Prioritizing prevention opportunities in the Washington State construction industry, 2003-2007

Objective

This study compares construction industry groups in Washington State by injury severity and cost, and ranks industry groups according to potential for prevention.

Methods

All Washington State workers' compensation compensable claims with date of injury between 2003 and 2007 were classified into North American Industrial Classification System (NAICS) industry groups. Claims were then aggregated by injury type and industry groups were ranked according to a prevention index (PI). The PI is the average of the rank orders of the claim count and the claim incidence rate. A lower PI indicates a higher need for prevention activities. The severity rate was calculated as the number of days of time loss per 10,000 full-time equivalents (FTEs).

Results

For all injury types, construction industry groups occupy 7 of the top 15 PI ranks in Washington State. The severity rate among construction industry groups was twice that for non-construction groups for all injury types. Foundation, structure, and building exterior contractors (NAICS 2381) ranked highest in prevention potential and severity among construction industry groups for most common injury types including falls from elevation, fall on same level, struck by/against, and musculo-skeletal disorders of the neck, back, and upper extremity (WMSDs). Median claim costs by injury type were generally higher among construction industry groups.

Conclusions

The construction industry in Washington State has a high severity rate and potential for prevention. The methods used for characterizing these industry groups can be adapted for comparison within and between other industries and states.

Impact on Industry

These data can be used by industry groups and employers to identify higher cost and higher severity injury types. Knowledge about the relative frequencies and costs associated with different injury types will help employers and construction industry associations make better informed decisions about where prevention efforts are most needed and may have the greatest impact. The results of this study can also be used by industry stakeholders to cooperatively focus on high cost and high severity injuries and explore best practices, interventions, and solutions as demonstrated by efforts to prevent musculoskeletal disorders in masonry (Entzel, Albers, & Welch, 2007). Initiating construction industry groups to focus on high cost and high severity injuries may also help prevent other types of injuries.     

Have government regulations improved workplace safety? : A test of the asynchronous regulatory effects in China's coal industry, 1995-2006

Problem

Empirical studies on the effectiveness of workplace safety regulations are inconclusive. This study hypothesizes that the asynchronous effects of safety regulations occur because regulations need time to become effective. Safety regulations will work initially by reducing the most serious accidents, and later by improving overall safety performance.

Method

The hypothesis is tested by studying a provincial level aggregate panel dataset for China's coal industry using two different models with different sets of dependent variables: a fixed-effects model on mortality rate, which is defined as fatalities per 1,000 employees; and a negative binominal model on the annual number (frequency) of disastrous accidents.

Results

Safety regulations can reduce the frequency of disastrous accidents, but have not reduced mortality rate, which represents overall safety performance.

Discussion and summary

Policy recommendations are made, including shifting production from small to large mines through industrial consolidation, improving the safety performance of large mines, addressing consequences of decentralization, and facilitating the implementation of regulations through carrying on institutional actions and supporting legislation.

Impact on industry

Until recently, about 4,000 coal miners perished annually in China, demonstrating that workplace safety in China's coal industry is an urgent and important issue. This research provides evidence that safety regulations have asynchronous effects and identifies the priorities in improving safety in China's current coal mining. This may assist the Chinese government to design more effective safety improvement policies and improve the effectiveness of safety regulations and safety performance.     

Older driver retraining: An updated systematic review of evidence of effectiveness

Problem and Objective

The number of older drivers who might benefit from driver retraining is growing. A previous review on the effectiveness of older driver retraining included intervention studies up to 2004. The objective was to perform an updated systematic review of the effectiveness of older driver retraining for improving driving-related skills and reducing crash rates.

Method

Articles published from 2004-2008 were grouped according to the intervention provided and outcome studied. Randomized clinical trials (RCTs) were appraised using the Physiotherapy Evidence Database (PEDro) Scale and scored for quality according to their internal validity. Each intervention's effectiveness was then rated and assigned a level of evidence by combining pre- and post- 2004 findings.

Results

Three RCTs and one matched-pairs cohort design met the inclusion criteria. There is strong evidence (Level 1a) that education combined with on-road training improves driving performance and moderate evidence (Level 1b) that it improves knowledge. There is moderate evidence (Level 1b) that physical retraining improves driving performance. There is moderate evidence (Level 1b) that an educational intervention curriculum alone is not effective in reducing crashes.

Summary

The updated evidence on the effectiveness of retraining aimed at older drivers is sufficiently encouraging to merit assertive health promotion actions regarding intervention and program planning.

Impact on Industry

These positive findings warrant a comprehensive plan that has both behavioral and monetary incentives encouraging older driver participation in programs aimed at driver safety.     

Integrated model of simulated occupant injury risk and real medical costs

Introduction

The purpose of this study was to develop an integrated methodology that links occupant injury risk functions, estimated in the laboratory, with real world medical treatment costs by using the abbreviated injury score (AIS). Using our model, the expected medical treatment costs for crash injuries to various body regions and of different severities can be investigated.

Methods

First, the simulation results are compared with NHTSA crash data. We used a modified kinematics simulation model that incorporates an F = E^b function as a supplement to the previous Steffan's model to obtain a more accurate acceleration history a(t). Second, head injury criteria HIC₃₆ can be calculated from a(t), and we use the injury probability P as a function of HIC_36, as proposed by Kuppa, to obtain the injury risk function for various AIS values. Third, medical treatment cost models for various AIS values can be calculated by using a regression cost model with real world data. Finally, the injury risk function and medical treatment cost models are linked through AIS values. We establish an integrated methodology and predict medical costs and car safety data using real world police reports, medical treatment costs, and laboratory simulation results.

Results

Using head injuries in frontal crashes as an example, we focus on simulation parameters for different vehicle models, with and without airbags. We specifically examine impact closing speed, Delta-V, and impact directions.

Conclusion

Simulation results can be used to supplement insufficient real crash data, in particular ΔV, and injury risk results from police crash reports.

Impact on industry

The proposed integrated methodology may provide the vehicle industry with a new safety assessment method. Real crash data coupling provides consumers with more realistic and applicable information.     

Global trend according to estimated number of occupational accidents and fatal work-related diseases at region and country level

Background

Although occupational accidents and work-related diseases have been of interest for a long time, due to lack of proper recording and notification systems the official numbers of occupational accidents and work-related diseases are missing for many countries. Presently, the demand for effectiveness and an interest in the economic aspects of accidents have increased prevention activities at company and country levels.

Methods

Occupational accident data of selected countries and of World Health Organization regional divisions together with the global burden of disease were used in estimating global occupational accidents and fatal work-related diseases. The trend of global occupational accidents and work-related diseases is presented at region and country levels. The years 1998, 2001, and 2003 are compared in the case of occupational accidents and the years 2000 and 2002 in the case of work-related diseases.

Results

The total number of occupational accidents and fatal work-related diseases has increased, but the fatality rates per 100,000 workers have decreased. There were almost 360,000 fatal occupational accidents in 2003 and almost 2 million fatal work-related diseases in 2002. Every day more than 960,000 workers get hurt because of accidents. Each day 5,330 people die because of work-related diseases.

Conclusions

Information on occupational accidents and work-related diseases is needed so that countries may understand better the importance of occupational health and safety at country and company level. Especially companies in developing countries are not familiar with occupational safety and health. Statistical data is essential for accident prevention; it is a starting point for the safety work.     

A note on the effectiveness of the house-arrest alternative for motivating DWI offenders to install ignition interlocks

Introduction

The effectiveness of ignition interlocks at reducing drunk driving has been limited by the ability of driving-while-intoxicated (DWI) offenders to avoid court orders to install the devices.

Methods

In a pilot program in New Mexico, four Santa Fe County judges imposed home confinement (via electronic monitoring bracelets) on offenders who claimed to have no car or no intention to drive. Interlock installation rates for Santa Fe County were compared with all other counties in New Mexico over a 2-year program and 2-year post-program period.

Results

During the two program years, 70% of the drivers convicted of DWI in Santa Fe County installed interlocks, compared to only 17% in the other counties, but when the program was terminated, the Santa Fe installation rate fell by 18.8 percentage points.

Summary

Mandating the alternative sanction of house arrest led to the highest reported interlock installation rate for DWI offenders.

Impact on Industry

Impaired driving is a substantial expense to employers, particularly when it bars driving that interferes with employment. Interlocks provide a method of protecting the public while permitting the offender to drive sober. This study was directed at increasing interlock use by DWI offenders.     

A Strategic Project Appraisal framework for ecologically sustainable urban infrastructure

Actors in the built environment are progressively considering environmental and social issues alongside functional and economic aspects of development projects. Infrastructure projects represent major investment and construction initiatives with attendant environmental, economic and societal impacts across multiple scales. To date, while sustainability strategies and frameworks have focused on wider national aspirations and strategic objectives, they are noticeably weak in addressing micro-level integrated decision making in the built environment, particularly for infrastructure projects. The proposed approach of this paper is based on the principal that early intervention is the most cost-effective and efficient means of mitigating the environmental effects of development projects, particularly macro infrastructure developments. A strategic overview of the various project alternatives, taking account for stakeholder and expert input, could effectively reduce project impacts/risks at low cost to the project developers but provide significant benefit to wider communities, including communities of future stakeholders. This paper is the first exploratory step in developing a more systematic framework for evaluating strategic alternatives for major metropolitan infrastructure projects, based on key sustainability principles. The developed Strategic Project Appraisal (SPA) framework, grounded in the theory of Strategic Environmental Assessment (SEA), provides a means of practically appraising project impacts and alternatives in terms of quantified ecological limits; addresses the neglected topic of metropolitan infrastructure as a means of delivering sustainability outcomes in the urban context and more broadly, seeks to open a debate on the potential for SEA methodology to be more extensively applied to address sustainability challenges in the built environment. Practically applied and timed appropriately, the SPA framework can enable better decision-making and more efficient resource allocation ensuring low impact infrastructure development.     

Estimating the variance in before-after studies

Problem

To simplify the computation of the variance in before-after studies, it is generally assumed that the observed crash data for each entity (or observation) are Poisson distributed. Given the characteristics of this distribution, the observed value (x_i) for each entity is implicitly made equal to its variance. However, the variance should be estimated using the conditional properties of this observed value (defined as a random variable), that is, f(x_i|μ_i), since the mean of the observed value is in fact unknown.

Method

Parametric and non-parametric bootstrap methods were investigated to evaluate the conditional assumption using simulated and observed data.

Results

The results of this study show that observed data should not be used as a substitute for the variance, even if the entities are assumed to be Poisson distributed. Consequently, the estimated variance for the parameters under study in traditional before-after studies is likely to be underestimated.

Conclusions

The proposed methods offer more accurate approaches for estimating the variance in before-after studies.     

The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

The effects of minimum legal drinking age 21 laws on alcohol-related driving in the United States

Objective

To examine trends in alcohol consumption and alcohol-related crashes among people younger than 21 in the United States and to review evidence on the effects of minimum legal drinking age (MLDA) laws.

Methods

Trends in alcohol-related crashes and alcohol consumption among young people were examined, and studies on the effects of lowering and raising the drinking age were reviewed.

Results

MLDA laws underwent many changes during the 20th century in the United States. Since July 1988, the MLDA has been 21 in all 50 states and the District of Columbia. Surveys tracking alcohol consumption among high school students and young adults found that drinking declined since the late 1970 s, and most of the decline occurred by the early 1990 s. These were the years when states were establishing, or reinstating, a MLDA-21. Among fatally injured drivers ages 16-20, the percentage with positive BACs declined from 61% in 1982 to 31% in 1995, a bigger decline than for older age groups; declines occurred among the ages directly affected by raising MLDAs (ages 18-20) and among young teenagers not directly affected (ages 16-17). Almost all studies designed specifically to gauge the effects of drinking age changes show MLDAs of 21 reduce drinking, problematic drinking, drinking and driving, and alcohol-related crashes among young people. Yet many underage people still drink, many drink and drive, and alcohol remains an important risk factor in serious crashes of young drivers, especially as they progress through the teenage years. Stepped-up enforcement of MLDA and drinking and driving laws can reduce underage drinking. Recent efforts to lower MLDAs to 18 and issue licenses to drink upon completion of alcohol education have gained local and national media attention. There is no evidence that alcohol education can even partially replace the effect of MLDA-21.

Conclusions

The cause and effect relationship between MLDAs of 21 and reductions in highway crashes is clear. Initiatives to lower the drinking age to 18 ignore the demonstrated public health benefits of MLDAs of 21.

Impact on Industry

Lowering the drinking age to 18 will increase highway crash deaths among young people.