Differences in urban and rural accident characteristics and medical service utilization for traffic fatalities in less-motorized societies

Introduction

Fatalities from traffic accidents in less-motorized societies are an important global issue. We aimed to characterize the geographic differences of fatalities in such societies to facilitate the development of targeted interventions.

Method

This study linked police reports, hospital data, and vital registration data from Taiwan with special reference to accident factors in pre-hospital deaths and medical care in hospital deaths.

Results

A higher percentage of pre-hospital deaths were observed following rural as compared to urban traffic accidents. The deaths due to rural accidents can be attributed to lower use of restraints (i.e., helmets or seat belts), lower percentage of motorcyclists, and more highway accidents. A higher percentage of victims in rural accidents were transported to distant medical centers rather than to local hospitals.

Conclusion

Specific interventions, such as intelligent emergency medical systems, campaigns for helmets and seat belt usage, enforcement of helmets and seat belt use, and speed control measures should be targeted to rural areas.

Impact on industry

Cooperation between the vehicle industry and emergency medical providers in rural traffic accident rescue teams may decrease the numbers of deaths in these regions.     

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.     

Social norms of accompanied young children and observed crossing behaviors

Introduction

Social norms for accompanied young children and crossing behaviors were examined in two studies conducted in an Ultra-Orthodox Jewish community in Israel.

Method

In Study 1, road behaviors of young children crossing with and without accompaniment and older children were observed, and the actual social norm for accompanied school children younger than 9-years-old was examined. In Study 2, the perceived norm of accompaniment was tested by questionnaires.

Results

Young children who crossed without accompaniment exhibited poorer crossing skills compared to older children and to young children crossing with accompaniment. In the four locations observed, the actual accompaniment rate ranged between 15%-60%. The perceived social norm for child accompaniment was lower than the actual norm.

Conclusions

The discussion refers to both theoretical issues and their practical implications.     

Survival risk factors for fatal injured car and motorcycle drivers in single alcohol-related and alcohol-unrelated vehicle crashes

Introduction

A high percentage of drivers who die as a result of a single vehicle crash are under the influence of alcohol. We aimed to better understand the prevalence of these fatalities and the ratio of death to injuries based on various risk factors. We focused on alcohol-related and -unrelated single-vehicle crashes to investigate the influence of such risk factors on the time until death for car and motorcycle drivers.

Methods

We combined data from national police reports and a vital registration database in Taiwan. Survival analysis using Cox regression models was used to identify the risk factors of time until death.

Results

Overall, nearly 60% of car driver fatalities and 40% of motorcycle driver fatalities involved the consumption of alcohol. Survival analysis of single-vehicle crashes suggested that the traffic island separation between a car moving at a higher speed and motorcycle traffic resulted in a higher risk of death over time for motorcycle drivers who consumed alcohol. The factors attributed to a higher risk of death over time for motorcycle drivers were older age, crashing into trees, night-time driving, driving on curved roads, and driving on local roads. Driving without restraints and driving on roads with higher speed limits attributed to a higher risk of death over time for car drivers.

Conclusions

The factors that influence the risk of death over time in a motor-vehicle accident involving alcohol depended on different elements, which should each be considered when attempting to reduce this risk.

Impact on Industry

More efforts should be made to investigate the various risk factors in areas with large motorcycle populations.     

Evaluation of guardrail systems for preventing falls through roof and floor holes

Introduction

Fall-related occupational injuries and fatalities are serious problems in the U.S. construction industry, especially incidents related to unguarded holes. The National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV conducted a project to evaluate the effectiveness of guardrail systems to prevent falls through roof and floor holes.

Methods

Two commercial edge-protection products were evaluated when used as perimeter guarding around a roof hole. Installations of the commercial products were compared to job-built guardrails constructed of 2^″ × 4^″ construction-grade lumber. Occupational Safety and Health Administration (OSHA) regulations require that “a force of at least 200 pounds” must be supported by the top rail of a guardrail system “in any outward or downward direction at any point along the top edge.” A laboratory testing system was developed to evaluate this requirement. A dynamic 200-lb force was generated against the top rail using a weighted manikin mounted on a hinged steel frame. Nine construction workers, who served as test subjects, each built five different guardrail configurations.

Results

All 45 configurations met the 200-lb OSHA requirement. Installation time for one commercial product was 32% quicker than the job-built configuration (25.6 min vs. 37.9 min).

Impact on Industry

This study: (a) indicates that the two edge-protection products can be used as perimeter guarding; (b) highlights the importance of using proper materials and fasteners to construct guardrails to protect workers from falling into unguarded roof and floor holes; and (c) discusses an overall-strength-testing methodology that can be used by fall-protection researchers.     

When may road fatalities start to decrease?

Introduction

The comparative analysis of macroscopic trends in road safety has been a popular research topic. The objective of this research is to propose a simple and, at the same time, reliable multiple regime model framework for international road safety comparisons, allowing for the identification of slope changes of personal risk curves and respective breakpoints.

Method

The trends of road traffic fatalities in several EU countries have been examined through the temporal evolution of elementary socioeconomic indicators, namely motorized vehicle fleet and population, at the country level.

Results

Piece-wise linear regression models have been fitted, using a methodology that allows the simultaneous estimation of all slopes and breakpoints. The number and location of breakpoints, as well as the slope of the connecting trends, vary among countries, thus indicating different road safety evolution patterns.

Impact on industry

Macroscopic analysis of road accident trends may be proved beneficial for the identification of best examples and the implementation of appropriate programmes and measures, which will lead to important benefits for the society and the economy through the reduction of road fatalities and injuries. Best performing countries and the related programmes and measures adopted may concern several safety improvements at the processes of the road, the vehicle and the insurance industries.

Conclusions

Lessons from the analysis of the past road safety patterns of developed countries provide some insight into the underlying process that relates motorization levels with personal risk and can prove to be beneficial for predicting the road safety evolution of developing countries that may have not yet reached the same breakpoints. Furthermore, the presented framework may serve as a basis to build more elaborate models, including more reliable exposure indicators (such as vehicle-km driven).     

Needle stick and sharps injuries among health care workers in Gondar city, Ethiopia

Background

All employees in health care settings handling needles or other sharps are at risk for needle stick and sharps injuries (NSSIs). Health care workers in under developed countries are at greater risk of infection from blood borne pathogens because of the lack of safety devices and the high prevalence of these pathogens.

Objectives

The aim of this study was to assess the prevalence of NSSIs and associated factors among health care workers in government health institutions in Gondar city, Ethiopia.

Methods

Institution based cross sectional study was conducted from May-December, 2010. The study included 344 health care workers who were selected from the source population using simple random sampling technique. Data were collected through interviews using structured and pre-tested questionnaire and the collected data were entered and analyzed using SPSS version 16.0.

Results

The prevalence of NSSIs among health care workers in the preceding 12 months was 106 (30.8%), of which 58 (54.7%) was reported by females. Lack of training on occupational health and safety, working more than 48 h/week, dissatisfaction with work environment and work culture, greater than 10 years of work experience and having low and moderate perception of risk were found to be significantly associated with NSSIs.

Conclusion

The study found high prevalence of NSSIs among health care workers. Effective training, ongoing awareness on the risk of hazards, preventive measures such as engineering control, and post-exposure prophylaxis following NSSIs are essential to reduce the risk of such injuries.     

The development and validation of a psychological contract of safety scale

Introduction

This paper builds on previous research by the author and describes the development and validation of a new measure of the psychological contract of safety. The psychological contract of safety is defined as the beliefs of individuals about reciprocal safety obligations inferred from implicit and explicit promises.

Method

A psychological contract is established when an individual believes that perceived employer and employee safety obligations are contingent on each other. A pilot test of the measure is first undertaken with participants from three different occupations: nurses, construction workers, and meat processing workers (N = 99). Item analysis is used to refine the measure and provide initial validation of the scale. A larger validation study is then conducted with a participant sample of health care workers (N = 424) to further refine the measure and to determine the psychometric properties of the scale.

Results

Item and correlational analyses produced the final employer and employee obligations scales, consisting of 21 and 17 items, respectively. Factor analyses identified two underlying dimensions in each scale comparable to that previously established in the organizational literature. These transactional and relational-type obligations provided construct validity of the scale. Internal consistency ratings using Cronbach's alpha found the components of the psychological contract of safety measure to be reliable.

Impact on Industry

The refined and validated psychological contract of safety measure will allow investigation of the positive and negative outcomes associated with fulfilment and breach of the psychological contract of safety in future research.     

Effectiveness of a worker-worn electric-field sensor to detect power-line proximity and electrical-contact

Problem

Construction workers suffer the most electrocutions among all industries. Currently, there are no electrical contact warning devices on the market to protect workers. This paper proposes a worker-worn electric-field sensor. As the worker is in proximity to, or in contact with, a live power-circuit, the sensor sets off an audible/visual warning alarm. The sensor also has the potential to wirelessly trip a wireless-capable circuit breaker, and to trigger a wireless transmitter to notify emergency response of an electrical contact.

Methods

An experiment was conducted to measure electric-field variation on simulated human-wrists (10 defrosted hog-legs) in various proximities and in electrical-contact to a simulated power-circuit. The purpose of these tests was to determine the feasibility of developing a worker-worn electric-field detection sensor for use in protecting workers from contact with energized electrical conductors.

Results

This study observed a significant electric-field-magnitude increase as a hog-leg approaches the live-circuit, and the distinct electric-field-magnitude jump as the leg contacts with the live-circuit. The observation indicates that this sensor can be an effective device to warn the workers of electrical hazards. Additionally, the sensor has the potential to wirelessly trip a wireless-capable circuit-breaker and trigger a wireless transmitter (such as a cell phone) to notify an emergency response. The prompt notification prevents the worker from further injury caused by postponed medical-care.

Impact on Industry

Widespread use of this sensor could lower electrocution and electrically related injury rates in the construction industry.     

Fall arrest characteristics of a scissor lift

Problem

Census of Fatal Occupational Injuries (CFOI) data indicate 306 aerial lift fatalities between 1992-2003. Seventy-eight of these fatalities specifically involved scissor lifts. Members of standards committees have requested that NIOSH conduct research to determine the effects of safety-control practices related to using fall-protection systems for scissor lifts.

Method

This research examined the structural and dynamic stability of a scissor lift subjected to fall arrest forces. This was accomplished by conducting drop tests from a scissor lift. Anchorage locations evaluated included manufacturer-supplied anchorage points on the scissor lift platform as well as mid-rail and top-rail locations.

Results

Preliminary drop tests determined that a 2400 lb maximum arrest force (MAF) could be generated by dropping 169 lb through a fall height of 36” using Nystron® rope as a lanyard. The scissor lift maintained structural and dynamic stability for all drop tests when fully extended and on an incline.

Discussion

Anchoring a fall arrest system to either the mid-rail or top-rail is not a recommended practice by the scissor lift manufacturer. Anchor points are provided on the platform floor of the scissor lift for this purpose. However, our results demonstrate that the mid-rail and top-rail absorb substantial energy from an arrested fall and may have potential as appropriate anchorage points.

Impact to Industry

Employers and workers should consider implementing fall arrest systems when using scissor lifts as part of their overall risk mitigation plan for fall injury prevention.     

Perceptions of personal vulnerability to workplace hazards in the Australian construction industry

Introduction

The importance of risk perception for workplace safety has been highlighted by the inclusion of risk appraisals in contemporary models of precautionary behavior at work. Optimism bias is the tendency to think that negative events are less likely to happen to oneself than to the average person, and is proposed to be related to the reduced use of precautions.

Method

Building on studies of optimism bias for workplace hazards using samples with heterogenous risk profiles, the current study aimed to investigate whether optimism bias is present in a sample of workers exposed to similar workplace hazards. 175 Australian construction workers completed a brief survey that asked them to rate the likelihood of common construction industry hazards occurring to them and to the average worker of the same age doing the same job. Significant levels of optimism bias were found for many hazards (including being electrocuted, being trapped in a confined space, falling from heights, and causing someone else to have an injury).

Results

Optimism bias was not related to perceived controllability, contrary to findings in other domains, yet consistent with findings of optimism bias for workplace hazards. Optimism bias was not found to be related to a reduction in safe work behaviors, though this may be due to difficulties in measuring safe or precautionary behavior, such as social desirability.

Impact on industry

That most workers think that hazards are less likely to happen to them than to the average worker presents a significant problem because it may ameliorate the efficacy of safety programs, yet constitutes a largely unexplored opportunity for improving workplace safety performance.     

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.     

Crash involvement during the different phases of the New Zealand Graduated Driver Licensing System (GDLS)

Introduction

The New Zealand Graduated Driver Licensing System (GDLS) is designed to allow novice drivers to gain driving experience under conditions of reduced risk.

Method

To examine the effectiveness of the GDLS, an analysis of how the crash involvement of novice drivers changes as drivers move through the GDLS was undertaken. Crash profiles were created by data matching the New Zealand license and crash databases, covering a time period from 1999-2006.

Results

The crash profiles show that the initial learner period of the GDLS is relatively safe and the time at which novice drivers have the highest rate of crash involvement is during the first few months of solo driving. Analysis using logistic regression also showed an effect of age and gender, with higher crash involvement associated with younger drivers and males. In addition, individuals who gained a full license within 12-18 months of holding a restricted license, due to completion of a time-discount associated educational program, had a higher level of involvement in crashes than individuals who gained a full license after 18 months.

Conclusions

The crash profiles provide an insight into the crash risk associated with different phases of the New Zealand GDLS.

Impact on Industry

Increasing the age at which drivers first begin to solo drive and the removal of the time-discount associated with completion of an educational program should be considered.     

Influence of daytime running lamps on visual reaction time of pedestrians when detecting turn indicators

Introduction

This article describes one experiment that studied the influence of Daytime Running Lamps (DRL) on pedestrian detection of turn indicators.

Method

An experimental device including one DRL and one turn indicator was used in order to determine Visual Reaction Times (VRT) of 148 observers in different situations involving turn indicator activation. Such situations were combinations of three main variables: color of DRL, separation between DRL and Turn Indicator, and observation angle.

Results

Significant changes in VRT were found depending on the configurations above, especially the observation angle and the color of DRL. This second result demonstrates that amber DRLs inhibit the detection of Turn Indicators.

Impact on industry

One of the main targets of this paper is to recommend that carmakers introduce only white DRLs on new vehicles. We also intend to advise regulatory bodies working on automotive regulation about the consequences of allowing amber DRLs and also about the danger of introducing constrains on the distance between DRL and Turn Indicator without further experimental evidences.     

Effects of safety climate on safety norm violations: exploring the mediating role of attitudinal ambivalence toward personal protective equipment

Problem

Research on the role of organizational and psychosocial factors in influencing risk behaviors and the likelihood of injury at work showed that safety climate also has great impact on workers’ behavior. However, the mechanisms through which this impact operates are still partially unclear.

Method

In order to explore the role that attitudinal ambivalence toward wearing PPE might play in mediating the impact of safety climate on safety norm violations, a questionnaire was administered to 345 Italian workers.

Results

Three dimensions of safety climate (i.e., company safety concern, senior managers’ safety concern, supervisors’ attitudes towards safety) were found to be positively associated with the individual ambivalence level, whereas the fourth one (i.e., work pressure) was negatively correlated with it. In turn, low levels of ambivalence were associated with a lower tendency to break the safety norms, even though the perception of a good safety climate also maintained a direct effect on unsafe behaviors.

Impact on industry

Designers of training program for the prevention of work related injuries must pay great attention to the psycho-social factors (such as the effects of the safety climate perception by employees on their attitudes and behaviors), and include specific contents into the prevention programs in order to improve workers compliance with safety norms.     

Implied-consent laws: A review of the literature and examination of current problems and related statutes

Problem

A substantial proportion of drivers arrested for DUI refuse the BAC test, thereby reducing the likelihood that they will be convicted and potentially increasing the number of high-risk multiple offenders contributing to alcohol-related crashes.

Method

This paper reviews the information on the current status of implied-consent laws (which impose a sanction on offenders who refuse the BAC test) in the 50 states and the other relevant traffic safety laws and policies that may influence state refusal rates.

Results

Although there appears to be only a weak relationship between state refusal rates and crash rates, there is strong evidence that BAC test refusals significantly compromise the arrest, prosecution, and sentencing of DUI suspects and the overall enforcement of DUI laws in the United States.

Discussion

Laws and policies that may reduce the number of refusals are discussed.

Impact on industry

Alcohol-related crash injuries are an important cost problem for U.S. industry because of property damage from crashes, crash injuries to employees that raise health costs, or the reduction of time on the job resulting from a highway injury.     

Epidemiology of subway-related fatalities in New York City, 1990-2003

Problem

Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction.

Method

Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings.

Results

There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention.

Conclusion

Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems.

Impact on industry

These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.     

An economic evaluation of a participatory ergonomics process in an auto parts manufacturer

Problem

We assess the costs and consequences of a participatory ergonomics process at a Canadian car parts manufacturer from the perspective of the firm.

Method

Regression modeling was used with interrupted time series data to assess the impact of the process on several health measures. Consequences were kept in natural units for cost-effectiveness analysis, and translated into monetary units for cost-benefit analysis.

Results

The duration of disability insurance claims and the number of denied workers' compensation claims was significantly reduced. The cost-effectiveness ratio is $12.06 per disability day averted. The net present value is $244,416 for a 23-month period with a benefit-to-cost ratio of 10.6, suggesting that the process was worth undertaking (monetary units in 2001 Canadian dollars).

Discussion

Our findings emphasize the importance of considering a range of outcomes when evaluating an occupational health and safety intervention.

Impact on industry

Participatory ergonomics process can be cost-effective for a firm.     

Project level analysis of special trade contractor fatalities using accident investigation reports

Introduction

Construction is among the most dangerous industries in the United States accounting for thousands of fatalities every year. Although there is data available on high risk work types and areas, the project-level detail is not readily available.

Method

This paper uses the accident investigation reports to categorize project types and presents project level analysis of 350 fatal accidents for special trade contractors.

Results

The results showed that Residential and Commercial projects lead the fatalities where Falls are observed as the leading cause. However, when the fatality causes and project categories are analyzed for each work type, the results showed different fatality cause proportions for each project type.

Impact on Industry

Project level analysis approach has a direct impact on identifying high risk work types and areas for special trade contractors by making it possible to focus the prevention and intervention efforts more accurately, while highlighting training and education needs.