back to work.” Similarly, another 17-year-old male who used to work at a fast food pizza restaurant said “[he’d] probably get burned about 3 times a day.” When asked if he thought it was a serious issue, he answered,“No I never did. I was taught growing up not to run and tattle about everything, so that was just kind of my personal reaction.” Some teens view speaking up about their safety concerns as risky, and speaking up about their injuries unnecessary or “tattling”, rather than viewing both of these things as ways to make their workplace safer for themselves and others.
Strong sense of self-blame
During the discussions with the teens, a strong sense of self-blame was apparent when they talked about their injuries at work. Fifty-two percent of the teens were injured at work, but most blamed themselves and few reported their injuries to their supervisors. As one 15-year old female who worked in a pizza parlor stated about her injury “ … .it already happened, so that there is nothing really that they can do because it is really my own fault when I get burned.” A 16-year old female who worked as a housecleaner with multiple cleaning agents displayed self-blame when she “used too much” of an agent and became sick: “One time I did use too much of a certain kind of cleaning agent and I did start feeling sick because I was breathing it in.” The most astonishing example of self-blame was the response from a 16-year-old female who worked at a car wash and had her foot run over by a car: “It [was] my fault because I didn’t watch out for the car and I wasn’t paying no bit of attention.” When talking about their injuries these teens saw themselves, not the system within which they were working, as theproblem.
Discussion
Teenagers are frequently injured on the job and many injuries are severe. Among the 42 working teens in this study, 52% of them reported being injured and almost half reported being afraid of getting injured at work. Supervision has been suggested as one factor in promoting workplace safety and preventing injury, although limited information about supervision exists.
Overall, there is a common perception among working teenagers that their supervisors cared about productivity, more so than safety and health. Many teens commented that their supervisors merely checked up on them to make sure the job was being done correctly, not for safety reasons. In some cases, this perception of indifference influenced the teen’s communication with the supervisor. Some teenagers who felt that their supervisors didn’t really care about them seemed less inclined to talk to them about their safety concerns and their injuries. Additionally, many teens voiced feelings of being dispensable and easily replaced at their jobs, which prohibited many of them from speaking up about their safety at work. Many teens did what they were told, regardless of safety and regardless of being injured. A study by Breslin et al. [29] found that power dynamics between supervisor and teen played a role in teens’ perceptions of being insignificant and dispensable. These feelings and other power dynamics not addressed in our study could be a reason why teens choose not to speak up about concerns and injuries atwork [29].
The teen-supervisor relationship and communication was strongly impacted by the issue of self-blame. Most of the injured teens blamed themselves for injuries rather than seeing them as a systematic problem. Instead of considering the interaction of many factors in injury occurrence, teens were more likely to attribute the injury to “being clumsy” or “not paying attention.” This self-blame disempowers workers and may make them less likely to talk with supervisors about injuries and safety concerns for fear of being fired or reprimanded.
The majority of teens in this study characterized relationships with supervisors as lacking care about safety and health and showing more interest in doing the job right, although this depiction was not completely consistent between all workers and supervisors. There were some teenagers who felt that supervisors did care about wellbeing, but they still did not speak up about safety concerns or injuries. In situations like these, the teens minimized their injuries, blamed themselves, or accepted their injuries as part of the job. Still other teens had relatively good reported communication with supervisors and did not have hesitations telling supervisors about safety concerns and injuries, but still did not feel that supervisors really cared about them. The relationship between perception of supervisors and communication with supervisors is clearly a complicated one, but both aspects may be important to understanding the role of supervision in injuryprevention.
While limited research exists regarding supervision for working teens and the impact on injury prevention and safety, research in other areas can provide some insight into the potential characteristics needed in a supervisor-teen relationship. Research among adult workers has confirmed the impact of supervisors on a work environment [16–22, 30]. In addition to the studies highlighted in the introduction, a recent study by Smith and DeJoy [30] found that support from supervisors in the workplace, including the perception that supervisors care about the wellbeing of those they supervise, was correlated with safety climate, which was a significant protective factor against workplace injury [30]. On top of a supportive and caring attitude, supervisors acting as mentors may promote safety at work. Research in dating violence prevention and new driving training for teenagers indicated mentoring by trained small group facilitators and parents respectively has been helpful in empowering and keeping teens’ safe [31–33]. These programs have helped reduce teen accident rates and better prepare teens for uncomfortable and dangerous situations. In qualitative evaluations of trained mentors in the Expect Respect program for teens at risk for dating violence, the teenagers spoke very highly of the trained mentors and valued their advice and support [31]. Perhaps if supervisors could act as mentors in the workplace, teenagers may feel more comfortable discussing dangerous situations, seeking advice, and reporting injuries. Supervisors, as mentors, who address the issues that are difficult to talk about could help close the power gap, making communication easier and more effective, and making the workplacesafer.
There are several strengths of this study. Our sample was diverse in age, gender, and race, although Hispanic-Americans were underrepresented. The teenagers interviewed had a variety of job experiences and had been working for different lengths of time. The teens were comfortable talking freely and were not influenced by comments other teens made regarding their views. There are several limitations of this study that need addressing. This study took place in Jefferson County, Kentucky, which might offer job opportunities for teens that are different compared with other areas of the country. However, we believe our population sample is relatively generalizable because the students were recruited from two public high schools and the jobs they held were similar to those reported on the national level. Kentucky is one of eight states that does not require work permits. While no research exists showing improved supervision for work permit holders, it is possible that there may be increased communication between supervisor and teen if work permits were required. For example, in the state of Indiana, a work permit can be revoked if a teen’s GPA drops or if a teen’s school attendance drops. These actions might make supervisors communicate more with the teen, for which a teen might perceive that the supervisor cares more.
Conclusions and implications
Supervision and the relationship between teen workers and their supervisors may be complicated and difficult to understand, but our results provide an essential framework for additional research. To date, limited information exists regarding young workers and supervision; therefore, this study highlights some important initial findings that may assist in promoting workplace safety and preventing teeninjury.
This study highlights that improved communication and a positive supervisor-teen relationship may be important factors in improving safety and health. Both quantity of supervision and quality of supervision is likely important in preventing workplace teen injury. The widespread finding of teen self-blame for injury may be an important issue for the supervisor to consider and/or address in safety training, because the self-blame caused teens to not report their injuries at work settings. Supervisors must be able to facilitate communication with their teenaged employees about the difficult issues at work, such as safety and injury, being especially sensitive to power dynamics and self-blame present among teenagers. Many supervisors may not be educated or trained how to communicate with teens, thus programs geared towards promoting a mentoring relationship might be useful tools for supervisors of teens.
Footnotes
Acknowledgments
This study was funded by the Centers for Disease Control and Prevention, National Institute of Occupational Safety and Health – R21 OH008934-02: Evaluation of Safety Training, Supervision, and Injury Among Working Teenagers. The authors would like to thank the students, staff, and faculty of Central High School Magnet Career Academy and Pleasure Ridge Park High School in Jefferson County, Kentucky.