Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

Problem

Nail guns are a common source of acute, and potentially serious, injury in residential construction.

Method

Data on nail gun injuries, hours worked and hours of tool use were collected in 2008 from union apprentice carpenters (n = 464) through classroom surveys; this completed four years of serial cross-sectional data collection from apprentices. A predictive model of injury risk was constructed using Poisson regression.

Results

Injury rates declined 55% from baseline measures in 2005 with early training and increased use of tools with sequential actuation. Injury rates declined among users of tools with both actuation systems, but the rates of injury were consistently twice as high among those using tools with contact trip triggers.

Discussion and impact

Nail gun injuries can be reduced markedly through early training and use of tools with sequential actuation. These successful efforts need to be diffused broadly, including to the non-union sector.     

Television news' coverage of motor-vehicle crashes

Problem

Traffic crashes are a major cause of injury and death. Although it has been argued that a skewed estimation of personal risks may be partly attributable to news representations of mortality causes, the manners in which traffic crashes are covered in the news have not received much attention in the literature.

Method

The current study used content analysis to examine the framing of traffic crashes in television news.

Results

The data indicated that Flemish television news does not report traffic crashes from a public health perspective and consequently it misses opportunities to inform the public on the causes and consequences of risk-taking in traffic.

Impact on industry

It is important that professionals are aware of these findings and stress contextual factors surrounding traffic crashes in their communication with journalists. This may lead to more accurate reports and a more accurate risk perception of viewers.     

Older driver retraining: An updated systematic review of evidence of effectiveness

Problem and Objective

The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.

Method

Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.

Results

Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.

Summary

The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.

Impact on Industry

These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.     

Results from a national survey of Crown prosecutors and defense counsel on impaired driving in Canada: A “System Improvements” perspective

Introduction

This article summarizes the main findings from a study designed to examine the legal process in Canada as it applies to alcohol-impaired driving from the point of view of Crown prosecutors and defense counsel, and to identify evidentiary or procedural factors that may impact the legal process, the rights of the accused, and interactions of all parts in the legal process.

Method

The data in this study were collected by means of a survey that was mailed out to the population of Crown prosecutors and defense counsel in Canada. In total, 765 prosecutors and 270 defense lawyers or an estimated 33% of all Canadian prosecutors and 15% of defense lawyers completed and returned the questionnaire. The "systems improvement" paradigm was used to interpret the findings and draw conclusions. Such an approach acknowledges the importance of the context in which countermeasures are implemented and delivered and the structures or entities used to deliver countermeasures to a designated target group.

Results

Results on type of charges and breath alcohol concentration, caseload, case outcomes, case preparation time, conviction rate at trial and overall conviction rate, reasons for acquittals and time to resolve cases are described.

Discussion

The findings from this national survey suggest that there are important challenges within the criminal justice system that impede the effective and efficient processing of impaired driving cases. Some of these challenges occur as a function of practices and policies, while others occur as a function of legislation.

Impact on industry

This study illustrates that a "system improvements" approach that acknowledges the importance of all elements of the criminal justice system and the interaction between those elements, can be beneficial in overcoming the alcohol-impaired driving problem.     

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.     

Nonfatal bathroom injuries among persons aged ≥15 years--United States, 2008

Problem

Information about where nonfatal unintentional injuries occur is limited, but bathrooms commonly are believed to be a hazardous location.

Methods

Data from a nationally representative sample of hospital emergency departments (ED) was used to quantify and characterize nonfatal unintentional bathroom injuries among people aged ≥ 15 years.

Results

In 2008, an estimated 234,094 nonfatal bathroom injuries were treated in EDs. Most injuries (81.1%) were caused by falls and 37.3% of injuries occurred when bathing, showering, or getting out of the tub or shower. Both injury and hospitalization rates increased with age.

Summary

These results suggest that bathrooms tend to be most hazardous for persons in the oldest age groups.

Impact on Industry

Bathroom injuries among all household members might be reduced by increasing awareness about potentially hazardous activities in the bathroom combined with simple environmental changes such as adding grab bars inside and outside the tub or shower.     

Effects of safety climate on safety norm violations: exploring the mediating role of attitudinal ambivalence toward personal protective equipment

Problem

Research on the role of organizational and psychosocial factors in influencing risk behaviors and the likelihood of injury at work showed that safety climate also has great impact on workers’ behavior. However, the mechanisms through which this impact operates are still partially unclear.

Method

In order to explore the role that attitudinal ambivalence toward wearing PPE might play in mediating the impact of safety climate on safety norm violations, a questionnaire was administered to 345 Italian workers.

Results

Three dimensions of safety climate (i.e., company safety concern, senior managers’ safety concern, supervisors’ attitudes towards safety) were found to be positively associated with the individual ambivalence level, whereas the fourth one (i.e., work pressure) was negatively correlated with it. In turn, low levels of ambivalence were associated with a lower tendency to break the safety norms, even though the perception of a good safety climate also maintained a direct effect on unsafe behaviors.

Impact on industry

Designers of training program for the prevention of work related injuries must pay great attention to the psycho-social factors (such as the effects of the safety climate perception by employees on their attitudes and behaviors), and include specific contents into the prevention programs in order to improve workers compliance with safety norms.     

Survival risk factors for fatal injured car and motorcycle drivers in single alcohol-related and alcohol-unrelated vehicle crashes

Introduction

A high percentage of drivers who die as a result of a single vehicle crash are under the influence of alcohol. We aimed to better understand the prevalence of these fatalities and the ratio of death to injuries based on various risk factors. We focused on alcohol-related and -unrelated single-vehicle crashes to investigate the influence of such risk factors on the time until death for car and motorcycle drivers.

Methods

We combined data from national police reports and a vital registration database in Taiwan. Survival analysis using Cox regression models was used to identify the risk factors of time until death.

Results

Overall, nearly 60% of car driver fatalities and 40% of motorcycle driver fatalities involved the consumption of alcohol. Survival analysis of single-vehicle crashes suggested that the traffic island separation between a car moving at a higher speed and motorcycle traffic resulted in a higher risk of death over time for motorcycle drivers who consumed alcohol. The factors attributed to a higher risk of death over time for motorcycle drivers were older age, crashing into trees, night-time driving, driving on curved roads, and driving on local roads. Driving without restraints and driving on roads with higher speed limits attributed to a higher risk of death over time for car drivers.

Conclusions

The factors that influence the risk of death over time in a motor-vehicle accident involving alcohol depended on different elements, which should each be considered when attempting to reduce this risk.

Impact on Industry

More efforts should be made to investigate the various risk factors in areas with large motorcycle populations.     

The effect of work hours on adverse events and errors in health care

Introduction

We studied the relationship between registered nurses' extended work duration with adverse events and errors, including needlestick injuries, work-related injuries, patient falls with injury, nosocomial infections, and medication errors.

Method

Using bivariate and multivariate logistic regression, this secondary analysis of 11,516 registered nurses examined nurse characteristics, work hours, and adverse events and errors.

Results

All of the adverse event and error variables were significantly related to working more than 40 hours in the average week. Medication errors and needlestick injuries had the strongest and most consistent relationships with the work hour and voluntary overtime variables.

Discussion

This study confirms prior findings that increased work hours raise the likelihood of adverse events and errors in healthcare, and further found the same relationship with voluntary overtime.

Impact on Industry

Legislation has focused on mandatory overtime; however, this study demonstrated that voluntary overtime could also negatively impact nurse and patient safety.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

Effect of a nurse back injury prevention intervention on the rate of injury compensation claims

Problem

This study evaluated the effect of introducing a No Lifting policy on back injuries to nurses, across an entire health care system.

Methods

Methods included: analysis of the data for all public health agencies in the Australian state of Victoria; compensation data from the Victorian Workcover Authority; data about workforce and program implementation from a retrospective survey of agencies; longitudinal analysis of standardized workers compensation claim rates for back injuries before, during and after the intervention.

Results

A statistically significant decline in back injury claim rates during implementation contrasted with no statistically significant trends within the periods before and after the intervention. A statistically significant reduction occurred in mean quarterly standard back injury claim incidence rates per 1,000 equivalent fulltime nursing staff (EFTNS), representing a 24% reduction in standard back injury claims/1000 EFTNS.

Discussion

Ergonomics principles encourage changing the work environment to suit the worker. This approach delivered a significant improvement in the immediate term.

Impact of industry

The substantial decline in back injury rates signifies a major improvement in the safety of a critical aspect of the work environment for nurses.     

Does the built environment affect when American teens become drivers? Evidence from the 2001 National Household Travel Survey

Problem

Motor vehicle crashes are the most common cause of death for American adolescents. However, the impact of where teens live on when they begin driving has not been studied.

Method

Data from the 2001 National Household Travel Survey were used to estimate the effect of residential density on the driver status of teens aged 16 to 19 years after matching on demographic characteristics.

Results

Controlling for demographic characteristics, 16 and 17 year old teens in high density neighborhoods had driver rates 15 percentage points below teens living in less dense areas (p < 0.001). The effect for 18 and 19 year olds was a 9 percentage point decrease (p < 0.001).

Summary

These results suggest teens living in less dense and more sprawling communities initiate driving at a younger age than comparable teens in compact areas, placing them at increased risk for crash related injuries. Impact on Industry: The role of environmental factors, such as neighborhood walkability and provision of transit, should be considered in young driver programs.     

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.     

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

Background

All employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens.

Objectives

The aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia.

Methods

Institution based cross sectional study was conducted from May-December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0.

Results

The prevalence of NSSIs among health care workers in the preceding 12 months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48 h/week, dissatisfaction with work environment and work culture, greater than 10 years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs.

Conclusion

The study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.     

Injuries and risk-taking behaviours in Portuguese adolescents: Highlights from the health behaviour in school-aged children survey

Aim

Injuries in adolescence are an important public health problem and a major cause of morbidity and mortality in this age group. This study aimed to determine the behaviour profile associated to risk of injury and the differences between genders, region and ethnic origin.

Methods

A cross-sectional study design of a nationally representative sample of 1581 adolescents of the Portuguese Health Behaviour in School-Aged Children study.

Results

An occurrence of one injury-related event in the previous year was reported by 21.4% of the respondents and 5.9% referred having more than one injury-related event. Boys reported higher frequency of those events when compared to girls, and non-Portuguese subjects referred higher frequency of events. Scoring higher in violence-related behaviour and psychosomatic complaints was associated to higher chances of referring more than one injury-related event.

Conclusion

Gender, social background and behaviour profile are factors that seem to influence the risk of injuries. This information should guide those involved in the planning of injuries prevention programs in youth.     

On-road and simulated driving: concurrent and discriminant validation

Introduction

A converging pair of studies investigated the validity of a simulator for measuring driving performance/skill.

Study 1

A concurrent validity study compared novice driver performance during an on-road driving test with their performance on a comparable simulated driving test.

Results

Results showed a reasonable degree of concordance in terms of the distribution of driving errors on-road and errors on the simulator. Moreover, there was a significant relationship between the two when driver performance was rank ordered according to errors, further establishing the relative validity of the simulator. However, specific driving errors on the two tasks were not closely related suggesting that absolute validity could not be established and that overall performance is needed to establish the level of skill.

Study 2

A discriminant validity study compared driving performance on the simulator across three groups of drivers who differ in their level of experience - a group of true beginners who had no driving experience, a group of novice drivers who had completed driver education and had a learner's permit, and a group of fully licensed, experienced drivers.

Results

The findings showed significant differences among the groups in the expected direction -- the various measures of driving errors showed that beginners performed worse than novice drivers and that experienced drivers had the fewest errors. Collectively, the results of the concurrent and discriminant validity studies support the use of the simulator as a valid measure of driving performance for research purposes.

Impact on industry

These findings support the use of a driving simulator as a valid measure of driving performance for research purposes. Future research should continue to examine validity between on-road driving performance and performance on a driving simulator and the use of simulated driving tests in the evaluation of driver education/training programs.     

Analysis of bus collision and non-collision incidents using transit ITS and other archived operations data

Introduction

This paper analyzes factors contributing to bus operations safety incidents at TriMet, the transit provider for the Portland Oregon metropolitan region.

Method

The analysis focuses on 4,631 collision and non-collision incidents that occurred between 2006 and 2009. Empirical analysis of these incidents draws on a wide array of operator-level data recovered by transit ITS technologies in combination with information from TriMet's human resources, scheduling, and customer relations databases. Incident frequencies are estimated in relation to operators' demographic characteristics, employment status, assigned work characteristics, service delivery and performance indicators, temporal factors, and customer information.

Results

Apart from identifying factors that are empirically related to the frequency of safety incidents, the findings offer insights into operations policies and practices that hold promise for improving safety.

Impact on Industry

Potential for safety improvement based on analysis of archived operations and human resource data.     

Injury crashes with bicyclists at roundabouts: influence of some location characteristics and the design of cycle facilities

Problem

Previous research indicated that conversions of intersections into roundabouts appear to increase the number of injury crashes with bicyclists. However, it was assumed that the effectiveness of roundabouts could vary according to some differences in design types of cycle, facilities and other geometrical factors.

Method

Regression analyses on effectiveness-indices resulting from a before-and-after study of injury crashes with bicyclists at 90 roundabouts in Flanders, Belgium.

Results

Regarding all injury crashes with bicyclists, roundabouts with cycle lanes appear to perform significantly worse compared to three other design types (mixed traffic, separate cycle paths, and grade-separated cycle paths). Nevertheless, an increase of the severest crashes was noticed, regardless of the design type of the cycle facilities. Roundabouts that are replacing signal-controlled intersections seem to have had a worse evolution compared to roundabouts on other types of intersections.

Impact on industry

The results might affect design guidelines for roundabouts, particularly for the accommodation of bicyclists.     

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).     

A traffic safety evaluation of California's traffic violator school citation dismissal policy

Introduction

This study evaluated California's traffic violator school (TVS) citation dismissal policy.

Method

This study identified and compared two large samples of drivers either completing a TVS (N = 210,015) or convicted of a traffic citation (N = 168,563).

Results

Prior to adjudication, the TVS group had characteristics (e.g., lower prior conviction rate and smaller proportion of males) that were predictive of a lower subsequent crash risk. However, the TVS group exhibited significantly more crashes than did the convicted group in the subsequent one-year period. The difference (4.83%) increased to 10% after adjusting for the more favorable characteristics of the TVS group. The TVS group also had a higher adjusted subsequent crash rate at each prior driver record entry level, reflecting a loss in the general and specific deterrence of the non-conviction masked status of TVS dismissed citations. It was reported that the TVS dismissal policy results in approximately 12,300 additional crashes annually with economic costs of approximately $398,000,000.

Conclusions

The avoidance of licensing actions resulting from the dismissal policy assists in explaining why the driving public is exposed to an increased crash risk. A number of recommendations are offered to reduce the negative traffic safety impact of the TVS citation dismissal policy.