Agricultural accidents in north eastern region of India

An investigation was conducted to characterize the agricultural accidents, their magnitude, causes, severity and economic consequences in one of the states of north eastern region of India, Arunachal Pradesh. The accident data for 6 years between years 2000 and 2005 were collected by conducting a survey and personal interview of the victims in 42 selected villages of 4 districts. Agricultural accident incident rate was 6.39 per 1000 workers/year. All the accidents were non-fatal. Farm implement-related accidents accounted for 40% of the accidents. Slashing of shrubs accounted for one-third of the accidents causing cut and hit injuries of moderate severity. Twenty-five per cent of the accidents occurred on the way to or from the field leading to severe or serious injuries. Two-third of the accidents occurred within 4 h of start of work. Thirty-three per cent of the victims were 40–49 years of age. Based on the analysis, both passive and active measures have been suggested to minimize or prevent the occurrence of agricultural accidents.     

Youth on racial minority operated U.S. farms, 2008: Demographics and injuries

IntroductionTo obtain injury surveillance data for youth on racial minority operated farms, the National Institute for Occupational Safety and Health developed the Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS) in collaboration with the U.S. Department of Agriculture.MethodsUsing a regionally stratified telephone survey of U.S. minority operated farm households, M-CAIS data were collected for youth less than 20 years of age.ResultsThere were an estimated 37,443 youth living on racial minority operated U.S. farms in 2008, almost half (46%) of these youth worked on the farm. Racial minority farm operators hired 6,443 youth, and reported an estimated 775,991 youth relative and other visitors on the farm. These youth suffered an estimated 516 injuries (5.9 injuries/1000 farms).ConclusionsHousehold youth had an injury rate of 7.8 injuries/1000 household youth and a work-related injury rate of 6.9 injuries/1000 working household youth.Practical applicationsThe research enables agricultural safety and health researchers, practitioners, and educators to identify priorities and design trainings and interventions to minimize the risk of farm hazards to youth on racial minority farm operations in the United States.     

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.     

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.     

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.     

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.     

Economic cost of occupational accidents: Evidence from a small island economy

Though a number of occupational accidents have occurred amongst the working population in Mauritius, no study has been carried out to measure the costs associated with such accidents to the best of our knowledge. This study bridges this gap by measuring the economic costs of occupational accidents by using both quantitative and qualitative approaches. The results show that occupational accidents result in costs amounting to nearly Rs. 168 mn of which a major part is accounted for, by loss in productivity. Alongside the highest rate of accidents took place within small enterprises and younger workers are the one taking higher risks mainly due to lack of knowledge and risk awareness. The findings also reveal that only 4% employers believe that investment in safety and health is important for maintaining good business partly because most of the costs are borne by the state. Such a situation therefore requires the need for awareness on practical health and safety systems and procedures among both employees and employers with a view to prevent accident and injuries.     

When bathing leads to drowning in older adults

Introduction: Bathing is the most problematic activity of daily living for aging adults, and the ability to perform it is influenced by physical capabilities that decrease with age. Drowning is an under-documented event related to bathing for older adults. This study investigates the circumstances of these tragedies, to prevent them. Methods: Census of 2005–2014 bathtub drownings in the province of Quebec (Canada) involving victims aged 65 +. Coroner's reports were analyzed using a grid based on factors previously associated with bath-related drownings in literature, iteratively modified. Results: Among the 92 bathtub drowning victims inventoried, 42% were aged 65 +. The average age of older victims is 79 (65–97, ± 9 years). Main probable cause of drowning is a cardiac problem, although only 19% of victims had a medical history of heart disease. Most victims were alone in their apartment or residence when drowning occurred. Risky periods appear to be springtime, Sundays, and evenings. Despite expectations, relevant information about the physical environment is very scarce. Conclusions: At least 39 Quebecers, aged 65 +, drowned in their bathtubs over a 10-year period. More older adults than children are victims of bathtub drownings in community-dwellings. It seems that bathing may induce heart distress, leading to an appreciable number of drownings. Practical implications: Since cardiac health problems are present in these deplorable events, promoting access to safety devices in the environment (emergency button, grab bars) and modified personal hygiene habits (bathing chair, showering) might be potential ways to prevent drowning and improve safety in older adults while they perform their personal hygiene, an essential activity for health and human dignity.     

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.     

The impact of the 2007 graduated driver licensing law in Massachusetts on the rate of citations and licensing in teenage drivers

ObjectiveWe recently demonstrated that the 2007 Massachusetts Graduated Driving Licensing (GDL) law decreased the rate of motor vehicle crashes in teenage drivers. To better understand this decrease, we sought to examine the law's impact on the issuance of driving licenses and traffic citations to teenage drivers.MethodsCitation and license data were obtained from the Massachusetts Department of Transportation. Census data were obtained from the Census Data Center. Two study periods were defined: pre-GDL (2002–2006) and post-GDL (2007–2012). Two populations were defined: the study population (aged 16–17) and the control population (aged 25–29). The rates of licenses per population were compared pre- vs. post-GDL for the study group. The numbers of total, state, and local citations per population were compared pre- vs. post-GDL for both populations. A sensitivity analysis was performed for the rates of citations using licenses issued as a denominator.ResultsWhile licenses per population obtained by the study group decreased over the entire period, there was no change in the rate of decrease per year pre- vs. post-GDL (2.0% vs. 1.4%; p = 0.6392). In the study population, total, state, and local citations decreased post-GDL (17.8% vs. 8.1%, p < 0.0001; 3.7% vs. 2.2%, p < 0.0001; 14.1% vs. 5.8%, p < 0.0001, respectively). In the control group, total and state citations did not change (26.7% vs. 23.9%, p = 0.3606; 9.2% vs. 10.2%, p = 0.3404, respectively), and local citations decreased (17.5% vs. 13.7%, p = 0.0389). The rates of decrease per year for total, state, and local citations were significantly greater in the study population compared with control (p < 0.0001, p = 0.0002, p < 0.0001, respectively).ConclusionsThe 2007 GDL law in Massachusetts was associated with fewer traffic citations without a change in the rate of licenses issued to teenagers. These findings suggest that 2007 GDL may be improving driving habits as opposed to motivating teenagers to delay the issuing of licenses.     

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.     

Risk factors associated with sick leave due to work-related injuries in Dutch farmers: an exploratory case-control study

Using data from an insurance company, the occurrence of sick leave among Dutch farmers due to work-related injuries, and the epidemiological risk factors were investigated. In this case-control study the cases had filed a sick leave claim for work-related injury from 1998–2001 and the controls had not filed any claim in this period. Most (74%) of all injuries were work-related. The most frequent types of injury (63%) were bruises, sprains/strains and fractures. Multivariable logistic regression analysis showed that farmers working in dairy farming (OR=2.6) or pig husbandry (OR=2.7), older farmers (OR=1.48 per 10 years) and smokers (OR=1.7) were at increased risk. Within dairy farming, a significant factor was contact with cows (OR=1.7 per 500 h); within pig husbandry, working > 60 h per week was a significant factor (OR=2.2). The population attributable risk was 24% for elimination of smoking, 23% for halving the number of hours' contact with cows in dairy farming and 18% for elimination of a working duration > 60 h per week in pig husbandry. Effective measures to prevent sick leave might be raising awareness that older farmers and smokers are at increased risk, and a focus on the risks of working with animals.     

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.     

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.     

Preventing fatal winch entanglements in the US southern shrimp fleet: A research to practice approach

IntroductionDuring 2000–2011, 35 injuries (8 fatal) involving winches were reported to the Coast Guard in the Southern shrimp fleet. Injuries involving the main winch drums had a higher risk for fatal outcomes compared to injuries involving the winch cathead (RR = 7.5; 1.1–53.7). The objective of this study was to design effective solutions to protect deckhands from entanglement hazards posed by winches found on the vessels in the Southern shrimp fleet.MethodsBased on injury characteristics, site visit observations, and input from vessel owners, NIOSH determined that the design and implementation of effective main-winch guarding was a feasible first-step in mitigating the entanglement hazard. Design considerations for stationary guards favor systems that are simple, affordable, durable, unobtrusive, and will not interfere with normal fishing operations. In addition, an auxiliary-stop method was tested to prevent entanglements in try-net winches.ResultsStandardized passive guards were designed for three commonly found main winch models. Initial prototype guards have been sea-tested. The design of six additional guards is underway, for a total of three iterations for each winch model identified. These will incorporate features found to be valued by fishermen, will be more efficient, and will reduce the overall cost of fabrication and maintenance. Sea testing of these iterations continues. The auxiliary-stop circuit control prototype system was designed to prevent entanglements in the try-net winch and is currently being sea tested.DiscussionNIOSH has completed initial designs for stationary-winch guards. Through collaborations with shrimper associations and safety groups, the successfully tested winch guard and auxiliary stop designs will be made available to qualified welders and craftsmen to use. This approach has proven effective in preventing other types of winch injuries.Practical applicationsInjury epidemiologic methods and industry input are an effective way to identify workplace hazards and to design effective safety interventions to control hazards.     

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.     

Substance exposure and helmet use in all-terrain vehicle accidents: Nine years of experience at a level 1 trauma center

IntroductionThe surging popularity of all-terrain vehicles (ATV) in the United States has caused an “epidemic of injuries and mortality.” The U.S. Consumer Product Safety Commission reported 99,600 injuries and 426 fatalities from ATV accidents in 2013. The aim of this study was to examine the relationship between helmet use and positive toxicology screenings on outcomes in ATV accident victims.MethodsThis is a retrospective study of patients admitted to a Level 1 Trauma Center in southwestern West Virginia following an ATV accident between 2005 and 2013. Data were obtained from the institution's Trauma Registry.ResultsA total of 1,857 patients were admitted during the study period with 39 (1.9%) reported deaths. Positive serum alcohol and/or urine drug screens were obtained in 66.4% of the patients tested (n = 1,293). Those with positive screenings were 9.5% less likely to utilize a helmet (13.2% vs. 22.7%, p < 0.001); and the lack of helmet use was associated with an increase in traumatic brain injury (57.1% vs. 41.7%, p < 0.001). Positivity for substances or the lack of helmet use was significantly associated with higher morbidity. Lack of helmet use resulted in a 3.94-fold increase in the risk of discharge in a vegetative state or death.ConclusionsDrugs and alcohol use may predispose riders to be less likely to wear helmets and significantly increase the risk of a poor clinical outcome following an ATV accident. Rigorous efforts should be made to enhance safety measures through educational endeavors and amendment of current regulations to promote safe and responsible use of ATVs.Practical applicationsModification of regulatory requirements should be considered in order to mandate the wearing of helmets during ATV operation. In addition, expansion of safety programs should be considered in an effort to improve availability, affordability and awareness of safe ATV practices.     

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.