Analysis of precipitation-related motor vehicle collision and injury risk using insurance and police record information for Winnipeg, Canada

Introduction

Police records are the most common source of data used to estimate motor-vehicle collision risks, understand causal or contributing factors, and evaluate the efficacy of interventions. The literature notes concerns about this information citing discrepancies between police reports and other sources of injury occurrence and severity data. The primary objective of the analysis was to assess the adequacy of police reports for an examination of weather-related injury collision risk.

Method

Analyses of relative risk were carried out using both police records and comprehensive insurance claim data for Winnipeg, Canada over the period 1999-2001.

Results and conclusions

Both data sets yielded very similar results—precipitation substantially increases the risk of injury collision (police records: RR 1.76, CI 1.55-2.00; insurance: RR 1.80, CI 1.62-1.99) and risk of injury (police records, RR 1.74, CI 1.55-1.96; insurance, RR 1.69, CI 1.55-1.85) relative to corresponding dry weather control periods. Both rainfall and snowfall were associated with large increases in collisions and injuries.

Impact on Industry

While relative risks are almost identical, over 64% more injury collisions and 74% more injuries were identified using the insurance data, which is an important difference for evaluating absolute risk and exposure.     

Assessment of perceived injury risks and priorities among truck drivers and trucking companies in Washington State

Problem

The trucking industry experiences one of the highest work-related injury rates. Little work has been conducted previously in the United States to assess the hazards, needs, and injury prevention priorities in trucking. Method: Two separate industry-wide surveys of 359 trucking companies and 397 commercial truck drivers were conducted in Washington State. Results: Trucking companies and drivers both ranked musculoskeletal and slip, trip, fall injuries as the top two priorities. Controlling heavy lifting, using appropriate equipment, and addressing slippery surfaces were frequently listed as solutions. There appears to be a gap in safety climate perception between workers and employers. However, driver and company priorities agreed with industry workers' compensation claims. There is room for safety program management improvement in the industry. The study findings detail opportunities for prioritizing and reducing injuries. Impact on Industry: This information can be used to focus and design interventions for the prevention of work-related injuries while improving industry competitiveness.     

The business cycle and the incidence of workplace injuries: evidence from the U.S.A

Introduction

The current study explored the association between the business cycle and the incidence of workplace injuries to identify cyclically sensitive industries and the relative contribution of physical capital and labor utilization within industries.

Method

Bureau of Labor Statistics nonfatal injury rates from 1976 through 2007 were examined across five industry sectors with respect to several macroeconomic indicators. Within industries, injury associations with utilization of labor and physical capital over time were tested using time series regression methods.

Results

Pro-cyclical associations between business cycle indicators and injury incidence were observed in mining, construction, and manufacturing but not in agriculture or trade. Physical capital utilization was the highest potential contributor to injuries in mining while labor utilization was the highest potential contributor in construction. In manufacturing each effect had a similar association with injuries.

Conclusion

The incidence of workplace injury is associated with the business cycle. However, the degree of association and the mechanisms through with the business cycle affects the incidence of workplace injuries was not the same across industries.

Impact on Industry

The results suggest that firms in the construction, manufacturing, and mining industries should take additional precautionary safety measures during cyclical upturns. Potential differences among industries in the mechanisms through which the business cycle affects injury incidence suggest different protective strategies for those industries. For example, in construction, additional efforts might be undertaken to ensure workers are adequately trained and not excessively fatigued, while safety procedures continue to be followed even during boom times.     

Injury outcomes and costs for cross-median and median barrier crashes

Introduction

The objective of this research was to quantify the injury outcomes and develop reliable and comprehensive injury costs for cross-median crashes (CMC) and median barrier crashes (MBC).

Method

A three-step methodology was developed to quantify the crash costs for each crash severity and type. All CMC and MBC between 2001 and 2007 in Wisconsin were identified and used in this analysis. The Wisconsin CODES database provided comprehensive injury costs based on the injury types and severities suffered by participants in study crashes.

Results

As expected, multi-vehicle CMC result in more total injuries and more severe injuries than single-vehicle CMC. Injury costs for the same injury level on KABCO scale are different for different crash types. Injury costs for concrete MBC are 33% to 50% less than those of multi-vehicle CMC, while the injury costs of concrete MBC for lower severities (B and C) are similar to those of single-vehicle CMC for the same severities; but for incapacitating injuries the costs are 30% less. As expected, concrete MBC result in lower severities than CMC. The costs, by crash severity, vary significantly between different crash types. Concrete median barrier injury crashes are roughly 20% of multi-vehicle CMC costs and 50% of single-vehicle CMC costs.

Conclusions

Results indicate that using one set of crash costs for all crash types biases any evaluation. Therefore, it is recommended that crash-type-specific costs be used in applications such as development of median barrier warrant where specific types of crashes are considered (CMC and MBC).

Impact on industry

Using crash specific costs can lead to a more realistic benefit-cost analysis and enable better decision-making.     

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.     

Injuries and risk-taking behaviours in Portuguese adolescents: Highlights from the health behaviour in school-aged children survey

Aim

Injuries in adolescence are an important public health problem and a major cause of morbidity and mortality in this age group. This study aimed to determine the behaviour profile associated to risk of injury and the differences between genders, region and ethnic origin.

Methods

A cross-sectional study design of a nationally representative sample of 1581 adolescents of the Portuguese Health Behaviour in School-Aged Children study.

Results

An occurrence of one injury-related event in the previous year was reported by 21.4% of the respondents and 5.9% referred having more than one injury-related event. Boys reported higher frequency of those events when compared to girls, and non-Portuguese subjects referred higher frequency of events. Scoring higher in violence-related behaviour and psychosomatic complaints was associated to higher chances of referring more than one injury-related event.

Conclusion

Gender, social background and behaviour profile are factors that seem to influence the risk of injuries. This information should guide those involved in the planning of injuries prevention programs in youth.     

Occupational fatalities due to electrocutions in the construction industry

Introduction

Occupational fatalities due to contact with electricity account for approximately 9% of all deaths in the construction industry and is the fourth leading cause of death in this industry.

Method

Differences in the proportions of electrocutions in the construction industry are significantly different from other industries based upon the age of the worker and the source of the electricity.

Results

This study found that, in the construction industry, the proportion of occupational fatalities due to contact with electric current is significantly higher for workers in the 16 to 19 years old age group. Contact with overhead power lines occurred more frequently with younger workers, while contact with electric wiring, transformers, and related equipment was found to occur more frequently with older workers. The proportion of fatalities due to this event was also found to account for a significantly greater proportion of fatalities in the construction industry overall.

Impact on industry

The proportions of electrocution fatalities in the construction industry were found to be significantly higher for younger workers when compared to all other industries. Focusing prevention measures toward younger workers who work near overhead power lines could have a significant impact upon death rates. For older workers, the focus should be on those who work on or near transformers, electrical wiring, and components. Across the construction industry, implementation of effective lockout-tagout programs, and verification of energy isolation, can prevent approximately 125 fatalities per year in the construction industry.     

Changes in fall prevention training for apprentice carpenters based on a comprehensive needs assessment

Problem

Falls from heights in residential construction are common, especially among inexperienced workers.

Methods

We conducted a comprehensive needs assessment to determine gaps in the school-based apprentice carpenters' fall prevention training. A team of carpenter instructors and researchers revised the fall prevention training to fill these gaps. Apprentice evaluation and feedback guided ongoing curricular improvements.

Results

Most apprentice carpenters performed work tasks at heights prior to training and fall protection techniques were not commonly used at residential construction sites. Priorities of the revised school-based training included safe ladder habits, truss setting, scaffold use, guarding floor openings, and using personal fall arrest systems. New apprentices were targeted to ensure training prior to exposure at the workplace. We used adult learning principles to emphasize hands-on experiences. A framed portion of a residential construction site was fabricated to practice fall protection behaviors in a realistic setting. The revised curriculum has been delivered consistently and apprentice feedback has been very favorable.

Conclusions

Integration of needs assessment results was invaluable in revising the school-based carpenters apprentice fall prevention curriculum. Working closely with the instructors to tailor learning experiences has provided preliminary positive results.

Impact on Industry

The fall safety of the residential construction industry continues to lag behind commercial construction and industrial settings. The National Occupational Research Agenda includes a Strategic Goal to strengthen and extend the reach of quality training and education in the construction industry via mechanisms such as construction safety and health training needs assessments. This study demonstrates how a structured process can be used to identify and remedy gaps and improve training effectiveness. We encourage others to take steps to assess and increase the impact of training efforts directed at all residential construction professionals; including both union and non-union workers. The implications are even greater in the non-union sector where most U.S. residential work is done.     

Making work safer: Testing a model of social exchange and safety management

Introduction

This study tests a conceptual model that focuses on social exchange in the context of safety management. The model hypothesizes that supportive safety policies and programs should impact both safety climate and organizational commitment. Further, perceived organizational support is predicted to partially mediate both of these relationships.

Methods

Study outcomes included traditional outcomes for both organizational commitment (e.g., withdrawal behaviors) as well as safety climate (e.g., self-reported work accidents). Questionnaire responses were obtained from 1,723 employees of a large national retailer.

Results

Using structural equation modeling (SEM) techniques, all of the model's hypothesized relationships were statistically significant and in the expected directions. The results are discussed in terms of social exchange in organizations and research on safety climate.

Impact on Industry

Maximizing safety is a social-technical enterprise. Expectations related to social exchange and reciprocity figure prominently in creating a positive climate for safety within the organization.     

The impact of a peer-led participatory health and safety training program for Latino day laborers in construction

Background

Immigrant Latino day laborers working in residential construction are at particularly high risk of fatal and non-fatal traumatic injury and benefit from targeted training.

Objective

To understand the impact of a participatory, peer-facilitated health and safety awareness training customized to the needs of Latino day laborers.

Methods

Baseline surveys exploring exposures, PPE use, attitudes, work practices and work-related injuries were collected from more than 300 New Jersey Latino day laborers in construction prior to their participation in a one day (minimum of six hour) Spanish language health and safety training class. The classes, led by trained worker trainers, engaged participants in a series of tasks requiring teamwork and active problem solving focused on applying safe practices to situations they encounter at their worksites. Follow-up surveys were difficult to obtain among mobile day laborers, and were collected from 70 men (22% response rate) 2-6 months following training. Chi-square analysis was used to compare pre- and post-intervention PPE use, self protective actions, and self-reported injury rates. Focus groups and in-depth interviews addressing similar issues provided a context for discussing the survey findings.

Results

At baseline, the majority of day laborers who participated in this study reported great concern about the hazards of their work and were receptive to learning about health and safety despite limited influence over employers. Changes from baseline to follow-up revealed statistically significant differences in the use of certain types of PPE (hard hats, work boots with steel toes, safety harnesses, and visible safety vests), and in the frequency of self-protective work practices (e.g., trying to find out more about job hazards on your own). There was also a suggestive decrease in self-reported injuries (receiving an injury at work serious enough that you had to stop working for the rest of the day) post-training based on small numbers. Sixty-six percent of workers surveyed post-training reported sharing information from their safety workbook with friends and co-workers. Focus groups and interview results generally confirmed the quantitative findings.

Conclusions

Participatory, peer led training tailored to the needs of construction day laborers may have a positive effect on Latino immigrant workers’ attitudes, work practices, and self reported injury rates, but major changes would require employer engagement.

Impact on Industry

Health and safety researchers have identified reducing the number of traumatic injuries among the immigrant construction workforce as an increasingly important priority. This project provides one model for collaboration between university-based researchers, a union, and a community-based organization. The specific elements of this project—participatory curriculum customized to the needs of day laborers in residential construction, training day laborers to facilitate training classes, and involving peer leaders in outreach and research—could be adapted by other organizations. The findings of this study suggest that the Latino day laborers have a strong interest in and some ability to act on health and safety information. Widespread implementation of this type of training, especially if supported with cooperation from residential contractors, could lead to reduced rates of traumatic injury in the residential construction industry.     

Effect of a nurse back injury prevention intervention on the rate of injury compensation claims

Problem

This study evaluated the effect of introducing a No Lifting policy on back injuries to nurses, across an entire health care system.

Methods

Methods included: analysis of the data for all public health agencies in the Australian state of Victoria; compensation data from the Victorian Workcover Authority; data about workforce and program implementation from a retrospective survey of agencies; longitudinal analysis of standardized workers compensation claim rates for back injuries before, during and after the intervention.

Results

A statistically significant decline in back injury claim rates during implementation contrasted with no statistically significant trends within the periods before and after the intervention. A statistically significant reduction occurred in mean quarterly standard back injury claim incidence rates per 1,000 equivalent fulltime nursing staff (EFTNS), representing a 24% reduction in standard back injury claims/1000 EFTNS.

Discussion

Ergonomics principles encourage changing the work environment to suit the worker. This approach delivered a significant improvement in the immediate term.

Impact of industry

The substantial decline in back injury rates signifies a major improvement in the safety of a critical aspect of the work environment for nurses.     

Television news' coverage of motor-vehicle crashes

Problem

Traffic crashes are a major cause of injury and death. Although it has been argued that a skewed estimation of personal risks may be partly attributable to news representations of mortality causes, the manners in which traffic crashes are covered in the news have not received much attention in the literature.

Method

The current study used content analysis to examine the framing of traffic crashes in television news.

Results

The data indicated that Flemish television news does not report traffic crashes from a public health perspective and consequently it misses opportunities to inform the public on the causes and consequences of risk-taking in traffic.

Impact on industry

It is important that professionals are aware of these findings and stress contextual factors surrounding traffic crashes in their communication with journalists. This may lead to more accurate reports and a more accurate risk perception of viewers.     

What is the potential of trauma registry data to be used for road traffic injury surveillance and informing road safety policy?

Introduction

Information from hospital trauma registries is increasingly being used to support injury surveillance efforts. This research examines the potential of using trauma registry data for road traffic injury surveillance for different types of road users in terms of both the information collected and how representative trauma data are compared to two population-based road traffic injury data collections.

Methods

The three data collections were assessed against recommended variables to be collected for injury surveillance purposes and the representativeness of the distribution of road traffic-related injury data from the trauma registry was compared to hospital admission and road traffic authority data collections.

Results

Data from the trauma registry was largely not representative of the distribution of age groups or activities compared to the two population-based collections, but was representative for gender for some road user groups to at least one population-based data collection.

Conclusions

Trauma data could be used to supplement information from population-based data collections to inform road safety efforts.

Impact on Industry

Road safety policy makers should be aware of the potential and the limitations of using trauma registry data for road traffic injury surveillance.     

The unrecognized danger of a new transportation mechanism of injury--pedicabs

Objective

Pedicabs are a new and controversial transportation innovation for tourists in congested areas in several U.S. cities. Scant literature on this trauma mechanism exists. The purpose of this study is to identify the incidence, demographics, morbidity, mortality, and potential for injury prevention of pedicab incidents amongst major trauma admissions at an urban, academic Level I Trauma Center.

Patients & Methods

Researchers conducted a retrospective review of the Trauma Registry from 2000 to 2009. All patients identified as being injured in a pedicab incident were reviewed. Demographics, diagnoses, toxicology, treatments, and injury severity scale (ISS) were collected. Outcomes included mortality, ICU, and hospital length of stay (LOS), discharge disposition, and hospital charges. A photographic survey of 50 local pedicabs was examined for the presence and use of safety equipment.

Results

During the period of January 2000 to July 2009 there were 15 major trauma victims from identified pedicab incidents. Falling from the pedicab was the mechanism of injury in 14 of 15 cases. There were two fatalities in victims following severe traumatic brain injury. Traumatic brain injury, skull fracture, or loss of consciousness was seen in 11/15 victims. Ethanol ingestion was detected in blood tests of 10 of the 14 adult victims. Median charges of hospitalization due to a pedicab related injury was US$29,956 ± 77,482. A photographic survey of 50 local pedicabs reveals very limited use of safety belts by passengers despite existing city ordinances.

Conclusions

Major trauma victims of pedicab incidents in the United States suffer significant injuries and death. Most cases occurred in passengers falling from the pedicab at night after alcohol ingestion. There is an opportunity for implementation of strategies toward improved injury prevention with this new form of transport.     

“Safety is everyone's job:” The key to safety on a large university construction site

Problem

Construction risk management is challenging.

Method

We combined data on injuries, costs, and hours worked, obtained through a Rolling Owner-Controlled Insurance Program (ROCIP), with data from focus groups, interviews, and field observations, to prospectively study injuries and hazard control on a large university construction project.

Results

Lost-time injury rates (1.0/200,000 hours worked) were considerably lower than reported for the industry, and there were no serious falls from height. Safety was considered in the awarding of contracts and project timeline development; hazard management was iterative. A top-down management commitment to safety was clearly communicated to, and embraced by, workers throughout the site.

Discussion and Impact

A better understanding of how contracting relationships, workers' compensation, and liability insurance arrangements influence safety could shift risk management efforts from worker behaviors to a broader focus on how these programs and relationships affect incentives and disincentives for workplace safety and health.     

Severity models of cross-median and rollover crashes on rural divided highways in Pennsylvania

Introduction

Crossover and rollover crashes in earth-divided, traversable medians on rural divided highways can lead to severe injury outcomes. This study estimated severity models of these two crash types. Vehicle, driver, roadway, and median cross-section design data were factors considered in the models. A unique aspect of the data used to estimate the models were the availability of median cross-slope data, which are not commonly included in roadway inventory data files.

Methods

A binary logit model of cross-median crash severity and a multinomial logit model of rollover crash severity were estimated using five years of data from rural divided highways in Pennsylvania.

Results

The highest probability of a fatal or major injury in cross-median and rollover crashes was found to occur in cases when a driver was not wearing a seatbelt. While flatter cross-slopes and narrower medians were associated with more severe cross-median crash outcomes, steeper cross-slopes and narrower medians significantly increased rollover crash severity outcomes. The presence of horizontal curves was associated with increased probabilities of high-severity outcomes in a median rollover crash.

Impact on Industry

Modeling results in this study confirmed that cross-median and median rollover crash severity outcomes are associated with median cross-section design characteristics. Based on the estimated models, it appears that flatter and narrower medians lead to more severe injury outcomes in cross-median crashes. Steeper median cross-slopes and narrower medians were associated with higher probabilities of more severe outcomes in median rollover crashes. The results presented in this study suggest that there is a trade-off between median cross-section design and cross-median and rollover crashes in earth-divided, traversable medians on rural divided highways. While the severity models can be included in a framework to develop design guidance in relation to this trade-off, models of crash frequency should also be considered.     

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

Problem

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

Method

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

Results

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

Discussion

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

Impact on industry

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

Continued progress in the prevention of nail gun injuries among apprentice carpenters: What will it take to see wider spread injury reductions?

Problem

Nail guns are a common source of acute, and potentially serious, injury in residential construction.

Method

Data on nail gun injuries, hours worked and hours of tool use were collected in 2008 from union apprentice carpenters (n = 464) through classroom surveys; this completed four years of serial cross-sectional data collection from apprentices. A predictive model of injury risk was constructed using Poisson regression.

Results

Injury rates declined 55% from baseline measures in 2005 with early training and increased use of tools with sequential actuation. Injury rates declined among users of tools with both actuation systems, but the rates of injury were consistently twice as high among those using tools with contact trip triggers.

Discussion and impact

Nail gun injuries can be reduced markedly through early training and use of tools with sequential actuation. These successful efforts need to be diffused broadly, including to the non-union sector.     

Effect of enhanced seat belt reminders on driver fatality risk

Objective

Enhanced seat belt reminders in automobiles have been shown to increase belt use rates by approximately 3 percentage points. The objective of this study was to estimate the effect of enhanced seat belt reminders on driver fatality risk.

Method

Data included all passenger vehicle driver deaths and vehicle registration counts in the United States for calendar years 2000-2007. Driver fatality rates per vehicle registration per year were compared for otherwise identical vehicle models with and without enhanced seat belt reminders.

Results

Driver fatality rates were 6% lower for vehicles with enhanced seat belt reminders compared with vehicles without enhanced belt reminders. After adjusting for vehicle age differences, the estimated effect of enhanced belt reminders on driver fatality risk ranged from a 9% reduction for General Motors vehicles to a 2% increase for Honda vehicles. Combining all manufacturers, enhanced belt reminders reduced fatality risk by approximately 2%. Although not statistically significant, the 2% reduction in fatality risk agrees with what should be expected from a 3 percentage point increase in seat belt use rates.

Conclusions

Enhanced seat belt reminders have raised driver belt use rates and reduced fatality rates, but more aggressive systems may be needed for some drivers. It can be inferred that nonfatal injury rates also have been reduced.

Impact on Industry

Manufacturers should be encouraged to put enhanced seat belt reminders on all vehicles as soon as possible.