SAFEST TO TRAVEL BY BICYCLE,CAR, OR BIG TRUCK?

This study compares highway crash incidence, injuries, and costs by vehicle type. Annual crash and injury incidence were estimated using Crashworthiness Data System (1988-1991), National Automotive Sampling System (1982-1986), General Estimates System (1992-1993), and Fatal Analysis Reporting System (1993) data. Costs were computed based on restraint use, body region, and threat-to-life severity of the injury. Costs were then allocated between vehicle types using three different methods in order to answer comparative safety questions. Motor vehicle and bicycle crash costs total $389 billion annually; 75% resulting from passenger vehicles. Motorcycles and bicycles have the highest costs per 1000 vehicle and passenger miles; costs per victim are highest for pedestrians, bicyclists, and motorcyclists. Costs per vehicle mile for heavy trucks and passenger cars are comparable but exceed costs for light trucks. Passenger vehicle occupants are safest if a crash occurs. Light truck, other single truck, and bus occupants have the lowest cost per passenger mile, but higher costs than air and rail travelers. Motorcyclists face the greatest risks. Combination trucks may not impose an excess risk to other drivers, but their drivers face large risks.     

Snowblower injuries in Vermont, 1981–1984

The Vermont Department of Health carried out two studies of snowblower injuries in Vermont during the winters of 1982–1983 and 1983–1984. The first was a case-control study in which we assessed risk factors that predisposed operators to injury during snowblower use. We found 20 persons who had been injured by snowblowers and matched 28 controls to these by neighborhood. In this study, owning a snowblower for 1 year or less and having operated a snowblower for 10 days or less in one's lifetime were significantly associated with injury. The second study was population-based. We estimated that approximately 1.5% of Vermont residents owned snowblowers during the winter of 1982–1983 and that, among snowblower owners, injuries occurred at a rate of 1.3/1,000 person-years of ownership (0.1% chance of injury).     

Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

Characterization of fatal occupational versus nonoccupational motor vehicle collisions in Kentucky (1998-2000)

Motor vehicle collisions (MVCs) are the leading cause of occupational fatalities in Kentucky as well as in the nation. The characteristics of and contributing factors for occupational versus nonoccupational MVC fatalities in the Commonwealth of Kentucky were examined from 1998 to 2000. Semi trucks were most frequently involved in fatal occupational MVCs, and passenger cars were most frequently involved in nonoccupational MVCs. More than half of the decedent drivers resided outside of Kentucky. The percentage of occupational fatalities occurring on a four-lane highway was double the percentage observed for nonoccupational MVC fatalities. In addition, an increased proportion of occupational MVC deaths occurred on limited access highways compared to nonoccupational fatalities. When human factors contributing to these fatal incidents were examined, the two primary human factors involved in occupational motor vehicle fatalities were driver distraction/inattention and falling asleep, whereas unsafe speed and alcohol were the primary human factors contributing to a nonoccupational fatality. These results suggest that semi drivers traveling on four-lane highways are more at risk for a fatal occupational injury in Kentucky. Therefore, additional epidemiological studies are needed to further examine human factors, the nature of the Kentucky highway system, and trucking controls (e.g., weigh station hours of operation) within the Kentucky transportation industry.     

Comparison of mid-block and intersection-related left turn collisions

OBJECTIVES: To evaluate the factors that might influence an occupant's injury severity during a left turn movement. METHODS: We used the National Automotive Sampling System Crashworthiness Data System (1995-2005) to compare crash characteristics and injury outcome between intersection and midblock left turn collisions. RESULTS: A total of 7,396 collisions were evaluated. Traffic control devices were present in 82% of intersection and 10% of mid-block collisions. After adjustment for potential confounding variables, drivers' injury severity was not significantly associated with the crash location. However, front seat passengers in mid-block collisions had 72% higher odds of experiencing an injury with injury severity score > or =9 (odds ratio: 1.72, 95% confidence interval: 1.09-2.69). Our analysis did not show that drivers or passengers in larger vehicles, e.g., sport utility vehicles and mini-vans, were at lower risk of more severe injuries in comparison to the car occupants in sedans. CONCLUSION: We found that in comparison to intersection-related left turn collisions, mid-block crashes are associated with more severe injuries for front seat passengers. Furthermore, size of the turning vehicle was not significantly associated with injury severity for drivers or front seat passengers.     

The epidemiology of lawn trimmer injuries in the United States: 2000-2009

IntroductionYard maintenance equipment is potentially dangerous, and some of the more frequency used equipment (e.g., lawn mowers) has been extensively studied. However, the extent of lawn trimmers as a source of injury has not previously been explored.MethodsData from the Consumer Product Safety Commission's National Electronic Injury Surveillance System were used to estimate the number of patients treated in U.S. emergency departments for lawn trimmer-related injuries. Injury rates were calculated according to age, sex, and race, and characteristics of the injury event were determined.ResultsAn estimated 81,907 injuries involving a lawn trimmer occurred from 2000–2009. The incidence generally increased over time. Men, people aged 40–49, and Caucasians were the groups most likely to be injured. The most commonly injured body part was the head, specifically the eye, accounting for 42.5% of the injuries. Contusions and abrasions were the most common type of injury to the head, but lacerations were the most common injury to the extremities, and strains/sprains were the most common injury to the trunk.DiscussionAlthough previous research on lawn trimmers has focused exclusively on injuries to the eyes, the results of the current study show that such injuries are one component of the problem. Because most of the injuries were due to foreign objects, it is important that the use of adequate safety gear be emphasized when operating lawn trimmers.Impact on IndustryResults suggest that lawn trimmer design changes and better safety education for trimmer use can reduce the rate of injury and reverse the current trend.     

An analysis of occupational stair accident patterns

This report describes an analysis of existing occupational injury data concerning stairway-related falls. Injury data based on reports obtained from the Ohio and California workers' compensation agencies were analyzed to identify common stair injury patterns. Frequency tabulations are provided for the following factors: (a) location (indoors vs. outdoors, on vs. off employer's premises, site category); (b) task (ascending vs. descending, body movement on the stair, task being attempted); and (c) events (precipitating actions and conditions). One of the most outstanding findings is that 92 % of the injuries occurred when the worker was descending the stair, i.e., 636 of the 688 cases in which direction of travel was indicated. Additionally, injury records from the New York and Ohio workers' compensation agencies were used to rank industries in terms of combined frequency and severity rates of stairway-related injuries.     

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

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

Trends in occupational injuries and fatality in Turkey

Introduction. The aim of this study was to evaluate the trend of occupational injuries in Turkey using epidemiologic criteria such as incidence mortality and fatality/all injuries recorded – rates. Materials and methods. Safety and health data were obtained from the Annual Statistic Books of the Social Insurance Institution (1988–2006) and Social Security Institution (2007–2011) of Turkey. Results. The results from the official data showed that although total employment is increasing the number of occupational injuries and incidence and mortality rates are decreasing. The results also demonstrate that occupational fatality/all injuries recorded – rate is increasing. The fatality/all injuries recorded – rate per 1000 injuries increased to 25.5 in 2011 from 8.6 in 1988. Each work day an average of five people died because of occupational injuries. Discussion and conclusions. The fatality/all injuries recorded – rate (the number of fatal cases per 1000 occupational injuries) is an important indicator of the injury rate for a country. Systems of occupational injury and illness surveillance constitute a critical resource for the management and reduction of occupational injuries and illness.     

Occupational road trauma and permanent medical impairment

Medically impairing occupational injuries sustained in traffic in Sweden were analysed. More than half of the cases with a permanent medical impairment were caused by minor injuries. Soft tissue injuries to the neck (whiplash injuries) made up nearly half of all permanently impairing injuries, and half of these were caused by rear-end collisions. As a final result, just over one third (37%) of the total group had a permanent decreased work capacity, or needed to change jobs because of residual problems from their injuries. Professional drivers had the highest injury incidence per employed and they accounted for 28% of the total number of permanent impairment cases, and for 43% of the fatalities. Professional drivers also had a higher percentage of serious injuries and severe permanent impairments than other occupational groups. This might be associated with the low use of safety belts (16%) compared to other occupational groups, where usage was 4–5 times higher. This occupational injury problem ought to be handled in the same way as other occupational safety problems, i.e. protective equipment in a vehicle should be used and the use of safe vehicles should be encouraged.     

Contributing factors of crash injury severity at public highway-railroad grade crossings in the U.S.

IntroductionThe Moving Ahead for Progress in the 21st Century (MAP-21) includes a separate program that supports safety improvements to reduce the number of fatalities and injuries at public highway-railroad grade crossings (HRGCs). This study identifies the significant factors affecting crash injury severity at public HRGCs in the United States.MethodCrashes from 2009 through 2013 on 5,528 public HRGCs, extracted from the Federal Railroad Administration database, were used in the analysis. A comprehensive list of risk factors was explored. Examples include predictors related to geographic region of crash, geometry (e.g., area type and pavement marking type), railroad (e.g., warning device type and railroad class), traffic (e.g., train speed and vehicles annual average daily traffic “AADT”), highway user (e.g., driver age and gender), and environment (e.g., lighting and weather conditions). The study used the mixed logit model to better capture the complex highway user behavior at HRGCs.ResultsFemale highway users were at higher risk of involvement in injuries and fatalities compared to males. Higher train speeds, very old drivers, open areas, concrete road surface types, and railroad equipment striking highway users before crash, were all found to increase the injury likelihood. On the other hand, young and middle-age drivers, non-passing of standing vehicles at HRGCs, industrial areas, and presence of warning bells were found to reduce injuries and fatalities.ConclusionsThe mixed logit model succeeded in identifying contributing factors of crash severity at public HRGCs and potential countermeasures to reduce both fatalities and injuries are suggested.Practical applicationsIt is important to install warning bells at public HRGCs, especially at those with high number of injury and fatality crashes. Enforcement of traffic nearby HRGCs is necessary to prevent vehicles from overtaking of standing vehicles.     

Development of a loading dock safety evaluation tool

INTRODUCTION: Companies that use forklifts to load and unload trucks at loading docks are well aware of the main danger associated with this type of activity (i.e., the possibility of the forklift falling or tipping over when the truck suddenly moves away from the dock). Even if various truck restraint measures can be implemented to reduce the possibility of this type of accident, a number of hazardous incidents that result in a forklift tipping over from a loading dock still do occur regularly in day-to-day activities. This situation has brought experts to examine and evaluate the effectiveness of different measures and systems depending on the context in which they are used. METHODS: The present study touched upon both the technical and the organizational aspects of the restraint measures that could have an impact on safety. Certain elements were examined very closely, especially the failure of mechanical devices and their relation to the environment in which they are used, as well as the systemic interaction between people and the various restraint measures in use in a given context. CONCLUSION: This article presents a safety evaluation tool regarding restraint measures or systems for trucks docked at loading platforms - a tool that, of course, would take into consideration both the specific contextual aspects related to the docking bay itself, and to the plant. IMPACT ON INDUSTRY: This tool is designed to help companies choose the optimal safety measures to implement, while remaining realistic in terms of the technical and economic aspects of any given situation.     

Horseback riding-related injuries treated in emergency departments: Risk factors and prevention strategies

IntroductionDespite inherit dangers of horseback riding (HBR), research on HBR-related injuries is sparse. This study used both quantitative and qualitative methods to (1) examine HBR-related injuries treated in emergency departments (EDs) and associated risk factors and (2) explore HBR-related injury experiences and recommendations for prevention strategies from the perspective of riders. Method: We retrospectively analyzed data from the Nationwide Emergency Department Sample (NEDS), identifying HBR-related ED visits between 2010 and 2014. Additionally, we conducted 10 phone interviews with active horseback riders to understand their experiences and perspectives regarding HBR-related injuries and recommendations for prevention measures. Results: A total of 21,899 ED visits for HBR-related injuries were identified. When weighted, these represented 100,964 ED visits in the United States. Females had a consistently higher proportion of ED visits compared to males across the study period, with the proportion of ED visits being highest in females aged 15–19. Most injuries (85.9%) were treated and released from the ED. Three primary themes were identified as key to the prevention of HBR-related injuries: (1) rider safety (e.g., use of protective equipment), (2) external factors (e.g., awareness of environment), and (3) rider and horse interactions (e.g., matching skill level of the rider to the horse). Conclusions: Results indicate that HBR-related injuries treated in EDs are prevalent, with female riders aged 15–19 years having the highest proportion of injuries treated in EDs. Practical Applications: There is a critical need for injury prevention programs that not only promote the use of protective equipment, but that also educate horseback riders on horse behavior, the proper handling of horses, and safe riding practices.     

Prevention of occupational injuries: Evidence for effective good practices in foundries

IntroductionOccupational injuries are a relevant research and practical issue. However, intervention studies evaluating the effectiveness of workplace injury prevention programs are seldom performed. Method: The effectiveness of a multifaceted intervention aimed at reducing occupational injury rates (incidence/employment-based = IR, frequency/hours-based = FR, severity = SR) was evaluated between 2008 and 2013 in 29 Italian foundries (22 ferrous; 7 non-ferrous; 3,460 male blue collar workers/year) of varying sizes. Each foundry established an internal multidisciplinary prevention team for risk assessment, monitoring and prevention of occupational injuries, involving employers, occupational physicians, safety personnel, workers' representatives, supervisors. Targets of intervention were workers, equipment, organization, workplace, job tasks. An interrupted time series (ITS) design was applied. Results: 4,604 occupational injuries and 83,156 lost workdays were registered between 2003 and 2013. Statistical analysis showed, after intervention, a reduction of all injury rates (− 26% IR, − 15% FR, −18% SR) in ferrous foundries and of SR (− 4%) in non-ferrous foundries. A significant (p = 0.021) ‘step-effect’ was shown for IR in ferrous foundries, independent of secular trends (p < 0.001). Sector-specific benchmarks for all injury rates were developed separately for ferrous and non-ferrous foundries. Conclusions: Strengths of the study were: ITS design, according to standardized quality criteria (i.e., at least three data points before and three data points after intervention; clearly defined intervention point); pragmatic approach, with good external validity; promotion of effective good practices. Main limitations were the non-randomized nature and a medium length post-intervention period. In conclusion, a multifaceted, pragmatic and accountable intervention is effective in reducing the burden of occupational injuries in small-, medium- and large-sized foundries. Practical Applications: The study poses the basis for feasible good practice guidelines to be implemented to prevent occupational injuries, by means of sector-specific numerical benchmarks, with potentially relevant impacts on workers, companies, occupational health professionals and society at large.     

Occupational injuries of immigrant and Finnish bus drivers

Problem

With baby boomers reaching retirement age, Western countries may need more immigrant workers to ensure productivity. Many studies have suggested a higher occupational injury frequency among immigrant workers, which could considerably reduce their contribution to society. The aim of this study was to examine whether immigrant workers have a higher injury frequency compared to Finnish workers when performing the exact same tasks under the same working conditions.

Method

A total of 176 Finnish and 130 immigrant bus drivers were asked about their occupational injuries during the past 12 months via a questionnaire. In addition, the data contained 134 injuries reported by the transport firm to an insurance company.

Results

There was no significant difference in reporting occupational injuries by self-reporting or by company-records. Because there were more accident-repeaters among Finnish drivers, their injury frequency (114) was higher than that of immigrant drivers (78).

Application/Impact

This study showed that immigrant workers did not have a higher injury frequency than other workers when they worked in the exact same conditions. Immigrant workers can work as safely as native-Finnish workers, when their working conditions and job contracts are at the same level as those of the original population. Immigrant workers can compensate for the shortage of workforce caused by an aging population.     

Evaluation of Vehicle-Based Crash Severity Metrics

Objective: Vehicle change in velocity (delta-v) is a widely used crash severity metric used to estimate occupant injury risk. Despite its widespread use, delta-v has several limitations. Of most concern, delta-v is a vehicle-based metric which does not consider the crash pulse or the performance of occupant restraints, e.g. seatbelts and airbags. Such criticisms have prompted the search for alternative impact severity metrics based upon vehicle kinematics. The purpose of this study was to assess the ability of the occupant impact velocity (OIV), acceleration severity index (ASI), vehicle pulse index (VPI), and maximum delta-v (delta-v) to predict serious injury in real world crashes.

Methods: The study was based on the analysis of event data recorders (EDRs) downloaded from the National Automotive Sampling System / Crashworthiness Data System (NASS-CDS) 2000–2013 cases. All vehicles in the sample were GM passenger cars and light trucks involved in a frontal collision. Rollover crashes were excluded. Vehicles were restricted to single-event crashes that caused an airbag deployment. All EDR data were checked for a successful, completed recording of the event and that the crash pulse was complete. The maximum abbreviated injury scale (MAIS) was used to describe occupant injury outcome. Drivers were categorized into either non-seriously injured group (MAIS2?) or seriously injured group (MAIS3+), based on the severity of any injuries to the thorax, abdomen, and spine. ASI and OIV were calculated according to the Manual for Assessing Safety Hardware. VPI was calculated according to ISO/TR 12353-3, with vehicle-specific parameters determined from U.S. New Car Assessment Program crash tests. Using binary logistic regression, the cumulative probability of injury risk was determined for each metric and assessed for statistical significance, goodness-of-fit, and prediction accuracy.

Results: The dataset included 102,744 vehicles. A Wald chi-square test showed each vehicle-based crash severity metric estimate to be a significant predictor in the model (p < 0.05). For the belted drivers, both OIV and VPI were significantly better predictors of serious injury than delta-v (p < 0.05). For the unbelted drivers, there was no statistically significant difference between delta-v, OIV, VPI, and ASI.

Conclusions: The broad findings of this study suggest it is feasible to improve injury prediction if we consider adding restraint performance to classic measures, e.g. delta-v. Applications, such as advanced automatic crash notification, should consider the use of different metrics for belted versus unbelted occupants.     

Associations of distraction involvement and age with driver injury severities

IntroductionThis paper investigates the associations between the severity of injuries sustained by a driver who is involved in a two-vehicle crash, the existence and type of driver distraction as well as driver's age. Few studies investigated distraction as it relates to injury severity. Moreover, these studies did not consider driver age which is a significant factor related to driving behavior and the ability to respond in a crash situation.MethodsAn ordered logit model was built to predict injury severity sustained by drivers using data from the U.S. National Automotive Sampling System's General Estimates System (2003 to 2008). Various factors (e.g., weather, gender, and speeding) were statistically controlled for, but the main focus was on the interaction of driver age and distraction type.ResultsThe trends observed for young and mid-age drivers were similar. For these age groups, dialing or texting on the cell phone, passengers, and in-vehicle sources resulted in an increase in a likelihood of more severe injuries. Talking on the cell phone had a similar effect for younger drivers but was not significant for mid-age drivers. Inattention and distractions outside the vehicle decreased the odds of severe injuries. For older drivers, the highest odds of severe injuries were observed with dialing or texting on a cell phone, followed by in-vehicle sources and talking on the cell phone. All these sources were associated with an increased likelihood of injury severity. Similar to young and mid-age drivers, distractions outside the vehicle decreased the odds of severe injuries. Other distraction types did not have a significant effect for the older age group.ConclusionsThe results support previous literature and extend our understanding of crash injury severity.Practical applicationsThe findings have implications for policy making and the design of distraction mitigation systems.     

Injuries associated with the use of riding mowers in the United States, 2002-2007

Context: To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower.Design and Setting: Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers.Results: From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR = 5.45 (95% CI = 3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury.Conclusions: Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. Application/Impact: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.