Cristian Ribeiro Giambrone was 18 years old when he died on the job. The Boston teenager was working at a drugstore when he and a co-worker tried to catch a shoplifter who had shoved nine tubes of toothpaste into his coat. Outside the store, the man turned on the two workers, stabbing them both and killing Giambrone.
His death in 2004 — or the rape two years ago of a 14-year-old volunteer at a Jamaica Plain hospital — is a reminder that young people can be put in harm’s way when they enter the adult world of work. Violence may be the most dramatic danger, but other hazards also pose threats, from burns in restaurant kitchens to back strains lifting nursing-home patients to broken bones in construction.
Young people tend to find employment outside white-collar occupations, taking jobs where the risk is higher for workers of all ages. By definition, teens are inexperienced at the work they do, heightening their chances of injury. Because eight out of 10 teenagers are employed before leaving high school, their safety is a public health concern that’s getting increasing attention.
At a meeting of the state Public Health Council last month, leaders of the Teens at Work Project reported that the nonfatal injury rate for 15- to 17-year-olds in the United States was 5.2 per 100 full-time equivalent workers per year, double the rate for adults 25 and older. In Massachusetts, an average of 857 work-related injuries to teenagers under 18 are treated in hospital emergency rooms each year. Restaurants, nursing homes, and retail stores, including grocery stores, lead the list of workplaces where young workers get the most injuries.
But there are some positive signs. While injury rates for all workers are declining in the state and the nation, they are falling faster for workers under age 18: 3 percent a year for adults and 5.5 percent annually for 15- to 17-year-olds from 1994 through 2008.
Letitia Davis, director of the Massachusetts Occupational Health Surveillance Program and the Teens at Work Project, would like to think better training, increased awareness, and stronger enforcement of child labor laws are responsible for the trend, but she said the data don’t allow her to draw such a direct line between cause and effect. Other dynamics may be at work. When the economy sputters, for example, construction jobs also stall. If fewer people are employed in higher-risk jobs, it is not surprising to see injuries also drop.
“We think jobs are really crucial for youth and we want to make sure they are safe,’’ Davis said in an interview.
Massachusetts public health specialists monitor work-related injuries by gathering data from workers’ compensation claims and from hospitals, which have been required to report work-related injuries for workers under 18 since 1993. That may not capture all the injuries, if the young people don’t seek medical attention or if they don’t say how they got hurt. But the information gives a sense of what might have gone wrong.
When researchers from the Teens at Work Project interviewed 208 teens under age 18 who had been injured at work from 2003 through 2007, about half said they had no safety training. About 15 percent said there was no supervisor on site when they were hurt. Almost a quarter said they had no work permit.
Workers from 14 to 17 years old are protected by laws limiting hours, requiring supervision after 8 p.m., and restricting equipment that they can use. The rules are printed on the back of the work permits these workers need to be hired, and their parents must sign papers spelling out limits for minors.
A change to state child labor laws in 2007 allowed the attorney general to bring civil rather than criminal complaints against employers, making enforcement attempts easier. Dozens of retailers were fined for hours violations after sweeps during the holiday season in the first year after the law took effect. Other businesses have been cited for allowing minors to serve alcohol or to operate equipment off-limits for their age group.
“Our goal continues to be to better protect our kids through effective enforcement as well as outreach efforts to educate our teens and employers regarding the child labor laws,’’ Massachusetts Attorney General Martha Coakley said in a statement.
Teens themselves are teaching one another about health, safety, and their rights under labor laws. The Massachusetts Coalition for Occupational Safety and Health trains peer leaders to educate other young workers.
Before they came to MassCOSH, Alana Johnson and Starling Anthony both worked in day camps.
“I didn’t really know the policies on health and safety in the workplace,’’ Johnson, 16, said recently in the nonprofit’s Dorchester office. “The wages weren’t up to par. We worked long hours and went on a lot of trips. I would have brought it up to my supervisors if I had known.’’
Anthony, 18, said his job required him to work with harsh cleaning chemicals, but he received no training on the proper way to use them. “I was concerned about my clothes, not what I was breathing.’’
Now Johnson and Anthony teach other teens about labor laws and how to approach a boss in a respectful manner with questions about health and safety, including sexual harassment. MassCOSH has been asked by Somerville and Boston to train its young summer employees. Nancy Luc, MassCOSH’s healthy schools coordinator, said the young trainers are effective.
“Sometimes you’ll see the little light bulbs go on when you speak,’’ Anthony said.
Even when workers are properly trained, work pressures can contribute to injury.
“A lot of teens work in an environment that is very fast-paced. A lot of injuries happen because they don’t have the time to take all the precautions,’’ Beatriz Vautin of the Teens at Work Project said.
A willingness to please is more likely than recklessness, in Davis’s view.
“They’re being responsible kids trying to do their job,’’ she said. “It’s their first foray into the adult world and they’re trying to prove themselves. They’re hesitant to complain or look foolish.’’
The parents of Giambrone, the CVS clerk who died chasing a shoplifter, filed a wrongful death lawsuit against his employer but the case was dismissed. A Massachusetts Supreme Judicial Court ruling said the state workers’ compensation law prohibits lawsuits against employers for work-related injuries because they are compensated through that system. The family contended that basing supervisors’ bonuses in part on controlling theft contributed to his death, which the company denied.
Marcy Goldstein-Gelb, executive director of MassCOSH, said there is more work to be done, especially when jobs for young people are scarce.
“We still have young people getting injured on the job and at risk of death,’’ she said. “We’re concerned about what kind of jobs young people [are able] to find at the bottom of the barrel. We’ve got to remain vigilant about it to ensure their safety.’’