Injury mechanisms in fatal Australian quad bike incidents

Objectives: The ability to determine risk management controls for quad bike use is confounded by limitations in crash and injury information. The aim of this article is to identify the injury mechanisms, crash characteristics, and contributing factors in fatal quad bike incidents in Australia by activity (recreation and work).

Methods: An in-depth case series study was undertaken of 106 Australian quad bike fatalities that had occurred between 2000 and 2013. All case material held by Australian coroners was obtained and reviewed.

Results: One hundred and six cases were categorized as occurring during recreation (53) and work (53). Fifty-two of the work cases occurred during farmwork. The mean age for those killed during a work activity was 56 years compared to 27 years for recreational riders. Two children under 16 years died while performing farmwork and 13 children under 16 years during recreational activities. The analyses show a very clear pattern for farmwork-related deaths: quad bike rolls or pitches over (farmworker, 85%; recreational rider, 55%), rider becomes pinned under quad bike (farmworker, 68%; recreational rider, 30%), and death by asphyxia (farmworker, 42%; recreational rider, 11%). In contrast, recreational riders suffered complex impact injuries to the head and chest that occurred when the rider was traveling at speed, lost control, was ejected, and collided with an object in the environment and/or interacted with the moving quad bike.

Conclusions: The analyses support the need to improve safe quad bike operation through consideration of the age of the rider, training, helmet use, reducing the propensity of quad bikes to roll, and improving handling so that loss of control events are reduced and to prevent crushing and pinning by the vehicle during and after a rollover crash.     

Determining the level and cost of sickness presenteeism among hospital staff in Turkey

Objective. This study aimed to determine the associations between sickness presenteeism and socio-demographic factors, perceived health status and health complaints among hospital staff and to calculate the cost burdens and productivity losses attributed to presenteeism. Methods. A cross-sectional study was conducted using 951 hospital staff, including physicians, nurses, midwives, other health personnel and administrative staff working in two hospitals located in K?r?kkale province in Turkey. The health and work performance questionnaire developed by Kessler et al. was revised to measure sickness presenteeism. Results. After performing Student’s t test and a one-way analysis of variance, presenteeism was mostly observed in women, nurse-midwives, young employees, university health staff and health workers with low health status. Average productivity loss and cost of lost productivity per staff member were calculated as 19.92?h/TRY 315.57 for 2 weeks and 478.08?h/TRY 7573.68 for 1 year. Conclusions. The problem of sickness presenteeism is mostly observed in women and nurses. It causes both financial burdens and productivity losses for hospitals. These survey results are thus expected to provide critically important information on presenteeism for decision-makers and healthcare managers.     

Percutaneous Exposure Incidents Among Australian Hospital Staff

We investigated all reported percutaneous exposure incidents (PEI) among staff from a large Australian hospital in the 3-year period, 2001-2003. There were a total of 373 PEI, of which 38.9% were needlestick injuries, 32.7% were cutaneous exposures and 28.4% sharps-related injuries. Nurses were the most commonly affected staff members, accounting for 63.5% of the total, followed by doctors (18.8%) and other staff ( 17.7%). Needlestick injuries were responsible for the majority of nurses’ PEI (44.7%). Sharps injuries constituted the major category for doctors (44.3%). Most needlestick injuries (67.6%) were caused by hollow-bore needles, while the majority of cutaneous exposures involved blood or serum (55.8%). Most sharps injures were caused by unknown devices (35.9%) or suture needles (34.9%). Overall, our investigation suggests that PEI is a considerable burden for health care workers in Australia. Further research is now required to determine the relationships, if any, between workers who suffer PEI and those who do not.     

Effect of occupational health nursing practice on musculoskeletal pains among hospital nursing staff in South Korea

Objective. The purpose of this study was to identify whether occupational health nursing variables serve as the contributing factors to musculoskeletal pains (MSP). Methods. A self-administered questionnaire composed of demographic characteristics, the practice of occupational health nursing and information regarding MSP was designed based on in-depth interviews with eight nurses. This study included 226 hospital nursing staff who worked at three university hospitals located in Seoul, South Korea. Statistical analysis was performed by using SPSS and AMOS 19.0. Results. Shoulder and neck pains occurred when subjects worked more than 46?h/week. Subjects who performed ‘work-time adjustment’ had lesser chance of having shoulder, leg/foot and wrist/finger pains. Overtime work hours showed an indirect effect on multiple sites of MSP by mediator variable, which was ‘work-time adjustment’. Organized night duty days eventually decreased multiple sites of MSP. Conclusion. Administration strategies for nurses to adjust work-time within 46?h/week should be considered.     

Duty hours and incidents in flight among commercial airline pilots

Introduction. Working long duty hours has often been associated with increased risk of incidents and accidents in transport industries. Despite this, information regarding the intermediate relationship between duty hours and incident risk is limited. This study aimed to test a work hours/incident model to identify the interplay of factors contributing to incidents within the aviation industry. Methods. Nine hundred and fifty-four European-registered commercial airline pilots completed a 30-item survey investigating self-report attitudes and experiences of fatigue. Path analysis was used to test the proposed model. Results. The fit indices indicated this to be a good fit model (χ²?=?11.066, df?=?5, p?=?0.05; Comparative Fit Index?=?0.991; Normed Fit Index?=?0.984; Tucker–Lewis Index?=?0.962; Root Mean Square of Approximation?=?0.036). Highly significant relationships were identified between duty hours and sleep disturbance (r?=?0.18, p?r?=?0.40, p?r?=?0.43, p?Discussion. A critical pathway from duty hours through to self-reported incidents in flight was identified. Further investigation employing both objective and subjective measures of sleep and fatigue is needed.     

Methods and impact of health screening for hospital staff

This study examines: (1) the impact of two methods of giving screening results on health behaviour and beliefs, evaluated in a randomized controlled trial. (2) The association between uptake of screening and health risk behaviours and beliefs. Two methods of feedback of screening results were given: simple informational feedback, and more extensive feedback, including target-setting and a written contract. At six month follow-up, those who received simple informational feedback had lost less weight and had increased their exercise less than those who received more extensive feedback. Attenders believed more strongly in the relationship between lifestyle and health, perceived themselves as less healthy than others and scored higher on the GHQ than staff who did not attend for screening. These results suggest that belief in the effectiveness of lifestyle change in promoting health, and anxiety about health, can influence uptake of screening. Second, the method of presenting screening results can influence the impact of screening on subsequent behaviour change.     

Epidemiology of musculoskeletal symptoms among Korean hospital nurses.

We investigated the epidemiology of musculoskeletal symptoms (MSS) among a complete cross-section of 330 nurses from a large Korean hospital, by means of a questionnaire survey (response rate: 97.9%). The prevalence of MSS at any body site was 93.6%, with symptoms most commonly reported at the shoulder (74.5%), lower back (72.4%), neck (62.7%), lower legs (52.1%) and hand/wrist (46.7%). Logistic regression indicated that nurses who undertook manual handling of patients were 7.2 times as likely to report MSS (OR 7.2, 95%CI 1.2-42.3, P = .0275), while nurses suffering from periodic depression experienced a 3.3-fold MSS risk (OR 3.3, 95%CI 1.3-8.3, P = .0104). Overall, our study suggests that Korean nurses incur a very high MSS burden when compared internationally. A greater commitment is needed to improve physical conditions, occupational tasks and psychosocial work issues among nurses in this country.     

A case control study of falling incidents among the hospitalized elderly

Falling incidents among the hospitalized elderly were investigated using a case/control methodology to identify high-risk individuals. The medical records of all patients who had a reported fall (N = 173) in 1978 in one geriatric facility were compared with the records of a random sample of patients without a reported fall (N = 339). The significant risk factors were male sex, urinary incontinence within 48 hours prior to the fall, and psychoactive medication 12 hours prior to the fall. It was concluded that some patients may have a greater tendency to fall than others and suggestions for exploring future means of prevention are presented.     

Self-reported incidents,accidents, and use of protective gear among small-scale forestry workers in Sweden

Self-reported data were collected from 156 self-employed small-scale forestry workers regarding their work, including use of safety gear and number and type of incidents and accidents. About 40% of the respondents reported that during the previous 24 months they had some kind of work-related accident where an injury occurred, and/or experienced in incident, a close call that could have resulted in an injury. Of those injured or involved in an accident, 50% reported that at the time of the accident or incident they were not fully using their safety gear. Sixty-seven percent of the accident victims reported seeking medical attention for their injuries. No significant relationships were found between production level, age, use of safety gear or sensation seeking tendencies and the reports of accidents and incidents. Accidents and incidents were most likely to occur during felling, thinning and transportation activities and were usually caused by unforeseen interactions with falling trees/branches or equipment. Compared to earlier surveys of Swedish small-scale forestry workers, consistent use of all required safety gear was down by 10% to 50%. Protective pants and gloves were the items least likely to be used while ear, eye and foot protection were most likely to be used. The results indicate that better planning during felling processes may be the key to reducing the number of accidents for this population.     

Validation of quasi-induced exposure representativeness assumption among young drivers

Objective: Young driver studies have applied quasi-induced exposure (QIE) methods to assess relationships between demographic and behavioral factors and at-fault crash involvement, but QIE's primary assumption of representativeness has not yet been validated among young drivers. Determining whether nonresponsible young drivers in clean (i.e., only one driver is responsible) 2-vehicle crashes are reasonably representative of the general young driving population is an important step toward ensuring valid QIE use in young driver studies. We applied previously established validation methods to conduct the first study, to our knowledge, focused on validating the QIE representativeness assumption in a young driver population.

Methods: We utilized New Jersey's state crash and licensing databases (2008–2012) to examine the representativeness assumption among 17- to 20-year-old nonresponsible drivers involved in clean multivehicle crashes. It has been hypothesized that if not-at-fault drivers in clean 2-vehicle crashes are a true representation of the driving population, it would be expected that nonresponsible drivers in clean 3-or-more-vehicle crashes also represent this same driving population (Jiang and Lyles 2010 Jiang XG, Lyles RW. A review of the validity of the underlying assumptions of quasi-induced exposure. Accid Anal Prev. 2010;42:1352–1358.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]). Thus, we compared distributions of age, gender, and vehicle type among (1) nonresponsible young drivers in clean 2-vehicle crashes and (2) the first nonresponsible young driver in clean crashes involving 3 or more vehicles to (3) all other nonresponsible young drivers in clean crashes involving 3 or more vehicles. Distributions were compared using chi-square tests and conditional logistic regression; analyses were conducted for all young drivers and stratified by license status (intermediate vs. fully licensed drivers), crash location, and time of day of the crash.

Results: There were 41,323 nonresponsible drivers in clean 2-vehicle crashes and 6,464 nonresponsible drivers in clean 3-or-more-vehicle crashes. Overall, we found that the distributions of age, gender, and vehicle type were not statistically significantly different between the 3 groups; in each group, approximately one fourth of drivers were represented in each age from age 17 through 20, half were males, and approximately 80% were driving a car/station wagon/minivan. In general, conclusions held when we evaluated the assumption within intermediate and fully licensed young drivers separately and by crash location and time.

Conclusions: It appears that the representativeness assumption holds among the population of young NJ drivers. We encourage young driver studies utilizing QIE methods to conduct internal validation studies to ensure appropriate application of these methods and we propose utilization of QIE methods to address broader foundational and applied questions in young driver safety.     

Time trends and predictive factors for safety perceptions among incoming South Australian university students

Problem

Young workers are over-represented in injury statistics. In order to develop injury prevention strategies, this study investigated time trends and predictive factors relating to safety skills, confidence, and attitudes.

Method

Annual surveys were conducted from 2006-2009 among incoming students at the University of Adelaide. The questions addressed safety training, injury experience, and health and safety perceptions.

Results

Time trends in training, perceived safety skills, confidence, and attitudes were not significant. In terms of skills and confidence, the most important correlate was safety training outside of high school (odds ratio = 1.6), especially when repeated, assessed, or in face to face mode. Feeling strongly about safety issues was best predicted by injury experience (OR = 1.7) and gender.

Discussion

These results emphasize the value of assessed training, but they are also consistent with published U.S. data, indicating no improvement over time. It is suggested that there be a more integrated approach in safety education, involving schools and workplaces.

Impact on industry

By developing an understanding of student safety perceptions and experiences, this research aims to target strategies to reduce the excess injury rate for young workers. Workplaces should be more aware of the limitations of school-based safety education and a more integrated and evidence-based approach should be developed, involving schools and workplaces.     

Self-reported occupational blood exposure among paramedics in Poland: a pilot study

Introduction. Paramedics are at risk of occupational blood exposure, increased by the immediacy of provided treatment. However, the issue has not been acknowledged to date by any research in Europe. Methods. This research aimed at assessing occupational blood exposure among paramedics in Poland. Respondents represented 21 Polish medical institutions. Their participation was voluntary and anonymous. Paramedics were provided with a self-directed job-specific questionnaire adapted to Polish conditions from an original US version. Results. 118 paramedics participated in the study from institutions constituting the National Emergency Medical System in Poland; including ambulance crews, Helicopter Emergency Medical Services and emergency department employees. Occupational exposure was reported by 18.64% of respondents and the main route of exposure was needlestick events. Conclusions. There is a further need to improve education among paramedics concerning the threat of being infected with blood-borne pathogens through all existing routes. Our findings point to the problem as being hidden and considered a shameful issue.     

Association between perceived demands and musculoskeletal disorders among hospital nurses of Shiraz University of Medical Sciences: a questionnaire survey.

Excessive demands on nurses may result in high rates of musculoskeletal disorders (MSDs). This study was conducted among hospital nurses of Iran's Shiraz University of Medical Sciences (SUMS) to determine the prevalence of MSDs and to examine the relationship between perceived demands and reported MSDs. In this study, 641 randomly selected nurses from 12 SUMS hospitals participated. The Nordic musculoskeletal disorders questionnaire and Job Content Questionnaire were used as collecting data tools. The results showed that 84.4% of the participants had experienced some form of symptoms of MSDs during the past 12 months. Lower back symptoms were found to be the most prevalent problem. Perceived physical demands were significantly associated with MSDs (OR = 1.5-2.7). No association was found between perceived psychological demands and reported symptoms. It was concluded that any intervention program for preventing MSDs among SUMS hospital nurses had to focus on reducing physical demands, particularly excessive postural demands.     

An awareness campaign decreases distracted driving among hospital employees at a rural trauma center

Abstract

Objective: To evaluate whether an educational campaign on distracted driving will have an impact in a given community.

Methods: Investigators were stationed in an employee parking lot of a 256-bed hospital to determine baseline distracted driving followed by a 4-week hospital-wide distracted-driving awareness campaign. The campaign included signs/posters in the hospital, a booth outside of the cafeteria with flyers, a large banner in the employee lot and an opportunity for people to sign a pledge form to drive distraction free. The same employee lot was observed at the same time of the day to re-assess distracted driving immediately following the campaign. The observations were repeated again one year later to evaluate the short and long-term impact of the campaign.

Results: A total of 485 vehicles were observed pre-campaign, identifying 170 (35%) distracted drivers at baseline. The awareness campaign resulted in 525 people pledging to drive distraction free. Following the campaign, 495 vehicles were observed and the number of distracted drivers was 64 (12.9%), showing a significant decrease in the number of distracted drivers by 22.1% (p?<?0.01). One year later, 530 drivers were observed with 150 (28%) displaying one form of distraction.

Conclusions: A local distracted driving educational campaign resulted in a significant decrease in the number of distracted drivers immediately following the campaign. However, one year after the campaign, there was an increase in distracted driving. The proportion of distracted drivers was still significantly lower than the initial rate of distracted-drivers.     

Occupational noise exposure and hearing defects among sawmill workers in the south of Thailand

The aim of this study was to investigate occupational noise exposure and hearing defects among sawmill workers in the south of Thailand. Seven hundred sawmill workers participated, of which 335 (47.9%) were male. The mean age of the sawmill workers was 33.5 years (SD 10.2), and more than 60% were <35 years old; 75.1% of the workers had less than 5 years of work experience. Only about one in four workers (25%) had been trained in use of personal protective equipment (PPE), and half of the participants never or rarely wore PPE while working. The prevalence rate of noise-induced hearing loss (NIHL) was 22.8% (N?=?42). Male workers had significantly higher risk than female workers (odds ratio [OR]?=?2.21). Workers aged older than 25 years had significantly higher risks for NIHL (OR?=?3.51–12.42) than workers younger than 25 years. Sawing workers had higher risk for NIHL than office workers (OR?=?3.07).     

Effectiveness of mandatory license testing for older drivers in reducing crash risk among urban older Australian drivers

Most licensing jurisdictions in Australia maintain mandatory assessment programs targeting older drivers, whereby a driver reaching a specified age is required to prove his or her fitness to drive through medical assessment and/or on-road testing. Previous studies both in Australia and elsewhere have consistently failed to demonstrate that age-based mandatory assessment results in reduced crash involvement for older drivers. However studies that have based their results upon either per-population or per-driver crash rates fail to take into account possible differences in driving activity. Because some older people maintain their driving licenses but rarely if ever drive, the proportion of inactive license-holders might be higher in jurisdictions without mandatory assessment relative to jurisdictions with periodic license assessment, where inactive drivers may more readily either surrender or lose their licenses. The failure to control for possible differences in driving activity across jurisdictions may be disguising possible safety benefits associated with mandatory assessment. The current study compared the crash rates of drivers in Melbourne, Australia, where there is no mandatory assessment and Sydney, Australia, where there is regular mandatory assessment from 80 years of age onward. The crash rate comparisons were based on four exposure measures: per population, per licensed driver, per distance driven, and per time spent driving. Poisson regression analysis incorporating an offset to control for inter-jurisdictional road safety differences indicated that there was no difference in crash risk for older drivers based on population. However drivers aged 80 years and older in the Sydney region had statistically higher rates of casualty crash involvement than their Melbourne counterparts on a per license issued basis (RR: 1.15, 1.02-1.29, p=0.02) and time spent driving basis (RR: 1.19, 1.06-1.34, p=0.03). A similar trend was apparent based on distance travelled but was of borderline statistical significance (RR: 1.11, 0.99-1.25, p=0.07). Collectively, it can be inferred from these findings that mandatory license re-testing schemes of the type evaluated have no demonstrable road safety benefits overall. Further research to resolve this on-going policy debate is discussed and recommended.     

Central auditory damage induced by solvent exposure.

Different studies have demonstrated that solvents may induce auditory damage. It has been suggested that part of this damage may be localised in central auditory pathways. The present study aimed to investigate possible auditory processing disorders related to solvent exposure. Thirty solvent-exposed workers and 30 gender-, age- and educational level-matched control subjects were selected to participate in the study. To select participants, a questionnaire, otoscopy, pure-tone audiometry and tympanometry were carried out. Filtered speech (FS), random gap detection (RGD) and hearing-in-noise tests (HINT) were conducted in the selected participants. Both groups of workers presented as a mean normal hearing thresholds. However, significant differences between groups were observed for RGD, FS and HINT. It is concluded that a possible auditory processing disorder may be related to solvent exposure.     

Electromagnetic fields: principles of exposure mitigation.

Basic principles of reducing exposure to electromagnetic fields are reviewed in this article. Measures to reduce exposure can be divided into organisational/administrative and technical/engineering actions. Both strategies are briefly analysed and the basic principles of the theory of shielding are presented. A definition of shielding effectiveness (SE) is given, and the results from the general Transmission Lines Theory are presented. Practical situations of shielding static and time-varying electric and magnetic fields are discussed on the basis of the physical properties of the fields and of the shield.     

某大型综合医院护理人员针刺及其他锐器损伤状况调查

了解医院护理人员针刺及其他锐器损伤流行现状,为进一步开展干预研究提供线索,并为干预措施效果评价提供基线数据.采用自填式调查问卷对某大型综合医院787名临床一线护理人员在2009年1月1日至2009年12月31日期间所发生的针刺及其他锐器损伤状况进行回顾性调查.护理人员在过去一年中发生针刺及其他锐器损伤共3258人次,针刺及其他锐器损伤年人均发生次数为4.14人次/人,接触发生率(％,人/100人)为88.31.发生针刺及其他锐器损伤的高风险人群为妇产科、重症监护室、外科、急诊科护理人员,其接触发生率(％,人/100人)和年人均发生次数(人次/人)分别为95.56和5.04、95.18和3.64、92.95和4.37、84.13和5.32;引起护理人员针刺及其他锐器损伤的主要医疗操作是掰安瓿、输液结束拔针、整理用毕的锐器、静脉穿刺(采血、加药、输液)和回套针帽,其接触发生率(％,人/100人)分别为67.85、46.89、37.99、14.61和9.28.护理人员针刺及其他锐器损伤主要是由安瓿瓶、头皮针、皮下注射针、缝合针和手术刀片,其损伤接触发生率(％,人/100人)分别为67.98、56.42、37.74、6.73和2.92.护理人员仍然面临较大的针刺及其他锐器损伤风险,不同科室护理人员在不同医疗操作及医疗操作的不同阶段、使用不同医疗锐器、使用锐器的用途不同发生针刺及其他锐器损伤的风险不同,应积极采取有针对性的综合性预防控制措施,全面贯彻落实《血源性病原体职业接触防护导则》(GBZ/T 213-2008).