Fatal occupational injuries.
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Accidents, Occupational↗
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Occupational injury and absence from work among African American, Hispanic, and non-Hispanic White workers in the national longitudinal survey of youth.
OBJECTIVES: We examined how race and ethnicity influence injury and illness risk and number of days of work missed as a result of injury or illness. METHODS: We fit logistic regression and negative binomial regression models using generalized estimating equations with data from 1988 to 2000 on currently employed African American, Hispanic, and non-Hispanic White participants in the National Longitudinal Survey of Youth. RESULTS: Occupational factors-having a blue-collar occupation, working full-time, having longer tenure, working 1 job versus 2, and working the late shift-were associated with increased odds of an occupational injury or illness. Although racial/ethnic minority workers were no more likely than Whites to report an occupational injury or illness, they reported missing more days of work. African American and Hispanic men missed significantly more days of work than non-Hispanic White men, and African American women missed significantly more days of work than non-Hispanic White women. CONCLUSIONS: Factors associated with occupational health are multifaceted and complex. Our findings suggest that race/ethnicity influences the duration of work absence owing to injury or illness both indirectly (by influencing workers' occupational characteristics) and directly (by acting independently of occupational factors).
Absenteeism↗
The effect of rate denominator source on US fatal occupational injury rate estimates.
BACKGROUND: The Current Population Survey (CPS) is often used as a source of denominator information for analyses of US fatal occupational injury rates. However, given the relatively small sample size of the CPS, analyses that examine the cross-classification of occupation or industry with demographic or geographic characteristics will often produce highly imprecise rate estimates. The Decennial Census of Population provides an alternative source for rate denominator information. We investigate the comparability of fatal injury rates derived using these two sources of rate denominator information. METHODS: Information on fatal occupational injuries that occurred between January 1, 1983 and December 31, 1994 was obtained from the National Traumatic Occupational Fatality surveillance system. Annual estimates of employment by occupation, industry, age, and sex were derived from the CPS, and by linear interpolation and extrapolation from the 1980 and 1990 Census of Population. Fatal injury rates derived using these denominator data were compared. RESULTS: Fatal injury rates calculated using Census-based denominator data were within 10% of rates calculated using CPS data for all major occupation groups except farming/forestry/fishing, for which the fatal injury rate calculated using Census-based denominator data was 24.69/100,000 worker-years and the rate calculated using CPS data was 19.97/100,000 worker-years. The choice of denominator data source had minimal influence on estimates of trends over calendar time in the fatal injury rates for most major occupation and industry groups. CONCLUSIONS: The Census offers a reasonable source for deriving fatal injury rate denominator data in situations where the CPS does not provide sufficiently precise data, although the Census may underestimate the population-at-risk in some industries as a consequence of seasonal variation in employment.
Accidents, Occupational↗
Occupational injuries among emergency medical services personnel.
BACKGROUND: Emergency medical services (EMS) personnel treat 22 million patients a year in the United States, yet little is known of their injury risks. OBJECTIVES: To describe the epidemiology of occupational injuries among EMS personnel, calculate injury rates, and compare the findings with those for other occupational groups. METHODS: This was a retrospective review of injury records kept by two urban agencies. The agencies submitted all 617 case reports for three periods between January 1, 1998, and July 15, 2002. The agency personnel worked an estimated 2,829,906 hours during the study periods. Cases were coded according to U.S. Department of Labor (DOL) criteria. RESULTS: Four hundred eighty-nine cases met the DOL inclusion criteria. The overall injury rate was 34.6 per 100 full-time (FT) workers per year (95% confidence interval [CI] 31.5-37.6). "Sprains, strains, and tears" was the leading category of injury; the back was the body part most often injured. Of the 489 cases, 277 (57%) resulted in lost workdays, resulting in a rate of 19.6 (95% CI 17.3-21.9) per 100 FT workers; in comparison, the relative risks for EMS workers were 1.5 (95% CI 1.35-1.72) compared with firefighters, 5.8 (95% CI 5.12-6.49) compared with health services personnel, and 7.0 (95% CI 6.22-7.87) compared with the national average. CONCLUSIONS: The injury rates for EMS workers are higher than rates reported by DOL for any industry in 2000. Funding and additional research are critical to further defining the high risks to EMS workers and developing interventions to mitigate this serious problem.
Accidents, Occupational↗
Severe occupational injuries among older workers: demographic factors, time of injury, place and mechanism of injury, length of stay, and cost data.
Between 2002 and 2012, the number of individuals > 55 years of age in the workforce is projected to climb by approximately 50%. Few studies have substantiated that severe occupational injury to older workers is a significant problem. To identify the variables related to traumatic injuries of older workers, data were abstracted retrospectively from a regional trauma center database, including demographic and injury characteristics, length of hospital and intensive care unit (ICU) stay, and cost. The results showed that older workers had higher fatality rates than younger workers. As age increased, the Injury Severity Score also increased. Most injuries were the result of falls, with orthopedic injuries being the most common type of injury. Patients spent an average of 6 days in the ICU at a cost of > 4920 US dollars/day. By identifying the characteristics associated with older workers' severe occupational injuries, further research and better industry programs targeting this group can be implemented.
Accidents, Occupational↗
Direct impact of non-fatal occupational injuries.
OBJECTIVE: The objectives of this study were to describe the pattern of certain direct impacts of non-fatal injuries among workers insured by the General Organization of Social Insurance, admitted to hospitals in Al-Khobar City, and to determine factors influencing these direct impacts. METHODS: This cohort study consisted of 65, 915 insured male workers in various industries, followed to determine those who were admitted to 2 private hospitals selected randomly in Al-Khobar City. A data-collection sheet was used to collect the necessary data from patients and their medical records on admission to the hospital. RESULTS: The majority of admissions (78%) were for periods of less than a week. Absence from work was longer than 3 weeks in 35.5% and shorter than 1 week in 25% of admissions. The majority of the cases (65%) visited clinics from 2 to 7 times. Direct medical cost per admission was less than SR2,000 in 64% of the cases in one of the hospitals (one United States dollar = 3.75 Saudi Riyals). Multiple linear regression analysis for period of absence from work, length of hospitalization, and number of clinic visits showed these direct impact variables to be inter-related. Injury outside the work place (road traffic accidents), and the hospital which the injured worker was referred to, were the other main risk factors determining the direct impact of the injury. Multiple linear regression for direct medical cost was positively associated and predicted by the younger age of the worker. CONCLUSIONS: The direct impact of occupational injuries in this study, though less than the same reported from Western countries, were responsible for significant medical charges, human suffering and loss of productivity. Efforts made by different industries to prevent occupational injuries should be encouraged and continued, and the General Organization of Social Insurance may monitor their success by conducting similar studies.
Absenteeism↗
Fatal occupational injuries in the North Carolina construction industry, 1978-1994.
Occupational injury is a major public health problem and the cause of high rates of fatalities. The construction industry is one of the leading industries for on-the-job fatalities. The North Carolina Medical Examiner's system was used to identify all fatal unintentional injuries that occurred on the job in the state's construction industry between 1978 and 1994. The populations at risk were estimated from the 1980 and 1990 U.S. censuses. There were 525 identified deaths. All except two decedents were male, and the majority were Caucasian (79.2%). The mean age of decedents was 39 years. Death rates were higher among older workers. The crude fatality rate for the overall study period was 15.4 per 100,000 worker-years, with higher rates found among African-Americans (22.9) than among Caucasians (14.5). Occupations within the industry with the highest rates were laborers (49.5), truck drivers (43.2), operating engineers (37.2), roofers (32.8), and electricians (29.0). Falls (26.7%), electrocutions (20.4%), and motor vehicle accidents (18.9%) were found to be the leading causes of death. These findings suggest a need for continued attention to the hazards of heights and electric currents and a need for occupational safety standards for motor vehicles. This study also suggests that the hazards facing construction laborers require further investigation.
Accidents, Occupational↗
Occupational injuries suffered by flight attendants while on board.
Inflight occupational injuries suffered by flight attendants are an important cause of medical disabilities. Mexicana Airlines has made an evaluation of this problem from 1983 to 1987. The injuries most frequently observed were contusions, skin cuts, sprains, fractures, spine disorders, and severe barotitis. The anatomic regions commonly affected were the hands, feet, and spine. These injuries are responsible for 15,573 work days lost for the average of 1,631 flight attendants. This study identified some unsafe actions and conditions in the flight attendants' working environment. The company has initiated an extensive training program to avoid unsafe actions and to eliminate certain unsafe conditions where possible.
Absenteeism↗
Occupational injury deaths of postal workers--United States, 1980-1989.
Extensive media coverage of work-related homicides at U.S. Postal Service facilities raised the concern about whether postal workers are at increased risk for work-related homicide, particularly from those committed by disgruntled coworkers. Based on national surveillance data, neither the Postal Service industry nor postal occupations are among the groups at increased risk for work-related homicide. To further assess this concern and to determine the relative magnitude of occupational injury deaths in the Postal Service, CDC's National Institute for Occupational Safety and Health (NIOSH) used data from its National Traumatic Occupational Fatalities (NTOF) surveillance system to examine occupational injury deaths in the Postal Service and compare Postal Service fatality rates with overall rates for all U.S. industries. This report summarizes the results of that analysis.
Accidents, Occupational↗
Compensation for occupational injuries and diseases: its effect upon prevention at the workplace.
In Switzerland, as in many other industrialized countries, the nature and extent of prevention at the workplace is determined, at least partially, by known cases of compensated occupational injuries and diseases. At both the national and international levels (ILO conventions), injuries and diseases that fit appropriate lists and definitions are eligible for compensation. It has been found, based upon an investigation of a representative sample (965 subjects) of the working population in the French-speaking region of Switzerland, that this restrictive view does not take into account the fact that a large proportion of injuries and diseases are claimed by the victims to be caused by their job. These injuries and diseases, responsible for at least one month's absence from work, are not considered to be eligible for compensation but must be covered by the patient's own insurance. Moreover, the survey showed that workers considered the ill effects on health and safety to be a consequence less of the physical working environment than of the work organization, and that this category of risks was not recognized. Thus, in addition to the reduction of hazards by the application of industrial hygiene, an informed improvement of the workplace and the work organization was required. Consequently, laws and regulations on occupational injuries and diseases should be changed in order to emphasize the role of more appropriate preventive tools, which includes ergonomics.
Absenteeism↗
Persistent medical problems and permanent impairment five years after occupational injury.
In a comprehensive, one year material of 1,785 occupational injuries in the township of Umeå, Sweden. 1985-04-01/1986-03-31, the proportion of persons with persistent medical problems, two years after the event, was 39%. These were investigated again in 1990, five years after the event, and the proportion of persons with persistent medical problems had dropped to 23%. Around 4% of the injured had a definable permanent medical impairment, most often caused by a fracture, luxation or amputation of an upper extremity. Back injuries, however, were the most frequent cause for persistent medical problems, mostly in the form of ache and pain. Persons in health care, social and nursing occupations had a twice as high proportion of persistent problems as the average in the material. Of the persons that reported persistent medical problems when interviewed in 1990, one in three had changed his leisure time activities, one in five had changed jobs, and one in ten had retired early or was on long term sick leave. The group of early retired and persons on long term sick leave had a large proportion of young females and old males. The reader is reminded that conclusions and comparisons must be made with reference to the assessment and benefit structure in the particular systems of social insurance and workers' compensation.
Adult↗
A strategic approach to occupational injuries.
The development of an integrated risk management approach to occupational injuries at Conrail had an enormously positive impact on injury incidence, lost work days, and company costs. Dr. Comstock describes managed care techniques that facilitate interface between quality assurance and risk management.
Accidents, Occupational↗
[Underreporting of occupational injuries to the Labour Inspection].
BACKGROUND: The Labour Inspection investigates occupational accidents and publishes injury statistics annually. Information is based upon two main sources: Copies of reports to the National Insurance Service and mandatory reports from employers to the Labour Inspection. MATERIAL AND METHODS: Occupational injuries treated by Oslo Emergency Ward and Oslo Ambulance Service during a period of three months were compared with injuries recorded by the Labour Inspection. RESULTS: Four months after the end of the study period, the Labour Inspection had received reports from the National Insurance Service on 150 (13%) of the 1,153 injuries recorded by Oslo Emergency Ward/Oslo Ambulance Service. Among all injuries registered, 208 were serious according to the criteria of the Labour Inspection. Only 19 (9%) of these were reported directly to the Labour Inspection from employers in accordance with the legal requirement. The study recorded 17 serious injuries caused by violence affecting employees; none of these were reported directly to the Labour Inspection. INTERPRETATION: Data on occupational injuries collected by the Labour Inspection are far from complete. In Oslo alone, the Labour Inspection may annually overlook some 900-1,000 serious injuries. Data quality can be improved and delayed reporting avoided by using information from doctors and medical institutions that provide treatment.
Accidents, Occupational↗
Occupational injury and illness recording and reporting requirements. Final rule.
The Occupational Safety and Health Administration (OSHA) is delaying the effective date of three provisions of the Occupational Injury and Illness Recording and Reporting Requirements rule published January 19, 2001 (66 FR 5916-6135) and is establishing interim criteria for recording cases of work-related hearing loss. The provisions being delayed are sections 1904.10 (a) and (b), which specify recording criteria for cases involving occupational hearing loss, section 1904.12, which defines "musculoskeletal disorder (MSD)" and requires employers to check the MSD column on the OSHA Log if an employee experiences a work-related musculoskeletal disorder, and section 1904.29(b)(7)(vi), which states that MSDs are not considered privacy concern cases. The effective date of these provisions is delayed from January 1, 2002 until January 1, 2003. OSHA will continue to evaluate sections 1904.10 and 1904.12 over the next year. OSHA is also adding a new paragraph(c) to section 1904.10, establishing criteria for recording cases of work-related hearing loss during calendar year 2002. Section 1904.10(c) codifies the enforcement policy in effect since 1991, under which employers must record work related shifts in hearing of an average of 25 dB or more at 2000, 3000 and 4000 hertz in either ear.
Accidents, Occupational↗
An estimate of the U.S. Government's undercount of nonfatal occupational injuries.
Debate surrounds the size of the underestimate of nonfatal occupational injuries produced by the U.S. Bureau of Labor Statistics (BLS). We developed models that separated categories of injuries: BLS Annual Survey, federal government, agriculture, state and local government, self-employed outside agriculture, and all other. The models generated varying estimates depending on the assumptions for each category pertaining to job risks and amount of underreporting. We offered justification for the assumptions based on published studies as well as our own analyses of BLS data. The models suggested the Annual Survey missed from 0% to 70% of the number of injuries (from private firms, excluding the self-employed) it was designed to capture. However, when we included firms and governments the Annual Survey was not designed to capture, and considered reasonable assumptions regarding underreporting, we estimated the BLS missed between 33% and 69% of all injuries. We concluded that there was substantial undercapture in the BLS Annual Survey, some due to the excluded categories of government workers and the self-employed, as well as some due to underreporting.
Accidents, Occupational↗
Occupational injury and illness recording and reporting requirements. Final rule.
The Occupational Safety and Health Administration (OSHA) is revising the hearing loss recording provisions of the Occupational Injury and Illness Recording and Reporting Requirements rule published January 19, 2001 (66 FR 5916-6135), scheduled to take effect on January 1, 2003 (66 FR 52031-52034). This final rule revises the criteria for recording hearing loss cases in several ways, including requiring the recording of Standard Threshold Shifts (10 dB shifts in hearing acuity) that have resulted in a total 25 dB level of hearing above audiometric zero, averaged over the frequencies at 2000, 3000, and 4000 Hz, beginning in year 2003.
Costs and Cost Analysis↗
Identification and characterization of Kentucky self-employed occupational injury fatalities using multiple sources, 1995-2004.
BACKGROUND: Identification and characterization of occupational injury fatalities in self-employed workers typically relies on a single data source and thus may miss some cases. METHODS: Kentucky self-employed worker injury fatalities were identified using Fatality Assessment and Control Evaluation (FACE) program data (1995-2004) and compared to non self-employed worker data. Occupations and industries listed on death certificates were compared to those in which the decedent was actually engaged. RESULTS: Of 1,281 Kentucky worker injury deaths, 28% were self-employed. Death certificates failed to identify 31% of these deaths as work-related; industry and occupation were incorrectly identified in 27% and 16%, respectively. Fifty-seven percent of the deaths were in agriculture, primarily tractor-related. For Kentucky, the self-employed crude death rate was higher (27.6/100,000) than the non self-employed worker (5.4/100,000) rate or the US (11.5/100,000) self-employed rate. CONCLUSIONS: Multiple information sources improve identification of self-employed status in work-related injury fatalities. Effective prevention requires accurate surveillance and examination of contributing factors. Self-employed worker injuries in high-risk industries should be more fully examined for development of effective injury prevention programs.
Accidents, Occupational↗
Fatal Occupational Injuries in the Forestry and Logging Industry in North Carolina, 1977-1991.
Fatal occupational injuries in the forestry and logging industry and occupation in the state of North Carolina from January 1, 1977, to December 31, 1991, were analyzed. Data were obtained through the North Carolina medical examiners system. The analysis was performed for the whole state as well as for the four forestry regions into which the state is divided. A total of 125 deaths happened over the study period. All were men, and the majority (60%) were white, with a mean age of 43 years. The crude fatality rate for the overall study period was 2.2 deaths per 1,000 person-years, with age-specific rates increasing with age. The Piedmont region had the highest proportion of cases (31.2%), while the Mountain region accounted for the highest overall rate (22.7 per 1,000 person-years). For all the forestry regions, the leading means of injury was found to be falling objects.
Journal Article↗