Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies

Introduction

Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions.

Method

This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths.

Results

A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals.

Conclusion

Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas.

Impact on industry

Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.     

Blood on the coal: The effect of organizational size and differentiation on coal mine accidents

Introduction

Each year, there are at least 100,000,000 occupational accidents and 100,000 occupational deaths in the world. In the United States, one of the safest countries in the world in which to work, there were more than 5,400 workplace fatalities and 5.9 million workplace injuries in 2007. The cost to American industry and taxpayers is estimated to be at least $170 billion per year. Further, as illustrated by accidents such as Three Mile Island and Bhopal, industrial accidents potentially impact a much wider sphere than that of the injured worker and his or her employer. As the repercussions of organizational accidents reverberate through organizations and are felt from human resources to accounting, firms are beginning to incorporate messages of safety in their missions and strategies. As firms organize to achieve safer work environments, they are faced with decisions on how to structure their activities in terms of, among other things, size and differentiation.

Method

This paper explores the impact on accident rates of size and differentiation at the corporate and mine levels of mining companies in an effort to create a framework for thinking about organizational accidents from a structural perspective.

Results

The results suggest that larger mines are safer than smaller mines, and that mines with less task diversity are safer than mines with greater task diversity. The results also suggest that at the corporate level, task diversity decreases mine accidents. These results may help mining executives and engineers structure their corporate activities and individual mines more effectively to help reduce accidents.     

Assessing public opinion regarding potential ATV-related policies

Problem

States with laws regarding ATV use and safety have lower mortality and injury rates than states with few or no restrictions. Our objective was to assess the attitudes of registered Ohio voters concerning potential legislation regarding ATV use and safety to determine the feasibility of its enactment.

Method

A statewide telephone survey of 838 registered Ohio voters was conducted and results were weighted by region to accurately represent all Ohio voters.

Results

Registered voters were in favor of restricting the use of ATVs by children < 16 years (81%), prohibiting passengers on ATVs (81%), requiring helmets (78%), and requiring all ATV owners and users to take a safety class (77%). ATV riders indicated that a mandatory helmet law would increase helmet use.

Impact on Industry

Assessing public opinion regarding public health and safety laws is a critical first step when considering legislation to improve ATV safety.     

Comparison of risk factors for falls from height between commercial and residential roofers

Introduction

The purpose of this investigation was to compare commercial roofers and residential roofers in terms of their behaviors, beliefs, working conditions, and attitudes toward the use of fall protection devices, which could lead to fall accidents.

Methods

A cross-sectional sample of 252 roofers participated in the survey in the Midwest (Wisconsin, Illinois, Michigan, Indiana, and Iowa).

Results

Residential roofers were more likely to fall (adjusted prevalence ratio = 1.57, 95% CI = 0.86, 2.27) than commercial roofers. Existence of fall protection programs, enforcement of fall protection device use, actual use of fall protection devices, work type, company size, and race/ethnicity were significantly associated with fall accidents.

Impact on industry

This study adds insight into fall accidents from roofs in the construction industry and provides industry-specific cautions against fall accidents that can be reflected in regulatory agency implementation.     

Injury severity analysis of accidents involving young male drivers in Great Britain

Introduction

Young male drivers are over-represented in traffic accidents; they were involved in 14% of fatal accidents from 1991 to 2003 while holding only 8% of all drivers licenses in the UK. In this study, a subset of the UK national road accident data from 1991 to 2003 has been analyzed. The primary aim is to determine how to best use monetary and progressive resources to understand how road safety measures will reduce the severity of accidents involving young male drivers in both London and Great Britain.

Method

Ordered probit models were used to identify specific accident characteristics that increase the likelihood of one of three categorical outcomes of accident severity: slight, serious, or fatal.

Results

Characteristics found to lead to a higher likelihood of serious and fatal injuries are generally similar across Great Britain and London but are different from those predicted to lead to a higher likelihood of slight injuries. Those characteristics predicted to lead to serious and fatal injuries include driving in darkness, between Friday and Sunday, on roads with a speed limit of 60 mph, on single carriageways, overtaking, skidding, hitting an object off the carriageway, and when passing the site of a previous accident. Characteristics predicted to lead to slight injuries include driving in daylight, between Monday and Thursday, on roads with a speed limit of 30 mph or less, at a roundabout, waiting to move, and when an animal is on the carriageway.

Impact on Industry

These results aid the selection of policy options that are most likely to reduce the severity of accidents involving young male drivers.     

Occupational accident rate in olive oil mills

Problem

This paper aims at examining the occupational accident rate in Spain in the olive oil mill industry. These mills produce olive oil by physical or mechanical, but not chemical procedures. Although Spain is the leading olive oil producer in the world with 1,200,000 tons/year and over 25% of the world olive farming area, the occupational accident rate in this sector has been little studied in the relevant scientific literature.

Method

Our study analyses all occupational accidents which occurred during 2004-2009, with or without sick leave, at 90 Andalusian olive oil mills covered by one of the biggest state insurance companies for accidents at work and occupational diseases (within the Spanish Social Security system).

Results and discussion

Slips or trips are the most frequent cause of occupational accidents in this sector, accounting for 14.86% of the cases. In second position, incorrectly coordinated bodily movements account for almost 13.51% of the accidents. Falls from height, 12.2% of the cases, are also statistically noteworthy. As for the seriousness of the injuries, entrapments are particularly important, since in 2.70% of the cases they result in the traumatic amputation of a part of the body. The analysis of accidents without sick leave reveals that a high number of incidents are caused by contact of the skin and eyes with hazardous substances (20% of the cases) and 10% of them involve superficial injuries.

Impact on the industry

This paper provides a clear and updated image of the accident rate in Spanish olive oil mills and can be a useful tool for the design and adequate adjustment of the management systems implemented in these plants to guarantee a satisfactory level of occupational health and safety by means of more efficient planning and monitoring of measures intended to reduce professional risks and improve working conditions.

Recommendations

Given not only the high incidence of falls on the same level and the potential seriousness of falls from different levels, but also the small, round fruit involved, with a high oil content and a hard round stone, it is extremely important to design and implement safe working procedures and specifically train both operatives and managers in charge of the tidiness, cleanliness and regular control of the premises and operations. The analysis of the accidents not requiring sick leave (mostly cases of contact with hazardous substances on the skin or eyes, or superficial injuries) clearly reveals that the use of suitable personal protective equipment and the relevant training are crucial issues.     

Explorative spatial analysis of traffic accident statistics and road mortality among the provinces of Turkey

Introduction

The aim of the study is to describe the inter-province differences in traffic accidents and mortality on roads of Turkey.

Method

Two different risk indicators were used to evaluate the road safety performance of the provinces in Turkey. These indicators are the ratios between the number of persons killed in road traffic accidents (1) and the number of accidents (2) (nominators) and their exposure to traffic risk (denominator). Population and the number of registered motor vehicles in the provinces were used as denominators individually. Spatial analyses were performed to the mean annual rate of deaths and to the number of fatal accidents that were calculated for the period of 2001-2006. Empirical Bayes smoothing was used to remove background noise from the raw death and accident rates because of the sparsely populated provinces and small number of accident and death rates of provinces. Global and local spatial autocorrelation analyses were performed to show whether the provinces with high rates of deaths-accidents show clustering or are located closer by chance. The spatial distribution of provinces with high rates of deaths and accidents was nonrandom and detected as clustered with significance of P < 0.05 with spatial autocorrelation analyses.

Results

Regions with high concentration of fatal accidents and deaths were located in the provinces that contain the roads connecting the Istanbul, Ankara, and Antalya provinces. Accident and death rates were also modeled with some independent variables such as number of motor vehicles, length of roads, and so forth using geographically weighted regression analysis with forward step-wise elimination. The level of statistical significance was taken as P < 0.05. Large differences were found between the rates of deaths and accidents according to denominators in the provinces. The geographically weighted regression analyses did significantly better predictions for both accident rates and death rates than did ordinary least regressions, as indicated by adjusted R² values. Geographically weighted regression provided values of 0.89-0.99 adjusted R² for death and accident rates, compared with 0.88-0.95, respectively, by ordinary least regressions.

Impact on industry

Geographically weighted regression has the potential to reveal local patterns in the spatial distribution of rates, which would be ignored by the ordinary least regression approach. The application of spatial analysis and modeling of accident statistics and death rates at provincial level in Turkey will help to identification of provinces with outstandingly high accident and death rates. This could help more efficient road safety management in Turkey.     

Occupational injuries of immigrant and Finnish bus drivers

Problem

With baby boomers reaching retirement age, Western countries may need more immigrant workers to ensure productivity. Many studies have suggested a higher occupational injury frequency among immigrant workers, which could considerably reduce their contribution to society. The aim of this study was to examine whether immigrant workers have a higher injury frequency compared to Finnish workers when performing the exact same tasks under the same working conditions.

Method

A total of 176 Finnish and 130 immigrant bus drivers were asked about their occupational injuries during the past 12 months via a questionnaire. In addition, the data contained 134 injuries reported by the transport firm to an insurance company.

Results

There was no significant difference in reporting occupational injuries by self-reporting or by company-records. Because there were more accident-repeaters among Finnish drivers, their injury frequency (114) was higher than that of immigrant drivers (78).

Application/Impact

This study showed that immigrant workers did not have a higher injury frequency than other workers when they worked in the exact same conditions. Immigrant workers can work as safely as native-Finnish workers, when their working conditions and job contracts are at the same level as those of the original population. Immigrant workers can compensate for the shortage of workforce caused by an aging population.     

Have government regulations improved workplace safety? : A test of the asynchronous regulatory effects in China's coal industry, 1995-2006

Problem

Empirical studies on the effectiveness of workplace safety regulations are inconclusive. This study hypothesizes that the asynchronous effects of safety regulations occur because regulations need time to become effective. Safety regulations will work initially by reducing the most serious accidents, and later by improving overall safety performance.

Method

The hypothesis is tested by studying a provincial level aggregate panel dataset for China's coal industry using two different models with different sets of dependent variables: a fixed-effects model on mortality rate, which is defined as fatalities per 1,000 employees; and a negative binominal model on the annual number (frequency) of disastrous accidents.

Results

Safety regulations can reduce the frequency of disastrous accidents, but have not reduced mortality rate, which represents overall safety performance.

Discussion and summary

Policy recommendations are made, including shifting production from small to large mines through industrial consolidation, improving the safety performance of large mines, addressing consequences of decentralization, and facilitating the implementation of regulations through carrying on institutional actions and supporting legislation.

Impact on industry

Until recently, about 4,000 coal miners perished annually in China, demonstrating that workplace safety in China's coal industry is an urgent and important issue. This research provides evidence that safety regulations have asynchronous effects and identifies the priorities in improving safety in China's current coal mining. This may assist the Chinese government to design more effective safety improvement policies and improve the effectiveness of safety regulations and safety performance.     

An economic evaluation of a participatory ergonomics process in an auto parts manufacturer

Problem

We assess the costs and consequences of a participatory ergonomics process at a Canadian car parts manufacturer from the perspective of the firm.

Method

Regression modeling was used with interrupted time series data to assess the impact of the process on several health measures. Consequences were kept in natural units for cost-effectiveness analysis, and translated into monetary units for cost-benefit analysis.

Results

The duration of disability insurance claims and the number of denied workers' compensation claims was significantly reduced. The cost-effectiveness ratio is $12.06 per disability day averted. The net present value is $244,416 for a 23-month period with a benefit-to-cost ratio of 10.6, suggesting that the process was worth undertaking (monetary units in 2001 Canadian dollars).

Discussion

Our findings emphasize the importance of considering a range of outcomes when evaluating an occupational health and safety intervention.

Impact on industry

Participatory ergonomics process can be cost-effective for a firm.     

Project level analysis of special trade contractor fatalities using accident investigation reports

Introduction

Construction is among the most dangerous industries in the United States accounting for thousands of fatalities every year. Although there is data available on high risk work types and areas, the project-level detail is not readily available.

Method

This paper uses the accident investigation reports to categorize project types and presents project level analysis of 350 fatal accidents for special trade contractors.

Results

The results showed that Residential and Commercial projects lead the fatalities where Falls are observed as the leading cause. However, when the fatality causes and project categories are analyzed for each work type, the results showed different fatality cause proportions for each project type.

Impact on Industry

Project level analysis approach has a direct impact on identifying high risk work types and areas for special trade contractors by making it possible to focus the prevention and intervention efforts more accurately, while highlighting training and education needs.     

Validity of police-reported alcohol involvement in fatal motor carrier crashes in the United States between 1982 and 2005

Objective

To examine the validity of police-reported alcohol data for drivers involved in fatal motor carrier crashes.

Material and Methods

We determined the availability of blood alcohol concentration (BAC) and police-reported alcohol data on 157,702 drivers involved in fatal motor carrier crashes between 1982 - 2005 using Fatality Analysis and Reporting System (FARS) data. Drivers were categorized as motor carrier drivers if they operated a vehicle with a gross vehicle weight rating of greater than 26,000 pounds. Otherwise, they were classified as non motor carrier drivers. The sensitivity and specificity of police-reported alcohol involvement were estimated for both driver types.

Results

Of the 157,702 drivers, 18% had no alcohol information, 15% had BAC results, 42% had police-reported alcohol data, and 25% had both. Alcohol information varied significantly by driver, crash, and vehicle characteristics. For example, motor carrier drivers were significantly more likely (51%) to have BAC testing results compared to non motor carrier drivers (31%) (p < 0.001). The sensitivity of police-reported alcohol involvement for a BAC level ≥ 0.08 was 83% (95% CI 79%, 86%) for motor carrier drivers and 90% (95% CI 89%, 90%) for non motor carrier drivers. The specificity rates were 96% (95% CI 95%, 96%) and 91% (95% CI 90%, 91%), respectively.

Conclusions

The sensitivity and specificity of police-reported alcohol involvement are reasonably high for drivers involved in fatal motor carrier crashes. Further research is needed to determine the extent to which the accuracy of police-reported alcohol involvement may be overestimated because of verification bias.

Impact on the Industry

Based on the results of this study, the federal government should continue to work with states to strengthen their strategies to increase chemical testing of all drivers involved in fatal crashes.     

Severity models of cross-median and rollover crashes on rural divided highways in Pennsylvania

Introduction

Crossover and rollover crashes in earth-divided, traversable medians on rural divided highways can lead to severe injury outcomes. This study estimated severity models of these two crash types. Vehicle, driver, roadway, and median cross-section design data were factors considered in the models. A unique aspect of the data used to estimate the models were the availability of median cross-slope data, which are not commonly included in roadway inventory data files.

Methods

A binary logit model of cross-median crash severity and a multinomial logit model of rollover crash severity were estimated using five years of data from rural divided highways in Pennsylvania.

Results

The highest probability of a fatal or major injury in cross-median and rollover crashes was found to occur in cases when a driver was not wearing a seatbelt. While flatter cross-slopes and narrower medians were associated with more severe cross-median crash outcomes, steeper cross-slopes and narrower medians significantly increased rollover crash severity outcomes. The presence of horizontal curves was associated with increased probabilities of high-severity outcomes in a median rollover crash.

Impact on Industry

Modeling results in this study confirmed that cross-median and median rollover crash severity outcomes are associated with median cross-section design characteristics. Based on the estimated models, it appears that flatter and narrower medians lead to more severe injury outcomes in cross-median crashes. Steeper median cross-slopes and narrower medians were associated with higher probabilities of more severe outcomes in median rollover crashes. The results presented in this study suggest that there is a trade-off between median cross-section design and cross-median and rollover crashes in earth-divided, traversable medians on rural divided highways. While the severity models can be included in a framework to develop design guidance in relation to this trade-off, models of crash frequency should also be considered.     

Is a hands-free phone safer than a handheld phone?

Introduction

Although it is becoming more and more accepted that driving while talking on a cell phone can be hazardous, most jurisdictions are making handheld phone use illegal while allowing hands-free phone use.

Methods

The scientific literature exploring the effects of these two types of cell phone use on driving and driving-related performance is reviewed here.

Results

Our review shows that talking on the phone, regardless of phone type, has negative impacts on performance especially in detecting and identifying events. Performance while using a hands-free phone was rarely found to be better than when using a handheld phone. Some studies found that drivers compensate for the deleterious effects of cell phone use when using a handheld phone but neglect to do so when using a hands-free phone.

Impact on Industry

Current research does not support the decision to allow hands-free phone use while driving.     

Whole-body vibration knowledge survey of U.S. occupational safety and health professionals

Problem

Whole-body vibration (WBV) is an occupational issue of concern due to adverse health effects or simple discomfort and annoyance. Unlike in Europe, WBV is an emerging topic in the U.S. safety and health (S&H) professional community. We hypothesized that at least one-half of the U.S. occupational S&H professionals knew little or nothing about WBV.

Method

We conducted a cross-sectional study (survey) of WBV knowledge among members of the American Society of Safety Engineers. A Likert scale (1-none to 5-expert) was used to determine WBV topic knowledge levels (KL_1-5).

Results

Analysis of 2,764 responses revealed that 69.5% of the participants self-reported a less than basic WBV understanding. The WBV KL_1-5 mean for all participants was 1.94 ± 1.00, corresponding to an awareness of WBV without a depth of understanding.

Summary

Many at-risk U.S. workers may not be supported by occupational S&H professionals with adequate WBV knowledge.

Impact on Industry

A significant number of U.S. workers may be exposed to unhealthy levels of whole-body vibration. However, the U.S. occupational safety and health community is generally unprepared to anticipate, monitor, and control the whole-body vibration hazard.     

When may road fatalities start to decrease?

Introduction

The comparative analysis of macroscopic trends in road safety has been a popular research topic. The objective of this research is to propose a simple and, at the same time, reliable multiple regime model framework for international road safety comparisons, allowing for the identification of slope changes of personal risk curves and respective breakpoints.

Method

The trends of road traffic fatalities in several EU countries have been examined through the temporal evolution of elementary socioeconomic indicators, namely motorized vehicle fleet and population, at the country level.

Results

Piece-wise linear regression models have been fitted, using a methodology that allows the simultaneous estimation of all slopes and breakpoints. The number and location of breakpoints, as well as the slope of the connecting trends, vary among countries, thus indicating different road safety evolution patterns.

Impact on industry

Macroscopic analysis of road accident trends may be proved beneficial for the identification of best examples and the implementation of appropriate programmes and measures, which will lead to important benefits for the society and the economy through the reduction of road fatalities and injuries. Best performing countries and the related programmes and measures adopted may concern several safety improvements at the processes of the road, the vehicle and the insurance industries.

Conclusions

Lessons from the analysis of the past road safety patterns of developed countries provide some insight into the underlying process that relates motorization levels with personal risk and can prove to be beneficial for predicting the road safety evolution of developing countries that may have not yet reached the same breakpoints. Furthermore, the presented framework may serve as a basis to build more elaborate models, including more reliable exposure indicators (such as vehicle-km driven).     

Social norms of accompanied young children and observed crossing behaviors

Introduction

Social norms for accompanied young children and crossing behaviors were examined in two studies conducted in an Ultra-Orthodox Jewish community in Israel.

Method

In Study 1, road behaviors of young children crossing with and without accompaniment and older children were observed, and the actual social norm for accompanied school children younger than 9-years-old was examined. In Study 2, the perceived norm of accompaniment was tested by questionnaires.

Results

Young children who crossed without accompaniment exhibited poorer crossing skills compared to older children and to young children crossing with accompaniment. In the four locations observed, the actual accompaniment rate ranged between 15%-60%. The perceived social norm for child accompaniment was lower than the actual norm.

Conclusions

The discussion refers to both theoretical issues and their practical implications.