Document Type


Date of Degree

Spring 2018

Degree Name

MS (Master of Science)

Degree In

Occupational and Environmental Health

First Advisor

Fethke, Nathan B

First Committee Member

Casteel, Carri

Second Committee Member

Rohlman, Diane S


Employee turnover is a complex problem with many intertwining contributors. In general newly hired employees at an organization have a higher risk of injury. However, few studies have explored occupational injury as a predictor of employment duration. In this study we hypothesized that employees who sustained an injury during the early stages of employment were prone to higher turnover rates.

All employees hired from 2012-2016 were identified using a large Midwestern manufacturing facilities human resources database (n=3765). Corresponding occupational injury information from the same time period was extracted from the onsite occupational health center.

Employment duration was the dependent variable which was dichotomized as (i) working < 60 days or (ii) working ≥60 days. The 60-day threshold was based on the employer’s internal estimation of the duration of employment required to recover training costs. The primary independent variable was a first-time visit to the occupational health center within the first 60 days of employment, categorized as (i) no visit, (ii) a visit within 1-20 days, or (iii) a visit within 21-60 days. A secondary independent variable incorporated the nature of injury, classified as repetitive strain, acute sprain/strain, or other occupational injury types. Covariates included demographics (e.g., age, gender, and race/ethnicity), shift placement (e.g. first, second, third), and nature of assigned job (e.g., assembly, fabrication, maintenance). Incidence rates of first-time visits were calculated (i) across the full study period and (ii) for a reduced period that included only the first 60 days of employment. Logistic regression was used to estimate adjusted associations between the primary/secondary independent variables and the dependent variable.

Of the 3765 employees, 1184 (31.5%) worked less than 60 days. About two-thirds were male, about half were white/Caucasian, and the overall mean age was 33.8±10.8 years. Between 2012 and 2016, 1105 first-time visits to the occupational health center were recorded for all new hires with an overall incidence rate (IR) of 47/100 person-years (PY). The IR for repetitive strain was 18/100PY. Of the 1105 first-time visits, 408 occurred within the first 60 days of employment with an overall IR of 85/100PY and an IR for repetitive strain of 36/100PY. Employees who visited the occupational health center in the first 20 days of employment were more likely to terminate prior to the 60-day threshold (adjusted odds ratio: 1.7; 95% confidence interval: 1.3-2.4). Elevated associations were seen for all nature of injury categories which occurred within 20 days when compared to non-injured employees.

Overall, the results suggest that experiencing an occupational injury (in particular, a repetitive strain injury) within the first 20 days of employment is associated with termination before 60 days. Our results may not be generalizable to all manufacturing enterprises, and we do not make a distinction between voluntary and involuntary termination. However, the results indicate that employers should examine policies and practices to minimize the burden of injury among new employees and reduce turnover. In the case of the study facility, an extended or modified work hardening program could maximize new employees’ adaptation to the physical demands of manufacturing work.


Injuries, Manufacturing, Occupational, Repetitive Strain, Retention, Turnover


x, 45 pages


Includes bibliographical references (pages 44-45).


Copyright © 2018 Nathan Huizinga