Raising the speed limit from 75 to 80 mph on Utah rural interstates: Effects on vehicle speeds and speed variance

IntroductionIn November 2010 and October 2013, Utah increased speed limits on sections of rural interstates from 75 to 80 mph. Effects on vehicle speeds and speed variance were examined.MethodsSpeeds were measured in May 2010 and May 2014 within the new 80 mph zones, and at a nearby spillover site and at more distant control sites where speed limits remained 75 mph. Log-linear regression models estimated percentage changes in speed variance and mean speeds for passenger vehicles and large trucks associated with the speed limit increase. Logistic regression models estimated effects on the probability of passenger vehicles exceeding 80, 85, or 90 mph and large trucks exceeding 80 mph.ResultsWithin the 80 mph zones and at the spillover location in 2014, mean passenger vehicle speeds were significantly higher (4.1% and 3.5%, respectively), as were the probabilities that passenger vehicles exceeded 80 mph (122.3% and 88.5%, respectively), than would have been expected without the speed limit increase. Probabilities that passenger vehicles exceeded 85 and 90 mph were non-significantly higher than expected within the 80 mph zones. For large trucks, the mean speed and probability of exceeding 80 mph were higher than expected within the 80 mph zones. Only the increase in mean speed was significant. Raising the speed limit was associated with non-significant increases in speed variance.ConclusionsThe study adds to the wealth of evidence that increasing speed limits leads to higher travel speeds and an increased probability of exceeding the new speed limit. Results moreover contradict the claim that increasing speed limits reduces speed variance.Practical applicationsAlthough the estimated increases in mean vehicle speeds may appear modest, prior research suggests such increases would be associated with substantial increases in fatal or injury crashes. This should be considered by lawmakers considering increasing speed limits.     

Fatally injured pedestrians and bicyclists in the United States with high blood alcohol concentrations

IntroductionLittle research has focused on the problem of alcohol impairment among pedestrians and bicyclists in the United States. The aim of the current study was to investigate the prevalence, trends, and characteristics of alcohol-impaired fatally injured pedestrians and bicyclists.MethodData from the Fatality Analysis Reporting System (FARS) were analyzed for fatally injured passenger vehicle drivers, pedestrians, and bicyclists 16 and older during 1982–2014. Logistic regression models examined whether personal, roadway, and crash characteristics were associated with high blood alcohol concentrations (BACs) among fatally injured pedestrians and bicyclists.ResultsFrom 1982 to 2014, the percentage of fatally injured pedestrians with high BACs (≥ 0.08 g/dL) declined from 45% to 35%, and the percentage of fatally injured bicyclists with high BACs declined from 28% to 21%. By comparison, the percentage of fatally injured passenger vehicle drivers with high BACs declined from 51% in 1982 to 32% in 2014. The largest reductions in alcohol impairment among fatally injured pedestrians and bicyclists were found among ages 16–20. During 2010–2014, fatally injured pedestrians and bicyclists ages 40–49 had the highest odds of having a high BAC, compared with other age groups.ConclusionsA substantial proportion of fatally injured pedestrians and bicyclists have high BACs, and this proportion has declined less dramatically than for fatally injured passenger vehicle drivers during the past three decades. Most countermeasures used to address alcohol-impaired driving may have only limited effectiveness in reducing fatalities among alcohol-impaired pedestrians and bicyclists.Practical applicationsEfforts should increase public awareness of the risk of walking or bicycling when impaired. Results suggest the primary target audience for educational campaigns directed at pedestrians and bicyclists is middle-age males. Further research should evaluate the effectiveness of potential countermeasures, such as lowering speeds or improving lighting in urban areas.     

Protective factors associated with young passenger intervening in risky driving situations

IntroductionWhile the negative influence of passengers on driving is usually studied, young passengers may protect against young drivers' crash involvement by speaking out and trying to stop unsafe driving behavior. This study sought to examine psychosocial constructs of young passengers who are likely to intervene in their friends' risky driving.MethodUniversity students aged 17 to 25 years who were single (n = 123) or in a romantic relationship (n = 130) completed an online survey measuring protective factors.ResultsThe combination of individual, friend and (for participants in a relationship) romantic partner protective factors predicted self-reported passenger intervening intentions.Impact on IndustrySince peer passengers often increase young drivers' crash risk, research on passenger intervening has significant implications for road safety strategies. The findings provide support for the operationalization of protective factors in strategies that target passenger intervening behavior.     

Marijuana-, alcohol-, and drug-impaired driving among emerging adults: Changes from high school to one-year post-high school

IntroductionDriving while impaired (DWI) increases the risk of a motor vehicle crash by impairing performance. Few studies have examined the prevalence and predictors of marijuana, alcohol, and drug-specific DWI among emerging adults.MethodsThe data from wave 3 (W3, high school seniors, 2012, N = 2407) and wave 4 (W4, one year after high school, N = 2178) of the NEXT Generation Health Study with a nationally representative cohort. W4 DWI (≥ 1 day of past 30 days) was specified for alcohol-specific, marijuana-specific, alcohol/marijuana-combined, illicit drug-related DWI. Multinomial logistic regression models estimated the association of W4 DWI with W3 covariates (perceived peer/parent influence, drinking/binge drinking, marijuana/illicit drug use), and W4 environmental status variables (work/school/residence) adjusting for W3 overall DWI, demographic, and complex survey variables.ResultsOverall DWI prevalence from W3 to W4 changed slightly (14% to 15%). W4 DWI consisted of 4.34% drinking-specific, 5.02% marijuana-specific, 2.41% drinking/marijuana combined, and 3.37% illicit drug-related DWI. W3 DWI was significantly associated with W4 alcohol-related and alcohol/marijuana-combined DWI, but not other DWI. W3 marijuana use, binge drinking, and illicit drug use were positively associated with W4 marijuana-specific, alcohol/marijuana-combined, and illicit drug-related DWI, respectively. W3 friend drunkenness and marijuana use were positively associated with W4 alcohol-specific and marijuana-related DWI, respectively. W3 peer marijuana use was negatively associated with W4 alcohol-specific DWI.ConclusionsDriving under the influence of alcohol, marijuana, and illicit drugs is a persistent, threatening public health concern among emerging U.S. adults. High school seniors' binge drinking as well as regular alcohol drinking and marijuana/illicit drug use were independently associated with respective DWI one year after high school. Peer drunkenness and marijuana use in high school may be related to subsequent DWI of emerging adults.Practical applicationsThe results support the use of injunctive peer norms about getting drunk and smoking marijuana in guiding the development of prevention programs to reduce youth DWI.     

Driver speed selection and crash risk: Insights from the naturalistic driving study

IntroductionThis study investigates how speed limits affect driver speed selection, as well as the related crash risk, while controlling for various confounding factors such as traffic volumes and roadway geometry. Data from a naturalistic driving study are used to examine how driver speed selection varies among freeways with different posted speed limits, as well as how the likelihood of crash/near-crash events change with respect to mean speed and standard deviation.MethodRegression models are estimated to assess three measures of interest: the average speed of vehicles during the time preceding crash/near-crash and baseline (i.e., normal) driving events; the variation in travel speeds leading up to each event as quantified by the standard deviation in speeds over this period; and the probability of a specific event resulting in a crash/near-crash based on speed selection and other factors.ResultsSpeeds were relatively stable across levels-of-service A and B, within a range of 1.5 mph on average. Speeds were marginally lower (3.3 mph) on freeways posted at 65 mph versus 70 mph. In comparison, speeds were approximately 10.2 to 13.4 mph lower on facilities posted at 55 mph or 60 mph. Speeds were shown to be 2.5 mph lower in rainy weather and 11 mph lower under snow or sleet.ConclusionsSignificant correlation was observed with respect to speed selection behavior among the same individuals. Mean speeds are shown to increase with speed limits. However, these increases are less pronounced at higher speed limits. Drivers tend to reduce their travel speeds in presence of junctions and work zones, under adverse weather conditions, and particularly under heavy congestion. Crash risk increased with the standard deviation in speed, as well as on vertical curves and ramp junctions, and among the youngest and oldest age groups of drivers.     

Bicycle helmet use among persons 5 years and older in the United States, 2012

IntroductionIn 2013, injuries to bicyclists accounted for 925 fatalities and 493,884 nonfatal, emergency department-treated injuries in the United States. Bicyclist deaths increased by 19% from 2010 to 2013. The greatest risk of death and disability to bicyclists is head injuries. The objective of this study was to provide estimates of prevalence and associated factors of bicycle riding and helmet use among children and adults in the United States.MethodCDC analyzed self-reported data from the 2012 Summer ConsumerStyles survey. Adult respondents (18 + years) were asked about bicycle riding and helmet use in the last 30 days for themselves and their children (5 to 17 years). For bicycle riders, CDC estimated the prevalence of helmet use and conducted multivariable regression analyses to identify factors associated with helmet use.ResultsAmong adults, 21% rode bicycles within the past 30 days and 29% always wore helmets. Respondents reported that, of the 61% of children who rode bicycles within the past 30 days, 42% always wore helmets. Children were more likely to always wear helmets (90%) when their adult respondents always wore helmets than when their adult respondents did not always wear helmets (38%). Children who lived in states with a child bicycle helmet law were more likely to always wear helmets (47%) than those in states without a law (39%).ConclusionsDespite the fact that bicycle helmets are highly effective at reducing the risk for head injuries, including severe brain injuries and death, less than half of children and adults always wore bicycle helmets while riding.Practical applicationStates and communities should consider interventions that improve the safety of riding such as policies to promote helmet use, modeling of helmet wearing by adults, and focusing on high risk groups, including Hispanic cyclists, occasional riders, adults, and children ages 10 to 14.     

Distracting behaviors among teenagers and young,middle-aged,and older adult drivers when driving without and with warnings from an integrated vehicle safety system

IntroductionNegative reinforcement from crash warnings may reduce the likelihood that drivers engage in distracted driving. Alternatively, drivers may compensate for the perceived safety benefit of crash warnings by engaging in distractions more frequently, especially at higher speeds. The purpose of this study was to examine whether warning feedback from an integrated vehicle-based safety system affected the likelihood that various secondary behaviors were present among drivers ages 16–17, 20–30, 40–50, and 60–70.MethodParticipants drove an instrumented sedan with various collision warning systems for an extended period. Ten 5-second video clips were randomly sampled from driving periods at speeds above 25 mph and below 5 mph each week for each driver and coded for the presence of 11 secondary behaviors.ResultsAt least one secondary behavior was present in 46% of video clips; conversing with a passenger (17%), personal grooming (9%), and cellphone conversation (6%) were the most common. The likelihood that at least one secondary behavior was present was not significantly different during periods when drivers received warnings relative to periods without warnings. At least one secondary behavior was 21% more likely to be present at speeds below 5 mph relative to speeds above 25 mph; however, the effect of vehicle speed was not significantly affected by warning presence. Separate models for each of the five most common secondary behaviors also indicated that warnings had no significant effect on the likelihood that each behavior was present.ConclusionsCollision warnings were not associated with significant increases or decreases in the overall likelihood that teen and adult drivers engaged in secondary behaviors or the likelihood of the behaviors at speeds above 25 mph or below 5 mph.Practical applicationsThere was no evidence that forward collision warning and other technologies like those in this study will increase or decrease distracted driving.     

Concussion attitudes,behaviors, and education among youth ages 12–17: Results from the 2014 YouthStyles survey

IntroductionThis study assessed young athletes' (ages 12 to 17) concussion attitudes and behaviors, particularly their self-reported experience learning about concussion and intentions to report a concussion and disparities in these experiences.MethodsWe used data from Porter Novelli's 2014 YouthStyles survey that is conducted each year to gather insights about American consumers.ResultsOf the 1,005 respondents, 57% reported sports participation. Fourteen percent reported they may have had a previous concussion, and among them 41% reported having a concussion more than once while playing sports. Males (17.7%) were significantly more likely to report having a concussion than females (10.0%; χ² (1) = 7.01, p = 0.008). Fifty-five percent of respondents reported having learned about what to do if they think they may have a concussion, and 92% reported that they would tell their coach if they thought they sustained a concussion while playing youth or high school sports. Youth from higher income families ($75,000–$124,999) were significantly more likely than youth from lower income families (less than $35,000) to report that they learned about what do if they suspected that they had a concussion.ConclusionAge of athlete, parental income level, athlete's sex, and living in a metro versus non-metro area led to disparities in athletes' concussion education. There is a need for increased access to concussion education and an emphasis on customizing concussion education efforts to meet the needs of different groups.Practical applicationWe identified athletes' self-reported previously sustained concussions and predictors of education related to concussion. Further research is needed to explore the age, gender and income gaps in concussion education among athletes.     

Using a cluster randomized controlled trial to determine the effects of intervention of battery and hardwired smoke alarms in New South Wales,Australia: Home fire safety checks pilot program

IntroductionIn 2014, Fire & Rescue New South Wales piloted the delivery of its home fire safety checks program (HFSC) aimed at engaging and educating targeted top “at risk” groups to prevent and prepare for fire. This pilot study aimed to assess the effectiveness of smoke alarms using a cluster randomized controlled trial.MethodsSurvey questionnaires were distributed to the households that had participated in the HFSC program (intervention group). A separate survey questionnaire was distributed to the control group that was identified with similar characteristics to the intervention group in the same suburb. To adjust for potential clustering effects, generalized estimation equations with a log link were used.ResultsMultivariable analyses revealed that battery and hardwired smoking alarm usage increased by 9% and 3% respectively among the intervention group compared to the control group. Females were more likely to install battery smoke alarms than males. Respondents who possessed a certificate or diploma (AOR = 1.31, 95% CI 1.00–1.70, P = 0.047) and those who were educated up to years 8–12 (AOR = 1.32, 95% CI 1.06–1.64, P = 0.012) were significantly more likely to install battery smoke alarms than those who completed bachelor degrees. Conversely, holders of a certificate or diploma and people who were educated up to years 8–12 were 31% (AOR = 0.69, 95% CI 0.52–0.93, P = 0.014) and 24% (AOR = 0.76, 95% CI 0.60–0.95, P = 0.015) significantly less likely to install a hardwired smoke alarm compared to those who completed bachelor degrees.ConclusionsThis pilot study provided evidence of the benefit of the HFSC in New South Wales. Practical Applications: Fire safety intervention programs, like HFSC, need to be targeted to male adults with lower level of schooling even when they are aware of their risks.     

Occupational stressors identified by small-scale,independent commercial crab pot fishermen

IntroductionWe interviewed fishermen to identify jobs and/or tasks of concern in order to guide and inform current ergonomic interventions.MethodsWe administered surveys to two groups of southeastern US commercial crab fishermen: a cohort contacted by telephone and fishermen recruited at 11 local fish houses. Fishermen were asked to rate physical stress of selected work tasks and conditions on a scale from 0 (no problem) to 10 (major problem). Fishermen were also asked open-ended questions about other work-issues of concern.ResultsFishermen who completed the survey (n = 91) were predominantly male (90%), white (96%), and over 40 years of age (71%). The five most physically strenuous tasks and conditions as rated by fishermen were pulling pots by hand (mean 6.4), rough weather (6.1) or rough water (6.2), unloading without mechanical assistance (5.8), and long work days (5.3). Task stress ratings with the most variability measured by the inter-quartile range (IQR) included: pulling pots by hand (IQR = 5), unloading without mechanical assistance (IQR = 5), gear maintenance (IQR = 4.5), and moving boxes and baskets on board (IQR = 4.5). Other situations that fishermen identified as a problem included: economic, off-shore work, declining industry, mental stress, environment, regulation, conflict with other commercial or recreational fishermen, issues with crew, sun (glare or burn), and breaking up frozen bait.ConclusionsIn general, stressful tasks identified from previous research were rated similarly by the fishermen surveyed. Development and testing of ergonomic interventions is ongoing.     

Demographic determinants of chemical safety information recall in workers and consumers in South Africa: A cross sectional study

BackgroundChemical hazard communication is intended to alert users of the potential hazards of chemicals. Hazard information needs to be understood and recalled. Recall of hazard communication is critical when the written form of the information is not available at the time it is required.MethodsA cross-sectional study investigating associations between recall of chemical safety information on labels amongst 402 participants including 315 workers and 87 consumers in two provinces of South Africa.ResultsRespondents were predominantly male (67.7%), the median age was 37 years (IQR: 30-46 years) and less than half of the participants completed high school (47.5%). Multivariate analysis identified the following positive associations with the recall of all the label elements listing the strongest association: call appropriate services and industrial vs consumer sector (OR = 2.4; 95% CI: 1.2; 4.6 ); call appropriate services and transport vs consumer sector (OR = 4.4; 95% CI: 1.2; 16.0); flammable symbol and male vs female gender (OR = 2.3; 95% CI: 1.0; 5.3); flammable symbol and home language English vs African languages (OR = 6.6; 95% CI: 2.1; 21.2); any hazard statement and home language Afrikaans vs African languages (OR = 14.0; 95% CI: 3.6; 54.2), any first aid statement and further education vs none (OR = 3.3; 95% CI: 1.3; 8.0), correct chemical name and industry blue collar workers vs non-industry blue collar workers (OR = 2.6; 95% CI: 1.1; 6.1), correct chemical name and non-industry white collar occupations vs non-industry blue collar workers (OR = 2.7; 95% CI: 1.0; 7.1).ConclusionThe study found a number of potential positive associations which influence recall of label elements of which some (e.g., sector, gender, occupation) suggest further research. Relevant policies in South Africa should ensure that the safety information on chemical labels is clearly visible to read and understandable which aids recall and the reduction in harmful chemical exposures.     

Fatal and serious injuries related to vulnerable road users in Canada

IntroductionThe goals of this study were to analyze possible trends of fatal and serious injuries related to vulnerable road users in Canada (pedestrians, cyclists and motorcyclists) from 1990 to 2012 and the role of alcohol and drugs in these cases. Drugs have rarely been documented with respect to vulnerable road users.MethodThe Traffic Injury Research Foundation's National Fatality and Serious Injury Databases and the Public Health Agency of Canada's Canadian Hospitals Injury Reporting and Prevention Program databases were used. Numbers and rates of fatalities and serious injuries among vulnerable road users were analyzed and regression models were used to assess changes over time.ResultsThe analyses show that while the absolute number of fatalities and the rate per 100,000 population among vulnerable road users may be decreasing, no such trends are apparent when looking at the proportions of these road user fatalities out of all motor-vehicle fatalities. The trend for the proportion of motorcyclist fatalities is significantly increasing (coef. = 0.16, p < 0.001). The elderly (76 years or older) are overrepresented among pedestrian fatalities, and serious injuries (they represent 18.5% of all pedestrian fatalities but only 5.8% of the population), while those 15 years or younger are overrepresented among cyclists (they represent 23.3% of cyclist fatalities but 19.5% of the population), and those 16 to 25 years old are overrepresented among motorcyclists (27.2% of motorcyclists fatalities and 13.6% of population). Alcohol and drug use among fatally injured vulnerable road users were significant problems, especially among pedestrians. Among fatally injured pedestrians tested for alcohol and drugs, 39.7% and 43.4% tested positive, respectively.ConclusionsWith the promotion of walking and cycling as forms of exercise and the popularity of motorcycling, the safety of vulnerable road users is an important issue. The results corroborate previous research and extend our understanding about the influence of alcohol and drugs in vulnerable road user injuries.Practical applicationsThese findings can help better inform prevention and mitigation initiatives for vulnerable road users.     

Association between safety leading indicators and safety climate levels

ObjectivesThe aim of this study was to evaluate the association of leading indicators for occupational health and safety, particularly safety inspections and non-compliances, with safety climate levels.MethodsNordic Occupational Safety Climate Assessment Questionnaire was employed to evaluate safety climate in cross-sectional design. The geographically diverse population of the inspection body made it possible to conduct the survey across 10 provinces in Iran. 89 completed questionnaires were obtained with a response rate of 47%. Except for management safety justice, the internal consistency of other six dimensions was found to be acceptable (α ≥ 0.7).ResultsMean scores of dimensions ranged from 3.50 in trust in the efficacy of safety systems (SD = 0.38) to 2.98 in workers' safety priority and risk non-acceptance (SD = 0.47). Tukey HSD tests indicated a statistically significant difference of mean scores among groups undergoing different number of safety inspections and those receiving different number of non-compliances (p < 0.05), with no significant differences based on safety training man-hours and sessions (p > 0.05). Spearman's rank-order correlation showed no relationship between work experience and number of non-compliances (correlation coefficient = − 0.04, p > 0.05) and between safety training man-hours and number of non-compliances (correlation coefficient = − 0.15, p > 0.05).ConclusionsOur results indicate that safety climate levels are influenced by number of safety inspections and the resultant non-compliances.Practical applicationsFindings suggest that safety non-compliances detected as a result of conducting safety inspections could be used to monitor the safety climate state. Establishing plans to conduct scheduled safety inspections and recording findings in the form of safety non-compliance and monitoring their trend could be used to monitor levels of safety climate.     

Is sledding safe? Beyond acute,traumatic injuries: Estimating the spine loads sustained by children while sledding

ObjectiveCompare acceleration level between two sleds used for downhill winter sliding. The hypotheses include (a) acceleration levels will differ significantly between sled types, (b) acceleration levels will be unsafe, (c) acceleration levels will not differ significantly between genders.DesignCross sectional study, within subject design. A cross correlation was used to verify similar terrain and path of travel between the two sleds. The trials with the highest correlation, between sleds, were then used in a t-test to analyze the differences in the mean, maximum, minimum, peak accelerations, average and maximum peak levels between the two sleds and genders. A one-way ANOVA evaluated the relationship among gender and all variables.SettingIn a randomized order, participants slid down the hill three times with one sled, followed by three times with the other. Acceleration was captured with a PBC piezoelectric accelerometer connected to a Larson Davis Human Vibration Meter 100.ParticipantsFive males and seven females, age 7–14 years, were recruited for this study. Participants were a sample of convenience.ResultsThe measured accelerations exceeded safe levels with values ranging from 1.07 m/s² to 1330 m/s² (mean = 241.97 m/s²). Two-tailed t-test showed no significant difference in acceleration between sleds. A one-way ANOVA determined that there is no significant difference between gender or sled for any measured variables.ConclusionAcceleration magnitudes did not differ significantly between sled types or between genders. Peak acceleration levels were determined to be unsafe, in particular with regard to the forces transmitted to the spine.     

Examining teen driver crashes and the prevalence of distraction: Recent trends, 2007–2015

IntroductionTeen drivers crash at a much higher rate than adult drivers, with distractions found as a factor in nearly 6 out of 10 moderate-to-severe teen crashes. As the driving environment continues to rapidly evolve, it is important to examine the effect these changes may be having on our youngest and most vulnerable drivers.MethodThe purpose of this study was to identify types of vehicle crashes teens are most frequently involved in, as well as the distracting activities being engaged in leading up to these crashes, with a focus on identifying changes or trends over time. We examined 2,229 naturalistic driving videos involving drivers ages 16–19. These videos captured crashes occurring between 2007 and 2015. The data of interest for this study included crash type, behaviors drivers engaged in leading up to the collision, total duration of time the driver's eyes were off the forward roadway, and duration of the longest glance away from forward.ResultsRear-end crashes increased significantly (annual % change = 3.23 [2.40–4.05]), corresponding with national data trends. Among cell phone related crashes, a significant shift occurred, from talking/listening to operating/looking (annual % change = 4.22 [1.15–7.29]). Among rear-end crashes, there was an increase in the time drivers' eyes were off the road (β = 0.1527, P = 0.0004) and durations of longest glances away (β = 0.1020, P = 0.0014).ConclusionsFindings suggest that shifts in the way cell phones are being used, from talking/listening to operating/looking, may be a cause of the increasing number of rear-end crashes for teen drivers.Practical applicationsUnderstanding the role that cell phone use plays in teen driver crashes is extremely important. Knowing how and when teens are engaging in this behavior is the only way effective technologies can be developed for mitigating these crashes.     

Better effect of the use of a needle safety device in combination with an interactive workshop to prevent needle stick injuries

ObjectivesThis study compares the effectiveness of two types of interventions with no intervention on the prevention of needle stick injuries (NSIs).MethodsHealth care workers, who were at risk for NSIs, were eligible for this three-armed cluster randomized controlled trial. In total, 23 hospital wards were randomly assigned to 1 of 2 intervention groups, which were given either a needle safety device and a workshop (NW; 7 wards, n = 267) or a workshop only (W; 8 wards, n = 263), or to a control group (C; 8 wards, n = 266). The primary outcome was the half-year incidence of NSIs, which was measured through questionnaires and official notification at the occupational health service at baseline (T0), 6 months (T1) and 12 months (T2) after baseline. Analysis were done by intention to treat. This study is registered as a prospective randomized trial, number NTR1207.ResultsA statistically significant difference was found between the groups for the half-year incidence of NSIs (p = 0.046) on the basis of questionnaire data with ORs for reported NSIs for the NW group compared with the control group of 0.34 (95% CI: 0.13–0.91) and 0.45 (95% CI: 0.19–1.06) for the W group compared with the control group. The officially registered NSIs during the study period showed no statistical differences between the groups.ConclusionsThe combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention.     

Characterization of fall patients: Does age matter?

IntroductionEvaluating age-specific fall characteristics is important for prevention programs. The aim was to characterize fallers who presented to our trauma center. We hypothesized that fall characteristics and outcomes would vary with age.MethodsData were retrospectively collected from the trauma registry and electronic medical records during January 1st, 2014-December 31st, 2015. Data were analyzed by Chi-square test with Yates’ continuity correction and one-way ANOVA with Bonferroni’s multiple comparisons test.ResultsThere were 1541 fallers, 814 (52.8%) were male. Ages ranged from 11 months to 100 years. The admission rate was high at 86%, with an average hospital stay of 5.7 days. Patients in the 0-18 and 19-45 age groups spent significantly less time in the hospital (p < 0.0001). Elderly patients had the highest average injury severity score (p < 0.0001). However, the youngest patients required surgery more often (p = 0.0004). The overall mortality rate was 3.6% and 52.8% were male. The mortality rate increased with age, from 0% for the 0-18 age group to 6.9% for patients ≥ 65 years of age. Remarkably, fallers in the 19-45 and 46-64 age groups predominantly died from ground level falls even though the average fall height in these groups was the highest (p < 0.0001). More fallers in the 19-45 and 46-64 age groups tested positive for alcohol/drug use (p < 0.0001). Middle-aged and elderly patients were more likely to be discharged to a skilled nursing or rehabilitation facility compared to younger patients who were discharged home.Conclusions and practical applicationsFall characteristics and outcomes varied with age. Data on age-specific characteristics, outcomes, and risk factors of falls will help in developing targeted interventions and may lead to better approaches to treat patients.     

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.