Traumatic brain injury mortality among U.S. children and adolescents ages 0–19 years, 1999–2017

IntroductionTo examine recent traumatic brain injury (TBI) mortality changes among Americans aged 0–19 years by sex, age, urbanicity, state, and intent/causes of injury. Method: TBI mortality per 100,000 population and average annual percent changes (AAPCs), plus 95% confidence intervals (CIs) based on Joinpoint regression models. Results: Age-adjusted TBI mortality among Americans aged 0–19 years declined consistently, though at varying rates between 1999 and 2013 (AAPC = −4.8%, 95%CI: −6.3%, −3.2%), and then significantly increased from 4.42 per 100,000 population in 2013 to 5.17 per 100,000 population in 2017 (AAPC = 3.4%, 95% CI: 1.7%, 5.1%). During the study time period, boys, rural children, and youth aged 15–19 years had higher TBI mortality rates than girls, urban children, and younger children, respectively. TBI mortality from unintentional transport crashes decreased substantially in all age groups between 1999 and 2017, and especially from 1999 to 2010. TBI mortality from suicide increased significantly from 2008 to 2017 in the 10–14-year age group (AAPC = 14.6%, 95% CI: 12.6%, 16.6%) and from 2007 to 2017 in the 15–19-year age group (AAPC = 6.3%, 95% CI: 3.8%, 8.7%). Unintentional transport crashes were the leading cause of TBI-related mortality in 46 states in 1999, but by 2017, suicide became the first leading cause in 14 states. Conclusions: Pediatric TBI mortality declined consistently between 1999 and 2013 and increased significantly from 2013 to 2017, driven primarily by the mortality decrease from unintentional transport crashes and increase in suicide mortality. The spectrum of leading causes of pediatric TBI mortality changed across age groups and over time from 1999 to 2017. Practical Applications: TBI mortality increases in the United States since 2013 are driven primarily by increasing suicide rates, a trend that merits the attention of policy-makers and injury researchers. Action should be taken to curb growing TBI mortality rates among adolescents aged 10–19 years.     

Fun ride or risky transport: Golf cart-related injuries treated in U.S. emergency departments from 2007 through 2017

Introduction: Golf cart-related injuries constitute a substantial source of morbidity, most notably in pediatric populations. Despite the high rate of injuries, there have been no meaningful changes in golf cart design or legislation to reduce the overall burden of these injuries. This study sought to characterize the epidemiology of golf cart-related injuries treated in United States hospital emergency departments. Method: A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for patients of all ages who were treated in emergency departments (EDs) (2007–2017) for a golf cart-related injury. Results: From 2007 through 2017, an estimated 156,040 (95% CI = 102,402–209,679) patients were treated in U.S. EDs for golf cart-related injuries. The average rate of traumatic brain injuries (TBIs) in children (1.62 per 100,000 children) was more than three times that of TBIs in adults (0.52 per 100,000 adults; rate ratio = 2.38; 95% CI = 2.36–2.41) and nearly twice that of TBIs in seniors (1.11 per 100,000 seniors; rate ratio = 1.21; 95% CI = 1.19–1.22). The rate of injuries in seniors increased significantly by 67.6% from 4.81 per 100,000 seniors in 2007 to 8.06 per 100,000 seniors in 2017 (slope = 0.096; p = 0.041). Conclusions: Golf cart use remains an important source of injury for people of all ages, especially in children. As use continues to increase, it is unlikely that golf cart-related injuries will decrease without substantial changes to product design, regulation, and/or legislation. Practical Applications: Use of golf carts pose a considerable risk of injury and morbidity; safety recommendations should be followed.     

Workers' compensation loss prevention representative contact and risk of lost-time injury in construction policyholders

IntroductionInsurance loss prevention (LP) representatives have access and contact with businesses and employees to provide targeted safety and health resources. Construction firms, especially those smaller in size, are a high-risk population. This research evaluated the association between LP rep contact and risk for lost-time injuries in construction policyholders.MethodsWorkers' compensation data were utilized to track LP rep contact with policyholders and incidence of lost-time injury over time. Survival analysis with repeated events modeling calculated hazard ratios (HR) and 95% confidence intervals (CI).ResultsCompared no LP contact, one contact was associated with a 27% reduction of risk (HR = 0.73, CI = 0.65–0.82), two with a 41% (HR = 0.59, CI = 0.51–0.68), and three or more contacts with a 28% reduction of risk (HR = 0.72, CI = 0.65–0.81).ConclusionsLP reps appear to be a valuable partner in efforts to reduce injury burden. Their presence or contact with policyholders is consistent with reduction in overall incidence of lost-time injuries.Practical applicationsReduction in lost-time injuries, resulting in reduced workers' compensation costs for policyholders and insurance companies, builds a business-case for safety and injury prevention. LP reps are often a low or no-cost benefit for insurance policyholders and may be an important injury prevention resource for small firms and/or those with lack of safety resources and staff.     

Crash risk factors for novice motorcycle riders

Background: Motorcycle riders have the highest injury and fatality rates among all road users. This research sought in-depth understanding of crash risk factors to help in developing targeted measures to reduce motorcycle crash injuries and fatalities. Methods: We used interview data from a study of 2,399 novice motorcycle riders in Victoria, Australia from 2010 to 2012 linked with their police-recorded crash and offence data. The outcome measure was self and/or police reported crash. The association between potential risk factors and crashes was explored in multivariable logistic regression models. Results: In the multivariable analysis, riders who reported being involved in three or more near crashes had 1.74 times (95% CI 1.11–2.74) higher odds of crashing compared to riders who reported no near-crash events, and riders who participated in a pre-learner course had 1.41 times higher odds of crashing (95% CI 1.07–1.87) compared with riders who did not attend a pre-learner course. Riders who had been involved in a crash before the study had 1.58 times (95% CI 1.14–2.19) higher odds of crashing during the study period compared with riders who were not involved in a crash. Each additional month of having held a license and learner permit decreased the odds of crashing by 2%, and each additional 1,000 km of riding before the study increased the odds of crashing by 2%. Conclusion: Measures of pre-learner training and riding experience were the strongest predictors of crashing in this cohort of novice motorcycle riders. At the time of the study there was no compulsory rider training to obtain a learner permit in Victoria and no on-road courses were available. It may be plausible that riders who voluntarily participated in an unregulated pre-learner course became or remained at high risk of crash after obtaining a rider license. We suggest systematically reviewing the safety benefits of voluntary versus mandatory pre-learner and learner courses and the potential need to include on-road components.     

Sport participation and injury rates in high school students: A Canadian survey of 2029 adolescents

Introduction: The objective of this study is to examine sport and recreational (S&R) activity participation and injury rates (IR) in high school students (ages 14–19). Methods: High school students (N = 24 schools, n = 2,029; 958 male, 1,048 female, 23 identified ‘other’ or missing; ages 14–19) in Alberta completed a web-based survey during class (October 2018–March 2019). Students identified their top three sports for participation in the past year. Primary outcome measures included IR for (a) any S&R-related injury, (b) most serious S&R-related injury resulting in medical attention, and (c) most serious injury resulting in restriction from S&R for at least one day. Results: In total, 1763/2029 (86.89%) respondents [861/958 (89.87%) male, 886/1048 (84.54%) female, 16/23 (69.57%) identifying as ‘other’ or missing] participated in an S&R activity in the past year. Top sports for male participation were basketball (33.08%; 95% CI 27.67–39.00), ice hockey (20.46%; 95% CI 14.87–27.47), and soccer (19.42%; 95% CI 15.67–23.80). Top sports for female participation were dance (22.52%; 95% CI 17.98–27.82), basketball (18.32%; 95% CI 14.32–23.14), and badminton (17.84%; 95% CI 13.35–23.43). Of the 1,971 students completing the S&R injury question, 889 reported at least one injury during the past year [(IR = 45.10 injuries/100 students/year (95% CI 39.72–50.61)]. The medical attention IR was 29.09 injuries/100 students/year (95% CI 24.49–34.17) and time loss IR was 36.00 injuries/100 students/year (95% CI 30.47–41.93). Conclusions: High school student S&R IRs are high with 29% of adolescents reporting at least one medical attention injury within the past year. Injury prevention strategies targeting youth are necessary. Practical Application: Participation in S&R activities has multiple physical, psychological, and health benefits for adolescents, but some S&R activities also have greater risks of injury. This study informs the next sports to target for implementation of optimal prospective surveillance and injury prevention strategies among high school aged students.     

Parents’ work injuries and children’s mental health: The moderating role of children’s work centrality

Introduction: The purpose of this study is to explore the relationship between parents’ work-related injuries and their children’s mental health, and whether children’s work centrality – the extent to which a child believes work will play an important part in their life – exacerbates or buffers this relationship. Method: We argue that high work centrality can exacerbate the relationship between parental work injuries and children’s mental health, with parental work injuries acting as identity-threatening stressors; in contrast, high work centrality may buffer this relationship, with parental work injuries acting as identity-confirming stressors. We test this relationship with a sample of Canadian children (N = 4,884, 46.2% female, M age = 13.67 years). Results:Children whose parents had experienced more frequent lost-time work-related injuries reported worse mental health with high work centrality buffering this negative relationship. Conclusions: Our study highlights the vicarious effects of work injuries on salient others, specifically parental work injuries on children’s mental health, as well as the role of work centrality in shaping children’s sense-making and expectations about the consequences of work.     

Road traffic injuries among riders of electric bike/electric moped in southern China

Objective: Electric bike/moped-related road traffic injuries have become a burgeoning public health problem in China. The objective of this study was to identify the prevalence and potential risk factors of electric bike/moped-related road traffic injuries among electric bike/moped riders in southern China.

Methods: A cross-sectional study was used to interview 3,151 electric bike/moped riders in southern China. Electric bike/moped-related road traffic injuries that occurred from July 2014 to June 2015 were investigated. Data were collected by face-to-face interviews and analyzed between July 2015 and June 2017.

Results: The prevalence of electric bike/moped-related road traffic injuries among the investigated riders was 15.99%. Electric bike/moped-related road traffic injuries were significantly associated with category of electric bike (adjusted odds ratio [AOR] = 1.36, 95% confidence interval [CI], 1.01–1.82), self-reported confusion (AOR = 1.77, 95% CI, 1.13–2.78), history of crashes (AOR = 6.14, 95% CI, 4.68–8.07), running red lights (AOR = 3.57, 95% CI, 2.42–5.25), carrying children while riding (AOR = 1.96, 95% CI, 1.37–2.85), carrying adults while riding (AOR = 1.68, 95% CI, 1.23–2.28), riding in the motor lane (AOR = 2.42, 95% CI, 1.05–3.93), and riding in the wrong traffic direction (AOR = 1.63, 95% CI, 1.13–2.35). In over 77.58% of electric bike/moped-related road traffic crashes, riders were determined by the police to be responsible for the crash. Major crash-causing factors included violating traffic signals or signs, careless riding, speeding, and riding in the wrong lane.

Conclusion: Traffic safety related to electric bikes/moped is becoming more problematic with growing popularity compared with other 2-wheeled vehicles. Programs need to be developed to prevent electric bike/moped-related road traffic injuries in this emerging country.     

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.     

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.     

Changes in motorcycle-related injuries and deaths after mandatory motorcycle helmet law in a district of Vietnam

Objective: Our study measured the change in head injuries and deaths among motorcycle users in Cu Chi district, a suburban district of Ho Chi Minh City.

Methods: Hospital records for road traffic injuries (RTIs) were collected from the Cu Chi Trauma Centre and motorcycle-related death records were obtained from mortality registries in commune health offices. Head injury severity was categorized using the Abbreviated Injury Score (AIS). Rate ratios (RRs) were used to compare rates pre- and post-law (2005/2006–2009/2010). Cu Chi's population, stratified by year, age, and sex, was used as the denominator.

Results: Of records identifying the transportation mode at the time of injury, motorcyclists accounted for most injuries (3,035, 87%) and deaths (238, 90%). Head injuries accounted for 70% of motorcycle-related hospitalizations. Helmet use was not recorded in any death records and not in 97% of medical records. Males accounted for most injuries (73%) and deaths (88%). The median age was 28 years and 32 years for injuries and deaths, respectively. Compared to the pre-law period, rates of motorcycle injuries (RR = 0.53; 95% confidence interval [CI], 0.49–0.58), head injuries (RR = 0.35; 95% CI, 0.31–0.39), severe head injuries (RR = 0.47; 95% CI, 0.34–0.63), and deaths (RR = 0.69; 95% CI, 0.53–0.89) significantly decreased in the post-law period.

Conclusions: Rates of head injuries and deaths among motorcycle riders decreased significantly after implementation of the mandatory helmet law in Vietnam. To further examine the impact of the motorcycle helmet law, including compliance and helmet quality, further emphasis should be placed on gathering helmet use data from injured motorcyclists.     

Incidence of injury in children and adolescents with intellectual and developmental disability

Introduction: Children and adolescents living with intellectual and developmental disability (IDD) have a higher risk of experiencing morbidities and premature death when compared to children and adolescents living without IDD. Childhood injuries are a leading cause of morbidity and death, yet there are limited studies that explore the prevalence of childhood injuries for individuals living with IDD. The purpose of this study was to analyze Ontario health administrative data to identify and compare rates of injury resulting in hospitalization in children and adolescents living with and without IDD. Methods: This is a cross-sectional study of all Ontarians aged 0–19 years with and without IDD. The outcome of interest was the rate of injury resulting in hospitalization. Results: This study found that children and adolescents with IDD had 1.79 (CI 1.66, 1.92) times higher rates of both intentional and unintentional injuries that resulted in hospitalization when compared to children and adolescents without IDD. Hospitalizations for self-harm related injuries were 3.16 (CI 3.09, 3.23) times higher in the IDD group. Conclusion: Children and adolescents with IDD have a higher risk of sustaining serious injuries, particularly injuries resulting from self-harm. Practical Applications: This study provides evidence of increased injury related hospitalizations for children and adolescents with IDD when compared to their peers without IDD.     

Severity of e-scooter rider injuries associated with trip characteristics

Introduction: E-scooter rider injuries have been growing, but little is known about how trip and incident characteristics contribute to their severity. Method: We enrolled 105 adults injured while riding e-scooters who presented to an emergency department in Washington, DC, during 2019. Enrolled participants completed an interview during the emergency department visit, and their charts were abstracted to document their injuries and treatment. Logistic regression examined the association of incident location and circumstances with the likelihood of sustaining an injury on the Abbreviated Injury Scale (AIS) ≥ 2, while controlling for rider characteristics. Results: The most common locations of e-scooter injuries in our study sample occurred on the sidewalk (58%) or road (23%). Accounting for other trip and rider attributes, e-scooter riders injured on the road were about twice as likely as those injured elsewhere to sustain AIS ≥ 2 injuries (RR, 1.96; 95% CI, 1.23–2.36) and those who rode at least weekly more often sustained AIS ≥ 2 injuries compared with less frequent riders (RR, 1.86; 95% CI, 1.11–2.32). Conclusions: Greater injury severity for riders injured on the road may reflect higher travel speeds. Practical applications: Injury severity associated with riding in the road is one factor that jurisdictions can consider when setting policy on where e-scooters should be encouraged to ride, but the risk of any crash or fall associated with facilities should also be examined. Although injuries are of lower severity on sidewalks, sharing sidewalks with slower moving pedestrians could potentially lead to more conflicts.     

Implementation of participatory organizational change in long term care to improve safety

Introduction: Long Term Care (LTC) facilities are fast-paced, demanding environments placing workers at significant risk for injuries. Health and safety interventions to address hazards in LTC are challenging to implement. The study assessed a participatory organizational change intervention implementation and impacts. Methods: This was a mixed methods implementation study with a concurrent control, conducted from 2017 to 2019 in four non-profit LTC facilities in Ontario, Canada. Study participants were managers and frontline staff. Intervention sites implemented a participatory organizational change program, control sites distributed one-page health and safety pamphlets. Program impact data were collected via Survey (self-efficacy, control over work, pain and general health) and observation (Quick Exposure Checklist). Interviews/focus groups were used to collect program implementation data. Results: Participants described program impacts (hazard controls through equipment purchase/modification, practice changes, and education/training) and positive changes in culture, communication and collaboration. There was a statistically significant difference in manager self-efficacy for musculoskeletal disorder (MSD) hazards between the control and intervention sites over time but no other statistical differences were found. Key program implementation challenges included LTC hazards, staff shortage/turnover, safety culture, staff time to participate, and communication. Facilitators included frontline staff involvement during implementation, management support, focusing on a single unit, training, and involving an external program facilitator. Conclusion: A participatory program can have positive impacts on identifying and reducing MSD hazards. Key to success is involving frontline staff in identifying hazards and creating solutions and management encouragement on a unit working together. High turnover rates, staffing shortages, and time constraints were barriers as they are for all organizational change efforts in LTC. The implementation findings are likely applicable in any jurisdiction. Practical Application: Implementing a participatory organizational change program to reduce MSD hazards is feasible in LTC and can improve communication and aid in identification and control of hazards.     

Prevalence of work-site injuries and relationship between obesity and injury among U.S. workers: NHIS 2004–2012

Introduction: Studies have reported associations between obesity and injury in a single occupation or industry. Our study estimated the prevalence of work-site injuries and investigated the association between obesity and work-site injury in a nationally representative sample of U.S. workers. Methods: Self-reported weight, height, and injuries within the previous three months were collected annually for U.S. workers in the National Health Interview Survey (NHIS) from 2004–2012. Participants were categorized as normal weight (BMI: 18.5–24.9 kg/m²), overweight (BMI: 25.0–29.9), obese I (BMI: 30.0–34.9), and obese II (BMI: 35 +). The prevalence of injury and prevalence ratios from fitted logistic regression models was used to assess relationships between obesity and injury after adjusting for covariates. Sampling weights were incorporated using SUDAAN software. Results: During the 9-year study period from 2004 to 2012, 1120 workers (78 workers per 10,000) experienced a work-related injury during the previous three months. The anatomical sites with the highest prevalence of injury were the back (14.3/10,000 ± 1.2), fingers (11.5 ± 1.3), and knees (7.1 ± 0.8). The most common types of injuries were sprains/strains/twists (41.5% of all injuries), cuts (20.0%), and fractures (11.8%). Compared to normal weight workers, overweight and obese workers were more likely to experience work-site injuries [overweight: PR = 1.25 (95% CI = 1.04–1.52); obese I: 1.41 (1.14–1.74); obese II: 1.68 (1.32–2.14)]. These injuries were more likely to affect the lower extremities [overweight: PR = 1.48, (95% CI = 1.03–2.13); obese I: 1.70 (1.13–2.55); obese II: 2.91 (1.91–4.41)] and were more likely to be due to sprains/strains/twists [overweight: PR = 1.73 (95% CI = 1.29–2.31); obese I: PR = 2.24 (1.64–3.06); obese II: PR = 2.95 (2.04–4.26)]. Conclusions: Among NHIS participants, overweight and obese workers were 25% to 68% more likely to experience injuries than normal weight workers. Practical applications: Weight reduction policies and management programs may be effectively targeted towards overweight and obese groups to prevent or reduce work-site injuries.     

The relationship of occupational injury and use of mental health care

Introduction: Symptoms of depression and anxiety are a common consequence of occupational injury regardless of its cause and type. Nevertheless, mental health care is rarely covered by workers’ compensation systems. The aim of this study was to assess the use of mental health care post-injury. Methods: We used a subsample of patient-care workers from the Boston Hospital Workers Health Study (BHWHS). We matched one injured worker with three uninjured workers during the period of 2012–2014 based on age and job title (nurse or patient-care associate) and looked at their mental health care use pre- and post-injury using medical claims data from the employer sponsored health plan. We used logistic regression analysis to assess the likelihood of mental health care use three and six months post-injury controlling for any pre-injury visits. Analyses were repeated separately by job title. Results: There were 556 injured workers between 2012 and 2014 that were matched with three uninjured workers at the time of injury (n = 1,649). Injured workers had a higher likelihood of seeking mental health care services than their uninjured counterparts during the six months after injury (OR = 1.646, 95% CI: 1.23–2.20), but not three months post-injury (OR = 0.825, 95% CI: 0.57–1.19). Patient-care associates had a higher likelihood to seek mental health care post-injury, than nurses (OR: 2.133 vs OR: 1.556) during the six months period. Conclusions: Injured workers have a higher likelihood to experience symptoms of depression and anxiety based on their use of mental health care post-injury and use is more predominant among patient-care associates; however, our sample has a small number of patient-care associates. Practical Applications: Treating depression and anxiety as part of the workers’ compensation system has the potential of preventing further physical ailment and improving the return to work process regardless of nature of injury.     

Hepatitis B virus infection among health care workers in Public Teaching Hospitals in Khartoum State, Sudan

Background

Hepatitis B virus (HBV) infection is a global public health problem. It is estimated that there are more than 300 million HBV carriers in the world.

Aim

The study aimed to examine the sero-prevalence of hepatitis B virus (HBV) markers among health care workers (HCWs) in Public Teaching Hospitals in Khartoum State, in the year 2004.

Methods

The study is an observational, cross sectional, facility-based study. It was conducted on stratified two-stage cluster random sample of 843 subjects. The study followed non-parametric statistical methods, using Z-test for single proportion.

Results

Among the 843 subjects tested for all HBV markers (Anti-HBc, HBsAg, HBsAb, and HBeAg), the prevalence of Anti-HBc, HBsAg, HBsAb, and HBeAg was found to be 57% (CI 95%:53-60%), 6% (CI 95%:4.0-8.0%), 37% (CI 95%:34-40%) and 9% (CI 95%:7-11%) respectively. P < 0.05.

Conclusion

Seroprevalence of all HBV markers (P < 0.05) was found to be significantly high, while the rate of immunity against HBV infection was low among health care workers In Public Teaching Hospitals in Khartoum State, Sudan.     

Injuries among electric power industry workers, 1995–2013

IntroductionWorkers in the electric power industry face many risks of injury due to the high diversity of work tasks performed in potentially hazardous and unpredictable work environments.MethodWe calculated injury rates by age, sex, occupational group, and injury type among workers in the Electric Power Research Institute’s (EPRI) Occupational Health and Safety Database (OHSD), which contains recordable injury, medical claims, and personnel data from 18 participating electric power companies from 1995 to 2013.ResultsThe OHSD includes a total of 63,193 injuries over 1,977,436 employee-years of follow-up, for an overall injury rate of 3.20 injuries per 100 employee-years. Annual injury rates steadily decreased from 1995 to 2000, increased sharply in 2001, and subsequently decreased to their lowest rate of 1.31 injuries per 100 employee-years in 2013. Occupations with the highest injury rates were welders (13.56 per 100 employee-years, 95% CI 12.74–14.37), meter readers (12.04 per 100 employee-years, 95% CI 11.77–12.31), and line workers (10.37 per 100 employee-years, 95% CI 10.19–10.56). Males had an overall higher injury rate compared to females (2.74 vs. 1.61 per 100 employee-years) although some occupations, such as meter reader, had higher injury rates for females. For all workers, injury rates were highest for those in the 21 to 30 age group (3.70 per 100 employee-years) and decreased with age. Welders and machinists did not follow this trend and had higher injury rates in the 65 + age group. There were 63 fatalities over the 1995 to 2013 period, with 21 fatalities (33.3%) occurring among line workers.ConclusionsAlthough injury rates have decreased over time, certain high-risk groups remain (i.e., line workers, mechanics, young males, older welders and machinists, and female meter readers).Practical applicationsProtective measures and targeted safety programs may be warranted to ensure the safety of electric power workers.     

Injury surveillance trends in career–technical education: New Jersey 1999–2018

Introduction: Adolescents engaging in school-sponsored work experiences may be at risk of injury due to factors such as inexperience. This article examines trends in 20 years of reported injuries among New Jersey (NJ) adolescents engaging in school-sponsored work experiences, and compares a transition from paper to online reporting format. Methods: New Jersey requires reporting of injuries occurring during school-sponsored work experiences to the NJ Department of Education. Injuries reported by NJ schools from 1999 to 2018 (n = 2,119) were examined; incidence rates for 2008 to 2018 (n = 743) were calculated using publicly available NJ Department of Education enrollment data for the denominator, including for specific groups of students: career and technical education; special healthcare needs. Results: A downward trend in reported injuries in NJ schools was observed. However, the year online reporting became required by code (2013), an increase of nearly 50% was seen from 2012 (59–89), followed by a decline in reported incidents 2014 to 2018 (mean = 65, range 76 down to 47). Injury rate trends over time paralleled those of reported incidents. Conclusions: This study suggested worker safety and public health benefits of improvements from State of NJ code required training programs and online injury surveillance report form. Practical Applications: One potential method to address the safety and health of adolescents engaging in work experiences is the use of online reporting forms, to aid in surveillance efforts, coupled with occupational safety and health training specifically geared toward teachers and administrators who both supervise young, relatively inexperienced and vulnerable workers and who make relatively frequent worksite visits. Incorporation of specific details of the instructions on the use of a reporting form into required trainings, in addition to providing a clear, accessible guidance manual online, could further help improve youth worker safety surveillance efforts.     

Occupational injury and psychological distress among U.S. workers: The National Health Interview Survey, 2004–2016

Introduction: Injuries at work may negatively influence mental health due to lost or reduced working hours and financial burden of treatment. Our objective was to investigate, in U.S. workers (a) the prevalence of serious psychological distress (SPD) by injury status (occupational, non-occupational, and no injury) and injury characteristics, and (b) the association between injury status and SPD. Methods: Self-reported injuries within the previous three months were collected annually for 225,331 U.S. workers in the National Health Interview Survey (2004–2016). Psychological distress during the past 30 days was assessed using the Kessler 6 (K6) questions with Likert-type scale (0–4, total score range: 0–24). SPD was defined as K6 ≥ 13. Prevalence ratios (PR) from fitted logistic regression models were used to assess relationships between injury and SPD after controlling for covariates. Results: The prevalence of SPD was 4.74%, 3.58%, and 1.56% in workers reporting occupational injury (OI), non-occupational injury (NOI), and no injury, respectively. Workers with head and neck injury had the highest prevalence of SPD (Prevalence: OI = 7.71%, NOI = 6.17%), followed by workers with scrape/bruise/burn/bite (6.32% for those with OI). Workers reporting OI were two times more likely to have SPD compared to those without injury (PR = 2.19, 95%CI: 1.62–2.96). However, there was no significant difference in SPD between workers with OI and workers with NOI (PR = 0.98, 95%CI: 0.65–1.48). Conclusion: The prevalence of SPD varied by injury status with the highest being among workers reporting OI. We found that the workers reporting OI were significantly more likely to have SPD than those without injury, but not more than those with NOI. Practical Applications: Mental health management programs by employers are necessary for workers who are injured in the workplace.     

What kinds of injuries do OSHA inspections prevent?

Objective

OSHA's enforcement program is one of the major public efforts to protect American workers. We examine both the scope of injury prevention that inspections can contribute and the types of standards that contribute the most.

Methods

We linked Pennsylvania Department of Labor and Industry files for lost-time injuries and employment to calculate injury rates for 1998-2005 for all single-establishment manufacturing firms. We linked these to OSHA inspection records.

Results

Inspections with penalties did affect injury types unrelated to standards as well as those related. We also found again that citations for violations of the standard requiring personal protective equipment had the largest impact on preventing injuries.

Impact on Industry

Programs requiring protective equipment use deserve added attention from consultants and inspectors. In addition, some inspections spur managers to undertake safety measures that go beyond compliance with standards.