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.     

Tracking the prevalence of rollover protective structures on U.S. farm tractors: 1993, 2001, and 2004

Problem

Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.

Methods

ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.

Results

In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.

Summary

The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.

Impact on Industry

The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.     

Effect of enhanced seat belt reminders on driver fatality risk

Objective

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

Method

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

Results

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

Conclusions

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

Impact on Industry

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.     

Trends and characteristics of animal-vehicle collisions in the United States

Introduction

Since 1990, fatal animal-vehicle collisions (AVCs) in the United States have more than doubled. This paper examines annual AVC trends in the United States over a 19-year period, seasonal and diurnal patterns of AVC risk, the geographic distribution of crash risk by state, and the association between posted speed limit and AVC crash risk in darkness.

Method

AVCs were compiled from the Fatality Analysis Reporting System (FARS) and the General Estimates System (GES) for the years 1990-2008 to examine annual crash trends for fatal and nonfatal crashes. Seasonal trends for fatal AVCs were examined with the aggregated FARS dataset; seasonal trends for fatal and nonfatal AVCs were also examined by aggregating four years of Michigan crash data. State-by-state distributions of fatal AVCs were also described with the aggregated FARS dataset. Finally, the relationship between posted speed limit and the odds that a fatal or nonfatal AVC occurred in darkness were examined with logistic regressions using the aggregated FARS and Michigan datasets.

Results

Between 1990 and 2008, fatal AVCs increased by 104% and by 1.3 crashes per trillion vehicle miles travelled per year. Although not all AVCs involve deer, daily and seasonal AVC crash trends follow the general activity pattern of deer populations, consistent with prior reports. The odds that a fatal AVC occurred in darkness were also found to increase by 2.3% for each mile-per-hour increase in speed; a similar, albeit smaller, effect was also observed in the aggregated Michigan dataset, among nonfatal crashes.

Conclusion

AVCs represent a small but increasing share of crashes in the United States. Seasonal and daily variation in the pattern of AVCs seem to follow variation in deer exposure and ambient light level. Finally, the relative risk that a fatal and nonfatal AVC occurred in darkness is influenced by posted speed limit, suggesting that a driver's limited forward vision at night plays a role in AVCs, as it does in pedestrian collisions.

Impact on Industry

The association between speed limit and crash risk in darkness suggests that AVC risk might be reduced with countermeasures that improve a driver's forward view of the road.     

What kinds of injuries do OSHA inspections prevent?

Objective

OSHA's enforcement program is one of the major public efforts to protect American workers. We examine both the scope of injury prevention that inspections can contribute and the types of standards that contribute the most.

Methods

We linked Pennsylvania Department of Labor and Industry files for lost-time injuries and employment to calculate injury rates for 1998-2005 for all single-establishment manufacturing firms. We linked these to OSHA inspection records.

Results

Inspections with penalties did affect injury types unrelated to standards as well as those related. We also found again that citations for violations of the standard requiring personal protective equipment had the largest impact on preventing injuries.

Impact on Industry

Programs requiring protective equipment use deserve added attention from consultants and inspectors. In addition, some inspections spur managers to undertake safety measures that go beyond compliance with standards.     

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.     

The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States

Objective

To examine trends in alcohol consumption and alcohol-related crashes among people younger than 21 in the United States and to review evidence on the effects of minimum legal drinking age (MLDA) laws.

Methods

Trends in alcohol-related crashes and alcohol consumption among young people were examined, and studies on the effects of lowering and raising the drinking age were reviewed.

Results

MLDA laws underwent many changes during the 20th century in the United States. Since July 1988, the MLDA has been 21 in all 50 states and the District of Columbia. Surveys tracking alcohol consumption among high school students and young adults found that drinking declined since the late 1970 s, and most of the decline occurred by the early 1990 s. These were the years when states were establishing, or reinstating, a MLDA-21. Among fatally injured drivers ages 16-20, the percentage with positive BACs declined from 61% in 1982 to 31% in 1995, a bigger decline than for older age groups; declines occurred among the ages directly affected by raising MLDAs (ages 18-20) and among young teenagers not directly affected (ages 16-17). Almost all studies designed specifically to gauge the effects of drinking age changes show MLDAs of 21 reduce drinking, problematic drinking, drinking and driving, and alcohol-related crashes among young people. Yet many underage people still drink, many drink and drive, and alcohol remains an important risk factor in serious crashes of young drivers, especially as they progress through the teenage years. Stepped-up enforcement of MLDA and drinking and driving laws can reduce underage drinking. Recent efforts to lower MLDAs to 18 and issue licenses to drink upon completion of alcohol education have gained local and national media attention. There is no evidence that alcohol education can even partially replace the effect of MLDA-21.

Conclusions

The cause and effect relationship between MLDAs of 21 and reductions in highway crashes is clear. Initiatives to lower the drinking age to 18 ignore the demonstrated public health benefits of MLDAs of 21.

Impact on Industry

Lowering the drinking age to 18 will increase highway crash deaths among young people.     

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.     

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.     

Dogs and cats as environmental fall hazards

Problem

Falls are the leading cause of non-fatal injuries in the United States. This study assessed the prevalence of fall injuries associated with cats and dogs in the United States and describes the types of injuries sustained, the location, activity, and circumstances under which they occurred.

Methods

Data were from a nationally representative sample of emergency department visits from January 1, 2001 to December 31, 2006, available through the National Electronic Injury Surveillance System All Injury Program (NEISS-AIP).

Results

Based on 7,456 cases, an estimated 86,629 fall injuries each year were associated with cats and dogs, for an injury rate of 29.7. There were 7.5 times as many injuries involving dogs as cats and females were 2.1 times more likely to be injured than males. Injury rates were highest among people aged ≥ 75, but pets were a fall hazard for all ages. Fractures and contusions or abrasions were the most common injuries; the highest rates were for injuries to the extremities. About 66.4% of falls associated with cats and 31.3 % of falls associated with dogs were caused by falling or tripping over the pet. An additional 21.2% of falls related to dogs were caused by being pushed or pulled.

Summary

Although pets were associated with fall injuries, this risk can be reduced by increasing public awareness about situations that can lead to falls, such as dog-walking and chasing pets, and by calling attention to the importance of obedience training for dogs to minimize hazardous behaviors such as pulling and pushing.

Impact on industry

Fall injuries represent a burden to individuals, our society and our health care system. Increasing public awareness and implementing basic prevention strategies can help people of all ages enjoy their pets, reduce their chances of experiencing pet-related falls, and lessen the impact of fall injuries on our health care system.     

Bicycle helmet use among children in the United States: The effects of legislation, personal and household factors

Introduction

Children ages 5-14 years have the highest rate of bicycle-related injuries in the country. Bicycle helmets can prevent head and brain injuries, which represent the most serious type of bicycle-related injury.

Objectives

This paper compares children's bicycle helmet use to that estimated from an earlier study, and explores regional differences in helmet use by existing helmet legislation.

Methods

This study was a cross-sectional, list-assisted random-digit-dial telephone survey. Interviews were completed by 9,684 respondents during 2001-2003. The subset with at least one child in the household age 5-14 years (2,409 respondents) answered questions about bicycle helmet use for a randomly selected child in their household.

Results

Almost half (48%) of the children always wore their helmet, 23% sometimes wore their helmet, and 29% never wore their helmet. Helmet wearing was significantly associated with race, ethnicity, and child age but was not associated with the sex of the child. Other significant predictors of use included household income, household education, census region, and bicycle helmet law status. Statewide laws were more effective than laws covering smaller areas. The proportion of children who always wore a helmet increased from 25% in 1994 to 48% in 2001-2002. Significant increases in helmet use from 20% to 26% were seen among both sexes, younger (5-9 years) and older (10-14 years) children, and in all four regions of the country.

Conclusions

While there has been substantial progress in the number of children who always wear their helmets, more than half do not. Further progress will require using a combination of methods that have been shown to successfully promote consistent helmet use. Impact on industry: minimal.     

Driving self-restriction in high-risk conditions: how do older drivers compare to others?

Introduction

Many older drivers self-restrict or avoid driving under high-risk conditions. Little is known about the onset of driving self-restrictions or how widespread self-restrictions are among drivers of all ages.

Methods

The Second Injury Control and Risk Survey (ICARIS-2) was a nationwide cross-sectional, list-assisted random-digit-dial telephone survey from 2001 to 2003. National prevalence estimates and weighted percentages of those reporting driving self-restrictions were calculated. Multivariable logistic regression was used to explore associations between specific self-restrictions and age group, adjusting for other personal characteristics.

Results

More than half of all drivers reported at least one driving self-restriction. The most commonly reported restriction was avoidance of driving in bad weather (47.5%), followed by at night (27.9%) and on highways or high-speed roads (19%). A greater percentage of young adult women (18-24 years) reported self-restricting in bad weather compared to women in other age groups, and the percentage of drivers self-restricting at night, in bad weather, and on highways or high-speed roads increased steeply after age 64. We found that women, those in low income groups, and those who had driven low annual mileage were more likely to self-restrict.

Conclusions

In addition to assessing self-restrictions among older drivers, a new finding from our study is that self-restrictions are also quite prevalent among younger age groups. Driving self-restrictions may be better understood as a spectrum across ages in which drivers’ reasons for restriction change.

Impact on industry

Future research on the ability of driving self-restrictions to reduce actual crash risk and prevent injuries is needed.     

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.     

Fall arrest characteristics of a scissor lift

Problem

Census of Fatal Occupational Injuries (CFOI) data indicate 306 aerial lift fatalities between 1992-2003. Seventy-eight of these fatalities specifically involved scissor lifts. Members of standards committees have requested that NIOSH conduct research to determine the effects of safety-control practices related to using fall-protection systems for scissor lifts.

Method

This research examined the structural and dynamic stability of a scissor lift subjected to fall arrest forces. This was accomplished by conducting drop tests from a scissor lift. Anchorage locations evaluated included manufacturer-supplied anchorage points on the scissor lift platform as well as mid-rail and top-rail locations.

Results

Preliminary drop tests determined that a 2400 lb maximum arrest force (MAF) could be generated by dropping 169 lb through a fall height of 36” using Nystron® rope as a lanyard. The scissor lift maintained structural and dynamic stability for all drop tests when fully extended and on an incline.

Discussion

Anchoring a fall arrest system to either the mid-rail or top-rail is not a recommended practice by the scissor lift manufacturer. Anchor points are provided on the platform floor of the scissor lift for this purpose. However, our results demonstrate that the mid-rail and top-rail absorb substantial energy from an arrested fall and may have potential as appropriate anchorage points.

Impact to Industry

Employers and workers should consider implementing fall arrest systems when using scissor lifts as part of their overall risk mitigation plan for fall injury prevention.     

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.     

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.     

The unrecognized danger of a new transportation mechanism of injury--pedicabs

Objective

Pedicabs are a new and controversial transportation innovation for tourists in congested areas in several U.S. cities. Scant literature on this trauma mechanism exists. The purpose of this study is to identify the incidence, demographics, morbidity, mortality, and potential for injury prevention of pedicab incidents amongst major trauma admissions at an urban, academic Level I Trauma Center.

Patients & Methods

Researchers conducted a retrospective review of the Trauma Registry from 2000 to 2009. All patients identified as being injured in a pedicab incident were reviewed. Demographics, diagnoses, toxicology, treatments, and injury severity scale (ISS) were collected. Outcomes included mortality, ICU, and hospital length of stay (LOS), discharge disposition, and hospital charges. A photographic survey of 50 local pedicabs was examined for the presence and use of safety equipment.

Results

During the period of January 2000 to July 2009 there were 15 major trauma victims from identified pedicab incidents. Falling from the pedicab was the mechanism of injury in 14 of 15 cases. There were two fatalities in victims following severe traumatic brain injury. Traumatic brain injury, skull fracture, or loss of consciousness was seen in 11/15 victims. Ethanol ingestion was detected in blood tests of 10 of the 14 adult victims. Median charges of hospitalization due to a pedicab related injury was US$29,956 ± 77,482. A photographic survey of 50 local pedicabs reveals very limited use of safety belts by passengers despite existing city ordinances.

Conclusions

Major trauma victims of pedicab incidents in the United States suffer significant injuries and death. Most cases occurred in passengers falling from the pedicab at night after alcohol ingestion. There is an opportunity for implementation of strategies toward improved injury prevention with this new form of transport.     

Evaluation of guardrail systems for preventing falls through roof and floor holes

Introduction

Fall-related occupational injuries and fatalities are serious problems in the U.S. construction industry, especially incidents related to unguarded holes. The National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV conducted a project to evaluate the effectiveness of guardrail systems to prevent falls through roof and floor holes.

Methods

Two commercial edge-protection products were evaluated when used as perimeter guarding around a roof hole. Installations of the commercial products were compared to job-built guardrails constructed of 2^″ × 4^″ construction-grade lumber. Occupational Safety and Health Administration (OSHA) regulations require that “a force of at least 200 pounds” must be supported by the top rail of a guardrail system “in any outward or downward direction at any point along the top edge.” A laboratory testing system was developed to evaluate this requirement. A dynamic 200-lb force was generated against the top rail using a weighted manikin mounted on a hinged steel frame. Nine construction workers, who served as test subjects, each built five different guardrail configurations.

Results

All 45 configurations met the 200-lb OSHA requirement. Installation time for one commercial product was 32% quicker than the job-built configuration (25.6 min vs. 37.9 min).

Impact on Industry

This study: (a) indicates that the two edge-protection products can be used as perimeter guarding; (b) highlights the importance of using proper materials and fasteners to construct guardrails to protect workers from falling into unguarded roof and floor holes; and (c) discusses an overall-strength-testing methodology that can be used by fall-protection researchers.     

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.