Job level risk assessment using task level strain index scores: a pilot study.

This paper explores 2 methods of modifying the Strain Index (SI) to assess the ergonomic risk of multi-task jobs. Twenty-eight automotive jobs (15 cases and 13 controls) were studied. The first method is based on the maximum task SI score, and the second method is modeled on the NIOSH Composite Lifting Index (CLI) algorithm, named cumulative assessment of risk to the distal upper extremity (CARD). Significant odds ratios of 11 (CI 1.7-69) and 24 (CI 2.4-240) were obtained using the modified maximum task and CARD, respectively. This indicates that modification of the SI may be useful in determining the risk of distal upper extremity injury associated with a multi-task job.     

Dental Workers,Musculoskeletal CumulativeTrauma,and Carpal Tunnel Syndrome: Who is at Risk? A Pilot Study

A pilot study was conducted at a dental clinic to identify (a) the prevalence of musculoskeletal cumulative trauma disorders (MCTD), (b) associated symptoms (with special attention paid to carpal tunnel syndrome [CTS]), and (c) practitioners at risk. Videotapes, two questionnaires, a medical record review, and interviews were used. Forty-five dental workers participated and were classified into three categories: (a) dentists, (b) dental assistants and special assistants (DA/SA), and (c) dental hygienists and dental assistant-expanded function (DH/DAEF). Categorical data were analyzed using the chi- square statistic and risk ratios. The Fisher exact probability test was used for categorical data with a small cell. One or more symptoms associated with CTS were noted by 75.6% of the dental workers, 11% reported diagnosed CTS, and 53% reported back and shoulder pain. Both psychosocial factors and job demands appear to be associated with MCTD. All three categories of dental workers reported MCTD symptoms, and the DH/DAEF group was found to be at greatest risk for developing upper extremity symptoms, CTS, and back pain.     

The influence of a real job on upper limb performance in motor skill tests: which abilities are transferred?

To investigate whether the specificities of real jobs create distinctions in the performance of workers in different motor tests for the upper limbs, 24 participants were divided into two groups according to their specific job: fine and repetitive tasks and general tasks. Both groups reproduced tasks related to aiming movements, handling and strength of the upper limbs. There were no significant differences between groups in the dexterity and performance of aiming movements. However, the general tasks group had higher grip strength than the repetitive tasks group, demonstrating differences according to job specificity. The results suggest that a particular motor skill in a specific job cannot improve performance in other tasks with the same motor requirements. The transfer of the fine and gross motor skills from previous experience in a job-specific task is the basis for allocating training and guidance to workers.     

Risk of injury to restrained children from passenger air bags

The objectives of this study were to estimate the prevalence of children's exposure to passenger air bag (PAB) deployments and to determine the relative risk of both minor and more serious nonfatal injuries to restrained children exposed to PABs in frontal impact collisions. Data were collected from 1 December 1998 to 30 November 2001 from a large-scale, child-specific crash surveillance system based on insurance claims, a telephone survey, and on-site crash investigations. Vehicles qualifying for inclusion were State Farm-insured, model year 1990 or newer, and involved in a crash with at least one child occupant < or =15 years of age. Qualifying crashes were limited to those that occurred in 15 states and the District of Columbia. A stratified cluster sample was designed in order to select vehicles (the unit of sampling) for the conduction of a telephone survey with the driver. For cases in which child occupants were seriously injured or killed, in-depth crash investigations were performed. The prevalence of exposure to PABs was calculated as the number of children occupying the right front seat in a PAB deployment crash among all children occupying the right front seat in vehicles equipped with PABs. Complete interview data were obtained on 9,779 vehicles involving 15,341 children. Among PAB-exposed children, 175 (14%) suffered serious injuries versus 41 (7.5%) of those in the comparison group (OR 2.0; 95% CI, 1.1-3.7). The overall risk of any injury (both minor and serious) was 86% among children exposed to PABs, compared to 55% among the comparison group (OR 5.3; 95% CI, 2.1-13.4). Exposure to PABs increased the risk of both minor injuries, including facial and chest abrasions, and more serious injuries, particularly upper extremity fractures.     

Estimated Injury Risk for Specific Injuries and Body Regions in Frontal Motor Vehicle Crashes

Objective: Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data.

Methods: Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15–105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate.

Results: Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4–4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4.6–9.9% risk). The 6 body region curves with the highest risks were for AIS 2+ lower extremity, upper extremity, thorax, and head injury and AIS 3+ lower extremity and thorax injury (15.9–43.8% risk).

Conclusions: These injury risk curves can be implemented into advanced automatic crash notification (AACN) algorithms that utilize vehicle EDR measurements to predict occupant injury immediately following a MVC. Through integration with AACN, these injury risk curves can provide emergency medical services (EMS) and other patient care providers with information on suspected occupant injuries to improve injury detection and patient triage.     

A detailed analysis of musculoskeletal disorder risk factors among Japanese nurses

INTRODUCTION: Although Musculoskeletal Disorders (MSD) represent a common occupational problem, few epidemiological studies have investigated MSD risk factors among Asian nurses, particularly those in Japan. METHOD: We administered a modified Japanese-language version of the Standardized Nordic Questionnaire to 1,162 nurses from a large teaching hospital. MSD categories focused on the neck, shoulder, upper back, and lower back regions. RESULTS: A total of 844 completed questionnaires were analyzed (response rate: 72.6%). The 12-month period-prevalence of MSD at any body site was 85.5%. MSD was most commonly reported at the shoulder (71.9%), followed by the lower back (71.3%), neck (54.7%), and upper back (33.9%). Alcohol consumption, tobacco smoking, and having children were shown to be significant risk factors, with adjusted Odds Ratios of 1.87 (95%CI: 1.17-2.96), 2.45 (95%CI: 1.43-4.35), and 2.53 (95%CI: 1.32-4.91), respectively. Workplace risk factors included manually handling patients (OR: 2.07 to 11.97) and undertaking physically laborious work (OR: 2.09 to 2.76). Nurses reporting pre-menstrual tension were 1.66 and 1.94 times more likely to suffer from lower back and upper back MSD, respectively. High mental pressure was also identified as a significant risk factor for MSD of the neck (OR: 1.53) and shoulder (OR: 2.07). IMPACT ON INDUSTRY: The complex nature of MSD risk factors identified during this study suggests that remediation strategies which focus only on manual handling tasks would probably be suboptimal in reducing MSD among nurses. Therefore, to help alleviate their considerable MSD burden, a greater emphasis will need to be placed on job satisfaction, work organization, and occupational stress, as well as the more traditional hazard reduction strategies such as manual handling, work tasks, and other occupational factors.     

Pooled analysis of two Swedish case-control studies on the use of mobile and cordless telephones and the risk of brain tumours diagnosed during 1997-2003.

Here we present the pooled analysis of 2 case-control studies on the association of brain tumours with mobile phone use. Use of analogue cellular phones increased the risk for acoustic neuroma by 5%, 95% confidence interval (CI) = 2-9% per 100 hrs of use. The risk increased for astrocytoma grade III-IV with latency period with highest estimates using >10-year time period from first use of these phone types. The risk increased per one year of use of analogue phones by 10%, 95% CI = 6-14%, digital phones by 11%, 95% CI = 6-16%, and cordless phones by 8%, 95% CI = 5-12%. For all studied phone types OR for brain tumours, mainly acoustic neuroma and malignant brain tumours, increased with latency period, especially for astrocytoma grade III-IV.     

Pooled Analysis of Two Swedish Case-Control Studies on the Use of Mobile and Cordless Telephones and the Risk of Brain Tumours Diagnosed During 1997–2003

Here we present the pooled analysis of 2 case–control studies on the association of brain tumours with mobile phone use. Use of analogue cellular phones increased the risk for acoustic neuroma by 5%, 95% confidence interval (CI) = 2-9% per 100 hrs of use. The risk increased for astrocytoma grade III—IV with latency period with highest estimates using >10-year time period from first use of these phone types. The risk increased per one year of use of analogue phones by 10%, 95% CI = 6-14%, digital phones by 11%, 95% CI = 6-16%, and cordless phones by 8%, 95% CI = 5-12%. For all studied phone types OR for brain tumours, mainly acoustic neuroma and malignant brain tumours, increased with latency period, especially for astrocytoma grade III—IV.     

Relationships between certain individual characteristics and occupational accidents

Background. Work accidents and injuries are an occupational health and safety problem. Methods. This cross-sectional study was conducted for 404 frontline workers who were randomly selected from the Arya Sasol Petrochemical Company in Bushehr, Iran, during 2016. A statistical analysis was performed using the χ² test and the logistic regression model with SPSS version 18. Results. The overall occupational accident rate among the participants was found to be 9.2%. Statistically significant differences were observed for body mass index, education, job experience, smoking habit, consumption of sedative pills and presence of sleep disorders. Three factors had significant adjusted odds ratios (ORs): body mass index (OR 2.41, 95% confidence interval [CI] [1.16, 5.04]), education (OR 0.25, 95% CI [0.07, 0.85]) and job experience (OR 0.29, 95% CI [0.15, 0.57]). Conclusions. Preventive programs should be implemented for industrial workers, especially young workers, workers who smoke, overweight workers and workers with psychosomatic disease.     

危险装置操作人员职业适应性研究的策略和方法

重大危险装置操作人员所涉及的是危险性高、责任重大的工种。这些工种也对从业人员在生心素质上提出了较为严格的要求。以“重大危险装置操作人员”为研究对象，面向一个工种群的职业适应性研究展开了探讨，提出了作业性质类别的概念和“抽取类别、交叉对应”的技术路线，概括了人在生理、心理方面与职业活动有关的二十七项指标，论述了重大危险装置操作人员所涉及的工种与职业适应性指标之间的关系。     

Driver mortality in frontal crashes: comparison of newer and older airbag designs

In 1997, the National Highway Traffic Safety Administration amended its requirements for frontal crash performance under Federal Motor Vehicle Safety Standard 208 to temporarily allow 30 mi/h (48 km/h) sled tests with unbelted dummies as an alternative to 30 mi/h head-on rigid-barrier vehicle tests. This change permitted automakers to reduce airbag inflation forces so that they would be less likely to injure occupants who are close to airbags when they first deploy. Most vehicle models were sled-certified starting in model year 1998. Airbag-related deaths have decreased since 1997; however, controversy persists about whether reduced inflation forces might be decreasing protection for some occupants in high-severity frontal crashes. To examine the effects of the regulatory changes, this study computed rate ratios (RR) and 95% confidence intervals (95% CI) for passenger vehicle driver deaths per vehicle registration during 2000-2002 at principal impact points of 12 o'clock for 1998-99 model year vehicles relative to 1997 models. Passenger vehicles included in the study had both driver and passenger front airbags, had the same essential designs during the 1997-1999 model years, and had been sled-certified for drivers throughout model years 1998 and 1999. An adjustment was made for the higher annual mileage of newer vehicles. Findings were that the effect of the regulatory change varied by vehicle type. For cars, sport utility vehicles, and minivans combined, there was an 11 percent decrease in fatality risk in frontal crashes after changing to sled certification (RR = 0.89; 95% CI = 0.82-0.96). Among pickups, however, estimated frontal fatality risk increased 35 percent (RR = 1.35; 95% CI = 1.12-1.62). For a broad range of frontal crashes (11, 12, and 1 o'clock combined), the results indicated a modest net benefit of the regulatory change across all vehicle types and driver characteristics. However, the contrary finding for pickups needs to be researched further.     

Work-related musculoskeletal disorders among workers in an MDF furniture factory in eastern Thailand

The purpose of this study was to analyze the factors contributing to musculoskeletal disorders (MSDs) among 439 workers in an MDF furniture factory using questionnaires and the risk assessment form of the Ergonomic Assessment Tool for Arthritis technique to assess aspects of the workstations and working postures of jobs. With regard to factors that affected MSDs, it was found that workers older than 50 years were having knee symptoms: their adjusted odds ratio (aOR) was 18.49, 95% confidence interval (CI) [1.51, 226.40]. Those who had been working for 1–2 years were having neck pain symptoms: aOR 12.01, 95% CI [1.82, 79.43]. The recommendation of this study is that health monitoring should be provided for workers who have pain in various parts of their bodies, especially those who have been working for 6–10 years, and those who are over 50 years old with knee pain.     

Risk factors in urban road traffic accidents

INTRODUCTION: The urban road traffic accident (RTA) risks for the city of Zagreb, Croatia, from 1999 through 2000 were analyzed with the aim of reducing the increasing injury incidence. METHOD: Simple and bivariate analysis using chi(2), odds ratio, and confidence interval of 95% was used to determine risks in three outcome groups: killed, severely, and mildly injured. RESULTS: There were 528 RTA victims consisting of 260 severely, 213 mildly injured, and 55 killed at the scene of an accident and during transportation. More fatal accidents occurred during night hours (OR=3.78; 95% CI, 2.08-6.85), on urban road links (OR=2.33; 95% CI, 1.30-4.19), and at exceeding speed limit (OR=2.56; 95% CI, 1.43-4.61). More people were injured than killed on urban junctions (OR=5.27; 95% CI, 2.21-12.57). The highest combined risk of dying or being severely injured was found in males, driving at excessive speed, on urban links, and during bad visibility (OR=16.15; 95% CI, 3.901-66.881). CONCLUSION: These results will influence the urban traffic police enforcement measures, which will change inappropriate behavior of drivers and protect the least experienced road users.     

Motor vehicle restraint system use and risk of spine injury

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.     

Harmful postures and musculoskeletal symptoms among sanitation workers of a fish processing factory in ghana: a preliminary investigation.

This study investigated musculoskeletal symptoms among sanitation workers of a fish-processing factory. The methods used included administration of a questionnaire, walk through observation, interview, task analysis and future workshop. All 27 male participants answered and submitted their questionnaires. Of the 11 operations identified, all except one was considered safe. Bent back, bent legs, and heavy manual handling were observed to impose intolerable health risk on participants. This corresponds with questionnaire results in which musculoskeletal symptoms were mostly prevalent in the neck, the shoulder, the low back, the wrists/hands and the upper back regions. Poor psychosocial complaints were also made on the job. There was no significant correlation (p < .05) between musculoskeletal symptoms and age, working hours and length of service. Neither was any significant correlation observed (p < .05) between psychosocial work factors and musculoskeletal symptoms. Recommendations such as task redesign to eliminate high-risk elements in operations, workplace changes and worker training were suggested.     

Parent driver characteristics associated with sub-optimal restraint of child passengers

OBJECTIVES: To identify parent driver demographic and socioeconomic characteristics associated with the use of sub-optimal restraints for child passengers under nine years. METHODS: Cross-sectional study using in-depth, validated telephone interviews with parent drivers in a probability sample of 3,818 vehicle crashes involving 5,146 children. Sub-optimal restraint was defined as use of forward-facing child safety seats for infants under one or weighing under 20 lbs, and any seat-belt use for children under 9. RESULTS: Sub-optimal restraint was more common among children under one and between four and eight years than among children aged one to three years (18%, 65%, and 5%, respectively). For children under nine, independent risk factors for sub-optimal restraint were: non-Hispanic black parent drivers (with non-Hispanic white parents as reference, adjusted relative risk, adjusted RR = 1.24, 95% CI: 1.09-1.41); less educated parents (with college graduate or above as reference: high school, adjusted RR = 1.27, 95% CI: 1.12-1.44; less than high school graduate, adjusted RR = 1.36, 95% CI: 1.13-1.63); and lower family income (with $50,000 or more as reference: <$20,000, adjusted RR = 1.23, 95% CI: 1.07-1.40). Multivariate analysis revealed the following independent risk factors for sub-optimal restraint among four-to-eight-year-olds: older parent age, limited education, black race, and income below $20,000. CONCLUSIONS: Parents with low educational levels or of non-Hispanic black background may require additional anticipatory guidance regarding child passenger safety. The importance of poverty in predicting sub-optimal restraint underscores the importance of child restraint and booster seat disbursement and education programs, potentially through Medicaid.     

Occupational risk of tunneling construction

This paper presents the quantification of occupational risk of the construction of a highway tunnel, located in Northern Greece. Risk assessment is based on the Workgroup Occupational Risk Model (WORM) project, developed in the Netherlands. This model can assess occupational risk at hazard level, activity level, job level and overall company risk. Seventeen job positions have been identified for this construction project, such as operators of a drilling machine, a loader, an excavator, a spraying machine, a crane operator, a blaster, a welder, the supervisor of the project, truck drivers and various other workers participating in the major construction phases. All risk profiles of workers have been quantified and jobs have been ranked according to their risk. Occupational risk has been assessed for two major tunnel construction phases which are (a) the excavation and primary support and (b) the final lining and support of the tunnel.     

Do speeding tickets reduce the likelihood of receiving subsequent speeding tickets? A longitudinal study of speeding violators in Maryland

OBJECTIVE: Speeding tickets are the most commonly used tool to deter speeders, yet little is known about how speeding citations affect individual drivers' behavior over time. This study examined the effects of being cited for speeding and types of legal consequences on drivers' subsequent speeding citations, which are an indicator of speeding behavior. METHODS: A cohort of 3,739,951 Maryland licensed drivers were identified and followed for one year. Drivers were categorized by whether or not they received a speeding citation in May 2002. Among those cited for speeding in May 2002, drivers were grouped by type of penalty (fines and points; probation before judgment [PBJ, which results in fines but no points]; or no legal consequences). The relative risks (RR) and 95 percent confidence intervals (CI) of receiving a speeding citation during follow-up were compared between drivers ticketed and not ticketed in May 2002, as well as among different penalty groups. Cox proportional hazards regression modeling was used to adjust for potential confounders, including age, gender, alcohol-impaired driving, and residence. Kaplan-Meier survival functions were used to examine timing of violations. RESULTS: Young drivers and male drivers were more likely to receive a speeding citation. Drivers who received a speeding citation in May 2002 had almost twice the risk of receiving a speeding citation during follow-up, compared with those not cited for speeding that month (RR 1.6, 95% CI 1.52-1.68). Overall legal consequences had no significant effect on the risk of receiving a repeat speeding citation relative to ticketed drivers who escaped those consequences (RR 0.98, 95% CI 0.84-1.15); however, stratified analyses showed a significant decrease in repeat citations among females (RR 0.75, 95% CI 0.63-0.90) and drivers who received PBJ (RR 0.81, 95% CI 0.67-0.96). Kaplan-Meier curves showed that the study group of speeders had a significantly shorter time between May 2002 until receipt of a speeding citation than controls. Among penalty groups, significantly shorter times until receipt of another citation were observed among drivers escaping consequences or receiving fines/points compared with drivers receiving fines/PBJ. CONCLUSIONS: Drivers who receive speeding citations are at increased risk of receiving subsequent speeding citations, suggesting that speeding citations have limited effects on deterrence in the context of the current traffic enforcement system. When comparing different penalties, PBJ is associated with a reduced rate of recidivism more than stronger penalties; however, it is unclear whether the reduction primarily is attributable to the penalty itself or to characteristics of drivers receiving PBJ. Increasing drivers' perceptions that they are at risk of being caught speeding may improve the effectiveness of speeding law enforcement.