Global estimates of occupational accidents

Information of occupational accidents is not standardized worldwide. Especially, developing countries do not have reliable information on their occupational accidents due to lack of proper recording and notification systems. The number of accidents is under-reported but figures are still used as a baseline for occupational safety work. In this paper global estimates of occupational accidents are presented for 175 countries. These estimates are based on figures from selected countries in eight different regions. Global estimates help to compare different countries and regions to each other to detect improvements in safety and safety work. In 1998 the average estimated number of fatal occupational accidents was 350 000 and there were 264 million non-fatal accidents. Global estimates are needed to guide national policies and decision-making.     

Epidemiology of occupational accidents among Iranian insured workers

Work-related accidents are considered as a major health problem worldwide. The aim of present study was to determine the epidemiological pattern of occupational accidents among workers insured by the Iranian Social Security Organization (ISSO) between 2001 and 2005.Subjects consisted of all workers and drivers who had a work-related accident during 2001–2005 and were registered in the Iranian Social Security Organization (ISSO) database according to the inspection reports. An ordinal logistic regression model (proportional odds regression model) was used to assess the concurrent effects of independent variables on accident outcomes.Overall, 86,437 work-related accidents were investigated. The accidents were more frequent in metal workplaces and electrical industries, respectively. More than half of the accidents were due to incautious activities. Workers’ age (age at the time of accident) (OR = 0.99, CI: 0.989–0.994), gender (OR = 1.3, CI: 1.191–1.683), marital status (OR = 1.25, CI: 1.143–1.675) as well as accident setting (OR = 1.88, CI: 1.728–1.975) had significant effect on accident outcomes. Pattern of occupational injuries in Iran was consistent with the global pattern for accident outcomes.     

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.     

Differences in risk perception,priorities, worry and demand for risk mitigation in transport among Norwegians in 2004 and 2008

The present study aimed to investigate differences in risk perception, the demand for risk mitigation, priorities and worry related to transport among the Norwegian public in 2004 and 2008. Age, gender, education, driver licence and number of injuries in transport were controlled for. The comparison was carried out with questionnaire surveys among representative samples of the Norwegian public in 2004 (n = 1730) and 2008 (n = 1864). The results showed that the perceived probabilities of transport accidents decreased, whereas the perceived severity of consequences increased during this period. Both samples estimated higher probabilities of accidents by private means of transport. The demand for risk mitigation and priorities related to transport safety increased significantly in the same period. The 2008 sample also reported more worry regarding accidents by private transport. Results were discussed in relation to transport safety campaigns, safety measures and significant accidents which occurred in this period.     

Safety compliance climate concerning risk assessment and preventive measures in EU legislation: A Finnish survey

The aim of the present study is to explore the process dynamics of the safety compliance climate and work relationships, including their antecedents and consequences. After investigating the many dimensions of safety compliance climate and of work relationships, the study concludes that a multi-component measure is needed to fully assess all of their dimensions. With respect to the impacting positively on safety compliance legislation, the present study found the following factors: “contribution measures”, “concrete preventive measures” and “risk assessment process”. For risk assessment factors on safety compliance the study identified “planning, guidelines, policy, management”, “prioritization of proactive measures”, “results in cooperation and information” and “active use of risks assessment document”. In a regression model for the workers, both risk assessment process and contribution measures had a statistically highly significant (p < 0.001) effect on concrete preventive measures. In the regression analysis of the employers risk assessment process had a statistically significant (p < 0.01) effect and contribution measures had a statistically highly significant (p < 0.001) effect on concrete preventive measures.     

Nursing student evaluation of NIOSH workplace violence prevention for nurses online course

Introduction: As primary targets of workplace violence in health care settings, nurses may suffer negative physical and psychological consequences. NIOSH created an online course to educate nurses about violence prevention techniques. Method: A mixed-methods approach assessed workplace violence awareness and knowledge among nursing students. A pre/post/post-test survey and focus group discussions evaluated participant awareness and knowledge, assessed course design, and solicited recommendations for increasing participation and strategies for improving message retention. Results: The mean awareness scores differed significantly between pre-course and both post-course time points (Wilk's λ = 0.319, F(2, 46) = 49.01, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased awareness of workplace violence from pre-course scores (M = 0.75, SD = 0.438) to immediate post-course (M = 2.13, SD = 0.789) and four-week post-course (M = 1.96, SD = 0.771) scores on a 3-item measure. Similarly, mean knowledge scores increased between pre-course and both post-course time points (Wilk's λ = 0.495, F(1.57, 73.66) = 37.26, p < 0.001). Post hoc tests using the Bonferroni correction revealed that course participation increased knowledge of workplace violence from pre-course scores (M = 6.65, SD = 1.45) to immediate post-course (M = 8.56, SD = 1.32) and four-week post-course (M = 8.19, SD = 1.42) scores on a 10-item measure. Qualitative data from the focus groups reinforced the quantitative findings. Participants citing benefits from the content strongly recommended including the course in nursing curriculums. Incorporating the course early in the nursing educational experience will better prepare students to deal with workplace violence when they enter health care professions. Conclusions: The results indicate that NIOSH and its partners created an effective online workplace violence awareness and prevention course. Practical applications: Nursing students and professionals can be effectively educated about workplace violence using an online format.     

Association between safety leading indicators and safety climate levels

ObjectivesThe aim of this study was to evaluate the association of leading indicators for occupational health and safety, particularly safety inspections and non-compliances, with safety climate levels.MethodsNordic Occupational Safety Climate Assessment Questionnaire was employed to evaluate safety climate in cross-sectional design. The geographically diverse population of the inspection body made it possible to conduct the survey across 10 provinces in Iran. 89 completed questionnaires were obtained with a response rate of 47%. Except for management safety justice, the internal consistency of other six dimensions was found to be acceptable (α ≥ 0.7).ResultsMean scores of dimensions ranged from 3.50 in trust in the efficacy of safety systems (SD = 0.38) to 2.98 in workers' safety priority and risk non-acceptance (SD = 0.47). Tukey HSD tests indicated a statistically significant difference of mean scores among groups undergoing different number of safety inspections and those receiving different number of non-compliances (p < 0.05), with no significant differences based on safety training man-hours and sessions (p > 0.05). Spearman's rank-order correlation showed no relationship between work experience and number of non-compliances (correlation coefficient = − 0.04, p > 0.05) and between safety training man-hours and number of non-compliances (correlation coefficient = − 0.15, p > 0.05).ConclusionsOur results indicate that safety climate levels are influenced by number of safety inspections and the resultant non-compliances.Practical applicationsFindings suggest that safety non-compliances detected as a result of conducting safety inspections could be used to monitor the safety climate state. Establishing plans to conduct scheduled safety inspections and recording findings in the form of safety non-compliance and monitoring their trend could be used to monitor levels of safety climate.     

Managers’ attitudes towards safety measures in the commercial road transport sector

Safety measures and related costs and benefits have been widely discussed and analysed in academic circles and by the authorities and industrial sectors. The study reported in this paper addresses these aspects from a cognitive based perspective. Risk management is about dealing with the conflict between production and safety. Enterprises which spend too much on safety will meet bankruptcy, and those not concerned with safety measures will meet with severe accidents and related damage. Inspired by James Reason’s theoretical framework, managers (n = 106) of commercial transport enterprises were asked about their attitudes towards safety management, what factors have contributed and their belief that further effort and investments in health, environment and safety (HES) measures will pay off. One half of the managers perceive HES work as too expensive and approximately one quarter assess mandatory HES work as compromising their competitiveness. One third of the managers do not find further safety measures than those already implemented necessary or remunerative. They claim that there are no other alternative ways of doing their activities and that there are no technical measures available that could meet outstanding safety challenges. Managers do acknowledge HES work as important for the reputation of the enterprise. The factor analysis gave five HES attitude factors: (I) concerned with formalities, (II) HES work improves health, environment and safety, (III) HES work is ineffective, (IV) HES regulation is appropriate, and (V) HES work can be improved.     

The relationship between patient safety climate and occupational safety climate in healthcare – A multi-level investigation

IntroductionPatient safety climate/culture is attracting increasing research interest, but there is little research on its relation with organizational climates regarding other target domains.The aim of this study was to investigate the relationship between patient safety climate and occupational safety climate in healthcare.MethodThe climates were assessed using two questionnaires: Hospital Survey on Patient Safety Culture and Nordic Occupational Safety Climate Questionnaire. The final sample consisted of 1154 nurses, 886 assistant nurses, and 324 physicians, organized in 150 work units, within hospitals (117 units), primary healthcare (5 units) and elderly care (28 units) in western Sweden, which represented 56% of the original sample contacted.ResultsWithin each type of safety climate, two global dimensions were confirmed in a higher order factor analysis; one with an external focus relative the own unit, and one with an internal focus. Two methods were used to estimate the covariation between the global climate dimensions, in order to minimize the influence of bias from common method variance. First multilevel analysis was used for partitioning variances and covariances in a within unit part (individual level) and a between unit part (unit level). Second, a split sample technique was used to calculate unit level correlations based on aggregated observations from different respondents. Both methods showed associations similar in strength between the patient safety climate and the occupational safety climate domains.ConclusionsThe results indicated that patient safety climate and occupational safety climate are strongly positively related at the unit level, and that the same organizational processes may be important for the development of both types of organizational climate.Practical applicationsSafety improvement interventions should not be separated in different organizational processes, but be planned so that both patient safety and staff safety are considered concomitantly.     

Safety compliance and safety climate: A repeated cross-sectional study in the oil and gas industry

IntroductionViolations of safety rules and procedures are commonly identified as a causal factor in accidents in the oil and gas industry. Extensive knowledge on effective management practices related to improved compliance with safety procedures is therefore needed. Previous studies of the causal relationship between safety climate and safety compliance demonstrate that the propensity to act in accordance with prevailing rules and procedures is influenced to a large degree by workers' safety climate. Commonly, the climate measures employed differ from one study to another and identical measures of safety climate are seldom tested repeatedly over extended periods of time. This research gap is addressed in the present study.MethodThe study is based on a survey conducted four times among sharp-end workers of the Norwegian oil and gas industry (N = 31,350). This is done by performing multiple tests (regression analysis) over a period of 7 years of the causal relationship between safety climate and safety compliance. The safety climate measure employed is identical across the 7-year period.ConclusionsTaking all periods together, the employed safety climate model explained roughly 27% of the variance in safety compliance. The causal relationship was found to be stable across the period, thereby increasing the reliability and the predictive validity of the factor structure. The safety climate factor that had the most powerful effect on safety compliance was work pressure.Practical applicationsThe factor structure employed shows high predictive validity and should therefore be relevant to organizations seeking to improve safety in the petroleum sector. The findings should also be relevant to other high-hazard industries where safety rules and procedures constitute a central part of the approach to managing safety.     

Healthcare utilization and costs among older adult female drivers and former drivers

PurposeThis study compared the healthcare utilization and costs for specific types of medical services among older adult women who currently drive and those who no longer drive.MethodsThis study included 347 women aged 65 or older who were either former (had stopped driving) or current drivers, randomly sampled from a large U.S. health plan to participate in a telephone survey, and who had automated health records with healthcare utilization and cost data. Bivariate analyses and generalized linear modeling were used to examine associations between driving status and healthcare utilization and costs.ResultsAdjusting for age, income, and marital status, former drivers were more likely than current drivers to use mental health care services (RR = 3.37; 95% CI: 1.03, 10.98). Former drivers also tended to use more inpatient (RR = 1.85; 95% CI: 0.88, 3.87) and emergency services (RR = 1.89; 95% CI: 0.96, 3.70), but results did not reach statistical significance. Total annual healthcare costs in 2005 were almost twice as high for former drivers compared with current drivers ($13,046 vs. $7,054; mean difference = $5,992; 95% CI: -$360, $12,344), although this relationship was not statistically significant (CR = 1.61; 95% CI: 0.88, 2.96).Impact on IndustryFormer drivers were more than three times as likely as current drivers to use mental health services, and tended to use more emergency and inpatient services. Further research on factors that potentially mediate the relationship between driving status and health service use is warranted.     

Assessing the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries

Surveillance systems are indispensable for injury prevention; yet, detailed electronic records are rarely available. The “Student’s Health Card” is a self-reporting electronic tool addressing health issues of University students, while aiming to actively involve them in preventive practices and health promotion. Utilizing data from the injury prevention related section, this study sought to investigate the impact of risk-taking behavior on road crash involvement among University students residing in two Mediterranean countries. A total of 978 University students, 451 Greek and 527 Italian, provided information on prior road crash involvement, as well as on eight behavioral variables, comprising a risky behavior score. Multiple logistic regression analysis was performed. The already known tendency for clustering of risky behaviors was evident. One degree increment in the risky behavior score was found to increase the risk of road crash involvement by 35%. Driving after drinking (OR = 2.55, CI = 1.53–4.26), riding with a drunk driver (OR = 2.19, CI = 1.08–4.45) and tobacco smoking (OR = 1.95, CI = 1.18–3.22) significantly multiplied the risk. Despite their better compliance with safety measures, Italian students, compared with Greek, reported worse alcohol-related driving habits and engaged more frequently in mobile phone use while driving. Clustering of risky behaviors was found to be an important predictor of road crash involvement. Screening and awareness of risk-taking propensity of University students could guide early intervention. The “Student’s Health Card” could provide, at minimal cost, reliable risk-taking and road crash involvement information, which is needed for both personal risk assessment and surveillance purposes.     

How perceptions of experience-based analysis influence explanations of work accidents

IntroductionThis article looks into how perceptions of experience-based analysis (EBA) influence causal explanations of accidents given by managers and workers in the chemical industry (n = 409) and in the nuclear industry (n = 222).MethodThe approach is based on the model of naive explanations of accidents (Kouabenan, 1999, 2006, 2009), which recommends taking into account explanations of accidents spontaneously given by individuals, including laypersons, not only to better understand why accidents occur but also to design and implement the most appropriate prevention measures. The study reported here describes the impact of perceptions about EBA (perceived effectiveness, personal commitment, and the feeling of being involved in EBA practices) on managers' and workers' explanations of accidents likely to occur at the workplace.ResultsThe results indicated that both managers and workers made more internal explanations than external ones when they perceived EBA positively. Moreover, the more the participants felt involved in EBA, were committed to it, and judged it effective, the more they explained accidents in terms of factors internal to the workers. Practical Applications: Recommendations are proposed for reducing defensive reactions, increasing personal commitment to EBA, and improving EBA effectiveness.     

Unintentional injuries treated in hospital emergency departments among persons aged 65 years and older,United States, 2006–2011

IntroductionWith the aging of the United States population, unintentional injuries among older adults, and especially falls-related injuries, are an increasing public health concern.MethodsWe analyzed emergency department (ED) data from the Nationwide Emergency Department Sample, 2006–2011. We examined unintentional injury trends by 5-year age groups, sex, mechanism, body region, discharge disposition, and primary payer. For 2011, we estimated the medical costs of unintentional injury and the distribution of primary payers, plus rates by injury mechanisms and body regions injured by 5-year age groups.ResultsFrom 2006 to 2011, the age-adjusted annual rate of unintentional injury-related ED visits among persons aged ≥ 65 years increased significantly from 7987 to 8163, per 100,000 population. In 2011, 65% of injuries were due to falls. Rates for fall-related injury ED visits increased with age and the highest rate was among those aged ≥ 100. Each year, about 85% of unintentional injury-related ED visits in this population were expected to be paid by Medicare. In 2011, the estimated lifetime medical cost of unintentional injury-related ED visits among those aged ≥ 65 years was $40 billion.ConclusionIncreasing rates of ED-treated unintentional injuries, driven mainly by falls among older adults, will challenge our health care system and increase the economic burden on our society. Prevention efforts to reduce falls and resulting injuries among adults aged ≥ 65 years have the potential to increase well-being and reduce health care spending, especially the costs covered by Medicare.Practical applicationsWith the aging of the U.S. population, unintentional injuries, and especially fall-related injuries, will present a growing challenge to our health care system as well as an increasing economic burden. To counteract this trend, we must implement effective public health strategies, such as increasing knowledge about fall risk factors and broadly disseminating evidence-based injury and fall prevention programs in both clinical and community settings.     

Cross-cultural comparisons of traffic safety,risk perception,attitudes and behaviour

The core aim of the present study is to examine cultural differences in risk perception and attitudes towards traffic safety and risk, taking behaviour in the Norwegian and the Ghanaian public. An additional aim is to discuss the applicability of various traffic measures, suited for low and middle income countries in Africa.Sample: The results of the present study are based on two self-completion questionnaire surveys carried out in February and March 2006. The first was a representative sample of the Norwegian public above 18 years of age (N = 247). The second was a stratified sample of Ghanaian respondents (N = 299). In Ghana the data was collected in Accra and Cape Coast.The results showed that there is potential for further improvement of safety attitudes and risk behaviour among Ghanaians as well as Norwegians. There were also differences in the respondents’ evaluation of attitudes, risk perception and behaviour. Perceived risk and attitudes also significantly predicted risk behaviour and accidents/collisions. The implications of these results for traffic safety will be discussed.     

Better effect of the use of a needle safety device in combination with an interactive workshop to prevent needle stick injuries

ObjectivesThis study compares the effectiveness of two types of interventions with no intervention on the prevention of needle stick injuries (NSIs).MethodsHealth care workers, who were at risk for NSIs, were eligible for this three-armed cluster randomized controlled trial. In total, 23 hospital wards were randomly assigned to 1 of 2 intervention groups, which were given either a needle safety device and a workshop (NW; 7 wards, n = 267) or a workshop only (W; 8 wards, n = 263), or to a control group (C; 8 wards, n = 266). The primary outcome was the half-year incidence of NSIs, which was measured through questionnaires and official notification at the occupational health service at baseline (T0), 6 months (T1) and 12 months (T2) after baseline. Analysis were done by intention to treat. This study is registered as a prospective randomized trial, number NTR1207.ResultsA statistically significant difference was found between the groups for the half-year incidence of NSIs (p = 0.046) on the basis of questionnaire data with ORs for reported NSIs for the NW group compared with the control group of 0.34 (95% CI: 0.13–0.91) and 0.45 (95% CI: 0.19–1.06) for the W group compared with the control group. The officially registered NSIs during the study period showed no statistical differences between the groups.ConclusionsThe combined intervention of the introduction of needle safety devices and an interactive workshop led to the highest reduction in the number of self-reported NSIs compared to a workshop alone or no intervention.     

Stochastic modeling of accident risks associated with an underground coal mine in Turkey

In this study, a methodology is proposed towards development of an uncertainty model that includes randomness in the occurrence of days-lost accidents in a coal mine. The accident/injury data consists of 1390 days-lost accident cases recorded at GLI-Tuncbilek underground lignite mine from January 1994 to December 2002. In the first step of proposed methodology, the frequency and the severity of the accidents have been modeled statistically by fitting appropriate distributions. The test done by BestFit software yields a chi-square value of 21.53 (p = 0.089) with 14 degrees of freedom and estimates the parameter of lambda for Poisson distribution as 12.87 accidents/month. For the severity component, a lognormal distribution is fitted to days-lost data and chi-square goodness-of-fit test calculates a value of 40.44 (p = 0.097) with 30 degrees of freedom. The parameters of lognormal distribution are estimated as a mean of 14.3 days and standard deviation of 23.1 days, respectively. Then, two distributions are basically combined by Monte Carlo simulation in order to construct relative risk levels in yearly base referring to the final cumulative distribution. Finally, a simple forecasting modeling is carried out in order to quantitatively predict the expected risk levels by using decomposition technique in time series analysis. Stochastic model estimates that although, there would be substantial reduction in the expected number of accidents in the near future, the higher level of risks still should be a concern for the mine management.     

Cultural and socio-demographic predictors of car accident involvement in Norway,Ghana, Tanzania and Uganda

The prevalence of road traffic accidents is increasing towards endemic proportions in developing countries. The present study investigated cultural and demographic predictors of car accident involvement in a developed country in Europe and three developing countries in Sub-Saharan Africa. The comparison was carried out with questionnaires among a randomly obtained representative sample of the Norwegian population (n = 247) as well as stratified samples in Accra and Cape-Coast in Ghana (n = 299), Dar-es-Salaam and Arusha areas in Tanzania (n = 599), and the central Kampala and the Mbarara district in Uganda (n = 415). Measurement instruments of culture as symbol exchange and destiny orientation were used to predict self-reported road traffic accident involvement by car among the respondents. Demographic characteristics, such as gender, age and education, were also included as predictors of car accidents. The results showed that male gender was the only significant predictor of accident involvement in Norway. Introverted and extroverted culture, destiny orientation and written culture were associated with accident involvement in the African countries. Male gender also predicted accidents in these countries. Non-technical injury preventive countermeasures in developing countries could focus on cultural practice and fatalistic beliefs. Countermeasures in both developed and developing countries should target male drivers.