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Work-Related Injuries in Early Childhood Services – Results of the 2017 ECE Quality and Employment Survey

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teacher exploitation stress sad bullied work related injuries

Work-related injuries.

Forty-six percent of staff reported experiencing work-related injuries, physical or mental health problems in the last 12 months, as part of the 2017 ECE Quality and Employment Survey of 900 staff (791 teaching staff and 109 service leaders/ supervisors). 

An earlier survey in 2014 asked staff the same question and 29 percent reported a work-related injury, physical or mental problem. This suggests that health and safety has worsened for staff.  However, it could also indicate a lower acceptance by staff of health and safety problems and a greater willingness to speak out. There may be increased awareness around health and safety in the workplace following the publicity around the Health and Safety at Work Act 2015 and the introduction of new laws.

Although many staff reported suffering physical injuries or work related mental health issues, their comments suggest they often attributed this to being something that was part and parcel of working in an ECE setting and therefore while the risks were known there was little focus on managing or reducing these risks. Some staff felt that they could not let on to their supervisor or employer that they had work related injuries as they feared they would get a negative hurtful response.  

It is possible for some staff to sometimes take care of their own health and safety:

I had severe fatigue and anxiety. However I have ensured I am sound to work and provide high quality care to children. I exercise, eat well, take multi-vitamins and am supported at work and home.

But not everyone is supported to take responsibility and in a position to take reasonable care of their own health and safety all of the time: 

ACC has put me on desk work.  But because I am the only qualified registered teacher in the under-twos children’s area I have to be on the floor remaining quite active.

Cartilage damage in my wrist and torn ligaments after a fall due to needing to rush work needing completion.

The cost, financially, emotionally and in terms of career development to staff working in the early childhood profession, a profession that is also known for its low pay, can sometimes be significant:

Extreme stress, sleeplessness and migraines – I have sought out counselling.

Very bad back problem and spent $2000 in massage and osteopath.

Anxiety, depression and I have had tetanus shots because of bites and scratches drawing blood. I am standing down as Head Teacher for a term to not be responsible for everybody. 

Therefore one response by staff can be to leave:

My previous employer (I left there 5 months ago) caused unnecessary stress and emotional hardship. I was often upset or worried and had major anxiety about going to work.

Another response by staff is to take anti-depressants or prescribed medication for pain relief – or resort to another way to manage pain for example: 

Sometimes I have used alcohol as a coping mechanism for the very hard tiring problematic days that I have experienced.

The survey results suggest a need for all (not just some) employers to accept their legal responsibility, undertake regular reviews, and be open to and inviting staff feedback to ensure staff are given the highest level of protection from workplace health and safety risks, so far as is reasonably practicable. 

It is not good in a workforce that makes such a valuable contribution to our society, to families, and children that any staff experience injury, mental or health problems that could be prevented.  When protection for staff from risks is inadequate children’s safety can be placed at risk too (see comments in the results section below).

All employers also need to check and ensure that every staff member (including supervisors) have appropriate support, resources and equipment to keep themselves safe.

Also, there is clearly a need for staff training on how to carry out their work in a safe way because as one teacher explained so well “back problems seem to be normal in working with babies in a centre.”  If every employer ensured staff received training on correct manual handling methods, back problems would become the exception and not the norm.

The survey

Work-Related injuries.

In 2017 an online survey was advertised widely through sector networks and social media.  Anyone working in a teaching or a supervisory/management capacity was invited to participate; this included centre managers who also taught children, managers who oversaw a number of centres, qualified and unqualified centre teachers, and home-based visiting teachers. 

Nine hundred people working in early childhood education responded and completed the online survey (791 teaching staff and 109 supervisors/leaders).  Most respondents were female (95%) and between 25 to 44 years of age (56%). The largest proportion of respondents came from childcare centres (76%).  The next largest group came from kindergartens operating under the management of a recognised public kindergarten association (16%). The remaining respondents came from a range of other services: home-based ECE, Playcentre, Kohanga Reo, hospital-based services and licensed playgroups.

The survey asked a range of questions about various employment matters.  One question – the focus of the present report – asked respondents if their work or workplace had caused them to experience an injury, physical or mental problem in the last 12 months.

Forty-six percent of staff indicated they had suffered a work-related injury, physical or mental health problem in the last 12 months. 

A difference was found between teaching staff and staff who were responsible for managing or leading other staff and teaching staff, with 29 percent of supervisors experiencing workplace harm compared to 49 percent of teaching staff. 

Staff under 25 years were more likely out of all age groups to report workplace harm (70% injury rate) while staff 65 years and older were least likely to.

Working for a privately-owned service as compared to a community or public service may increase the chance of harm but the difference was not found to be significant (49% injury rate for staff working in privately-owned services; 42% for staff working in community/public services).

The nature of the work-related injuries

teacher exploitation stress sad bullied work related injuries

Comments about mental health problems were made almost as often as comments about injuries and physical problems. 

Mental health

Factors of exhaustion and overwork, bullying, and dealing with difficult issues were related to high levels of stress and depression for both teaching staff and supervisors.  Some of the comments on this were: 

I am both physically and mentally drained, I cry often at work owing to stress and not being supported by management.

I’m very run down and stressed at times.  Have so much annual leave but finding it hard to get time off, it never seems to be ‘convenient’.

Mentally the bullying and having management blame me for being bullied.

Mental stress. Not enough hours to do everything that needs to be done, being told this is what you have to do or you’ll be in trouble, lack of positive feedback on what I do.

Emotional and mental health owing to being extremely unhappy.  I don’t feel like a teacher more a cleaner/babysitter.  Undervalued and overworked.  For pretty shitty pay as well.


There was some overlap between descriptions of physical and mental health problems, with about one-fifth of respondents who had experienced an injury or mental or physical health problem stating that they had experienced both, for example:

Stress owing to also not being able to have regular breaks to use toilet and have something to eat and drink.  No teacher is allowed a lunch break if they only work 6 hours. 

Migraines, anxiety, depression. Recurrent strep throat owing to being under stress.

Stress, loss of weight, loss of period, anxiety, not being able to sleep.

My back, hearing loss, children physically abusing teachers, stress, and expectations to be “on the job” via email text and call at all times of the day or night.

Put my back out having to move furniture and was made to feel guilty for having time off. 

Physical injuries and problems

Some staff reported physical injuries caused by children or others, for example:

Damage to leg from a chair being thrown.

Been randomly hit, bitten and kicked by children with learning and behavioural difficulties. 

Have been injured by one of the children (badly bruised knee) kicking me in anger.

We have a large number of children with additional needs and no learning support for them. Some days I can go home battered and bruised, I know they don’t mean it. 

Shoulder injury by a very heavy child with special needs that I needed to physically restrain occasionally to stop hurting others or destroying equipment.

Other physical injuries resulted from playground, playroom and environmental hazards, for example: 

I hit my head 3 times which led to a nasty concussion. I’ve been off work since the beginning of March and only working 2 hours a day. ACC is paying 80% of my wages while I’m trying to return to work and gradually increase my hours back to full-time. The owner still has not dealt with the area of the playground where I hit my head 2 out of the 3 times I was injured.

Twisted ankle from slipping over on a slippery ramp.

I am on ACC at the moment with an injury from work. I slipped on the wet ramp and injured my back. Have been to a specialist and I have an annular tear at the L4–L5 vertebral level.

I have a perforated ear drum. The noise is unbearable sometimes and particularly when I get the flu. I would think I would be fine to go to work but when I’m there I leave owing to echo and the high pitch noise.

I have suffered hearing loss as the result of loud noise with too many children in a small space.

I fell out of the sandpit and scraped my shin and damaged my shoulder.

Cut toe needed stitches when slipped on clear-file on floor.

Supervisors additionally reported injuries linked to their responsibilities for administration and overall service management and planning, such as:

My posture is terrible owing to the office chair.

Neck problem, hand problems needed a ligament replaced.

I have had a back problem after lifting heavy equipment, changing around the outdoor area.

Manual handling of children and objects, including furniture and equipment resulted in the most injuries and reported physical problems, such as:  

Back issues owing to terrible changing table where we have to lift the children onto it. The step ladder doesn’t reach to table.

Lumbar disc protrusion lifting children up to old style changing table. We now have a walk up one with stairs for the children.

Torn ligament from pushing a large wheelie bin full of rubbish, required surgery.

I do get sore back and shoulders, and also a weak wrist. I work with babies so mostly it’s from lifting and carrying.

Twisted pelvis and back pain caused by an accident involving a child.

Back injury moving outside equipment with a colleague.

Sprained ribs lifting play equipment with another teacher.

Been expected (by parents and colleagues) to lift and carry children who are of nearly school age. This has caused back and knee related problems.  Lower back injury is ongoing now.  Shoulder injury.  Neck and shoulder strain that causes time off to be taken to recover. 

Broken wrist and popped out shoulder.

Have a cyst in my knee from working in baby’s room, getting up and down of floor. No decent sized adult chairs.  Cannot work with under-twos now as I cannot get up and down from the floor. Am left with a permanent injury now.

Sprain to back and torn meniscus right knee.

Back injury – bulging disc from repetitive leaning over in under-two area and lifting children.

My back hurts and is so sore from constantly picking up children to change nappies.

Back problems owing to being on my feet seven hours of the day.

Injured my lower back trying to lift a child (which I knew I shouldn’t lift, but he was endangering himself and other children, kicking chairs over in anger).

Have an ongoing problem re muscle spasms and the height of the chairs and tables, also lifting heavy children can make the condition worse.

I have hurt my back several times when children have required to be picked up or when a child with special needs has landed on me whilst I’ve been seated on the floor.

I was pregnant and had back problems while changing nappies/lifting children.

I have an ongoing back problem and I need to ask for a better height chair for putting infants to sleep in the cot room.

Overuse in my wrists from lifting children.

Knee pain from crouching and sitting on children’s chairs.

We promote lap feeding for our little babies that are unable to get themselves in and out of our chairs.  I have three little babies that require lap-feeding whilst still sitting at the table in uncomfortable chairs which has placed strain on my back. 

Physical injuries (back strain; numerous bruises) from lifting/carting equipment and in taking equipment from and returning to storage facilities. Inadequate storage to store equipment safely.

Back/shoulder issues from rocking babies to sleep and leaning over cots to calm children.

Implications for children

Staff health and safety has implications for children’s safety. Risks for staff can in some situations place children in possible danger, for example one teacher rolled his/ her ankle “rushing down stairs while carrying a child”.  Had the teacher not managed to keep hold of the child it may have been serious for the child.  Another teacher whose hearing has been affected by noise levels reported difficulty now in hearing children and this could have serious consequences should a child be saying something that needed an urgent response for safety (e.g. if another child needs help or is injured).

Unborn children also need protection, for example one teacher said “I had premature labour owing to stress”.  Another teacher pulled her abdomen lifting heavy children and being pregnant was worried about the risk to her baby and difficulty of doing her job.

Recommendations arising from the findings on work-related injuries

The Health and Safety at Work Act 2015 and related regulations require that staff are given the highest level of protection from workplace health and safety risks, so far as is reasonably practicable. However, it would seem from staff reports that not all early childhood services are providing a healthy and safe environment for their staff to work in. So what would help to change this?  

Early childhood staff should receive training from health and safety experts knowledgeable about early childhood education environments to learn practical ways they can lessen their chance of work-related injuries.

Hazards in the environment should not be left for staff to cope with or work around, and should be controlled, reduced or removed. (It does not support staff safety when for example, “the owner still has not dealt with the area of the playground where I hit my head 2 out of the 3 times I was injured”).

Staff need to be provided with equipment that will help to keep them safe while performing caregiving and other tasks (such as steps for children to use instead of lifting heavy children onto changing tables), and the help of other adults when needed to make sure their work is safe, for example, to help them lift a table safely.  

There is some overlap between physical problems and emotional and mental health, so by investing in staff around injury prevention, this may help to improve staff psycho-social wellbeing.

Support must be given to staff to speak up about concerns and how their health is affected, and have their concerns listened to and addressed. 

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