Prevalence of work-site injuries and relationship between obesity and injury among U.S. workers: NHIS 2004–2012

Introduction: Studies have reported associations between obesity and injury in a single occupation or industry. Our study estimated the prevalence of work-site injuries and investigated the association between obesity and work-site injury in a nationally representative sample of U.S. workers. Methods: Self-reported weight, height, and injuries within the previous three months were collected annually for U.S. workers in the National Health Interview Survey (NHIS) from 2004–2012. Participants were categorized as normal weight (BMI: 18.5–24.9 kg/m²), overweight (BMI: 25.0–29.9), obese I (BMI: 30.0–34.9), and obese II (BMI: 35 +). The prevalence of injury and prevalence ratios from fitted logistic regression models was used to assess relationships between obesity and injury after adjusting for covariates. Sampling weights were incorporated using SUDAAN software. Results: During the 9-year study period from 2004 to 2012, 1120 workers (78 workers per 10,000) experienced a work-related injury during the previous three months. The anatomical sites with the highest prevalence of injury were the back (14.3/10,000 ± 1.2), fingers (11.5 ± 1.3), and knees (7.1 ± 0.8). The most common types of injuries were sprains/strains/twists (41.5% of all injuries), cuts (20.0%), and fractures (11.8%). Compared to normal weight workers, overweight and obese workers were more likely to experience work-site injuries [overweight: PR = 1.25 (95% CI = 1.04–1.52); obese I: 1.41 (1.14–1.74); obese II: 1.68 (1.32–2.14)]. These injuries were more likely to affect the lower extremities [overweight: PR = 1.48, (95% CI = 1.03–2.13); obese I: 1.70 (1.13–2.55); obese II: 2.91 (1.91–4.41)] and were more likely to be due to sprains/strains/twists [overweight: PR = 1.73 (95% CI = 1.29–2.31); obese I: PR = 2.24 (1.64–3.06); obese II: PR = 2.95 (2.04–4.26)]. Conclusions: Among NHIS participants, overweight and obese workers were 25% to 68% more likely to experience injuries than normal weight workers. Practical applications: Weight reduction policies and management programs may be effectively targeted towards overweight and obese groups to prevent or reduce work-site injuries.     

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.     

Improving the safety effect of speed camera programs through innovations: Evidence from the French experience

Problem: This study investigates the effect of the French Automated Speed Enforcement Program (ASEP) on casualties involving different types of road users. Method: Interrupted time-series analyses were conducted to estimate the effect of the ASEP. Results: Overall, the ASEP was associated with a decrease of 19.7% in traffic fatalities and crashes with injuries. Significant diminutions were observed for passenger vehicles/light SUVs (− 25.4%), motorcyclists (− 39.0%), and trucks (− 15.7%). Adding red light cameras and devices taking pictures of both ends of the vehicle produced, in some cases, additional gains among specific categories of road users. Conclusion: Traffic fatalities, crashes with injuries and the severity of crashes significantly declined following the introduction of the ASEP in November 2003. Practical applications: ASEPs are an effective strategy to prevent traffic casualties. Innovations such as red light cameras and devices taking pictures of both ends of the vehicle can improve an ASEP.     

Safety effects of automated section speed control on the Italian motorway network

Introduction: Automated Section Speed Control (ASSC) has been identified as an effective countermeasure to reduce speeds and improve speed limit compliance. Method: An Empirical Bayes (EB) before-and-after study was performed in this research in order to evaluate the impact of the ASSC system on the expected crash frequency. The study was carried out on a sample of 125 ASSC sites of the Italian motorway network covering 1252 km, where a total of 21,721 crashes were recorded during a 10-year analysis period from 2004 to 2013. Results: Overall, the EB analysis estimated a significant 22% reduction in the expected crash frequency due to the implementation of the ASSC system. The analysis indicated that the effect is slightly larger on property damage only (PDO) crashes (− 23%) than on fatal injury (FI) crashes (− 18%) and that the highest reductions in crash frequency are expected for multi-vehicle FI crashes (− 25%) and multi-vehicle PDO crashes (− 31%). Furthermore, the results indicated that the ASSC system is more effective in reducing crash rates when traffic volume increases and it is therefore strongly recommended as a countermeasure to improve safety on high-traffic-volume motorway sections.     

Epidemiology of occupational accidents among Iranian insured workers

Work-related accidents are considered as a major health problem worldwide. The aim of present study was to determine the epidemiological pattern of occupational accidents among workers insured by the Iranian Social Security Organization (ISSO) between 2001 and 2005.Subjects consisted of all workers and drivers who had a work-related accident during 2001–2005 and were registered in the Iranian Social Security Organization (ISSO) database according to the inspection reports. An ordinal logistic regression model (proportional odds regression model) was used to assess the concurrent effects of independent variables on accident outcomes.Overall, 86,437 work-related accidents were investigated. The accidents were more frequent in metal workplaces and electrical industries, respectively. More than half of the accidents were due to incautious activities. Workers’ age (age at the time of accident) (OR = 0.99, CI: 0.989–0.994), gender (OR = 1.3, CI: 1.191–1.683), marital status (OR = 1.25, CI: 1.143–1.675) as well as accident setting (OR = 1.88, CI: 1.728–1.975) had significant effect on accident outcomes. Pattern of occupational injuries in Iran was consistent with the global pattern for accident outcomes.     

Fatigue and on-duty injury among police officers: The BCOPS study

IntroductionPolicing involves inherent physical and psychological dangers as well as occupational stressors that could lead to chronic fatigue. Although accounts of adverse events associated with police fatigue are not scarce, literature on the association between chronic fatigue and on-duty injury are limited. Methods: Participants were officers from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. A 10-item questionnaire was administered to assess how tired or energetic the officers generally felt irrespective of sleep hours or workload. The questionnaire consisted of five positively worded and five negatively phrased items that measured feelings of vigor/energy and tiredness, respectively. Total as well as separate scores for positive and negative items were computed by summing scores of individual items. Payroll records documenting each officer's work history were used to assess occurrence of injury. Poisson regression was used to estimate prevalence ratios (PR) of injury. Results: Nearly 40% of officers reported feeling drained. Overall prevalence of on-duty injury during the past year was 23.9%. Injury prevalence showed a significant increasing trend across tertiles of total fatigue score: 19.6, 21.7, and 30.8% for lowest, middle and highest tertiles, respectively (trend p-value = 0.037). After controlling for potential confounders, a 5-unit increase in total fatigue score was associated with a 12% increase in prevalence of injury which was marginally significant (p = 0.075). A 5-unit increase in fatigue score of the positively worded items was associated with a 33% increase in prevalence of injury (PR = 1.33, 95% CI: 1.04–1.70, p = 0.022). Conclusion: Officers who do not feel active, full of vigor, alert, or lively had a significantly higher prevalence of non-fatal work place injury compared to their counter parts. Practical applications: With additional prospective evidence, workplace interventions designed to enhance level of energy may reduce feelings of tiredness and hence may prevent workplace injury.     

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.     

Agricultural injuries in Etawah district of Uttar Pradesh in India

Increased use of farm machinery along with other agricultural inputs has enhanced the production and productivity of Indian farms. Simultaneously, it has also increased occupational health hazards on the farms. Major occupational health hazards are farm related injuries. Very little information is available about the type and nature of agricultural injuries on Indian farms. In the present study, agriculture injuries data were collected for the period 1996–2000 for the Etawah district of Uttar Pradesh in India. It has a total population of 1.4 million while 0.75 million were associated with agricultural activities. The agricultural injuries incidence rate was 0.8 per thousand workers per year in the study area. Out of all agricultural injuries, 9% injuries were fatal. The highest number of injury victims were in the age group of 30–44 years. The highest percentages of injured victims were literate but non-matric. The monetary loss due to agricultural injuries in the study area was estimated to be about US $730,000 per year. To minimize agricultural injuries, development of interventions and trainings needs to be organized at block levels for proper and safe operation of agricultural equipment.     

Validation of the principles of injury risk zones for motorcycle protective clothing

IntroductionThe distributions of motorcycle crash impacts and injuries were compared to the four impact risk zones and protective performance specified in the European Standard for motorcycle clothing (EN 13595).MethodsCrashed motorcyclists' (n = 117) injuries and clothing damage were categorized by body area into the four risk zones. Three levels of protection were defined: protective clothing with impact protection, protective clothing only and non-protective clothing.ResultsThe distribution of impact/injury sites corresponded to the predictions of EN 13595, with the proportion of all injuries decreasing from 43.9% in Zone 1, to 18.0%, 16.7%, and 11.5% in Zones 2 to 4, respectively. Protective clothing modified the distribution of injuries with substantially more injuries (OR = 2.69, 95% CL: 20.1–3.59) at unprotected impact sites.Practical applicationThese findings support an appropriate framework for determining performance specifications for the manufacture of motorcycle clothing that will effectively reduce the risk of injury in crashes.     

Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older,United States, 2006–2011

IntroductionWith the aging of the United States population, unintentional injuries among older adults, and especially falls-related injuries, are an increasing public health concern.MethodsWe analyzed emergency department (ED) data from the Nationwide Emergency Department Sample, 2006–2011. We examined unintentional injury trends by 5-year age groups, sex, mechanism, body region, discharge disposition, and primary payer. For 2011, we estimated the medical costs of unintentional injury and the distribution of primary payers, plus rates by injury mechanisms and body regions injured by 5-year age groups.ResultsFrom 2006 to 2011, the age-adjusted annual rate of unintentional injury-related ED visits among persons aged ≥ 65 years increased significantly from 7987 to 8163, per 100,000 population. In 2011, 65% of injuries were due to falls. Rates for fall-related injury ED visits increased with age and the highest rate was among those aged ≥ 100. Each year, about 85% of unintentional injury-related ED visits in this population were expected to be paid by Medicare. In 2011, the estimated lifetime medical cost of unintentional injury-related ED visits among those aged ≥ 65 years was $40 billion.ConclusionIncreasing rates of ED-treated unintentional injuries, driven mainly by falls among older adults, will challenge our health care system and increase the economic burden on our society. Prevention efforts to reduce falls and resulting injuries among adults aged ≥ 65 years have the potential to increase well-being and reduce health care spending, especially the costs covered by Medicare.Practical applicationsWith the aging of the U.S. population, unintentional injuries, and especially fall-related injuries, will present a growing challenge to our health care system as well as an increasing economic burden. To counteract this trend, we must implement effective public health strategies, such as increasing knowledge about fall risk factors and broadly disseminating evidence-based injury and fall prevention programs in both clinical and community settings.     

Hospitalizations for immersion-related injuries in Alaska 1991–2000

ObjectiveThis study analyzed factors associated with injuries to hospitalized victims of nonfatal immersion-related events in Alaska from 1991 through 2000.DataAlaska Trauma Registry (ATR) records of victims of nonfatal immersion events requiring hospitalization were examined to identify factors associated with injury outcomes. Subjects were divided into two groups: the “immersion only” (IO) group had no additional injuries associated with their immersion-related events, while subjects in the “associated injury” (AI) group incurred additional trauma during injury events.ResultsThere were 176 ATR records of nonfatal immersion events. In 87 (49.5%) cases, hospitalizations were due to the effects of immersion only (IO group). In 89 (50.5%) cases, hospitalizations were due not only to the effects of immersion, but also due to additional injuries occurring immediately before or while immersion took place (AI group). The final logistic regression model revealed statistically significant relationships between age greater than 12 years, female gender, white ethnicity, and operation of water transport vehicles, and increased risk for associated injury outcomes (p < 0.05).DiscussionThis study is the first of its kind to analyze factors associated with the most severe nonfatal immersion-related injuries in Alaska, and identifies target populations for future safety campaigns.     

Educational status and organizational safety climate: Does educational attainment influence workers’ perceptions of workplace safety?

From a practical perspective, understanding the impact of education on perceptions of workplace safety would benefit management’s decisions regarding workers’ adaptability, general work effectiveness, accident frequency, implementation of safety management policies, and handling of education-related accident characteristics. The current study thus examined the relationship between educational attainment and (i) safety perception, (ii) job satisfaction, (iii) compliance with safety management policies, and (iv) accident frequency. Participants were Ghanaian industrial workers (N = 320) categorized into four educational groups based on their responses: basic education 50% (n = 159); secondary education, n = 98 (30%); vocational/professional education, 17% (n = 56); and university education, 3% (n = 7). Workplace safety perception was assessed with Hayes et al.’s 50-item Work Safety Scale (WSS): a scale that effectively captures the dimensions identified by safety experts to influence perceptions of workplace safety. Multivariate analysis (MANOVA) was used to test for differences of statistical significance. Posterior comparison with t-test consistently revealed significant differences between the two higher-educated cohorts and their lower-educated counterparts. The results indicated a positive association between education and safety perception. Higher-educated workers recorded the best perceptions on safety, indicated the highest level of job satisfaction, were the most compliant with safety procedures and recorded the lowest accident involvement rate.     

The development of an intervention to improve the safety of community care nurses while driving and a qualitative investigation of its preliminary effects

This paper details the development of, and perceived role and effectiveness of an innovative intervention designed to ultimately improve the safety of a group of community care (CC) nurses while driving. Recruiting participants from an Australian CC nursing car fleet, qualitative responses from a series of open-ended questions were obtained from drivers (n = 36), supervisors (n = 22), and managers (n = 6). The findings supported the effectiveness of the intervention in reducing self-reported speeding and promoting greater insight into one’s behaviour on the road. This research has important practical implications in that it highlights the value of developing an intervention based on a sound theoretical framework and which is aligned with the needs and beliefs of personnel within a particular organisation.     

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

ProblemRoadway incidents are the leading cause of work-related death in the United States.MethodsThe objective of this research was to evaluate whether two types of feedback from a commercially available in-vehicle monitoring system (IVMS) would reduce the incidence of risky driving behaviors in drivers from two companies. IVMS were installed in 315 vehicles representing the industries of local truck transportation and oil and gas support operations, and data were collected over an approximate two-year period in intervention and control groups. In one period, intervention group drivers were given feedback from in-cab warning lights from an IVMS that indicated occurrence of harsh vehicle maneuvers. In another period, intervention group drivers viewed video recordings of their risky driving behaviors with supervisors, and were coached by supervisors on safe driving practices.ResultsRisky driving behaviors declined significantly more during the period with coaching plus instant feedback with lights in comparison to the period with lights-only feedback (ORadj = 0.61 95% CI 0.43–0.86; Holm-adjusted p = 0.035) and the control group (ORadj = 0.52 95% CI 0.33–0.82; Holm-adjusted p = 0.032). Lights-only feedback was not found to be significantly different than the control group's decline from baseline (ORadj = 0.86 95% CI 0.51–1.43; Holm-adjusted p > 0.05).ConclusionsThe largest decline in the rate of risky driving behaviors occurred when feedback included both supervisory coaching and lights.Practical applicationsSupervisory coaching is an effective form of feedback to improve driving habits in the workplace. The potential advantages and limitations of this IVMS-based intervention program are discussed.     

Do fixed-term workers have a higher injury rate?

One of the most remarkable changes in the labour markets of industrialised countries has been the increase of fixed-term employment. Naturally, the ways in which this development impacts on the quality of working life has awoken increasing scientific discussion. The aim of this paper is to examine these connections from the perspective of occupational injury. The majority of research literature in this field has shown that fixed-term workers have a risk of occupational injury that is several times higher than permanent workers.The analysis presented here is based on three large independent statistical data sets. In the Work and Health Study 10.9% of fixed-term and 10.0% of permanent workers experienced occupational injury during the previous 12 months. In The Victim Survey of Finland 5.4% of fixed-term and 6.5% of permanent workers were injured at work. In The Quality of Working Life Survey 3% of fixed-term and 5% of permanent workers were involved in occupational injury. These three data sets showed unanimously that fixed-term workers did not have a higher occupational injury rate than permanent workers. The most important explanatory factor was that in Finland fixed-term contracts are concentrated in public services such as education and health care with a predominance of female workers. Still, the connection remained after adjusting the basic background variables of age, socio-economic status and industry.     

A study of pedestrian and bicyclist exposure to head injury in passenger car collisions based on accident data and simulations

The objective was to assess head injury risks and kinematics of adult pedestrians and bicyclists in primary impact to the passenger cars and secondary impact to the ground using real world accident data and computer reconstructions of the accidents. For this purpose, a subsample of 402 pedestrians and 940 bicyclists from the GIDAS database, Germany, was used for the statistical analysis, from which 22 pedestrian and 18 bicyclist accidents were further selected for reconstruction. PC-Crash was used to calculate impact conditions, such as vehicle impact velocity, vehicle kinematic sequence, and thrown distance. These conditions were employed to identify the initial conditions in reconstruction in MADYMO program. A comparable analysis was conducted based on the results from accident analysis and computer reconstructions for the impact configurations and the resulting injury patterns of pedestrians and bicyclists in view of head injury risks. Differences in HIC, head-relative impact velocity, linear acceleration, maximum angular velocity and acceleration, contact force, thrown distance, Wrap Around Distance (WAD), and head contact time were evaluated. Injury risk curves were generated by using a logistic regression model for vehicle impact velocity. The results indicate that bicyclists suffered less severe injuries compared with severity of pedestrian injuries. In the selected samples, the AIS 2+ and AIS 3+ head injury risks for pedestrians are 50% probability at impact speed of 38.87 km/h and 54.39 km/h respectively, while for bicyclists at 53.66 km/h and 58.89 km/h respectively. The findings of high injury risks suggested that in the area with high frequency car-pedestrian accidents, the vehicle speed limit should be 40 km/h, while in the area with high frequency car-cyclist accidents the vehicle speed limit should be 50 km/h.     

The self-defensive attribution hypothesis in the work environment: Co-workers’ perspectives

The study explored the possible influences of situational, personal and non-relevant perception on causality attributions and responsibility assignment in Ghana’s work environment. Ghanaian industrial workers (co-workers) who were witnesses to industrial accidents (n = 117) assigned causality for the mishap and their responses were compared. Analyses were based on the co-workers’ responses to open-ended questions. Three categories of co-workers were identified and labelled as situationally relevant (n = 34), personally relevant (n = 43) and non-relevant co-workers (n = 40). The results showed that co-workers (witnesses) who had some perception of situational and or personal relevance with the accident victims attributed less responsibility to the accident victims than did their counterparts who had no perception of relevance. This observation, like other motivated attributional distortions, seems to reflect a tendency towards self-protection from the three categories of co-workers. It confirms the self-defensive attribution hypothesis in causal attributions about accidents in the work environment.     

Work-safety tension, perceived risk, and worker injuries: a meso-mediational model

IntroductionWork-safety tension arises when workers perceive that working safely is at odds with effectively doing their jobs. We proposed that workers’ perceptions of work-safety tension would be associated with higher levels of perceived risk, which would, in turn, relate to worker injuries on the job.MethodGrocery store workers (n = 600) completed an online survey and organizational worker injury reports were obtained for a two-year period following the survey. Survey results were linked to subsequent worker injuries using hierarchical generalized linear modeling.ResultsWe found support for the proposed meso-mediation model: department work-safety tension predicted subsequent worker injuries, partially through an association with workers’ risk perceptions.ConclusionsSafety researchers and consultants and organizational leaders should look beyond typically-examined safety climate constructs, such as management commitment to safety, and pay particular attention to workers’ perceptions of work-safety tension.