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PubMed2006

Costs differences across demographic groups and types of occupational injuries and illnesses.

BACKGROUND: Little is known about cost differences for demographic groups or across occupational injuries and illnesses. METHODS: In this incidence study of nationwide data for 1993, an analysis was conducted on fatal and non-fatal injury and illness data recorded in government data sets. Costs data were from workers' compensation records, estimates of lost wages, and jury awards. RESULTS: The youngest (age < or = 17) and oldest (age > or = 65) workers had exceptionally high fatality costs. Whereas men's costs for non-fatal incidents were nearly double those for women, men's costs for fatal injuries were 10 times the costs for women. The highest ranking occupation for combined fatal and non-fatal costs--farming, forestry, and fishing--had costs-per-worker (5,163 US dollars) over 18 times the lowest ranking occupation-executives and managers (279 US dollars). The occupation of handlers, cleaners, and laborers, ranked highest for non-fatal costs. Gunshot wounds generated especially high fatal costs. Compared to whites, African-Americans had a lower percentage of costs due to carpal tunnel syndrome, circulatory, and digestive diseases. CONCLUSIONS: Costs comparisons can be drawn across age, race, gender, and occupational groups as well as categories of injuries and illnesses.

Administrative Personnel↗
PubMed2005

The effect of roof strength on reducing occupant injury in rollovers.

Roof crush occurs and potentially contributes to serious or fatal occupant injury in 26% of rollovers. It is likely that glazing retention is related to the degree of roof crush experienced in rollover accidents. Occupant ejection (including partial ejection) is the leading cause of death and injury in rollover accidents. In fatal passenger car accidents involving ejection, 34% were ejected through the side windows. Side window glass retention during a rollover is likely to significantly reduce occupant ejections. The inverted drop test methodology is a test procedure to evaluate the structural integrity of roofs under loadings similar to those seen in real world rollovers. Recent testing on many different vehicle types indicates that damage consistent with field rollover accidents can be achieved through inverted drop testing at very small drop heights. Drop test comparisons were performed on 16 pairs of vehicles representing a large spectrum of vehicle types. Each vehicle pair includes a production vehicle and a vehicle with a reinforced roof structure dropped under the same test conditions. This paper offers several examples of post-production reinforcements to roof structures that significantly increase the crush resistance of the roof as measured by inverted drop tests. These modifications were implemented with minimal impact on vehicle styling, interior space and visual clearances. The results of these modifications indicate that roof crush can be mitigated by nearly an order of magnitude, as roof crush was reduced by 44-91% with only a 1-2.3% increase in vehicle weight. Additionally, this paper analyzes the glazing breakage patterns in the moveable tempered side windows on the side adjacent to the vehicle impact point in the inverted drop tests. A comparison is made between the production vehicles and the reinforced vehicles in order to determine if the amount roof crush is related to glazing integrity in the side windows. Lastly, two drop test pairs, performed with Hybrid III test dummies, indicates that the reduction of roof crush resulted in a direct reduction in neck loading and therefore an increase in occupant protection.

Accident Prevention↗
PubMed1993

OSHA recordkeeping guidelines for occupational injuries and illnesses.

The U.S. Department of Labor's Bureau of Labor Statistics administers the occupational injury and illness recordkeeping regulations established by the Occupational Safety and Health Act of 1970. Medical facilities must comply with the law's requirements. This article provides both an overview of the regulations and information on how to obtain the required instructions and forms. While some states administer their own occupational safety and health programs, they must adopt standards and enforce requirements that are at least as effective as federal requirements.

Documentation↗
PubMedDate not supplied

Services provided by family physicians for patients with occupational injuries and illnesses.

PURPOSE: Many family doctors provide care to patients with occupational injuries and illnesses, but little is known about the type of medical services provided, or how they compare with services provided by other types of physicians. This study used national data to develop a statistical profile of office-based medical care delivered by family physicians to patients with work-related disorders. METHODS: Using data from 4 years (1997-2000) of the National Ambulatory Medical Care Survey, we classified visits for patients with work-related conditions according to patient and physician characteristics, services provided, and other visit characteristics. For comparison, we also compiled profiles for visits to other types of physicians for treatment of work-related disorders, and for visits to family physicians for treatment of nonoccupational conditions. RESULTS: Analyses were based on 96,183 office visits made to 4,947 physicians. A majority of visits made to family physicians for occupational conditions involved patients seeing their regular primary care doctor. Possibly for this reason, patients at these visits were more likely to have their blood pressure taken, receive diagnostic and screening services, and have prescription drugs prescribed or administered, compared with patients seeing other types of physicians. Only 73.3% of visits to family physicians for work-related disorders were expected to be paid for by workers' compensation insurance. CONCLUSIONS: Our findings suggest that the distinctive types of care provided by family physicians to injured workers may be related to their role as the patients' regular physician. This finding is relevant to the proposals being considered by many states to expand employers' and insurers' ability to choose the treating physician in workers' compensation cases.

Accidents, Occupational↗
PubMed2000

Fatal occupational injuries in a new development area in the People's Republic of China.

Fatal occupational injuries in a new development region in Shanghai in east China are described. All occupational deaths in the East Pujiang New Area during the period 1991 through 1997 were abstracted from multiple, overlapping source documents. There were 426 deaths and a crude mortality rate of 9.1 per 100,000 workers. The death rate was highest in 1995 (14.6%), when expansion in the area was most rapid. The construction sector accounted for 55% of the deaths, followed by manufacturing (23%) and transport, storage, and telecommunications (11%). Falls, collisions, struck by/against incidents, and electrocutions accounted for 80% of all deaths. Falls led all other causes of deaths (33%) and were particularly prevalent in the construction industry (46% of all deaths in construction). The development of ongoing, comprehensive injury surveillance systems in the People's Republic of China will be essential to target and evaluate injury prevention activities in the future.

Accidents, Occupational↗
PubMed1994

Preventive effects of work place investigations in connection with musculo-skeletal occupational injuries.

One hundred and ninety-five reports on musculo-skeletal occupational injuries were collected and randomised into two groups: one group where the work places of the injured were visited by labour inspectors (LIs) and one control group. The inspectors were instructed to issue inspection notices (INs) where appropriate. Ninety-two such visits were paid and resulted in 20 INs. Approximately 15 months later all 195 work places were visited by 3 ergonomists and the ergonomic situations were assessed. When compared with the control group neither the visits from the LIs nor the INs issued were associated with reduced work load among the injured. However, at most work places also other employees were performing the same tasks as the injured persons. Among these employees there was a significant reduction of work load where INs had been issued to the employers. Thus, the main effects of the LI interventions were in primary preventive measures.

Decision Trees↗
PubMed1988

Occupational skin diseases, United States. Results from the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, 1973 through 1984.

The overall incidence rates, numbers, and proportions of occupational skin diseases recorded in the Bureau of Labor Statistics Annual Survey of Occupational Injuries and Illnesses, from 1973 through 1984, were reviewed, and a detailed analysis of occupational skin diseases recorded in the 1984 Annual Survey was performed. Overall incidence rates and numbers of cases declined from 1973 through 1983, but increased slightly in 1984. The major industrial divisions of agriculture and manufacturing have consistently had the highest rates and numbers of cases, respectively; skin diseases have accounted for almost two thirds of all occupational illnesses within agriculture. In the 1984 Annual Survey, 11 industries were ranked in the "Top 15" for both incidence rates and numbers of cases, at the two-digit Standard Industrial Classification level. At the four-digit level for manufacturing, four industries were also ranked in the "Top 15" for both indexes. This analysis has identified industries toward which research efforts should be directed to characterize those occupational activities or exposures most responsible for these higher risks.

Absenteeism↗
PubMed2005

Occupational injuries in Tehran.

As the first step in evaluation of the magnitude of the occupational injuries (OIs) in our community, we focused on hospital records of more than 8400 hospitalized trauma patients in six large university hospitals during 13 months of data gathering process. Fourteen percent of 8426 trauma patients had OIs (1180 cases) and 95% of them were male. Adults 19-39 years comprised 63% of the patients. Eleven percent of the patients were 18 years old or younger. Construction workers (26%), simple workers (26%), and industrial workers (17%) comprised nearly 70% of the OIs. Falls (39%) and striking by blunt objects (29%) were the most common mechanisms of injury. More than 60% of the patients did not have any type of insurance. A younger patient has a higher the probability of being uninsured. Head (49%) wrist and hand (46%) and knee and leg (36%) injuries were the most common regions injured. Additional community-based studies are needed to determine the risk of OIs among different occupational categories, as well as to identify the most vulnerable groups.

Accidental Falls↗
PubMed1991

Occupational injuries and perception of hazards among road-side welding workers.

A cross-sectional survey was conducted to understand the extent of occupational injuries and the perception of hazards among the road-side welders in the city of Karachi. Burns and foreign body in eyes were reported to be the most common injuries. Few workers perceived their occupation as hazardous. Consequently, few of them reported using protective measures. A 3-step strategy was recommended to improve occupational safety for this and other related groups of workers.

Attitude to Health↗
PubMed2004

Fatal and nonfatal occupational injuries involving wood chippers--United States, 1992-2002.

Tree damage from storms and routine tree-trimming operations prompt the need for disposing of branches and brush. Mobile wood chippers shred branches and tree trimmings into mulch. Branches are fed into a chute, in which rotating blades macerate the wood. Mobile chippers pose potential dangers to operators, who can become caught in the feed mechanism and pulled into the rotating chipper knives or struck by the hood of the machine while it is being opened or closed with the knives still rotating. This report summarizes data describing fatal and nonfatal injuries related to occupational wood chipper use, which indicate that those working with mobile wood chippers are at risk for serious injury and death, but that these injuries can be prevented through proper training, machine maintenance, and the use of personal protective equipment.

Accidents, Occupational↗
PubMed2004

Costs of occupational injury and illness across states.

The objective of this study was to estimate occupational injury and illness costs per worker across states. Analysis was conducted on injury data from the Bureau of Labor Statistics and costs data from workers' compensation records. The following states were at the top of the list for average cost (cost per worker): West Virginia, Alaska, Wyoming, Kentucky, and Mississippi. The following states were at the bottom: South Carolina, Delaware, Minnesota, Massachusetts, and New Hampshire. The following variables (and signs on regression coefficients comparing this industry with manufacturing) were important in explaining the variation across states: employment in farming (+), agricultural service, forestry, fishing (+), mining (+), transportation and public utilities (+), wholesale trade (-), and finance, insurance, real estate (-). Southern and especially Western states were disproportionately represented in the high cost per worker list. A significant amount of the variation in cost per worker across states was explained by the composition of industries.

Accidents, Occupational↗
PubMed1998

Occupational injuries and illnesses reported by zoo veterinarians in the United States.

A 14-page comprehensive survey was mailed to all 565 United States members of the American Association of Zoo Veterinarians to identify the frequency of physical injuries, radiation exposures, chemical exposures, allergic or irritant reactions, infections, and use of preventive measures, and 315 (55.8%) veterinarians responded. Significant findings include major animal-related injury (61.5%), back injury (55%), necropsy injury (44.1%), adverse formalin exposure (40.2%), animal allergy (32.2%), zoonotic infection (30.2%), and insect allergy (14.2%). We also found that gender, length of experience, and practice type affected the number and type of incidents encountered in practice. Females reported a higher rate of zoonotic infection, insect allergy, and adverse exposure to anesthetic gas, formalin, and disinfectants/sterilants. Zoo veterinarians with more years of experience were more likely to receive major animal-related injury and associated hospitalization, back injury, and lost work time associated with back injury. Full-time zoo veterinarians were more likely to report back injury and inadequate knowledge of occupational hazards. Results are compared with hazards reported by veterinarians working in other fields. The frequency of injuries reported demonstrates a greater need for comprehensive health and safety programs for zoo veterinarians.

Accidental Falls↗
PubMed1995

Machine-related occupational injuries in farm residents.

Farm machinery is an important contributor to the high rates of occupational injury in agriculture. As part of a population-based case-control study, we studied risk factors for machine-related farm injuries. Case patients were farm residents residing in a geographically defined area of central Wisconsin who experienced a farm injury associated with a tractor, farm implement, or other machine which required medical or chiropractic care from May 1990 through April 1992. Controls were selected from an ad hoc census of farm residents in the same area. Telephone interviews regarding demographic characteristics, safety behaviors, and farming practices were completed for 97.8% of 90 case patients and for 82.8% of 221 control subjects. Personal characteristics significantly associated with an increased risk of machine-related injury included the number of hours worked per week and working primarily as a farmer. Dairy farms, farms with nonresident workers, and large farms were associated with an increased risk of injury while farms with registered cows and farms where cows were fed in the barn even in summer experienced fewer injuries. Based on a logistic regression model, the independent risk factors for machine-related farm injury included hours worked per week (2% increased risk/nonresident workers on farm (odds ratio) (OR) = 2.32; 95% confidence interval (CI): 1.07 to 5.06), cows fed in barn in summer (OR = 0.28; 95% CI: 0.12 to 0.64), and registered cows on farm (OR = 0.36; 95% CI: 0.17 to 0.79). Farm safety practices did not appreciably influence the risk of machine-related farm injury.

Accidents, Occupational↗
PubMed2006

Non-fatal occupational injuries in British agriculture.

OBJECTIVES: To investigate the incidence, nature and determinants of non-fatal occupational injuries in British agriculture. METHODS: As part of a postal survey, data on lifetime histories of work in agriculture and occupational accidents were obtained from men born between 1933 and 1977 and residing in three rural areas of England and Wales. Incidence rates for different categories of accident were compared with those derived from statutory reporting. Associations with risk factors were explored by Poisson regression, and summarised by incidence rate ratios (IRRs). RESULTS: Of the 10 765 responders (response rate = 31%), 3238 (30%) reported at least one occupational accident at the ages of 14-64 years, leading to absence from work for >or=3 days, including 1492 accidents that could be linked to a specific job listed in the history of agricultural work. The reported incidence of injuries in agriculture was markedly higher than that derived from statutory reporting, particularly for self-employed farmers. During 1996-2003, the highest rates of agricultural accidents were from handling, lifting or carrying (4.9/1000 person-years), falls from a height (4.6/1000 person-years) and injury by animals (3.4/1000 person-years). After adjustment for calendar period and age, the risk of accidents was elevated in men who had only recently entered agricultural work (IRR 3.7, 95% CI 2.7 to 5.1 for men who had worked in agriculture for up to 1 year relative to those who had entered the industry >25 years earlier), and in those who carried out forestry (IRR 1.7, 95% CI 1.5 to 1.9). CONCLUSION: Our findings confirm the substantial underascertainment of serious accidental injuries in agriculture through statutory reporting, particularly for the self-employed. The risk of accidents is highest in new recruits to the industry and in those undertaking forestry, and these groups should be a target for further preventive action.

Accidents, Occupational↗
PubMed2001

Epidemiology of occupational injuries and illnesses in a university population: a focus on age and gender differences.

BACKGROUND: Occupational injuries and illnesses are a major preventable public health problem. METHODS: This study evaluated the incidence, nature, and cause of awarded workers' compensation claims for a large state university and teaching hospital. Rates and types of injury were compared across age and gender. RESULTS: Rates of injury varied over twofold with age, with those 16-25 having the lowest rates of injury and those 36-45 having the highest rates. Claims rates were 1.36-fold higher for women than men. Women had higher rates for injury resulting from lifting, falling, noxious exposures, repetitive motion, and carpal tunnel syndrome. Similarly women had significantly higher rates of claims for pain, sprains, bruises, burns, concussion, and inhalation injury; with lower rates of cuts, ligament injury, and jammed joints. CONCLUSIONS: These group differences suggest the need to examine age and gender job distributions and relevant ergonomic and environmental causative factors.

Accidents, Occupational↗
PubMed2000

Predictors of first nonfatal occupational injury following employment in a Brazilian steelworks.

OBJECTIVES: This study investigated the influence of sociodemographic and occupational factors on the risk of 1st injury among Brazilian steelworkers. METHODS: Workers 1st employed between 1 January 1977 and 31 December 1985 and still employed on 1 December 1983 were followed from the date of hire until 30 October 1992. Occupational injuries were ascertained from a database. Kaplan-Meier curves for time to 1st injury were calculated for the total cohort and for different subgroups. A multivariate analysis of risk factors for 1st injury was carried out using the Cox proportional hazards regression model. RESULTS: Forty-one percent of the workers had > or = 1 occupational injuries, and 39% of 1st injuries occurred in the 1st year of employment. Lacerations, contusions, penetration by foreign bodies, bums, sprains, and fractures constituted the main diagnostic groups. Injuries to the hands, eyes, feet, arms, and legs dominated. Over 5% of the injured workers were on temporary disability leave (cumulative total 10,660 days). The probability for an occupational injury was 16% for the 1st year, rising to 25% in the 2nd year. The risk of nonfatal injury was highest for laborers [hazard ratio (HR) 1.76, 95% confidence interval (95% CI) 1.35-2.29] and employees in the steel mill (HR 1.40, 95% CI 1.21-1.63), and inversely related to worker age and educational level. The risk of injury decreased significantly with calendar period of employment. CONCLUSIONS: Substantial reductions in nonfatal injuries may reflect changes in work organization, increased automation, and improved safety standards. Knowledge of predictors of work-related injury may contribute to injury prevention strategies, especially among newly employed workers.

Adolescent↗
PubMed1981

Motor vehicle occupant injuries in noncrash events.

Data on injuries sustained by child occupants in motor vehicles occurring in noncrash events are generally unrecorded. This study was undertaken to ascertain the occurrence of medically confirmed injuries sustained by child occupants in motor vehicles as a result of noncrash events. Seventy-nine children were seen in the emergency room for evaluation of injuries that they incurred as occupants in motor vehicle incidents over a period of 18 months. The majority of injuries occurred in crash events. However, 18 (23%) were injured in noncrash events. These events included sudden stops, swerves, turns, and movement of an unrestrained child within the vehicle. The mechanism of injury was either ejection from the vehicle or impact with an interior area of the vehicle. In five of the 18 cases safety restraint use could not be established. Of the 13 cases in which information was obtained, no child was restrained. Although the injuries were predominantly minor (Abbreviated Injury Scale (AIS) 1), two children sustained moderate injury (AIS 2), and one child sustained severe injury (AIS 3). These results need to be confirmed by a larger study and if confirmed, the additional hazard of injury from noncrash events should be incorporated into health education messages that currently place primary emphasis on the potential for injury in crash events.

Abdominal Injuries↗