Ergonomic Program Effectiveness: Ergonomic and Medical Intervention

The implementation of a successful ergonomic and medical intervention program designed to reduce the number and severity of injuries and illnesses and the associated levels of discomfort in the workplace is presented. Because of the recent activity concerning the on-again-off-again Occupational Safety and Health Administration (OSHA) Ergonomic Program Standard questions have been raised as to the value and effectiveness of an organization’s ergonomics program. In light of these concerns, the immense cost associated with work-related injury and illness, and the related pain and suffering associated with such injuries and illnesses, it is important to present a workable and effective ergonomic and medical intervention program. The results of this applied study demonstrate that through the application of an ergonomic and medical intervention program, workplace-related injuries and illnesses can be reduced or eliminated.     

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.     

The need for detailed gender-specific occupational safety analysis

IntroductionThe female work in population is growing in the United States, therefore the occupational health and safety entities must start to analyze gender-specific data related to every industry, especially to nontraditional occupations. Women working in nontraditional jobs are often exposed to extreme workplace hazards. These women have their safety and health threatened because there are no adequate policies to mitigate gender-specific risks such as discrimination and harassment. Employers tend to aggravate this situation because they often fail to provide proper reporting infrastructure and support. According to past studies, women suffered from workplace injuries and illnesses that were less prominent among men. Statistics also confirmed that men and women faced different levels of risks in distinct work environments. For example, the rates of workplace violence and murders by personal acquaintances were significantly higher among women.MethodsIn this paper, the authors analyze prior public data on fatal and nonfatal injuries to understand why we need to differentiate genders when analyzing occupational safety and health issues.ResultsThe analyses confirmed that women dealt with unique workplace hazards compared to men.ConclusionsIt is urgent that public agencies, such as the U.S. Department of Labor, record gender-specific data in details and by occupations and industries.Practical applicationThe reader will become aware of the current lack – and need – of data and knowledge about injuries and illnesses separated by gender and industry. Finally, safety and health researchers are encouraged to investigate the gender-specific data in all industries and occupations, as soon as they become available.     

Employee assistance programs,drug testing,and workplace injury

IntroductionLittle is known about the effects of employee assistance programs (EAPs) on occupational injuries.Materials and methodsMultivariate regressions probed a unique data set that linked establishment information about workplace anti-drug programs in 1988 with occupational injury rates for 1405 establishments.ResultsEAPs were associated with a significant reduction in both no-lost-work and lost-work injuries, especially in the manufacturing and transportation, communication and public utilities industries (TCPU). Lost-work injuries were more responsive to specific EAP characteristics, with lower rates associated with EAPs staffed by company employees (most likely onsite). Telephone hotline services were associated with reduced rates of lost-work injuries in manufacturing and TCPU. Drug testing was associated with reductions in the rate of minor injuries with no lost work, but had no significant relationship with lost-work injuries.Practical applicationsThis associational study suggests that EAPs, especially ones that are company-staffed and ones that include telephone hotlines, may prevent workplace injuries.     

Under-Reporting of Accidents Involving Biological Material by Nursing Professionals at a Brazilian Emergency Hospital

Background. Pathogens can be transmitted to health professionals after contact with biological material. The exact number of infections deriving from these events is still unknown, due to the lack of systematic surveillance data and under-reporting. Methods. A cross-sectional study was carried out, involving 451 nursing professionals from a Brazilian tertiary emergency hospital between April and July 2009. Through an active search, cases of under-reporting of occupational accidents with biological material by the nursing team were identified by means of individual interviews. The Institutional Review Board approved the research project. Results. Over half of the professionals (237) had been victims of one or more accidents (425 in total) involving biological material, and 23.76% of the accidents had not been officially reported using an occupational accident report. Among the under-reported accidents, 53.47% were percutaneous and 67.33% were bloodborne. The main reason for nonreporting was that the accident had been considered low risk. Conclusions. The under-reporting rate (23.76%) was low in comparison with other studies, but most cases of exposure were high risk.     

Temporary jobs and the severity of workplace accidents

Introduction. From the point of view of workplace safety, it is important to know whether having a temporary job has an effect on the severity of workplace accidents. We present an empirical analysis on the severity of workplace accidents by type of contract. Method. We used microdata collected by the Italian national institute managing the mandatory insurance against work related accidents. We estimated linear models for a measure of the severity of the workplace accident. We controlled for time-invariant fixed effects at worker and firm levels to disentangle the impact of the type of contract from the spurious one induced by unobservables at worker and firm levels. Results. Workers with a temporary contract, if subject to a workplace accident, were more likely to be confronted with severe injuries than permanent workers. When correcting the statistical analysis for injury under-reporting of temporary workers, we found that most of, but not all, the effect is driven by the under-reporting bias. Conclusions. The effect of temporary contracts on the injury severity survived the inclusion of worker and firm fixed effects and the correction for temporary workers' injury under-reporting. This, however, does not exclude the possibility that, within firms, the nature of the work may vary between different categories of workers. For example, temporary workers might be more likely to be assigned dangerous tasks because they might have less bargaining power. Practical implications. The findings will help in designing public policy effective in increasing temporary workers' safety at work and limiting their injury under-reporting.     

Prevention of occupational injuries: Evidence for effective good practices in foundries

IntroductionOccupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. Method: The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based = IR, frequency/hours-based = FR, severity = SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. Results: 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (− 26% IR, − 15% FR, −18% SR) in ferrous foundries and of SR (− 4%) in non-ferrous foundries. A significant (p = 0.021) ‘step-effect’ was shown for IR in ferrous foundries, independent of secular trends (p < 0.001). Sector-specific benchmarks for all injury rates were developed separately for ferrous and non-ferrous foundries. Conclusions: Strengths of the study were: ITS design, according to standardized quality criteria (i.e., at least three data points before and three data points after intervention; clearly defined intervention point); pragmatic approach, with good external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large.     

6th National Occupational Injury Research Symposium: Advancing Occupational Injury Research Through Integration and Partnership

IntroductionThe National Occupational Injury Research Symposium (NOIRS) is the only regularly held forum exclusively dedicated to occupational injury research and prevention.MethodThe 2015 conference theme, advancing occupational injury research through integration and partnership, shaped the conference and is reflected in articles selected for this special issue.Results' ConclusionThe 6th NOIRS, held May 19–21, 2015, brought together more than 250 researchers, occupational safety practitioners and students to share and discuss occupational injury research. Articles in this special issue highlight some of the research presented at the conference, reflect multiple scientific disciplines and approaches, cover a breadth of occupational injury causes and worker populations, and provide examples of research advanced by partnerships.Practical ApplicationsThe next NOIRS, tentatively scheduled for 2018, will build upon the theme of integration and partnership as well as feedback from conference attendees.     

美国职业卫生法规、监管及统计体系

美国是工业发达国家,是世界上最早建立“职业安全和卫生法”的国家之一。基于该法,美国确立以职业安全卫生监察局(OSHA)为执法机构、职业安全卫生复审委员会(OSHRC)为监督机构的职业卫生监管体系;同时,以劳工统计局(BLS)为统计主管机构,建立以“1904规范”为基础的企业雇主对其作业场所职业卫生记录和报告制度,并辅以两种形式的政府主动调查,形成了自下至上和自上至下相结合的调查统计体系。目前,我国职业卫生的调查统计体系尚未形成。因此,需要从工业发达国家的职业卫生法规、监管入手,以系统的方法和思路,分析其调查统计体系,学习工业发达国家的经验。研究结果认为美国的职业卫生统计体系具有上层法律及相关条例完备、组织体系职责分明、形成了政府主动调查与企业记录报告相结合的调查统计体系等明显的特点。     

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review

IntroductionMore than 5,000 fatalities and eight million injuries occurred in the workplace in 2007 at a cost of $6 billion and $186 billion, respectively. Neurotoxic chemicals are known to affect central nervous system functions among workers, which include balance and hearing disorders. However, it is not known if there is an association between exposure to noise and solvents and acute injuries. Method: A thorough review was conducted of the literature on the relationship between noise or solvent exposures and hearing loss with various health outcomes. Results: The search resulted in 41 studies. Health outcomes included: hearing loss, workplace injuries, absence from work due to sickness, fatalities, hospital admissions due to workplace accidents, traffic accidents, hypertension, balance, slip, trips, or falls, cognitive measures, or disability retirement. Important covariates in these studies were age of employee, type of industry or occupation, or length of employment. Discussion: Most authors that evaluated noise exposure concluded that higher exposure to noise resulted in more of the chosen health effect but the relationship is not well understood. Studies that evaluated hearing loss found that hearing loss was related to occupational injury, disability retirement, or traffic accidents. Studies that assessed both noise exposure and hearing loss as risk factors for occupational injuries reported that hearing loss was related to occupational injuries as much or more than noise exposure. Evidence suggests that solvent exposure is likely to be related to accidents or other health consequences such balance disorders. Conclusions: Many authors reported that noise exposures and hearing loss, respectively, are likely to be related to occupational accidents. Practical applications: The potential significance of the study is that findings could be used by managers to reduce injuries and the costs associated with those injures.     

Trends in occupational injuries and fatality in Turkey

Introduction. The aim of this study was to evaluate the trend of occupational injuries in Turkey using epidemiologic criteria such as incidence mortality and fatality/all injuries recorded – rates. Materials and methods. Safety and health data were obtained from the Annual Statistic Books of the Social Insurance Institution (1988–2006) and Social Security Institution (2007–2011) of Turkey. Results. The results from the official data showed that although total employment is increasing the number of occupational injuries and incidence and mortality rates are decreasing. The results also demonstrate that occupational fatality/all injuries recorded – rate is increasing. The fatality/all injuries recorded – rate per 1000 injuries increased to 25.5 in 2011 from 8.6 in 1988. Each work day an average of five people died because of occupational injuries. Discussion and conclusions. The fatality/all injuries recorded – rate (the number of fatal cases per 1000 occupational injuries) is an important indicator of the injury rate for a country. Systems of occupational injury and illness surveillance constitute a critical resource for the management and reduction of occupational injuries and illness.     

Injuries among electric power industry workers, 1995–2013

IntroductionWorkers in the electric power industry face many risks of injury due to the high diversity of work tasks performed in potentially hazardous and unpredictable work environments.MethodWe calculated injury rates by age, sex, occupational group, and injury type among workers in the Electric Power Research Institute’s (EPRI) Occupational Health and Safety Database (OHSD), which contains recordable injury, medical claims, and personnel data from 18 participating electric power companies from 1995 to 2013.ResultsThe OHSD includes a total of 63,193 injuries over 1,977,436 employee-years of follow-up, for an overall injury rate of 3.20 injuries per 100 employee-years. Annual injury rates steadily decreased from 1995 to 2000, increased sharply in 2001, and subsequently decreased to their lowest rate of 1.31 injuries per 100 employee-years in 2013. Occupations with the highest injury rates were welders (13.56 per 100 employee-years, 95% CI 12.74–14.37), meter readers (12.04 per 100 employee-years, 95% CI 11.77–12.31), and line workers (10.37 per 100 employee-years, 95% CI 10.19–10.56). Males had an overall higher injury rate compared to females (2.74 vs. 1.61 per 100 employee-years) although some occupations, such as meter reader, had higher injury rates for females. For all workers, injury rates were highest for those in the 21 to 30 age group (3.70 per 100 employee-years) and decreased with age. Welders and machinists did not follow this trend and had higher injury rates in the 65 + age group. There were 63 fatalities over the 1995 to 2013 period, with 21 fatalities (33.3%) occurring among line workers.ConclusionsAlthough injury rates have decreased over time, certain high-risk groups remain (i.e., line workers, mechanics, young males, older welders and machinists, and female meter readers).Practical applicationsProtective measures and targeted safety programs may be warranted to ensure the safety of electric power workers.     

The Relationships Between Biomechanical and Postural Stresses,Musculoskeletal Injury Rates,and Perceived Body Discomfort Experienced by Industrial Workers: A Field Study

A combination of archival, subjective, and observational field data collection methods were used to investigate the relationship between biomechanical and postural stresses, and the resulting physical strain experienced by industrial workers of a packaging plant. Assessment of physical strain was based on the number and incidence rate of Occupational Safety and Health Administration (OSHA)-reportable injuries that were recorded over a period of 27 months, and based on the self-reported ratings of perceived body discomfort. Both the biomechanical and postural stresses correlated with the musculoskeletal injury rate. The results illustrate the usefulness of postural and biomechanical analyses for assessing the risk of injury in industry.     

Workers' compensation insurer risk control systems: Opportunities for public health collaborations

IntroductionWorkers' compensation (WC) insurers offer services and programs for prospective client selection and insured client risk control (RC) purposes. Toward these aims, insurers collect employer data that may include information on types of hazards present in the workplace, safety and health programs and controls in place to prevent injury/illness, and return-to-work programs to reduce injury/illness severity. Despite the potential impact of RC systems on workplace safety and health and the use of RC data in guiding prevention efforts, few research studies on the types of RC services provided to employers or the RC data collected have been published in the peer-reviewed literature.MethodsResearchers conducted voluntary interviews with nine private and state-fund WC insurers to collect qualitative information on RC data and systems.ResultsInsurers provided information describing their RC data, tools, and practices. Unique practices as well as similarities including those related to RC services, policyholder goals, and databases were identified.ConclusionsInsurers collect and store extensive RC data, which have utility for public health research for improving workplace safety and health.Practical applicationsIncreased public health understanding of RC data and systems and an identification of key collaboration opportunities between insurers and researchers will facilitate increased use of RC data for public health purposes.     

The effect of first aid training on Australian construction workers' occupational health and safety motivation and risk control behavior

METHOD: A 24-week experiment was conducted to assess how first aid training affects the motivation of small business construction industry employees in avoiding occupational injuries and illnesses and its effect on their occupational health and safety behavior. A simplified multiple baseline design across workplace settings was used to evaluate the effects of first aid training. Participants' motivation to control occupational safety and health risks was explored during in-depth interviews before and after receipt of first aid training. Objective measurement of occupational safety and health behavior was conducted by a researcher directly observing the workplace before and after participants received first aid training. RESULTS: The observations at participants' worksites suggested that, for the most part, the first aid training had a positive effect on the occupational safety and health behavior of participants. First aid training appeared to reduce participants' "self--other" bias, making them more aware that their own experience of occupational safety and health risks is not beyond their control but that their own behavior is an important factor in the avoidance of occupational injury and illness. First aid training also appeared to reduce participants' willingness to accept prevailing levels of occupational safety and health risk and increase the perceived probability that they would suffer a work-related injury or illness. Participants expressed greater concern about taking risks at work after receiving first aid training. IMPACT ON INDUSTRY: It appears that first aid training enhances participants' motivation to avoid occupational injuries and illnesses and improves their risk control behavior. The implications of this are that first aid training can have a positive preventive effect and could complement traditional occupational health and safety training programs. As such, there may be benefit in providing first aid training to all employees rather than limiting this training to a small number of designated "first aiders."     

Occupational Safety and Health in Finland

In Finland, occupational safety is the responsibility of the employer, while the occupational safety and health laws are enforced by the Labour Inspection Service, an organization of the state. The Labour Inspection is divided in 11 administrative districts, and it employs 360 professionals. They are mandated to carry out site visits without prearranged appointments to inspect safe work situations, working hours, construction safety, or any aspect of accident risks. The inspectors are also mandated to verify the existence of sufficient occupational health services as prescribed by the Occupational Health Services Act for all employees. The occupational health services are typically provided by enterprise-owned medical departments, by mutually owned health care centers, by private practitioners, or by municipal health care centers. The latter are required by law to provide all services as prescribed by the legislation to anyone who comes to the facility. This situation is prevalent in the countryside, where there are very few private caregiving centers. Declaring occupational accidents and disease cases is mandatory, and the Inspection districts examine all accidents to establish causes and consequences, and to initiate prosecution in case of criminal negligence. Labour Inspection Districts are also notified of the new occupational disease cases as they are declared to insurance companies. Insurance for occupational disease, accidents, and death is an obligation of the employer, although they can choose the insurance company. The medical confidentiality between the workers and their occupational health care providers is very strict. Official statistics are maintained by the state Statistics Finland organization, and they may be used, for example, for research purposes by scientific institutes like the Finnish Institute of Occupational Health. Construction industry accounts for 25% of all fatal accidents (120 cases per 1 million working hours), followed by mechanical, wood, metal, machinery, and pulp and paper industry (10% each of fatal accidents) with rates ranging from 100–160 cases per 1 million working hours. There are some 5,000 occupational disease cases per year (rate 22/10,000 employed). The major disease categories include repetitive strain injuries (1,300 cases), respiratory allergies (600 cases), occupational skin diseases (1,000 cases), and 900 cases of noise-caused hearing loss. In 1998, 589 cases of asbestos-related diseases were reported.