The role of design issues in work-related fatal injury in Australia

PROBLEM: This study aimed to provide an assessment of the contribution of design to the occurrence of fatal work-related injuries in Australia. METHODS: The Australian National Coroners' Information System was the data source for fatal injuries. Deaths resulting from workplace injuries on or between 1 July 2000 and 30 June 2002 were included. RESULTS: Seventy seven (37%) of the 210 identified workplace fatalities definitely or probably had design-related issues involved. In another 29 (14%), the circumstances were suggestive that design issues were involved. The most common scenarios involved problems with rollover protective structures and/or associated seat belts; inadequate guarding; lack of residual current devices; inadequate fall protection; failed hydraulic lifting systems in vehicles and mobile equipment; and inadequate protection mechanisms on mobile plant and vehicles. SUMMARY: Design is a significant contributor to work-related fatal injury in Australia. There is considerable scope for preventing serious work-related injury through improving design of plant, equipment, and vehicles used for work-related purposes.     

Aerial lift fall injuries: a surveillance and evaluation approach for targeting prevention activities

PROBLEM: Work on aerial lift platforms exposes workers to fall hazards. The objective of this study was to identify the most common injury scenarios and determine current research gaps for addressing fall incidents associated with aerial lifts. METHODS: Three databases were searched: Census of Fatal Occupational Injuries (CFOI), NIOSH Fatality Assessment and Control Evaluation (FACE) reports, and OSHA Incident Investigation Records. RESULTS: The majority of falls/collapses/tipovers were within the height-category of 10-29 feet. Tipovers comprised 44-46% of boom-lift falls and 56-59% of scissor-lift falls. Constructing and repairing activities were most commonly associated with fall/collapse/tipover incidents. DISCUSSION: CFOI and OSHA/FACE show convergent data, suggesting similar scenarios for aerial lift tipovers. IMPACT ON INDUSTRY: The analysis provides the aerial lift industry information to prioritize their efforts on aerial lift design.     

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.     

Blasting injuries in surface mining with emphasis on flyrock and blast area security

PROBLEM: Blasting is a hazardous component of surface mining. Serious injuries and fatalities result from improper judgment or practice during rock blasting. This paper describes several fatal injury case studies, analyzes causative factors, and emphasizes preventive measures. METHOD: This study examines publications by MSHA, USGS, and other authors. The primary source of information was MSHA's injury-related publications. RESULTS: During the 21-year period from 1978 to 1998, the mean yearly explosive-related injuries (fatal and nonfatal) for surface coal mines was 8.86 (95% CI: 6.38-11.33), and for surface metal/nonmetal mines 10.76 (95% CI: 8.39-13.14). Flyrock and lack of blast area security accounted for 68.2% of these injuries. This paper reviews several case studies of fatal injuries. Case studies indicate that the causative factors for fatal injuries are primarily personal and task-related and to some extent environmental. A reduction in the annual injuries in surface coal mines was observed during the 10-year period of 1989-1998 [5.80 (95% CI: 2.71-8.89) compared to the previous 10-year period of 1979-1988 [10.90 (95% CI: 7.77-14.14)]. However, such reduction was not noticed in the metal/nonmetal sector (i.e., 9.30 [95% CI: 6.84-11.76] for the period 1989-1998 compared with 11.00 [95% CI: 7.11-14.89] for the period 1979-1988). DISCUSSION: A multifaceted injury prevention approach consisting of behavioral/educational, administrative/regulatory, and engineering interventions merits consideration. IMPACT ON INDUSTRY: The mining community, especially the blasters, will find useful information on causative factors and preventive measures to mitigate injuries due to flyrock and lack of blast area security in surface blasting. Discussion of case studies during safety meetings will help to mitigate fatal injuries and derive important payoffs in terms of lower risks and costs of injuries.     

Occupational accidents while walking on stairways

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

CDC's research portfolio in older adult fall prevention: a review of progress, 1985-2005, and future research directions

PROBLEM: Falls are a leading cause of mortality and morbidity among adults age 65 and older. Population models predict steep increases in the 65 and older population bands in the next 10-15 years and in turn, public health is bracing for increased fall rates and the strain they place on health care systems and society. To assess progress in fall prevention, the Centers for Disease Control and Prevention conducted a research portfolio review to examine the quality, relevance, outcomes and successes of the CDC fall prevention program and its impact on public health. METHODS: A peer review panel was charged with reviewing 20 years of funded research and conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis for extramural and intramural research activities. Information was collected from grantees (via a survey instrument), staff were interviewed, and progress reports and products were reviewed and analyzed. RESULTS: CDC has invested over $24,900,000 in fall-related research and programs over 20 years. The portfolio has had positive impacts on research, policies and programs, increasing the public health injury prevention workforce, and delivering effective fall prevention programs. DISCUSSION: Public health agencies, practitioners, and policy makers recognize that while there are some evidence-based older adult fall prevention interventions available, many remain unused or are infeasible to implement. Specific recommendations across the public health model, include: additional research in gathering robust epidemiologic data on trends and patterns of fall-related injuries at all levels; researching risk factors by setting or sub-population; developing and testing innovative interventions; and engaging in translation and dissemination research on best practices to increase uptake and adoption of fall prevention strategies. CDC has responded to a number of suggestions from the portfolio review including: funding translation research of a proven Tai Chi fall intervention; beginning to address gaps in gender, ethnic, and racial differences in falls; and collaborating with partner organizations who share in CDC's mission to improve public health by preventing falls and reducing fall-related injuries. IMPACT ON INDUSTRY: Industry has an opportunity to develop more accessible and usable devices to reduce injury from falls (for example, hip protectors and force reducing flooring). By implementing effective, evidence-based interventions to prevent falls and reduce injuries from falls, significant decreases in health care costs can be expected.     

Factors associated with motorcycle traffic crash fatalities among active duty U.S. Army personnel

Objective: Research on factors associated with motorcycle fatalities among active duty U.S. Army personnel is limited. This analysis describes motorcycle crash–related injuries from 1995 through 2014 and assesses the effect of alcohol use and helmet use on the risk of fatal injury among active duty U.S. Army motorcycle operators involved in a traffic crash, controlling for other factors shown to be potentially associated with fatality in this population.

Methods: Demographics, crash information, and injury data were obtained from safety reports maintained in the Army Safety Management Information System. Traffic crashes were defined as crashes occurring on a paved public or private roadway or parking area, including those on a U.S. Army installation. Analysis was limited to motorcycle operators. Odds ratios (ORs) and 95% confidence intervals (95% CIs) from a multivariable analysis estimated the effect of alcohol use and helmet use on the risk of a fatal injury given a crash occurred, controlling for operator and crash characteristics.

Results: Of the 2,852 motorcycle traffic crashes, most involved men (97%), operators aged 20–29 years of age (60%), and operators who wore helmets (95%) and did not use alcohol (92%). Two thirds of reported crashes resulted in injuries requiring a lost workday; 17% resulted in fatality. Controlling for operator and crash characteristics, motorcycle traffic crashes involving operators who had used alcohol had a 3.1 times higher odds of fatality than those who did not use alcohol (OR =3.14; 95% CI, 2.17–4.53). Operators who did not wear a helmet had 1.9 times higher odds of fatality than those who did wear a helmet (OR =1.89; 95% CI, 1.24–2.89).

Conclusions: Among U.S. Army motorcycle operators, alcohol use and not wearing a helmet increased the odds of fatality, given that a crash occurred, and additional modifiable risk factors were identified. Results will help inform U.S. Army motorcycle policies and training.     

A multinomial logit model of motorcycle crash severity at Australian intersections

Introduction: Motorcyclists are exposed to more fatalities and severe injuries per mile of travel as compared to other vehicle drivers. Moreover, crashes that take place at intersections are more likely to result in serious or fatal injuries as compared to those that occur at non-intersections. Therefore, the purpose of this study is to evaluate the contributing factors to motorcycle crash severity at intersections. Method: A data set of 7,714 motorcycle crashes at intersections in the State of Victoria, Australia was analyzed over the period of 2006–2018. The multinomial logit model was used for evaluating the motorcycle crashes. The severity of motorcycle crashes was divided into three categories: minor injury, serious injury and fatal injury. The risk factors consisted of four major categories: motorcyclist characteristics, environmental characteristics, intersection characteristics and crash characteristics. Results: The results of the model demonstrated that certain factors increased the probability of fatal injuries. These factors were: motorcyclists aged over 59 years, weekend crashes, midnight/early morning crashes, morning rush hours crashes, multiple vehicles involved in the crash, t-intersections, crashes in towns, crashes in rural areas, stop or give-way intersections, roundabouts, and uncontrolled intersections. By contrast, factors such as female motorcyclists, snowy or stormy or foggy weather, rainy weather, evening rush hours crashes, and unpaved roads reduced the probability of fatal injuries. Practical Applications: The results from our study demonstrated that certain treatment measures for t-intersections may reduce the probability of fatal injuries. An effective way for improving the safety of stop or give-way intersections and uncontrolled intersections could be to convert them to all-way stop controls. Further, it is recommended to educate the older riders that with ageing, there are physiological changes that occur within the body which can increase both crash likelihood and injury severity.     

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.     

The Costs and Characteristics of Occupational Injuries Admitted to a Trauma Unit

Abstract

Occupational injuries requiring admission to a trauma unit were examined to outline the events surrounding the injury and to examine the costs. Sixty-nine patients were admitted over a 12-month period, representing 4.30% of all work-related injuries attending the emergency department and 4.25% of all admissions to the trauma unit. Most were male (91%), working in skilled trade occupations (65%), with a mean age of 38.8 years. Personal protective equipment was used only by 46% of injured workers who should have been using it. Sixty-one percent of patients believed that their injury was preventable. Half of the injuries were to the upper limb, fall was the most frequent mechanism (25%) and the median duration of admission was 2 days. The direct hospital costs were estimated at over 300 000 GBP. Failure to use protective equipment and to follow health and safety guidelines suggests that opportunities exist for injury prevention.     

Aging without injury in the United States requires action today

Introduction: In 2017, unintentional injuries were the seventh leading cause of death among older adults (age ≥ 65), resulting in over 55,000 deaths. Falls accounted for more than half of these deaths. Given that older adults are the fastest growing age group in the United States, we can anticipate that injuries will become an even greater health concern in the near future. Methods: Aging without injury is possible. There are evidence-based strategies that can reduce falls. However, older adults may not realize that falls can be prevented or they may be afraid to admit their fear of falling or difficulty with walking as these issues may signal their inability to live independently. Results: In this commentary, we will highlight what the Centers for Disease Control and Prevention is doing to prevent older adult falls. We also highlight the importance of broadening older adults' awareness about falls to successfully empower them to begin contemplating and preparing to adopt fall prevention strategies that can help them age in place. Conclusions: Older adult falls are common and can result in severe injury and death but they can be prevented. Broadening older adults' awareness about falls can empower them to take the actions necessary to reduce their fall risk. Practical applications: Increasing awareness about falls can help older adults, healthcare providers, and local and state health departments take steps to reduce fall risk.     

Self-reported falls and fall-related injuries among persons aged>or=65 years--United States, 2006

PROBLEM: In 2005, 15,802 persons aged>or=65 years died from fall injuries. How many older adults seek outpatient treatment for minor or moderate fall injuries is unknown. METHOD: To estimate the percentage of older adults who fell during the preceding three months, the Centers for Disease Control and Prevention (CDC) analyzed data from two questions about falls included in the 2006 Behavioral Risk Factor Surveillance System (BRFSS) survey. RESULTS: Approximately 5.8 million (15.9%) persons aged>or=65 years reported falling at least once during the preceding three months, and 1.8 million (31.3%) of those who fell sustained an injury that resulted in a doctor visit or restricted activity for at least one day. DISCUSSION: This report presents the first national estimates of the number and proportion of persons reporting fall-related injuries associated with either doctor visits or restricted activity. SUMMARY: The prevalence of falls reinforces the need for broader use of scientifically proven fall-prevention interventions. IMPACT ON INDUSTRY: Falls and fall-related injuries represent an enormous burden to individuals, society, and to our health care system. Because the U.S. population is aging, this problem will increase unless we take preventive action by broadly implementing evidence-based fall prevention programs. Such programs could appreciably decrease the incidence and health care costs of fall injuries, as well as greatly improve the quality of life for older adults.     

Deaths in construction related to personnel lifts, 1992-1999

Problem: This study examined deaths of construction workers due to personnel lifts (boom-supported and scissor lifts, suspended scaffolds, and crane platforms). Methods: Deaths of construction workers for 1992–1999 were examined using data from the Census of Fatal Occupational Injuries, a Bureau of Labor Statistics database. Results: The study identified 339 deaths: 42% from boom-supported lifts; 26% from suspended scaffolds; 19% from scissor lifts; 5% from crane platforms; and 7% from unapproved lifts (e.g., forklift platforms). The main causes of death were falls (36%), collapses/tipovers (29%), and electrocutions (21%). Discussion: Recommendations include: following OSHA regulations, wearing personal fall protection equipment, adequate maintenance, inspection before use, and training on the model of lift used. Precautions are also needed to prevent contact with overhead power lines. Impact on industry: The increasing popularity of boom-supported lifts and scissor lifts, both in construction and other industries, make their safety an important issue.     

Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies

IntroductionDespite inherit dangers of horseback riding (HBR), research on HBR-related injuries is sparse. This study used both quantitative and qualitative methods to (1) examine HBR-related injuries treated in emergency departments (EDs) and associated risk factors and (2) explore HBR-related injury experiences and recommendations for prevention strategies from the perspective of riders. Method: We retrospectively analyzed data from the Nationwide Emergency Department Sample (NEDS), identifying HBR-related ED visits between 2010 and 2014. Additionally, we conducted 10 phone interviews with active horseback riders to understand their experiences and perspectives regarding HBR-related injuries and recommendations for prevention measures. Results: A total of 21,899 ED visits for HBR-related injuries were identified. When weighted, these represented 100,964 ED visits in the United States. Females had a consistently higher proportion of ED visits compared to males across the study period, with the proportion of ED visits being highest in females aged 15–19. Most injuries (85.9%) were treated and released from the ED. Three primary themes were identified as key to the prevention of HBR-related injuries: (1) rider safety (e.g., use of protective equipment), (2) external factors (e.g., awareness of environment), and (3) rider and horse interactions (e.g., matching skill level of the rider to the horse). Conclusions: Results indicate that HBR-related injuries treated in EDs are prevalent, with female riders aged 15–19 years having the highest proportion of injuries treated in EDs. Practical Applications: There is a critical need for injury prevention programs that not only promote the use of protective equipment, but that also educate horseback riders on horse behavior, the proper handling of horses, and safe riding practices.     

Time of day effects on railroad roadway worker injury risk

IntroductionThe purpose of this study is to examine how time of day affects injury risk of railroad maintenance of way employees and signalmen (roadway workers). Railroads reported 15,654 serious roadway worker injuries between 1997 and 2014. Roadway workers primarily work outdoors on or near railroad tracks and frequently encounter hazardous conditions. To avoid closing an active rail line during peak hours, railroads sometimes require roadway workers to work at night. Previous studies of roadway worker injury have not adequately accounted for exposure to time of day effects, nor have they investigated the human factors issues contributing to roadway worker injury.MethodThe Federal Railroad Administration (FRA) database of injury reports provided data for circadian rhythm models of the odds of fatal and nonfatal injuries. The FRA database and fatal injury investigation reports also permitted an analysis of the circumstances and the human factors issues associated with injuries that occur at different times of day.ResultsOdds of injury increased during nighttime work. The odds of nonfatal injury for both roadway worker crafts rose above 9:1 in the early morning hours. The relative odds of a fatal injury also increased significantly at night. A human factors analysis suggested that during all three shifts most nonfatal injuries involve workload, but workload was not identified as a factor in fatal injuries.ConclusionsNighttime work is more hazardous for roadway workers than daytime work. Several factors related to fatigue and other conditions appear to increase the risk of injury during the outdoor, nighttime work required of roadway workers.Practical applicationFor practical reasons, nighttime roadway work is sometimes unavoidable. Therefore, new practices for nighttime work must be developed to adequately address fatigue and protect roadway workers from harm.     

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

Introduction

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

Method

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

Results

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

Impact on industry

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

Assessing gait changes in firefighters due to fatigue and protective clothing

Each year, roughly 11,000 firefighters are injured as a result of slips, trips and falls, which account for over 25% of all fireground injuries. Wearing personal protective equipment (PPE) can increase risk of fall-related injuries due to its weight, restrictiveness, and increased heat stress. Modification of PPE may serve to mitigate firefighter injuries related to loss of balance and falls. We examined the effects of choosing ‘enhanced’ protective clothing (lightweight, breathable, and less restrictive compared to typical firefighting PPE) and simulated firefighting tasks (18-min bout over four activities) on subsequent gait performance. To assess the effect of wearing protective clothing and firefighting activity, seven gait parameters and three movement errors were assessed during level and obstacle-crossing walking tasks. Forty-four firefighters wore one of two types of PPE (‘Standard’, ‘Enhanced’) during three testing conditions (baseline in station uniform, pre-firefighting activity in PPE, and post-firefighting activity in PPE). The effect of donning any PPE was found to significantly impair gait performance. Fatigue may impact effective mobility since more movement errors were observed during post-activity than pre-activity assessments. Although the Enhanced PPE did not lead to any significant differences in gait parameters compared to Standard PPE, participants in Enhanced PPE made twice as many movement errors, potentially attributed to lack of familiarity with the gear. These results suggest that wearing firefighting PPE and heat-stress induced fatigue are associated with reduced gait performance and increased risk for tripping over obstacles.