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PubMed1992

Occupational injury and disease among patients presenting to general practitioners in a community health centre.

A prospective survey was conducted of all patients presenting over a six-month period to the primary medical care unit of a community health centre in an urban industrial area to determine the number and types of work-related injuries and disease, the causes, and details of the injured workers and their workplaces. Two-hundred and eighty-three patients, 7.2 per cent of the total number of patients attending, were diagnosed as having a work-related injury or disease; 250 patients had occupational injuries and 33 had occupational diseases. The most common injuries were open wounds, sprains and strains, contusions and eye injuries; the most frequent diseases were musculoskeletal strain syndromes, dermatitis and respiratory conditions. Most of those injured were skilled tradesmen or labourers from small (less than 30 employees) or medium-sized (30 to 99 employees) manufacturing workplaces. In five of the local medium-sized workplaces, more than 10 per cent of the workforce presented with occupational injury or disease in the six months. The mechanisms of injury for common injuries such as back strain and eye injuries are described. Most patients were managed totally within the primary care setting. Thirty per cent of all patients surveyed received a worker's compensation certificate. It is possible that occupational diseases were underdiagnosed and that worker's compensation was underutilized. The information obtained from the survey is being used in planning prevention.

Accidents, Occupational↗
PubMed1994

Occupational injury deaths--United States, 1980-1989.

During 1980-1989, 63,589 workers died from occupational injuries, an average of 17 deaths per day. CDC's National Institute for Occupational Safety and Health (NIOSH) monitors occupational injury deaths through the National Traumatic Occupational Fatalities (NTOF) surveillance system. This report summarizes occupational injury deaths compiled by NTOF* for 1980-1989.

Accidents, Occupational↗
PubMed2001

Non-fatal occupational injuries and illnesses treated in hospital emergency departments in the United States.

OBJECTIVES: To estimate the number and rate of occupational injuries and illnesses treated in hospital emergency departments and to characterize the nature, event, and source of injury and illness. SETTING: Twenty four hour emergency departments in hospitals in the United States. METHODS: Surveillance for occupational injuries and illnesses was conducted in a national probability based sample of hospital emergency departments through the National Electronic Injury Surveillance System (NEISS). Worker demographics, nature of injury and disposition, and incident circumstances were abstracted from emergency department medical records, typically within 24-72 hours of treatment. RESULTS: Approximately 3.6 million occupational injuries and illnesses were treated in emergency departments in 1998. Younger workers, particularly males, continue to have the highest rates of work related injuries. Together, lacerations, punctures, amputations, and avulsions represented one fourth of the emergency department treated injuries, mostly to hand and fingers. Sprains and strains, largely to the trunk, also accounted for one fourth of the injuries. The three leading injury events were contact with objects, bodily reactions and exertions, and falls. CONCLUSIONS: Despite apparent decreases in rates, youth continue to have a high burden of injury in the workplace. However, three fourths of all emergency department treated injuries occur to workers 20-44 years of age. Emergency department surveillance is particularly amenable to capture of young worker injuries and provides a wealth of injury details to guide prevention efforts--efforts that will likely reduce occupational injuries as these workers age. Emergency department surveillance also provides injury estimates with few demographic or employer constraints, other than the medical venue used.

Accidents, Occupational↗
PubMed1995

Occupational injuries in Bahrain.

A study was conducted to show the problem of occupational injuries in Bahrain and try to highlight some solutions that may help to prevent or reduce workplace hazards. The data for occupational injuries between 1988 to 1991 from the social insurance records were reviewed and analysed. The data were summarized, grouped and tabulated according to age, sex, nationality, work place, type of injuries, cause and site of injury. Data were analysed statistically, frequencies were computed and results represented graphically. The study shows that there was a decline in the number of injuries in 1990 and 1991 due to a slow-down of economic activities in general in the Arabian Gulf region during the Gulf War. It also shows that Asian workers are at a high risk of occupational injuries.

Accidents, Occupational↗
PubMed1994

Occupational injury deaths among females. The US experience for the decade 1980 to 1989.

From 1980 through 1989, females accounted for 44% of the total employed population. Thus, occupational safety and health issues specific to the experience of women merit consideration. Research has demonstrated that the occupational fatality experience of females is not adequately described by the group of all workers. The leading cause of death for all workers is motor vehicle incidents, while the leading cause of occupational injury death of females is homicide. The National Institute for Occupational Safety and Health (NIOSH) has compiled a decade of data on the fatal occupational injury experience of US workers, providing a sufficient number of female cases to allow separate analyses. Over the decade, 3821 females died as a result of injuries sustained at work, with an average annual fatality rate of 0.82/100,000 female workers. Among industries, retail trade and services accounted for nearly half of all occupational injury deaths to females. The detailed occupations with the highest rates of work-related injury death were airplane pilots and navigators, drivers of heavy trucks, construction laborers, and police and detectives. Information on the causes of work-related injury death by occupation is fundamental to the prevention of these deaths. The causes of death in the highest-risk occupations included aircraft crashes, motor vehicle collisions, pedestrians struck by motor vehicles, and homicides by firearms. These data provide a foundation for the prevention of occupational injury deaths among females in the United States.

Accidents, Occupational↗
PubMed2003

Worker substance use, workplace problems and the risk of occupational injury: a matched case-control study.

OBJECTIVE: This study examines the tendency toward problem behavior as an explanation for the relationship between problem substance use and occupational injury. METHOD: The authors used a matched case-control study nested in a cohort of 26,413 workers, in which cases (n = 3,994) were workers suffering an occupational injury. Five controls per case (n = 19,970) were selected from the cohort of workers active on the day of the injury and matched on job type. Conditional logistic regression modeled the association of problem substance use with occupational injury, controlling for problem behaviors and worker characteristics. Problem substance use was indicated indirectly if any of the following were alcohol/drug-involved during the comparison period: Employee Assistance Program visit, excused absence or disciplinary action. Discipline records identified minor (absenteeism) and serious (dishonesty, theft, assault, harassment, disrespect) problem behaviors during the comparison period. RESULTS: The odds of injury among workers with an indicator of problem substance use was 1.35 (p = .015) times greater than the odds among workers without an indicator, controlling for job type and demographics as well as adjusting for exposure. This ratio declined to 1.21 (p = .138) when problem behaviors were also controlled for. Minor and serious problem behaviors were significantly associated with occupational injury (odds ratio [OR] = 1.73, p < .001, and OR = 2.19, p < .001, respectively), controlling for demographics and substance use. CONCLUSIONS: The relationship of problem substance use with occupational injury was weak when problem behaviors were controlled for, suggesting that this relationship, observed in previous studies, may be explained by a workers tendency toward problem behaviors. Workplace injury prevention programs should address the expression of problem behaviors as a complement to drug and alcohol deterrent programs.

Accidents, Occupational↗
PubMed2001

Costs of occupational injuries and illnesses in California.

OBJECTIVES: The purpose of this study was to estimate the annual incidence, the mortality, and the direct and indirect costs associated with occupational injuries and illnesses in California in 1992. To achieve this, we performed aggregation and analysis of national and California data sets collected by the U.S. Bureau of Labor Statistics, California Workers' Compensation Insurance Rating Bureau, California Division of Industrial Relations, the National Center for Health Statistics, and the U.S. Health Care Financing Administration. METHODS: To assess incidence of and mortality from occupational injuries and illnesses, we reviewed data from state and national surveys and applied an attributable risk proportion method. To assess costs, we used the cost-of-illness, human capital, method that decomposes costs into direct categories such as medical expenses and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from California data, whereas others were drawn from a national study but were adjusted to reflect California's differences. Cost estimates for injuries were calculated by multiplying average costs by the number of injuries. For the majority of diseases, cost estimates relied on the attributable risk proportion method. RESULTS: Approximately 660 job-related deaths from injury, 1.645 million nonfatal injuries, 7,079 deaths from diseases, and 0.133 million illnesses are estimated to occur annually in the civilian California workforce. The direct ($7.04 billion, 34%) plus indirect ($13.62 billion, 66%) costs were estimated to be $20.7 billion. Injuries cost $17.8 billion (86%) and illnesses $2.9 billion (14%). These estimates are likely to be low because: (1) they ignore costs associated with pain and suffering, (2) they ignore home care provided by family members, and (3) the numbers of occupational injuries and illnesses are likely to be undercounted. CONCLUSION: Occupational injuries and illnesses are a major contributor to the total cost of health care and lost productivity in California. These costs are on a par with those of all cancers combined and only slightly less than the cost of heart disease and stroke in California. Workers' compensation covers less than one-half of the costs of occupational injury and illness.

California↗
PubMed1996

Personal health-risk predictors of occupational injury among 3415 municipal employees.

Little information exists about the effectiveness of health-promotion programs in reducing occupational injury rates. A historical cohort study was conducted to examine the relationship between personal health-risk factors and risk of occupational injury. Workers were grouped on the basis of nonoccupational risk-taking behaviors, psychosocial risks, cardiovascular risk factors, and a total risk-factor variable. All analyses were controlled for sex, smoking status, age, and job classification. An increased risk of occupational injury (P < .0001) was found to be significantly associated with nonoccupational risk-taking behavior. This association may be the result of continued risk-taking behavior in the occupational environment, or assignment of risk-taking individuals to more hazardous job tasks. Psychosocial, cardiovascular, and total risk-factor variables were not associated with an increased risk of occupational injury.

Adult↗
PubMedDate not supplied

Occupational injuries in welders--results from a six month follow-up study.

BACKGROUND: Injuries are an under recognized public health problem globally. We assessed the number and type of occupational injuries in welders, in a prospective manner. METHODS: A cohort of 208 welders was re-interviewed twice at three-month intervals to determine the type and frequency of injuries in the welders primarily involved in the automobile sector, in the twin cities of Islamabad and Rawalpindi in Pakistan. Data was analyzed for frequencies and counts with STATA 8. RESULTS: Cumulatively, 105 injuries were reported by 61 welders in the two follow-ups, who took 28 days off as a result of these injuries, in the past six months. Four welders reported multiple injuries involving the same injury episode. None of the welders reported any permanent disfigurement as a result of these injuries. CONCLUSION: Occupational injuries are common in the welders working primarily in the automobile sector in the twin cities of Islamabad and Rawalpindi. Foreign bodies in the eyes are the most common type of injuries sustained by these welders.

Accidents, Occupational↗
PubMed2000

Diagnosis and monetary quantification of occupational injuries by indices related to human capital loss: analysis of a steel company as an illustration.

Prevention of occupational injuries is an important task of human resource management. In this study, new indices of human capital loss of occupational injury including cumulative injury rate, proportion of potential workdays lost, and potential salary lost were applied to the analysis of registry data of occupational injuries from 1986 to 1994 of a steel company in Taiwan. In addition, we compared these indices with disabling frequency rate and severity rate. The results showed that the average disabling frequency rate and cumulative injury rate of the whole company were 4.12 and 0.41, respectively; and the average disabling severity rate and proportion of potential workdays lost of the whole company were 563 and 229 x 10(-6), respectively, during 1986-1994. There was no consistent improvement in occupational safety in this period. The average potential salary lost of the whole company was more than US$ 2 million per year with a discount rate of 0.04, which was equivalent to 92 times of average annual income of a worker. The major monetary loss were due to non-traffic injuries of operators and traffic injuries of non-operators, which amounted to US$ 145 and 152 per person per year. As the new indices can provide additional information on lifetime occupational risk and human capital loss in monetary values, we concluded that they may be useful supplementary tools for monitoring and analyzing occupational injury data in a company.

Accidents, Occupational↗
PubMed1997

Occupational injury and illness in the United States. Estimates of costs, morbidity, and mortality.

OBJECTIVE: To estimate the annual incidence, the mortality and the direct and indirect costs associated with occupational injuries and illnesses in the United States in 1992. DESIGN: Aggregation and analysis of national and large regional data sets collected by the Bureau of Labor Statistics, the National Council on Compensation Insurance, the National Center for Health Statistics, the Health Care Financing Administration, and other governmental bureaus and private firms. METHODS: To assess incidence of and mortality from occupational injuries and illnesses, we reviewed data from national surveys and applied an attributable risk proportion method. To assess costs, we used the human capital method that decomposes costs into direct categories such as medical and insurance administration expenses as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Some cost estimates were drawn from the literature while others were generated within this study. Total costs were calculated by multiplying average costs by the number of injuries and illnesses in each diagnostic category. RESULTS: Approximately 6500 job-related deaths from injury, 13.2 million nonfatal injuries, 60,300 deaths from disease, and 862,200 illnesses are estimated to occur annually in the civilian American workforce. The total direct ($65 billion) plus indirect ($106 billion) costs were estimated to be $171 billion. Injuries cost $145 billion and illnesses $26 billion. These estimates are likely to be low, because they ignore costs associated with pain and suffering as well as those of within-home care provided by family members, and because the numbers of occupational injuries and illnesses are likely to be undercounted. CONCLUSIONS: The costs of occupational injuries and illnesses are high, in sharp contrast to the limited public attention and societal resources devoted to their prevention and amelioration. Occupational injuries and illnesses are an insufficiently appreciated contributor to the total burden of health care costs in the United States.

Accidents, Occupational↗
PubMed2003

Relationships of job and some individual characteristics to occupational injuries in employed people: a community-based study.

This study assessed the associations of job and some individual factors with occupational injuries among employed people from a general population in north-eastern France; 2,562 workers were randomly selected from the working population. A mailed auto-questionnaire was filled in by each subject. Statistical analysis was performed with loglinear models. The annual incidence rate of at least one occupational injury was 4.45%. Significant contributing factors for occupational injuries were job category (60.8%), sex (16.2%), regular psychotropic drug use (8.5%), age groups (7.5%), and presence of a disease (7.0%). The men had higher risk than the women (adjusted odds-ratio 1.99, 95% CI 1.43-2.78). Compared to executives, intellectual professionals and teachers, labourers had the highest risk (6.40, 3.55-11.52). They were followed by farmers, craftsmen and tradesmen (6.18, 2.86-13.08), technicians (3.14, 1.41-6.70), employees (2.94, 1.59-5.48) and other subjects (3.87, 1.90-7.88). The young (< or = 29 yr) showed an increased risk. Similar odds-ratios were observed for regular psychotropic drug use (1.54, 1.16-2.05) and the presence of a disease (1.50, 1.11-2.02). Univariate analysis showed that smoking habit, overweight and excess alcohol use were also associated with injuries. The loglinear model results showed that there were associations between some of these independent factors. It was concluded that job, sex, young age, smoking habit, excess alcohol use, overweight, psychotropic drug use, and disease influenced the occupational injuries. Preventive measures concerning work conditions, risk assessment and job knowledge should be conducted in overall active population, especially in men, young workers, smokers, alcohol users, overweight workers and in individuals with a disease or psychosomatic disorders.

Accidents, Occupational↗
PubMed1997

Advancing epidemiologic studies of occupational injury--approaches and future directions.

Despite increased attention to the epidemiology of occupational injuries and work-related musculoskeletal disorders, little is known about the relative contribution of risk factors for specific injuries and diseases and effective ways to prevent them. Building on the knowledge and ideas presented in the previous papers in this special issue, this paper describes the salient issues regarding the needs and the opportunities in design, conduct, and analysis of epidemiologic research on occupational injury. There is a clear need for standardization of definitions on exposure variables and health outcomes, since basic terminology is not used consistently across studies. Improved surveillance systems with linkage to other databases offer excellent opportunities to evaluate trends in risk factors and occupational injuries. New opportunities for etiologic studies include the case-crossover design, which focuses on relations between intermittent exposures and injuries, as well as several hybrid designs that combine advantages and strength of the traditional case-control and cohort study designs. Various suggestions are presented to capture the dynamics of exposure, including both intermittent and continuous factors in the assessment strategy. The importance of cohort studies is emphasized to clarify the temporal relations between causes and effects in work-related injury research. Finally, intervention studies are much needed and a hierarchical approach is suggested, starting with observational surveys, continuing with quasi-experimental studies and concluding with randomized controlled experiments of those interventions that hold the largest promise.

Accidents, Occupational↗
PubMed1988

One-year incidence of occupational injuries among teenagers in a Swedish rural municipality.

The aim of this study was to investigate occupational injuries among teenagers in a defined population and geographical area with regard to incidence and severity and to compare our registration system with that of the Swedish Occupational Injury Information System. All occupational accidents in the age group 15-19 years were registered at public health centres. We found a higher incidence compared to school accidents in the same age group as well as in relation to occupational accidents in the older population. Part-time work, lack of experience, temporary employment, unskilled work, and age-specific behavioural patterns are factors that might explain the higher incidence rate. The highest rates were found in service, military and unspecified occupations. Only 25% of the work-related accidents in our study were registered by the Swedish Occupational Injury System (ISA). It seems possible to reduce the number of accidents through the instigation of fairly simple measures. The coverage of the registration by the ISA seems to be incomplete.

Accidents, Occupational↗
PubMed2005

Sleep-related risk of occupational injuries in Japanese small and medium-scale enterprises.

A cross-sectional study evaluated the contribution of daily sleep habits to occupational injuries. A self-administered questionnaire solicited answers about sleep, symptoms of depression, occupational injury, demographics, presence of diseases and lifestyle factors from 2,903 workers between the ages of 16-83 (mean 45) yr in small and medium-scale enterprises. Eight sleep habits were queried and dichotomized: 1) less or more than 6 hr of daily sleep, 2) taking more or less than 30 min to fall asleep (Difficulty initiating sleep; DIS), 3) awakening during sleep more or less than 3 times/wk (Difficulty maintaining sleep; DMS), 4) early morning awakening more or less than 3 times/wk (EMA), 5) definitely/somewhat difficulty waking up or not, 6) sleeping very poorly/not so well at night or not, 7) definitely/somewhat insufficient nightly sleep or not, and 8) difficulty in breathing during sleep more than once/week or less. Occupational injury was assessed by asking subjects 'Have you ever been injured during your work, including minor scratches and cuts (Yes/No)?' Both sleep and injury were assessed over the previous one year period. One-third of workers answered that they had experienced injury. Workers with sleep features of DIS, sleeping poorly at night, insufficient sleep, and insomnia had a significantly higher prevalence for injury after adjusting for multiple confounders. The findings suggest that poor nocturnal sleep habits are associated with self-reported occupational injury.

Accidents, Occupational↗
PubMedDate not supplied

Costs of occupational injuries in agriculture.

OBJECTIVE: This study was conducted to estimate the costs of job-related injuries in agriculture in the United States for 1992. METHODS: The authors reviewed data from national surveys to assess the incidence of fatal and non-fatal farm injuries. Numerical adjustments were made for weaknesses in the most reliable data sets. For example, the Bureau of Labor Statistics (BLS) Annual Survey estimate of non-fatal injuries is adjusted upward by a factor of 4.7 to reflect the BLS undercount of farm injuries. To assess costs, the authors used the human capital method that allocates costs to direct categories such as medical expenses, as well as indirect categories such as lost earnings, lost home production, and lost fringe benefits. Cost data were drawn from the Health Care Financing Administration and the National Council on Compensation Insurance. RESULTS: Eight hundred forty-one (841) deaths and 512,539 non-fatal injuries are estimated for 1992. The non-fatal injuries include 281,896 that led to at least one full day of work loss. Agricultural occupational injuries cost an estimated $4.57 billion (range $3.14 billion to $13.99 billion) in 1992. On a per person basis, farming contributes roughly 30% more than the national average to occupational injury costs. Direct costs are estimated to be $1.66 billion and indirect costs, $2.93 billion. CONCLUSIONS: The costs of farm injuries are on a par with the costs of hepatitis C. This high cost is in sharp contrast to the limited public attention and economic resources devoted to prevention and amelioration of farm injuries. Agricultural occupational injuries are an underappreciated contributor to the overall national burden of health and medical costs.

Accidents, Occupational↗
PubMed1994

Application of two secondary documentary sources to identify the underreporting of fatal occupational injuries in Cape Town, South Africa.

We reviewed 8,502 deaths registered at the Salt River state mortuary, Cape Town (medical examiner records) for an 18-month period (1/1/90-6/30/91). When fatal occupational injuries located from this data source were matched with the records of the occupational safety inspectorate of the Department of Manpower, it was found that 28% had not been reported in terms of statutory regulations. Unreported deaths accounted for 25% of all fatal occupational injuries in the construction industry. None of the fatal occupational injuries in agriculture and fishing had been reported. Falls constituted 45% of the unreported fatalities. High levels of unreported fatal occupational injury indicate deficiencies in current occupational safety surveillance and enforcement in South Africa.

Accidents, Occupational↗