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Methodological challenges to the study of occupational injury--an international epidemiology workshop.

Occupational and work-related injuries comprise the majority of reported workplace morbidity in the employed population in the United States. Despite intervention attempts, the overall trend for these injuries has been relatively stable over the past several decades. Three significant problems are raised as potentially contributing to this stability. Minimal progress in reduction may be due to: lack of etiologic understanding, lack of appropriate intervention selection, or lack of appropriate intervention implementation. Focusing on the first of these problems, a workshop symposium of injury epidemiologists and related scientists was held that developed a series of collaborative manuscripts on issues in injury epidemiology and recommendations for future research. The contributions of each are briefly summarized.

Accidents, Occupational↗

Serious occupational injuries in Australia: some deficiencies of the existing data collections.

This study examines the incidence in Australia of "serious" occupational injuries, arbitrarily defined as those which resulted in absence from work for six months or more. The raw data were contained in computer print-outs specially prepared by the State offices of the Australian Bureau of Statistics (ABS) and the study includes analyses by age, sex, occupation and industry of the injured person. The unexpectedly large total of 14,281 high-severity injuries cannot be supported with confidence since the principal finding was the large and consistent variation in injury rates between the States. For males, the overall injury rates (per 10,000 persons) for Victoria, South Australia and Tasmania were in the range 11 to 16: those for Queensland and Western Australia were in the high 30s; whilst that for New South Wales exceeded 50. A similar ranking of injury rates prevailed in almost every subset. The highest rates arose in New South Wales, Queensland and Western Australia in six of the seven occupation groups, in nine of the ten industry groups and in all eleven age groups. It is difficult to find any scientific explanation for these variations in terms of levels or extent of exposure to risk. In the opinion of this author, these variations should be attributed to differences in the institutional arrangements for the coverage, collection and/or compilation of compensation data.(ABSTRACT TRUNCATED AT 250 WORDS)

Accidents, Occupational↗

Occupational injuries among North Carolina migrant farmworkers.

A population-based cross-sectional study of occupational injuries among a random sample of 287 migrant farmworkers demonstrated frequent obstacles to health care; 65% (11/17) of the more seriously injured subjects did not receive prompt care or never received care. Subjects not receiving prompt care were twice as likely to have incomplete recovery. Employers covered medical expenses for only 5/13 (38%) of the injured workers, and only 3/15 were compensated for lost work. This study indicates that comprehensive Workers' Compensation coverage is urgently needed in North Carolina.

Accidents, Occupational↗

Hazard perception and occupational injuries in the welders and lathe machine operators of Rawalpindi and Islamabad.

OBJECTIVE: To study the prevalence of occupational injuries in the welders and lathe machine operators and their hazard perception. SETTING: This study was conducted in the welders and lathe machine operators working in the welding and metal working shops in Rawalpindi and Islamabad. METHODS: A cross-sectional survey was conducted by two trained health interviewers using uniform questionnaire with both close and open-ended questions. RESULTS: Two hundred and eight welders and 104 lathe machine operators were interviewed. Thirty nine (18.7%) welders and 27 (26%) lathe machine operators reported an injury in the past three months, while 63 (30.3%) welders and 76 (73.8%) lathe machine operators reported sustaining an injury in the past twelve months. However, only half of the welders and 31 (29.8%) lathe machine operators believed that their occupation was hazardous for health. CONCLUSION: For effective public health policy there is a need preventive education and enforcement of safety regulations for the informal occupational sector in Pakistan.

Adolescent↗

Occupational injuries among minors doing farm work in Washington State: 1986 to 1989.

BACKGROUND: There is growing evidence that many children are injured while engaged in agricultural work. However, little specific information on farm work-related injuries among minors is available, probably because employment or workers' compensation data for children are hard to obtain. METHODS: Workers' compensation data were used to evaluate occupational injuries among children in Washington State from 1986 through 1989. The frequency and severity of injuries among minors doing farm work were compared with the distributions of injuries among minors working in food service and all other occupations by year of injury, age of injury, and month and hour of injury. RESULTS: A total of 16,481 claims filed by children under age 18 were evaluated. Although farm workers accounted for only 7% of all claims, they made up 36% of claims filed by children under age 14, and 17% of claims filed by children aged 14 or 15. Injuries classified as serious accounted for 26% of farm worker claims compared with only 16% of all claims filed by children. CONCLUSIONS: Although injury rates could not be developed owing to the lack of denominator data, this study demonstrates that farm work is dangerous for young children.

Accidents, Occupational↗

Occupational injury deaths of 16- and 17-year-olds in the United States.

Data from the National Traumatic Occupational Fatalities surveillance system were used to analyze occupational injury deaths of civilian 16- and 17-year-olds during 1980 through 1989. There were 670 deaths; the rate was 5.11 per 100,000 full-time equivalent workers. The leading causes of death were incidents involving motor vehicles and machines, electrocution, and homicide. Workers 16 and 17 years old appear to be at greater risk than adults for occupational death by electrocution, suffocation, drowning, poisoning, and natural and environmental factors. Improved enforcement of and compliance with federal child labor laws, evaluation of the appropriateness of currently permitted activities, and education are encouraged.

Accidents, Occupational↗

Occupational injuries in the Finnish furniture industry.

OBJECTIVES: The purpose of the study was to determine the types of occupational injuries that occur in the Finnish furniture industry and to see whether they differ as regards production type and company size. METHODS: During a one-year registration period accident events, the actual and potential severity of the injuries, the causes of the accidents, and the measures needed to prevent such accidents were examined in 18 Finnish furniture factories of different types. An analysis of covariance determined the variables affecting the actual and potential severity of the injuries. RESULTS: The 214 accidents registered were lost-time injuries; two of them resulted in slight partial loss of fingertips. The disabling injury rate was 14.4 per 100 workers per year. Wooden furniture production and kitchen cupboard production in large companies had the highest rate. Accidents involving machines comprised half of the material. Saws were the most common machine type. Forty-two percent of the injuries could have been more severe; one injury could have been fatal. The injured persons and their foremen identified the causal factors of the accidents and the needed safety countermeasures well. Sixty-six percent of the causes and 65% of the safety countermeasures were associated with the actions of the workers and the workplace procedures. Nevertheless, only 6% of the identified safety countermeasures were put into force. CONCLUSIONS: It was estimated that, in 1987, 2000 on-site accidents leading to at least first-aid at some health care center occurred in the Finnish furniture industry. Special efforts should be taken to improve safety in furniture production in Finland.

Accidents, Occupational↗

Using Labour Force Survey and census data to generate denominators for occupational injury rates: an application and expansion of Haggar-Guénette's method.

The calculation of rates of occupational injury claims is essential to identify groups at high risk, yet limitations of denominator data have often restricted our capacity to do this. Haggar-Guénette's method of using Statistics Canada's data on paid workers from the Labour Force Survey as denominators has been expanded by incorporating information from the Census. The method is illustrated by calculating denominators for male construction industry workers within the province of Ontario. Information for paid workers employed in construction occupations was derived from the Labour Force Survey to produce denominators for those aged 15-64, overall and by 10-year age groups. Census data on the distribution of construction occupational roles were applied to produce denominators both overall, then simultaneously by age and by occupational role. Advantages and disadvantages, including the limitations or biases due to the differing sources for denominators and numerators are identified.

Accidents, Occupational↗

Occupational injuries in Italy: risk factors and long term trend (1951-98).

OBJECTIVES: Trends in the rates of total injuries and fatal accidents in the different sectors of Italian industries were explored during the period 1951-98. Causes and dynamics of injury were also studied for setting priorities for improving safety standards. METHODS: Data on occupational injuries from the National Organisation for Labour Injury Insurance were combined with data from the State Statistics Institute to highlight the interaction between the injury frequency index trend and the production cycle-that is, the evolution of industrial production throughout the years. Multiple regression with log transformed rates was adopted to model the trends of occupational fatalities for each industrial group. RESULTS: The ratios between the linked indices of injury frequency and industrial production showed a good correlation over the whole period. A general decline in injuries was found across all sectors, with values ranging from 79.86% in the energy group to 23.32% in the textile group. In analysing fatalities, the trend seemed to be more clearly decreasing than the trend of total injuries, including temporary and permanent disabilities; the fatalities showed an exponential decrease according to multiple regression, with an annual decline equal to 4.42%. CONCLUSIONS: The overall probability of industrial fatal accidents in Italy tended to decrease exponentially by year. The most effective actions in preventing injuries were directed towards fatal accidents. By analysing the rates of fatal accident in the different sectors, appropriate targets and priorities for increased strategies to prevent injuries can be suggested. The analysis of the dynamics and the material causes of injuries showed that still more consideration should be given to human and organisational factors.

Accidents, Occupational↗

Surveillance for nonfatal occupational injuries treated in hospital emergency departments--United States, 1996.

CDC's National Institute for Occupational Safety and Health (NIOSH) uses the National Electronic Injury Surveillance System (NEISS) for surveillance of nonfatal occupational injuries treated in hospital emergency departments (EDs). This report, based on 1996 NEISS data, is the first since 1983 to provide updated national estimates of the magnitude and risk for nonfatal occupational injuries treated in EDs; the findings indicate that the workers at highest risk are young and male.

Accidents, Occupational↗

[Occupational injuries assessed in a physico-medical practice].

BACKGROUND: In Norway over the last decade, we have seen an increase in disability claims based on occupational injury. Though much is known about the injury events, so far there have been few Norwegian studies of the relationship between work-related injuries and their somatic and functional consequences. MATERIAL AND METHODS: Over the period 1994 - 2002, 503 individuals who had filed claims for work-related musculoskeletal injuries were examined with special emphasis on the clinical consequences of the injury. The median interval between accident and examination was three years. Injury severity was scored using the Abbreviated Injury Scale (AIS). RESULTS: Falls were the most frequent type of accident; contusions, sprains and strains the most frequent injuries sustained. Many accidents were poorly documented. 16 % of the injuries were found to exceed an AIS score of 1. 30 % were working full time, while around two thirds were receiving incapacity benefits. There was no association between disability and AIS score. INTERPRETATION: In spite of the low overall level of injury severity, there was a high rate of disability subsequent to the accidents. Our results seem to indicate that injury severity is only one of several factors related to outcome after work-related injuries.

Accidental Falls↗

Entry-level physiotherapists' strategies to lower occupational injury risk in physiotherapy: a qualitative study.

The purpose of this study was to identify entry-level physiotherapists perceptions of workplace injuries in private practice and the strategies they may use to reduce occupational injury risk in physiotherapy. Seventy-nine final year physiotherapy students were presented with a private practice workplace scenario, recent injury statistics, and common job risk factors in physiotherapy and were required to choose between the options of being a salaried employee or contractor and to discuss self-management strategies. This question was part of a substantive written examination that is a compulsory aspect of the final assessment for these students. Students identified nine categories for self-management and reducing injury risk with the majority of students choosing the option of being a contractor in preference to being a salaried employee. Regardless of the preferred employment option, students tended to select self-management strategies that would have a negative impact on income and service delivery and may be reflective of the relative inexperience of these students in private sector workplace settings. Given the high prevalence of work-related musculoskeletal disorders (WRMDs) in the 5 five years postgraduation, the findings from this study highlight the need for educational institutions and employers to address occupational health and risk factors in physiotherapy, which would include education on prevention as well as appropriate self-management strategies within each workplace.

Attitude of Health Personnel↗

Non-fatal occupational injuries requiring admission to hospitals in Al-Khobar City, Saudi Arabia: prospective cohort study.

AIM: To determine the incidence rate of non-fatal occupational injuries among the workers insured by the General Organization of Social Insurance requiring admission to private hospitals in Al-Khobar city during 1995. METHODS: This cohort study was conducted on 65,915 insured industry workers admitted to 2 randomly selected private hospitals in Al-Khobar City. At admission to hospital, a data sheet was filled out with necessary data collected directly from the patient and his medical file. RESULTS: The injury incidence rate was 7.1 per 1,000 full-time workers a year. Nationality-wise, 1. 5% were Saudis, 13.2% were Filipinos, and 74.8% were from the Indian subcontinent. Hands and fingers were most often injured (32.1%) and fall was the main cause of injury (33.4%). The majority of admissions (77.8%) lasted for less than a week. Absence from work was longer than 3 weeks in 35.5%, and shorter than 1 week in 24.9% of admissions. Majority of the injured workers (65.0%) visited the clinic 2-7 times. Direct medical cost per admission was less than US$533 (SR2,000) in 63.9% of the cases in one of the hospitals. CONCLUSIONS: The incidence rate of work injuries in Saudi Arabian workers was comparable to the rates from other countries. As these injuries cause high medical charges, human suffering, and loss of productivity, it seems that the social insurance organization should take measures to improve the current situation and encourage similar studies to be conducted in this field, particularly on severe injuries.

Absenteeism↗

Completeness of provincial workers' compensation files to identify fatal occupational injuries.

The objective of the study was to ascertain the completeness of Workers' Compensation files to identify fatal occupational injuries. The number of fatalities was counted using two independent sources: the Quebec Workers' Compensation Board (QWCB), and the Coroner's Death Certificates (CDCs), for the years 1987 and 1988. The observed number of cases was 352. The QWCB identified 83.8% of those and CDCs 69.3%. The true number of deaths was estimated, using the capture-recapture methods, to be between 369 and 401. The compensation coverage of work-related fatalities was 66.1% in workers 55 years of age and older and 8.3% in farming occupations. Therefore, Workers' Compensation statistics are inadequate as the single source in these two categories and their exclusive use thus far has led to a failure in recognizing these issues as public health priorities.

Accidents, Occupational↗

Occupational injury among Rhode Island adolescents: an analysis of workers' compensation claims, 1998 to 2002.

OBJECTIVES: We sought to examine occupational injuries sustained by adolescent workers during a 5-year period. METHODS: Workers' compensation claims from Rhode Island were used to assess injuries of 15- to 19-year-old employees (n = 8321) from 1998 to 2002. Baseline employee population estimates were derived using the Current Population Survey. RESULTS: The annual estimated adolescent claim rate was 6.6 per 100 workers (95% confidence interval = 6.1-7.1), with annual average costs of $614,182. Injury rates increased with employee age, hours worked, and for day and nightshift employees relative to evening shift workers. The highest proportion of claims by industry was in eating establishments, and the average indemnification duration was 13.0 days. CONCLUSIONS: Specific emphasis should be placed on increasing safety training and preventative interventions for teenagers in hazardous occupations and for those working longer hours.

Adolescent↗