Occupational accidents while walking on stairways

Nagata, H., 1991. Occupational accidents while walking on stairways. Safety Science, 14: 199–211.An analysis of occupational injury data related to falls while walking on stairways, and the causes associated with these stair accidents is described. The study was based on labour casualty reports. A total of 1486 stair accidents including 10 deaths, were collected from occupational accidents occurring within greater Tokyo. From these reports 425 cases were selected to undertake actual surveys including personal interviews, direct observations and field measurements. For the purpose of comparison with stairs where no accidents had been reported, a total of 1043 stairs were selected at random from drawings of various buildings.Nine fatal victims had received head injuries. Nearly half of the non-fatal victims received bruises mostly to the legs and feet. Most accidents occurred while descending stairways in haste. Young female employees wearing high or semi-high heeled footwear were relatively prone to fall on stairs. In winter, more stair accidents tended to occur to some extent. The proportion of female accidents was relatively higher than for males when compared to their population ratios. Employees were especially prone to receive injuries by misstep on straight flights of stairs.     

Study of factors associated with risk of work-related stairway falls

This report describes a study of stairway risk factors based on video tape recordings of workers using 31 flights of stairs selected from among the industries with the highest frequency and severity rates for stair-related injuries. The video tapes were reviewed to identify all incidents, i.e., falls, trips, slips, missteps, and moments of temporary instability. The characteristics of the 98 stair users who were involved in an incident were compared to the characteristics of a matched group of stair users who did not have incidents. The factors that best discriminated between the incident group and the nonincident group were: (a) The incident group tended to be those whose movement was impeded by others and who were older; and (b) The nonincident group tended to be those who were wearing glasses and those who were very large or heavy individuals. The influence of stairway physical features on the risk of injury was examined using correlation analysis. The measure of risk was the incidence rate (observed incidents per number of observed uses) for each flight as well as for each tread. Among the several variables significantly correlated with higher incidence rate are: (a) higher effective riser height and less effective tread depth; the safest stairs have an effective riser height not greater than 7 in. (18 cm) and an effective tread depth no less than 11 in. (27 cm); and (b) for descent only (92% of the injuries), the size of the nosing projection; it appears that nosing projections that exceed $\text{11}\text{16}$ in. (1.8 cm) are associated with higher incidence rates.     

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.     

Beach and patio umbrella injuries treated at emergency departments

Introduction: Beach and patio umbrellas may cause injury. There is limited published information on injuries due to beach and patio umbrellas. This study sought to describe beach and patio umbrella injuries reported to United States emergency departments (EDs). Method: An analysis was performed of beach and patio umbrella injuries using data from the National Electronic Injury Surveillance System during 2000–2019. Results: An estimated 5,512 beach umbrella injuries and 7,379 patio umbrella injuries were identified. The patient was age 40 years or older in 62.1% of the beach umbrella and 65.1% of the patio umbrella injuries. The patient was female in 68.0% of the beach umbrella and 66.9% of the patio umbrella injuries. Wind was reported involved in 50.6% of the beach umbrella and 27.5% of the patio umbrella injuries. The most frequently reported injuries with beach and patio umbrella injuries, respectively, were laceration (44.0% vs 33.0%), contusions or abrasions (19.8% vs 19.0%), and internal organ injury (16.6% vs 17.0%) and most often affected the head/neck (60.2% vs 44.0%) and upper extremity (16.3% vs 30.1%). Conclusions: The majority of patients with beach and patio umbrella injuries treated at EDs were age 40 years or older and most patients were female. For both types of umbrella injury, the most frequently reported injury was laceration followed by contusions or abrasions and internal organ injury, and the body part with the highest proportion of injuries was the head/neck followed by the upper extremity. Practical Applications: Persons should use sturdier models of beach or patio umbrella, use a rocking motion to dig into the sand and secure the beach umbrella with a metal anchor and screws, add weight to the bottom of the umbrella, and tilt the umbrella into the wind. Policy-makers should educate the public about the potential dangers of beach and patio umbrellas.     

Characteristics of work-related injuries involving forklift trucks

Industrial lift trucks or forklift trucks are a common source of occupational injuries. In 1983, over 13,000 workers' compensation claims for lost-workday injuries involving forklift trucks were filed in 30 states. An estimated 24,000 forklift-related injuries were treated in U.S. emergency rooms in 1983, and an estimated 34,000 in 1985. This paper presents the results of an analysis of forklift injuries reported in two occupational injury databases — the National Electronic Injury Surveillance System (NEISS) and the Bureau of Labor Statistics (BLS) Supplementary Data System (SDS). Characteristics of these injuries (e.g., type of injury, diagnosis, body part affected) and of the injury victims (e.g., age, sex, occupation) are described, and scenarios of typical forklift injuries in various occupations are presented. Trends in forklift injuries from 1983–1985 are also discussed.     

An evaluation of the association between vehicle type and the source and severity of pedestrian injuries

To evaluate the effect of vehicle type (passenger vehicle vs. light truck vehicle) on crash trajectory and on the consequent source and severity of pedestrian injury, we analyzed data from the Pedestrian Crash Data Study (PCDS), conducted by National Highway Traffic Safety Administration (NHTSA) from 1994 to 1998. While 62% of the adults in PV (passenger vehicle)-related crashes were carried by the vehicle, such pedestrian-vehicle interaction was observed only in 28% of LTV (light truck vehicle)-adult crashes. Being thrown forward or knocked down were the most common (65%) type of pedestrian-vehicle interactions for LTV-adult crashes. For children, 93% of those struck by LTVs and 46% of those struck by PVs were thrown forward or knocked down. For adults, LTVs were more likely than PVs to cause thorax (37% vs. 20%) and abdomen injuries (33% vs. 18%). For children, LTVs were more likely than PVs to cause injuries to the upper extremity (71% vs. 56%) and abdomen (14% vs. 8%). For adults struck by PVs the most common sources of injury were windshield for head injuries (63%), hood surface for thorax (67%), abdomen (58%), spine (30%), and upper extremity (36%) injuries, and bumper for the lower extremity injuries (60%). The leading causes of injury for adult-LTV crashes were ground for head (39%) and upper extremity (37%) injuries, hood edge for thorax (48%) and abdomen (56%) injuries, hood surface for spine injuries (36%), and bumper for lower extremity injuries (45%). For child-PV crashes, ground was the most common source of face (37%) abdomen (83%), spine (43%), and upper extremity injuries (54%). For children hit by LTVs, 52% of face, 67% of abdomen, 100% of spine, and 60% of upper extremity injuries were attributed to ground contacts. Altogether, the major sources of injury were hood surface and windshield for PV-pedestrian crashes and hood surface and hood edge for LTV-pedestrian crashes. Changes in design, such as altering the geometry and stiffness of front-end structures, might be associated with considerable decrease in the frequency and severity of pedestrian injury.     

Fall from equipment injuries in U.S. mining: Identification of specific research areas for future investigation

Introduction

The objective of this study was to evaluate the circumstances leading to fall from equipment injuries in the mining industry.

Method

The 2006 and 2007 Mine Safety and Health Administration annual injury databases were utilized for this study whereby the injury narrative, nature of injury, body part injured, mine type, age at injury, and days lost were evaluated for each injury.

Results

The majority of injuries occurred at surface mining facilities (∼ 60%) with fractures and sprains/strains being the most common injuries occurring to the major joints of the body. Nearly 50% of injuries occurred during ingress/egress, predominately during egress, and approximately 25% of injuries occurred during maintenance tasks. The majority of injuries occurred in relation to large trucks, wheel loaders, dozers, and conveyors/belts. The severity of injury was independent of age and the median days lost was seven days; however, there was a large range in severity.

Impact on industry

From the data obtained in this study, several different research areas have been identified for future work, which include balance and stability control when descending ladders and equipment design for maintenance tasks.     

The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

Vibration and jarring as a cause of back injury in the NSW coal mining industry

Head neck and back injury represents 32% of injuries in the NSW coal mining industry. There is considerable hearsay evidence that rough rides in vehicles are a significant cause of such injuries but no objective studies have been carried out.Analysis of workers compensation data showed that overexertion and slips and falls were the most significant causes of head neck and back injuries but approximately 11% of all head neck and back injuries were reported to be due to vehicle jarring. Two types of underground vehicles accounted for 53% of all injuries. These were Shuttlecars and Underground Transporters.There was no evidence from the compensation data that whole body vibration was a significant factor in head neck and back injuries.     

Changes in logging injury rates associated with use of feller-bunchers in West Virginia

Problem: It is well documented that logging is one of the most dangerous occupations and industries in which to work, and trees fellers are at greatest risk of injury. The objective of this study was to determine whether West Virginia (WV) logging companies experienced a reduction in injuries after beginning to use feller-bunchers (tree cutting machines, which replace some of the work done with a chainsaw) during harvesting operations. Methods: WV workers compensation claims and employment data from 1995 to 2000 were used to calculate injury rates. Injury trends in the rest of the WV logging industry, not using feller-bunchers, were also assessed. Results: For 11 companies, the pre-feller-buncher injury claims rate was 19.4 per 100 workers and the post-feller-buncher rate was 5.2 per 100 workers. This was a significant difference, with an adjusted rate ratio of 2.8 (95% CI: 1.8–4.5) of pre to post claims. Struck by injuries also showed significant decline, with the pre-feller-buncher injury rate being 3.8 (95% CI: 1.8–8.2) times as great as post-feller-buncher rate. During the time of the study, the injury rate rose in the rest of the WV logging industry. The average cost of a workers compensation claim in the WV logging industry during the time of the study was approximately $10,400. Impact on industry: As mechanization of logging tasks becomes more widespread, the WV logging industry as a whole may see substantial injury declines and a reduction in the total cost of injury claims. Struck by injuries, the most common and potentially fatal of logging injury types, appear to be particularly affected. However, logging operations in areas of very steep terrain where it is not possible to use these machines may need to rely on strategies other than feller-bunchers to reduce injuries.     

Fewer workers' compensation claims and lower claim costs if employers with high injury rates achieved the rates of their safer peers

Introduction: Employers engaged in similar business activities demonstrate a range of workers' compensation claim rates. Workplace injuries and illnesses could be prevented if employers with high claim rates achieved the claim rates of their safer peers. Methods: We used Washington workers' compensation claims data for years 2013–2015 to calculate rates of compensable claims (eligible for disability or time loss benefits, if unable to work four days after injury) and total accepted claims (compensable plus medical-aid only claims) for each employer. We estimated the number and cost of claims to occur if employers with high claim rates reduced them to the rates of employers at the 25th percentile, adjusted for insurance risk class, employer size, and injury type. To evaluate the impact of setting more or less ambitious goals, we also estimated reductions based on claim rates at the 10th and 50th percentiles. Results: Over 43% of claims and claim costs would be prevented if employers with higher claim rates lowered them to the 25th percentile using either total accepted or compensable claim rates as the benchmark outcome. The estimated claim cost savings from benchmarking to compensable claims was nearly as great as the estimate based on benchmarking to total accepted claims ($308.5 mil annually based on compensable claims vs. $332.4 mil based on total accepted claims). Restaurants and Taverns had the greatest number of potentially prevented compensable claims. Colleges and Universities and Wood Frame and Building Construction had the greatest potential reduction in compensable claim costs among larger and smaller employers, respectively. Conclusion: Substantial reductions in workers' compensation claims and costs are possible if employers achieve the injury rates experienced by their safer peers. Practical application: Evaluating the range of workplace injury rates among employers within industry groups identifies opportunities for injury prevention and offers another approach to resource allocation.     

Pediatric electric bicycle injuries and comparison to other pediatric traffic injuries

Objective: The objective of this study was to conduct a comprehensive analysis of demographics, injury characteristics and hospital resource utilization of significant pediatric electric bicycle (e-bike) injuries leading to hospitalization following an emergency department visit in comparison to pediatric injuries caused by other traffic related mechanisms.

Methods: A retrospective review of all pediatric traffic injury hospitalizations following an emergency department visit to a level I trauma center between October 2014 and September 2016 was conducted. Data regarding age, sex, number of computed tomography (CT) scans obtained, number of major procedures, length of hospital stay (LOS), Injury Severity Score (ISS), and number of injuries per patient were collected and compared between e-bike injuries and other traffic injuries.

Results: Three hundred thirty-seven admissions were analyzed: 46 (14%) were due to e-bike injuries (29% of patients >12 years). Age, proportion of brain injuries, and use of CT were significantly increased compared to mechanical bicycle injuries (13.1?±?3.4 vs. 10.6?±?3.6, 13% vs. 3%, 1 [0–3] vs. 1 [0–1], P < .01, P = .03, P = .05). Age, LOS, and use of CT were significantly increased compared to injuries caused to automobile passengers (13.1?±?3.4 vs. 7.4?±?5.3, 1 [1–3] vs. 1 [1–2], 1 [0–3] vs. 0 [0–1], P < .01, P = .03, P = .01), as well as ISS and number of injuries per patient (P = .04, P < .01). Injuries caused by e-bikes were similar to injuries caused to pedestrians, except for age (13.1?±?3.4 vs. 8.5?±?3.7, P < .01). Multivariable analysis revealed a significant association between mechanism of injury and ISS, with increased ISS among e-bike injuries compared to mecahnical bike injuries (OR 2.56, CI 1.1–5.88, P = 0.03) and automobile injuries (OR 4.16, CI 1.49–12.5, (P < .01).

Conclusion: E-bikes are a significant cause of severe injury in children compared to most other traffic injuries, particularly in older children.     

Emergency room evidence on the role of alcohol intoxication in injury at work in the U.S.

Alcohol is a known risk factor for many kinds of injuries, but past research has failed to implicate alcohol intoxication as a major cause of work injuries in the U.S. Local and regional studies have indicated that alcohol-related injuries are relatively less common in work settings than non-work settings. In a six-month study, the National Electronic Injury Surveillance System collected the first national sample data on alcohol and injuries presenting to hospital emergency rooms. The study included both work injuries and product-related non-work injuries. Alcohol intoxication was ascertained by emergency room chart review. Alcohol involvement was much lower than in other studies, probably because of poor sensitivity in ascertainment, and it was 10 times lower among work injuries than non-work injuries. “Non-work activities at the time of injury” were a significant risk factor for alcohol-related injuries (odds ratio = 7). Thus, results of this national study are consistent with previous research in finding that alcohol poses a greater risk for nonwork injury than for work injury.     

The use of state workers' compensation administrative data to identify injury scenarios and quantify costs of work-related traumatic brain injuries

PROBLEM: Traumatic brain injury (TBI) is a public health problem but little is known about the nature of that problem in the working population. METHOD: The author used a national definition to identify cases in Washington State from workers' compensation (WC) hospital billing data, quantified the cost of WC insurance benefits using actuarial cost estimates, and identified high risk industries using ANSI Z16.2 typology. RESULTS: There were 928 cases of TBI with a lifetime claim cost of $159 million from the Washington State Fund (1994-2001). Sixty percent of injuries resulted in death or disability. The highest risks of TBI are concentrated in 16 industrial insurance risk classes and the highest costs in 19 North American Industry Classification codes. Injury scenarios were identified for nine industrial insurance risk classes. CONCLUSIONS: TBI is a disabling and costly workplace injury in the state of Washington, affecting even teenagers and seniors who are not generally considered to be part of the workforce. Injury typology codes provide useful information for improving workplace safety. IMPACT ON INDUSTRY: This research provides industry with quantitative information regarding the cost of work-related traumatic brain injury and the usefulness of using workers' compensation claims data to reduce the burden of workplace injury.     

Reporting occupational injuries: The first step

Attempts to evaluate occupational injury surveillance systems have centered on employer compliance. Surveillance systems also rely on employees reporting injuries, and the reliability of such reporting is unknown. In this study of hospital environmental service workers, 29.2% (108 of 372) recalled having been injured in the previous year, and of these, 38.9% (42 of 108) had not reported one or more injuries. Among those injured, older workers (mean age 40.6 years vs. 36.2 years; p = 0.024) and those having worked longer at the same job (mean duration 6.7 years vs. 4.3 years; p = 0.032) were more likely to not report an injury. The most frequently cited reason for not reporting was that the injury had seemed too minor, though 64.4% of unreported injuries required medical care and 44.1% resulted in lost work time.     

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders

IntroductionInsurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders.MethodsWorkers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI).ResultsCompared no LP contact, one contact was associated with a 27% reduction of risk (HR = 0.73, CI = 0.65–0.82), two with a 41% (HR = 0.59, CI = 0.51–0.68), and three or more contacts with a 28% reduction of risk (HR = 0.72, CI = 0.65–0.81).ConclusionsLP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries.Practical applicationsReduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.     

Assessing disabling and non-disabling injuries and illnesses using accepted workers compensation claims data to prioritize industries of high risk for Oregon young workers

Introduction: Young workers are especially vulnerable to occupational injuries and illnesses. There is a continued need to investigate injury burden among young workers across demographics and industry to inform targeted interventions. Workers compensation (WC) claims are important for quantifying work-related injuries and illnesses, however published studies have focused on disabling claims. This study extended previous research on Oregon young workers by including the most recent WC claims data to identify patterns of injury and high risk industries. Methods: We obtained all accepted disabling claims (N = 13,360) and a significant portion of non-disabling claims (N = 24,660) on workers aged 24 years and under from 2013 to 2018. Claim count, rate and cost were calculated by year, age, gender, industry, and injury type. A prevention index (PI) method was used to rank industries in order to inform prevention efforts. Results: Average annual disabling and non-disabling claim rates were 111.6 and 401.3 per 10,000 young workers. Workers aged 19–21 (disabling: 119.0 per 10,000 and non-disabling: 429.3) and 22–24 years (115.7 and 396.4) and male workers (145.3 and 509.0) had higher claim rates than workers aged 14–18 (80.6 and 297.0) and female workers (79.8 and 282.9). The most frequent injury types were “struck by/against” (35.6%) and “work-related musculoskeletal disorders (WMSDs)” (19.5%). High risk industries included agriculture, construction, and manufacturing for both genders combined. For female young workers, the highest risk industry was healthcare. Conclusions: This study demonstrated the added value of non-disabling WC claims data. Using both disabling and non-disabling data and PI method, agriculture, construction, manufacturing and healthcare industries were identified as priority workplaces to prevent common and costly injuries among Oregon young workers. Practical Applications: While the industries identified are considered hazardous for all workers, findings in this study can guide targeted research and prevention efforts specific to young workers.     

Using state administrative data to study nonfatal worker injuries: challenges and opportunities

PROBLEM: Administrative data from states have the potential to capture broader representation of worker injury, facilitating examination of trends, correlates, and patterns. While many states use their workers' compensation (WC) data to document frequency and type of injury, few conduct in-depth examinations of patterns of injury and other etiologies. Administrative data are generally an untapped resource. METHOD: Comparisons are made among four state databases used in a study linking worker injuries and patient outcomes in hospitals and nursing homes. RESULTS: Worker injury data varies in terms of inclusion criteria, variables, and coding schemes used. Linkages to organizational level characteristics can be difficult. CONCLUSIONS: Despite limitations, data can be used to study injury patterns and etiologies. Users must be knowledgeable and recognize how database characteristics may influence results.     

The direct cost burden of 13 years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index

Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem. Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs. Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd. Practical application: The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States.