The prevalence,seriousness,and causes of teenage work accidents: A gender difference?

1 Introduction

Work accidents are an ongoing threat to public health [1–3]. The gradual decrease in the frequency of occupational accidents in Europe in the second half of the 20th century levelled out around the millennium [4]. Statistics show that a higher proportion of men than women suffer non-fatal accidents at work [2, 6], and that the vast majority of victims of fatal work accidents is male [3, 6]. The main explanation for this gender gap in occupational accidents is the gender segregation of the labour market [2, 6] where men and women often work in different occupations in which accident risk disseminates differently [6, 7]. Another, more recent explanation, is that dominant forms of masculinities such as images of male strength and perseverance in the face of danger and adversity hinders men, and especially men in male dominated jobs, from taking safety precautions [8, 9]. In addition to the gender differences in work injuries, studies show that young workers are more likely to suffer non-fatal work injuries than older workers [10–13]. This paper addresses work accidents amongst teenage workers in Iceland. This is the youngest part of the group that is typically classified as young workers within occupational health and safety (OHS) studies [14]. Teenagers have their whole lives ahead of them, and, as such, the significance of protecting them from any harm is obvious. This concern is reflected in international and national laws that secure those aged under 18 special OHS protections, and prohibit this age-group from undertaking dangerous work. Teenagers, whether under 18 or under 20, are also guaranteed the same OHS rights as adults [15].

A number of shared characteristics have been identified among teenage workers in Western societies [16, 17]. Due to their school attendance, Western teenagers are usually not in permanent, full-time employment, but instead take on part-time and/or temporary work. Typically, teenagers move from one job to another and work flexible hours. Also, their lack of qualifications and work-experience means that they are usually in unskilled, low-paid jobs, commonly within the retail and food service sectors [16, 19]. The jobs they undertake are at the bottom of the workplace hierarchy, the work is sometimes informal, and commonly breaches child labour laws that stipulate the work of those under 18 [15]. Also, teenage workers lack necessary OHS resources. They do not get adequate OHS training and supervision at work [17, 21], and a lack of confidence and/or a feeling of powerlessness can hinder them from speaking up about their safety concerns [22–24]. These shared characteristics of teenage work call for separate OHS research on the group, including research specifically on work injuries. As identical gender segregation has been identified within the group of teenage workers as among adult workers [16], a gendered focus is also needed.

Rasmussen et al. [12] estimate an incidence of 65 accidents per million working hours among 17-year-olds in Denmark, which is twice as high as among the adult working population. However, because of the flexibility of teenage work, it is difficult to accurately measure work accident incidence among the age-group [16, 19]. A comparison of findings on the prevalence of teenage work accidents is also difficult, in part because of different definitions. As such, studies from Western societies show figures ranging from 3%–5%[12] to 21%[25] depending on whether the focus is on all paid work or only on formal employment, and whether all accidents are included regardless of their seriousness or only accidents that cause some absence from work/require medical treatment.

So far, studies that focus specifically on gender differences in work accidents within the group of teenage workers are rare [12, 25–28], and the findings are not unanimous regarding gender patterns. For example, boys were measured at a higher injury risk than girls in a Danish study that focused on injuries that required medical attention [12], and a study among high-school students in Wisconsin, US showed that more boys than girls had an accident at work, with more boys having suffered severe injuries [27]. On the other hand, a study among 13–17-year-olds in Iceland showed a gender difference regarding having an accident, but no gender difference appeared concerning severe injuries [25]. Also, no gender differences were shown in a Canadian study that examined micro-accidents (or ‘non-lost-time-injuries’ (p. 40)) among young workers aged 15–25 [28]. Few studies have applied multivariate analysis to examine the risk factors of teenage work accidents. Those studies suggest that gender is not an independent risk factors, but that work-related factors first and foremost predict the risk [12, 29]. However, those studies rely on perceived, or expected, work hazards, and not on the hazards that actually cause the accidents. Studies on the actual hazards, or causes, of teenage work accidents are scarce, even though sharp objects and something that burns have been recognised as among the most common causes of accidents [25, 30].

The aim of this study is to use data from a cross-sectional survey on work accidents among 13–19-year-olds in Iceland to examine: the level of teenage work accidents measured in a combination of their prevalence and seriousness; types of injuries; causes of accidents; and, whether gender differences exist within these factors. Iceland is an interesting case for a study like this as the country is known for a relatively high participation of work among teenagers [31]. It is also of interest to analyse gender differences as the labour market participation of Icelandic women is high in international comparisons [32], and the country is rated amongst the highest in the world in general gender equality [33]. Also, Iceland is a relatively safe country in terms of occupational health, reflecting the fact that sick leave from work is low, at around 2%[34], which is an indicator of a healthy work environment, and the country practises advanced OHS policy in the Nordic tradition [35].

2 Methods

This study rests on a cross-sectional survey and is part of a larger research study on teenage OHS in Iceland. Work is defined as all paid work undertaken in a workplace or within a household. Therefore babysitting, a common job for girls in their early teens [16], is included. The questions on work accidents were based on a questionnaire designed for research on teenage work conducted by the Nordic Administrations of Safety and Health [36]. The Ethical Committee of the University of Iceland where the study was conducted gave a positive review of the research proposal.

The population of the study is all 13–19-year-olds registered in Iceland. A random sample of a total of 2,800 teenagers was obtained from Registers Iceland for use in the survey. The Registers holds an up-to-date registry of the whole population in the country. The data were collected from February to April, 2018. The selected participants were contacted by telephone in order to seek consent for participation. For those under the age of 18, verbal consent of a parent/guardian was sought prior to that of the young person. Those who agreed to participate were sent a digital questionnaire through on-line channels. In total, 1339 young people responded, giving a response rate of 48.8%.

3 Results

In Iceland, the tradition exists to differentiate between work that teenagers undertake during the summer holidays (summer work), and work that they undertake while schools are operating (term-time work) [16]. In total, 80.1%of the respondents reported having held a job during the summer of 2017, with an equal proportion of girls (79.7%) and boys (80.5%). Just over half (51.9%) reported having held a term-time job during school year 2017–2018, with statistically significantly more girls (56.2%) than boys (45.2%). Jobs in the retail sector were the most common type of main term-time job (42.7%), followed by jobs in restaurants (16.8%). A statistically significant gender segregation appeared in the main term-time jobs. More girls than boys held jobs in babysitting (6.8%vs. 0.9%) and in caring (7.9%vs. 1.7%), but more boys had jobs delivering (6.9%vs. 1.9%) and unskilled manual jobs (17.6%vs. 4.6%). Also, a gender segregation exists within the retail jobs. More boys (19.7%) than girls (9.0%) work in supermarkets, but more girls work in other kinds of stores (35.7%vs. 19.7%). Regarding summer jobs, an identical percentage held retail jobs (23.0%) and unskilled manual jobs (20.9%). Identical statistically significant gender differences appear in the summer jobs as in the term-time jobs, although the differences are not as great in percentages as in the term-time jobs.

The vast majority, 83.7%, of the teenage respondents reported not having suffered a work accident, as Table 1 reveals. However, 16.3%, reported having had an accident at work, 11.1%reported having had an accident that did not cause any absence from work, 4%had an accident that caused an absence of one week or less, and 1.2%had an accident that caused an absence of more than one week. To be off work for more than one week is an indicator of a serious work injury. Gender differences in the level of work accidents are not statistically significant.

Table 2 shows that cuts (32%) are the most common type of work injury of teenage workers, followed by burns (21.5%), and bruises and swellings (15.1%). However, sprains and bone fractures cause absences from work of more than one week more often. Gender differences in the types of injuries are significant. Cuts (42.7%) are by far the most common injuries among the boys, but burns (28.9%), cuts (22.2%), and bruises and swellings (17.8%) are the most common injuries among the girls. A higher percentage of girls than boys reports suffering sprains (11.1%vs. 7.3%), but the opposite is the case regarding bone fractures (6.1%vs. 3.3%).

Sharp instruments (26.5%), hot instruments or liquids (17.5%), and lifting or carrying a (heavy) object are the most common causes of teenage work accidents, accounting for a total of 58%of the injuries (see Table 3). On the other hand, falling or jumping off something most often (35.7%) caused serious injuries that led to more than a week’s absence from work. The table also shows significant gender differences in the causes of the teenage work accidents. Whereas sharp instruments were the most common cause among the boys, causing one third of all male injuries, hot instruments or liquids (22.1%), sharp instruments (20.2%), and lifting or carrying a (heavy) object (19.2%) each caused around one fifth of the female injuries.

The aim of the study was to examine the level of work accidents amongst 13–19-year-old teenagers in Iceland, the types of injuries the teenage workers suffer, the actual causes of the accidents, and whether gender differences exist within these factors. Teenagers are the workforce of the future and the importance of protecting them from any occupational harm is recognised, inter alia within child labour laws [15]. Nevertheless, the findings of the study show that their work can cause them harm. Thus, some 16.3%of young Icelanders reported having experienced at least one work accident, of which 1.2%reported such a serious accident that it led to more than one week’s absence from work. Although cuts and burns were the most common types of injuries the teenage workers suffered, sprains and bone fractures were identified as the most serious ones as these injuries usually led to more than one week’s absence. Such a serious injury was most commonly caused by the teenager falling or jumping off something. No gender differences were observed in the level of work accidents. However, the findings reveal gender differences in both the minor and the severe injuries, as well as in their causes. The boys most commonly cut themselves on a sharp instrument, while the girls most commonly suffered a burn caused by something hot. Also, the boys were more prone to bone fractures, but the girls to sprains, and the causes of these more severe accidents differ between the sexes.

The findings of no gender differences existing in the level of teenage accidents in Iceland are inconsistent with European statistics showing that adult men are more likely to suffer fatal and non-fatal work accidents than adult women [3]. The findings, therefore, raise the question as to whether general gender equality in Iceland has generated non-gender-segregated jobs among Icelandic teenagers, and thus levelled out the gendered work accident risk. The findings on gender differences in the types of jobs Icelandic teenagers undertake do not confirm that question, nor do the findings on the gender differences in the actual causes of the teenage work accidents. Also, recent studies from Iceland show gender differences in the association between teenage work and both musculoskeletal and mental symptoms. The associations were identified within the group of girls but not within the group of boys [31, 37]. One the other hand, another recent study among young Icelandic males shows that they are not as burdened by traditional masculinity as the older generations. Possibly, that includes masculinity that emphases male strength and perseverance in the face of danger and adversity, although the study did not specially focus on such type of masculinity [38].

Instead, the findings of the research indicate that although teenagers undertake gender segregated jobs with different accident risks, the overall accident risk that teenage workers face is gender-free. The gender-free trend could be recent, because of the implementation of child labour laws in Iceland and changes in the types of jobs and tasks the young people undertake [16]. As such, in an Icelandic study that relies on data collected ten years earlier than the current one, traditional gender differences were identified regarding whether 13–17-year-olds had had a work accident of any severity or not [25]. Also, North American studies relying on data collected around the millennium show gender differences in teenage work accidents [26, 27], whereas a more recent study by Turner, Tucker [28] show no gender difference in micro accidents among young Canadian workers. It is important to further study the gender pattern in teenage work accidents, to determine whether the pattern has changed over time and if so, how these changes can be explained. It is also important to examine the gender differences in the types and causes of teenage work accidents, and whether the accident risk of boys and girls differs within the same types of jobs/tasks due to different social constructions of the genders and/or physical differences [7].

Comparisons of the prevalence of teenage work accidents between countries/populations should be taken with a degree of caution because of different research designs. The current findings show lower percentages of teenage work accidents than in the Icelandic study of data collected ten years earlier, which showed a prevalence of 21%[25]. That study used the same definition of work and of work accidents as this one, however the age range was more restricted [13–17], and the prevalence was calculated from the population of teenagers with some experience of work, not from the population of all teenagers. On the other hand, the percentages presented here are considerably higher than in an earlier Danish study [3%–5%], but that study only focused on accidents that required medical attention [12]. Standardised measurements of the prevalence of work accidents are an important tool in the effort to prevent work accidents. Nevertheless, the flexibility of teenage work undermines the validity of standardised measurements such as injury rates [10] or the incidence of work accidents [12] within the teenage population. In this study, another type of measurement was introduced: the level of work accidents in a teenage population regarding both their prevalence and seriousness. This measurement offers the possibility of comparing the level of teenage work accidents between teenage populations in future research.

The outcome of the present measurement of the level of work accidents among teenagers in Iceland is difficult to accept in light of the fact that Iceland practises advanced OHS policy in the Nordic tradition [35]. It is striking that in such a country nearly one out of every six teenager has experienced a work accident, and even more marked is that more than one out of every one hundred has suffered a serious accident. The findings on the types of injuries add to that remarkable outcome, as they show that more than a quarter of the injured workers suffered sprains, bone fractures, or back injuries. Such injuries are not only serious in the sense that they often cause a long absence from work, but also because they can have long-term implications that can even last into the young worker’s adulthood [25]. The results on the causes of the accidents reveal that teenage work injuries could often be avoided. It should be quite easy to prevent a teenage worker from falling or jumping off something, from being hit by an (heavy) object, as well as from lifting or carrying such an object. Together, these hazards caused nearly one third of the total work accidents, and half of the most serious ones.

The present research has its strengths and limitations. The response rate was under 50%, which weakens the outer validity and the generalisability of the findings [39]. However, the sample was randomly drawn from the whole population of 13–19-years-olds in Iceland which in turn strengthens the generalisability of the survey findings. Globally, it is rare that national registers allow for such sampling from a whole population [12]. What also strengthens the study is that it relies on data of the actual hazards, or the causes, of teenage work injuries, not on expected risks. However, as the cases of work accidents that led to more than one week’s absence from work were quite few, it was not possible to calculate whether the association between absence at work and types of injuries/ causes was statistically significant or not. In addition, a recall bias could be a limitation. The respondents were asked if they had ever had a work accident(s), and the recall of accidents that happened some time ago could be diminished, particularly regarding minor accidents [39].

5 Conclusions

Neither child labour policy, nor advanced OHS policy in the Nordic tradition, sufficiently protect teenage workers form harm caused by work accidents. All stakeholders need to take responsibility for preventing teenage work accidents more seriously. Employers need to reduce avoidable hazards that both teenage girls and teenage boys face at their workplaces and provide suitable safety devices and training for unavoidable hazards. Also, the authorities as well as parents need to educate the young on the hazards inherent in teenage jobs, and how to confront them. One work accident among this age-group is one too many. Future research should focus on the development of a standardised measurement of the prevalence of teenage work accidents, and on whether the gender pattern of the accidents has changed over time.