12-Year longitudinal study linking within-person changes in work and family transitions and workplace injury risk

Introduction: Despite the rich tradition of research on predictors of workplace injury, most studies rely on cross-sectional, between-person designs. Furthermore, prior research has often overlooked the possibility that factors outside the work domain can influence the occurrence of actual injuries at work. To address these limitations, the current study examined the effects of work and family demands on the occurrence of workplace injury. Drawing on the intuition of the work-home resources model (W-HR), we investigated how within-person level changes in demands and resources from both domains influence work injuries over a 12-year period. Method: We used 12 years of longitudinal data (N = 7,820) to study the long-term within-person changes in work and family domains and to capture the event of low frequency incidence such as workplace injury. Specifically, we conducted multilevel analyses to study the links between within-person change in time and energy resources both in work and family domains and within-person change in the likelihood of experiencing a workplace injury. Results and conclusion: The findings showed that within-person changes in work hours, spousal work hours, income and number of children, were significantly associated with changes in the likelihood of experiencing a workplace injury. We conclude with a discussion of implications for theory and future research of workplace injuries. Practical application: The research provided useful insights on the intimate association between work and family domains in the context of safety management.     

Does seeing it make a difference? The self-reported deterrent impact of random breath testing

Introduction: Random Breath Testing (RBT) remains a primary method to both deter and apprehend drink drivers, yet a large proportion of road fatalities continue to be caused by the offense. Outstanding questions remain regarding how much exposure to RBT operations is needed to influence deterrence-based perceptions and subsequent offending. Method: Given this, licensed motorists (N = 961) in Queensland were recruited to complete a questionnaire either in the community (N = 741) or on the side of the road after just being breath tested (N = 243). Survey items measured different types of exposure to RBT operations (e.g., “seen” vs. “being tested”) and subsequent perceptions of apprehension as well as self-reported drink driving behaviors. Results: The key findings that emerged were: motorists were regularly exposed to RBT operations (both viewing and being tested), such exposure was not significantly correlated with perceptions of apprehension certainty, and a sizable proportion reported engaging in drink driving behaviors (e.g., approx. 25%), although roadside participants naturally reported a lower percentage of offending behaviors. Importantly, it was revealed that current “observations” of RBT was sufficient, but not actual levels of active testing (which needed to be doubled). Nevertheless, higher levels of exposure to RBT operations was found to be predictive of a lack of intention to drink and drive again in the future. Conclusions: This paper suggests that mere exposure to enforcement may not create the intended rule compliance, and that the frequency of exposure is also essential for the roadside.     

Required hours of practice for learner drivers: A comparison between two Australian jurisdictions

Problem

This study considers whether requiring learner drivers to complete a set number of hours while on a learner license affects the amount of hours of supervised practice that they undertake. It compares the amount of practice that learners in Queensland and New South Wales report undertaking. At the time the study was conducted, learner drivers in New South Wales were required to complete 50 hours of supervised practice while those from Queensland were not.

Method

Participants were approached outside driver licensing centers after they had just completed their practical driving test to obtain their provisional (intermediate) license. Those agreeing to participate were interviewed over the phone later and asked a range of questions to obtain information including socio-demographic details and amount of supervised practice completed.

Results

There was a significant difference in the amount of practice that learners reported undertaking. Participants from New South Wales reported completing a significantly greater amount of practice (M = 73.3 hours, sd = 29.12 hours) on their learner license than those from Queensland (M = 64.1 hours, sd = 51.05 hours). However, the distribution of hours of practice among the Queensland participants was bimodal in nature. Participants from Queensland reported either completing much less or much more practice than the New South Wales average.

Summary

While it appears that the requirement that learner drivers complete a set number of hours may increase the average amount of hours of practice obtained, it may also serve to discourage drivers from obtaining additional practice, over and above the required hours.

Impact on Industry

The results of this study suggest that the implications of requiring learner drivers to complete a set number of hours of supervised practice are complex. In some cases, policy makers may inadvertently limit the amount of hours learners obtain to the mandated amount rather than encouraging them to obtain as much practice as possible.     

The effect of contextual information on professional judgment: Reliability and biasability of expert workplace safety inspectors

Introduction: A critical aspect of occupational safety is workplace inspections by experts, in which hazards are identified. Scientific research demonstrates that expectation generated by context (i.e., prior knowledge and experience) can bias the judgments of professionals and that individuals are largely unaware when their judgments are affected by bias. Method: The current research tested the reliability and biasability of expert safety inspectors’ judgments. We used a two-study design (Study 1, N = 83; Study 2, N = 70) to explore the potential of contextual, task-irrelevant, information to bias professionals’ judgments. We examined three main issues: (1) the effect that biasing background information (safe and unsafe company history) had on professional regulatory safety inspectors’ judgments of a worksite; (2) the reliability of those judgments amongst safety inspectors and (3) inspectors’ awareness of bias in their judgments and confidence in their performance. Results: Our findings establish that: (i) inspectors’ judgments were biased by historical contextual information, (ii) they were not only biased, but the impact was implicit: they reported being unaware that it affected their judgments, and (iii) independent of our manipulations, inspectors were inconsistent with one another and the variations were not a product of experience. Conclusion: Our results are a replication of findings from a host of other professional domains, where honest, hardworking professionals underappreciate the biasing effect of context on their decision making. The current paper situates these findings within the relevant research on safety inspection, cognitive bias and decision making, as well as provides suggestions for bias mitigation in workplace safety inspection. Practical Application: Our results have implications for occupational health and safety given that inspection is an integral aspect of an effective safety system. In addition to our findings, this study contributes to the literature by providing recommendations regarding how to mitigate the effect of bias in inspection.     

Slips and falls on ice and snow in relation to experience in winter climate and winter sport

The objective of this paper was to investigate whether living experience in winter climate and winter sport helps to prevent slips and falls on ice and snow. A questionnaire survey was conducted among foreigners at Luleå University of Technology of Sweden, where winter season lasts for six months in a year. Seventy respondents replied. The results of ordinal regression showed that the slip frequency according to a 5-point rating scale decreased as the living experience in cold environments increased (B=−0.0113, p=0.019). A logistic regression was applied to model the probability of fall events occurrence based on the experience of living in cold climate. The results showed that the fall events reduced as living experience increased (B=−0.030, p=0.001). Chi-square test showed that fall events in those who took part in winter sport were significantly less than in those who did not participate in winter sport (χ²=10.745, p=0.001). The findings imply that experience of living in cold environments and training in gait balance on ice and snow can have positive effects in preventing slips and falls for inexperienced workers and pedestrians. This study also revealed that the majority of fall events happened on hard ice covered with snow while wearing ordinary winter footwear, indicating the need to improve slip resistance.     

The correlation between gradients of descending roads and accident rates

The traffic accident rate on descending roads on mountainous highways is quite high. To study the effects of vertical gradient and length of road on traffic accidents on continuous descending roads, data from 1413 traffic accidents over an 85.43 km section of road were collected. By taking parameters such as the gradients in accident sites, and taking the average gradient in N km (N = 1, 2, 3, 4, 5) just prior to the accident sites as the profile parameter, scatter diagrams were drawn to explore the effects of the profile parameters on the distribution of traffic accidents. Analysis of the exponential regression and correlation analysis between accident rates and profile parameters was carried out as well. The research results show that the accident rate increases with average vertical gradient exponentially; the differences between accident rate and different profile parameters are significant; the accident rate has a good exponential relationship with average gradients when a section has a 2 km or 3 km slope just prior to the accident sites i.e. the accident rate at a specific section on a continuous descending road is related to the average gradient in 2–3 km descending sections just prior to the accident site. The findings indicate that a steep gradient alone is not the reason for an accident, but we also have to take into consideration the presence of a “continuous long” descent prior to it.     

Weighted expectation: a new risk-based method for assessing land use development proposals in the vicinity of major hazards

BG Technology and the Major Hazard Assessment Unit (MHAU) of the Chemicals and Hazardous Installations Division (CHID) of the HSE have developed a novel approach for the management of the risk of harm to people in the vicinity of major hazards. Particular attention is given to such risk in the vicinity of high-pressure gas pipelines.The objective of the approach is to provide a means of allowing reasonable development of land whilst ensuring that a tolerable level of risk is maintained.One means of managing this type of risk is known as the F/N approach. The F/N approach expresses and manages the risk in terms of the frequency, F, of N or more casualties occurring. However, the F/N approach may lead to a perceived inconsistency as it may allow some initial development of a particular type of dwelling in a particular location, then preclude further development in adjacent locations.The approach derived herein provides some alleviation to this perceived inconsistency by discouraging localised regions of high population density, thereby promoting a more uniform distribution of development of land.The essence of the approach is to apply a weighting (≥1) to casualty density prior to the evaluation of casualty expectation. The resulting parameter, which has been aptly named weighted expectation (WE), is assessed according to a criterion based on true casualty expectation (E). The weighting on casualty density is derived directly from an appropriately constructed F/N criterion line (or envelope), thereby ensuring a close relationship between the outcomes of WE and F/N assessments.The Scaled Risk Integral (SRI), which has been developed previously, is shown to be a special case of WE.The practical application of WE and its relationship with F/N are demonstrated through simple high-pressure pipeline case studies.     

Seasonal variation in fall-related emergency department visits by location of fall – United States, 2015

Introduction: In the United States, fall-related emergency department (ED) visits among older adults (age 65 and older) have increased over the past decade. Studies document seasonal variation in fall injuries in other countries, while research in the United States is inconclusive. The objectives of this study were to examine seasonal variation in older adult fall-related ED visits and explore if seasonal variation differs by the location of the fall (indoors vs. outdoors), age group, and sex of the faller. Methods: Fall-related ED visit data from the National Electronic Injury Surveillance System-All Injury Program were analyzed by season of the ED visit, location of the fall, and demographics for adults aged 65 years and older. Results: Total fall-related ED visits were higher during winter compared with other seasons. This seasonal variation was found only for falls occurring outdoors. Among outdoor falls, the variation was found among males and adults aged 65 to 74 years. The percentages of visits for weather-related outdoor falls were also higher among males and the 65–74 year age group. Conclusions: In 2015, there was a seasonal variation in fall-related ED visits in the United States. Weather-related slips and trips in winter may partially account for the seasonal variation. Practical Implications: These results can inform healthcare providers about the importance of screening all older adults for fall risk and help to identify specific patients at increased risk during winter. They may encourage community-based organizations serving older adults to increase fall prevention messaging during winter.     

An examination of the concordance between self-reported collisions,driver records,and insurance claims in older drivers

Background Previous studies of older drivers have found that there are discrepancies between their retrospective self-reports of collisions and the official jurisdictional record. Objectives The purpose of this study was to examine how older drivers self-report collisions in comparison to what was recorded in their official driver abstract as well as insurance claims, in a prospective study. Methods Participants (n = 125, age ≥ 70 years) in this study were part of the University of Manitoba site of the Candrive longitudinal study of older drivers. During the operation of the Manitoba site (2009 to 2013), participants were periodically asked to report on any collisions (at-fault or not) in which they were involved, while they were enrolled in the study. In addition, driver records (abstracts and insurance claims) from the provincial licensing agency and public insurer (Manitoba Pubic Insurance; MPI) were provided annually. Results In total there were 101 separate instances of collisions (regardless of at-fault status), whether self-reported, or recorded by MPI. There were 20 at-fault collisions that were recorded on the driver abstract. Eighteen of these collisions were self-reported by participants. In total, our participants were involved in 70 insurance claims (42 at-fault) — 61 of these were self-reported to study staff. In addition, there were 31 collisions that were self-reported to study staff, that were not reported to MPI. Conclusions In this prospective study, older drivers were diligent in reporting collisions in which they were involved. While some collisions were not reported that ultimately became a claim or part of their driver abstract, the biggest discrepancy was in the collisions that were reported to study staff but that were not reported to authorities.     

Fall-related injuries for three ages groups – Analysis of Swedish registry data 1999–2013

Introduction: The objective of this study was to analyze which factors (including factors pertaining to the individual, the household, and the local area) increase the risk of fall injuries for the three age groups with the highest risk for fall injuries in Sweden. Method: The study combined longitudinal data covering the period 1999–2013 from several different official registries from Statistics Sweden as well as from the Swedish health care system and fitted the models to data using mixed model regressions. Results: Three age groups had a markedly heightened risk for fall injuries: 1–3-year olds, 12–14 year olds, and the elderly (65+). The home was the most common location for fall injuries, as about 40% of all fall injuries occur in the home. Only for the elderly strong predictors for fall injuries were found, and these were: age, single household, and special housing. Conclusions: There is preventive potential in the special residences for the elderly and disabled. People living in these special residences make up a strongly selected group that needs extra safe environments. Our findings indicate that their needs are currently not meet. Practical applications: Design of special residences for the elderly and disabled should aim at reducing the consequences of falling.     

Changes in fall prevention training for apprentice carpenters based on a comprehensive needs assessment

Problem

Falls from heights in residential construction are common, especially among inexperienced workers.

Methods

We conducted a comprehensive needs assessment to determine gaps in the school-based apprentice carpenters' fall prevention training. A team of carpenter instructors and researchers revised the fall prevention training to fill these gaps. Apprentice evaluation and feedback guided ongoing curricular improvements.

Results

Most apprentice carpenters performed work tasks at heights prior to training and fall protection techniques were not commonly used at residential construction sites. Priorities of the revised school-based training included safe ladder habits, truss setting, scaffold use, guarding floor openings, and using personal fall arrest systems. New apprentices were targeted to ensure training prior to exposure at the workplace. We used adult learning principles to emphasize hands-on experiences. A framed portion of a residential construction site was fabricated to practice fall protection behaviors in a realistic setting. The revised curriculum has been delivered consistently and apprentice feedback has been very favorable.

Conclusions

Integration of needs assessment results was invaluable in revising the school-based carpenters apprentice fall prevention curriculum. Working closely with the instructors to tailor learning experiences has provided preliminary positive results.

Impact on Industry

The fall safety of the residential construction industry continues to lag behind commercial construction and industrial settings. The National Occupational Research Agenda includes a Strategic Goal to strengthen and extend the reach of quality training and education in the construction industry via mechanisms such as construction safety and health training needs assessments. This study demonstrates how a structured process can be used to identify and remedy gaps and improve training effectiveness. We encourage others to take steps to assess and increase the impact of training efforts directed at all residential construction professionals; including both union and non-union workers. The implications are even greater in the non-union sector where most U.S. residential work is done.     

History and current status of state graduated driver licensing (GDL) laws in the United States

Introduction: The objective of this study is to describe changes in teenage driver licensing policies in the United States during the past two decades with the introduction of graduated driver licensing (GDL) programs, assess GDL laws currently in place, and discuss the possibilities and likely consequences of further changes.Methods: The history of laws introducing and amending GDL programs was tracked, based on records maintained by the Insurance Institute for Highway Safety (IIHS). Counts of states included the District of Columbia.Results: A few states had elements of GDL prior to the mid-1990s, and between 1996 and 2006 all other states adopted a learner period of 2 months or more, a minimum supervised practice hours requirement for the learner period, or a night or passenger restriction once initially licensed. All but seven states have upgraded their original laws one or more times. Very few states weakened their laws, usually in minor ways. In 158 instances, minimum learner periods, minimum practice hour requirements, or night or passenger restrictions were added or strengthened. Fifteen states raised the minimum age for a license allowing any unsupervised driving.Conclusion: GDL policies have reduced teenage driver crashes. Most states now have at least minimum requirements for basic GDL features, although there is substantial opportunity for strengthening existing policies. Additional upgrades would result in further crash reductions, but very few have been made in recent years.Practical applications: Guidelines for maximizing the crash reduction potential of GDL programs are available, based on the experience of U.S. states, other countries with GDL programs, and the evaluation literature in regard to GDL components.     

Fall-related emergency department visits involving alcohol among older adults

Problem: Falls are the leading cause of injury deaths among adults aged 65 years and older. Characteristics of these falls may vary with alcohol use. Objective: Describe and compare characteristics of older adult fall-related emergency department (ED) visits with indication of alcohol to visits with no indication. Methods: Using nationally-representative 2015 National Electronic Injury Surveillance System-All Injury Program data, we compared demographic characteristics for fall-related ED visits by indication of alcohol consumption. Alcohol-indicated ED visits were matched on age group, sex, treatment month, and treatment day to ED visits with no alcohol indication using a 1:4 ratio and injury characteristics (i.e., diagnosis, body part injured, disposition) were compared. Results and discussion: Of 38,640 ED records, 906 (1.9%) indicated use of alcohol. Fall-related ED visits among women were less likely to indicate alcohol (1.0%) compared to ED visits among men (3.8%). ED visits indicating alcohol decreased with age from 4.1% for those 65–74 years to 1.5% for those 75–84 and <1% for those 85+. After controlling for age-group, sex, and month and day of treatment, 17.0% of ED visits with no alcohol indication had a traumatic brain injury compared to 34.8% of alcohol-indicated ED visits. Practical applications: Alcohol-indicated fall ED visits resulted in more severe head injury than those that did not indicate alcohol. To determine whether alcohol use should be part of clinical risk assessment for older adult falls, more routinely collected data and detailed information on the amount of alcohol consumed at the time of the fall are needed.     

Parents’ work injuries and children’s mental health: The moderating role of children’s work centrality

Introduction: The purpose of this study is to explore the relationship between parents’ work-related injuries and their children’s mental health, and whether children’s work centrality – the extent to which a child believes work will play an important part in their life – exacerbates or buffers this relationship. Method: We argue that high work centrality can exacerbate the relationship between parental work injuries and children’s mental health, with parental work injuries acting as identity-threatening stressors; in contrast, high work centrality may buffer this relationship, with parental work injuries acting as identity-confirming stressors. We test this relationship with a sample of Canadian children (N = 4,884, 46.2% female, M age = 13.67 years). Results:Children whose parents had experienced more frequent lost-time work-related injuries reported worse mental health with high work centrality buffering this negative relationship. Conclusions: Our study highlights the vicarious effects of work injuries on salient others, specifically parental work injuries on children’s mental health, as well as the role of work centrality in shaping children’s sense-making and expectations about the consequences of work.     

Evaluating 24/7 Sobriety Program participant reoffense risk

Objective: Our study investigated risk factors in survival among a subpopulation of drivers in North Dakota’s 24/7 Sobriety Program. Participants mandated for a second driving-under-the-influence of alcohol (DUI) arrest were studied for a three-year interval that commenced with the start date for a 360-day enrollment. Method: A Stratified Cox regression model was developed to compute the hazard ratios for survival. A subsequent DUI-related offense as event of interest. Relation to the explanatory variable array that could be construed from administrative records were investigated. Results: Older drivers were 6.31 times more likely to reoffend than the younger driver cohort of 18–35-years. The survival curve slope showed the fastest decline in the 361-day to 730-day interval. Neither gender nor residence region was a significant predictor in DUI reoffense over the three-year monitoring interval. Preliminary work suggests reoffense was more likely if an individual had program history prior to this court mandated 360-day term in the 24/7 Sobriety Program for a second DUI. The program experience finding was unexpected but could not be studied in greater detail due to data and resource limitations. Conclusions: Administrative records access created a novel opportunity to explore an evolving impaired driving prevention strategy that has shown early promise. Individual driver survival in and after the 24/7 Sobriety Program was studied for three-years. Findings show age, post-program time interval, and possibly program history as areas to explore to improve survival rates. Driver DUI offense were most common shortly after program completion. Although limited to a single state, findings increase knowledge for refining strategies designed to impact driver subpopulations at higher risk for reoffense.     

Fall-related traumatic brain injury in children ages 0–4 years

Introduction: Falls are the leading cause of traumatic brain injury (TBI) for children in the 0–4 year age group. There is limited literature pertaining to fall-related TBIs in children age 4 and under and the circumstances surrounding these TBIs. This study provides a national estimate and describes actions and products associated with fall-related TBI in this age group. Method: Data analyzed were from the 2001–2013 National Electronic Injury Surveillance System–All Injury Program (NEISS–AIP), a nationally representative sample of emergency departments (ED). Case narratives were coded for actions associated with the fall, and product codes were abstracted to determine fall location and product type. All estimates were weighted. Results: An estimated 139,001 children younger than 5 years were treated annually in EDs for nonfatal, unintentional fall-related TBI injuries (total = 1,807,019 during 2001–2013). Overall, child actions (e.g., running) accounted for the greatest proportion of injuries and actions by others (e.g., carrying) was highest for children younger than 1 year. The majority of falls occurred in the home, and involved surfaces, fixtures, furniture, and baby products. Conclusions: Fall-related TBI in young children represents a significant public health burden. The majority of children seen for TBI assessment in EDs were released to home. Prevention efforts that target parent supervision practices and the home environment are indicated. Practical applications: Professionals in contact with parents of young children can remind them to establish a safe home and be attentive to the environment when carrying young children to prevent falls.     

Child pedestrian behaviors: Influence of peer social norms and correspondence between self-reports and crossing behaviors

Objective: The aims of this study were to determine if children's perception of peers' behavioral norms for crossing streets relates to their personal norms for doing so and if children's self-reports about crossing relates to their actual crossing in a virtual traffic situation. Method: Children (8–10 years, N = 86) completed questionnaires about peer's norms and their personal norms about crossing streets, and also reported on their recent crossing behaviors. These self-reports about crossing were then related to children's actual crossing behaviors measured using a fully immersive virtual reality (VR) system. Results: Children's perception of peers' behavioral norms for crossing related to their personal norms for doing so, and their norms related to their reports of how they have crossed in the past few weeks. When crossing virtual streets, children with higher scores on self-reports about risky crossing behaviors selected smaller (riskier) inter-vehicle gap sizes to cross into, showed less start delay (less time appraising traffic before starting), and experienced more hits. Conclusion and practical applications: Children's perception of peers' behavioral norms for crossing are relevant to their crossing behaviors and may be one way that peers elevate children's risk of pedestrian injury. Children's self-reports about crossing risk may be useful for identifying at-risk youth and strategically targeting interventions to these children.     

A cost–benefit analysis of three older adult fall prevention interventions

IntroductionOne out of three persons aged 65 and older falls annually and 20% to 30% of falls result in injury. The purpose of this cost–benefit analysis was to identify community-based fall interventions that were feasible, effective, and provided a positive return on investment (ROI).MethodsA third-party payer perspective was used to determine the costs and benefits of three effective fall interventions. Intervention effectiveness was based on randomized controlled trial results. National data were used to estimate the average annual benefits from averting the direct medical costs of a fall. The net benefit and ROI were estimated for each of the interventions.ResultsFor the Otago Exercise Program delivered to persons aged 65 and older, the net benefit was $121.85 per participant and the ROI was 36% for each dollar invested. For Otago delivered to persons aged 80 and older, the net benefit was $429.18 and the ROI was 127%. Tai chi: Moving for Better Balance had a net benefit of $529.86 and an ROI of 509% and Stepping On had a net benefit of $134.37 and an ROI of 64%.ConclusionsAll three fall interventions provided positive net benefits. The ROIs showed that the benefits not only covered the implementation costs but also exceeded the expected direct program delivery costs. These results can help health care funders and other community organizations select appropriate and effective fall interventions that also can provide positive returns on investment.     

Modeling crash severity by considering risk indicators of driver and roadway: A Bayesian network approach

Introduction: Traffic crashes could result in severe outcomes such as injuries and deaths. Thus, understanding factors associated with crash severity is of practical importance. Few studies have deeply examined how prior violation and crash experience of drivers and roadways are associated with crash severity. Method: In this study, a set of risk indicators of road users and roadways were developed based on their prior violation and crash records (e.g., cumulative crash frequency of a roadway), in order to reflect certain aspect or degree of their driving risk. To explore the impacts of those indicators on crash severity and complex interactions among all contributing factors, a Bayesian network approach was developed, based on citywide crash data collected in Kunshan, China from 2016 to 2018. A variable selection procedure based on Information Value (IV) was developed to identify significant variables, and the Bayesian network was employed to explicitly explore statistical associations between crash severity and significant variables. Results: In terms of balanced accuracy and AUCs, the proposed approach performed reasonably well. Bayesian modeling results indicated that the prior crash/violation experiences of road users and roadways were very important risk indicators. For example, migrant workers tend to have high injury risk due to their dangerous violation behaviors, such as retrograding, red-light running, and right-of-way violation. Furthermore, results showed that certain variable combinations had enhanced impacts on severity outcome than single variables. For example, when a migrant worker and a non-motorized vehicle are involved in a crash happening on a local road with high cumulative violation frequency in the previous year, the probability for drivers suffering serious injury or fatality is much higher than that caused by any single factor. Practical applications: The proposed methodology and modeling results provide insights for developing effective countermeasures to reduce crash severity and improve traffic system safety performance.