Characteristics of work-related injuries involving forklift trucks

Industrial lift trucks or forklift trucks are a common source of occupational injuries. In 1983, over 13,000 workers' compensation claims for lost-workday injuries involving forklift trucks were filed in 30 states. An estimated 24,000 forklift-related injuries were treated in U.S. emergency rooms in 1983, and an estimated 34,000 in 1985. This paper presents the results of an analysis of forklift injuries reported in two occupational injury databases — the National Electronic Injury Surveillance System (NEISS) and the Bureau of Labor Statistics (BLS) Supplementary Data System (SDS). Characteristics of these injuries (e.g., type of injury, diagnosis, body part affected) and of the injury victims (e.g., age, sex, occupation) are described, and scenarios of typical forklift injuries in various occupations are presented. Trends in forklift injuries from 1983–1985 are also discussed.     

Changes in logging injury rates associated with use of feller-bunchers in West Virginia

Problem: It is well documented that logging is one of the most dangerous occupations and industries in which to work, and trees fellers are at greatest risk of injury. The objective of this study was to determine whether West Virginia (WV) logging companies experienced a reduction in injuries after beginning to use feller-bunchers (tree cutting machines, which replace some of the work done with a chainsaw) during harvesting operations. Methods: WV workers compensation claims and employment data from 1995 to 2000 were used to calculate injury rates. Injury trends in the rest of the WV logging industry, not using feller-bunchers, were also assessed. Results: For 11 companies, the pre-feller-buncher injury claims rate was 19.4 per 100 workers and the post-feller-buncher rate was 5.2 per 100 workers. This was a significant difference, with an adjusted rate ratio of 2.8 (95% CI: 1.8–4.5) of pre to post claims. Struck by injuries also showed significant decline, with the pre-feller-buncher injury rate being 3.8 (95% CI: 1.8–8.2) times as great as post-feller-buncher rate. During the time of the study, the injury rate rose in the rest of the WV logging industry. The average cost of a workers compensation claim in the WV logging industry during the time of the study was approximately $10,400. Impact on industry: As mechanization of logging tasks becomes more widespread, the WV logging industry as a whole may see substantial injury declines and a reduction in the total cost of injury claims. Struck by injuries, the most common and potentially fatal of logging injury types, appear to be particularly affected. However, logging operations in areas of very steep terrain where it is not possible to use these machines may need to rely on strategies other than feller-bunchers to reduce injuries.     

Health Impact of Injuries: A Population-Based Epidemiological Investigation in a Local Community of Bangladesh

Due to the lack of valid injury data, the objective of this study was to assess the injury morbidity and mortality in a local community of Bangladesh. A population-based survey of 3,258 households was conducted in 1996. The information was collected by trained field-level health workers using three pretested structured forms. The estimated crude morbidity from injuries was 311 per 1,000 population per year, and injury accounted for 13% of all morbidity. The children and old-age groups experienced higher injury rates than others, and male children aged 5–15 years had the highest incidence rates (546/1,000 person-years). Falls and cutting injuries tended to be the most frequently (62.4%) observed types of injuries in this survey. The home (42%) and workplace (42%) were where most of the injuries occurred, and the majority (70.7%) of the injuries were minor. Of all deaths, mortality from injuries was 2.9%, and drowning (27.8%) and homicide (16.7%) were found as common forms of injury-causing deaths. This study invites more detailed investigation on injury morbidity and mortality.     

Gender aspects of work-related injuries in a Swedish municipality

The purpose of this study was to investigate gender aspects of work-related injuries in a Swedish municipality (population 41,000). All unintentional injuries treated at in- and out-patient facilities were recorded during a period of 1 year. The work-related injuries were mapped out in more detail with the help of standardized and structured surveys via telephone interviews and hospital records. The rate of work-related injuries among the gainfully employed was 33 per 1000. Males were observed to suffer more work-related injuries than females (46 compared to 12 per 1000 gainfully employed persons), and there were gender differences with regard to work-related injuries and injury event patterns. Young men showed the highest rate of injuries. Injuries caused during machine operation were the most common for both males and females, amounting to almost one quarter of all injuries. Injuries caused by falls were most common amongst females in the age groups 15–24 (25%) and 45–64 (28%). More attention should be given to gender aspects of work-related injuries and their prevention.     

Beach and patio umbrella injuries treated at emergency departments

Introduction: Beach and patio umbrellas may cause injury. There is limited published information on injuries due to beach and patio umbrellas. This study sought to describe beach and patio umbrella injuries reported to United States emergency departments (EDs). Method: An analysis was performed of beach and patio umbrella injuries using data from the National Electronic Injury Surveillance System during 2000–2019. Results: An estimated 5,512 beach umbrella injuries and 7,379 patio umbrella injuries were identified. The patient was age 40 years or older in 62.1% of the beach umbrella and 65.1% of the patio umbrella injuries. The patient was female in 68.0% of the beach umbrella and 66.9% of the patio umbrella injuries. Wind was reported involved in 50.6% of the beach umbrella and 27.5% of the patio umbrella injuries. The most frequently reported injuries with beach and patio umbrella injuries, respectively, were laceration (44.0% vs 33.0%), contusions or abrasions (19.8% vs 19.0%), and internal organ injury (16.6% vs 17.0%) and most often affected the head/neck (60.2% vs 44.0%) and upper extremity (16.3% vs 30.1%). Conclusions: The majority of patients with beach and patio umbrella injuries treated at EDs were age 40 years or older and most patients were female. For both types of umbrella injury, the most frequently reported injury was laceration followed by contusions or abrasions and internal organ injury, and the body part with the highest proportion of injuries was the head/neck followed by the upper extremity. Practical Applications: Persons should use sturdier models of beach or patio umbrella, use a rocking motion to dig into the sand and secure the beach umbrella with a metal anchor and screws, add weight to the bottom of the umbrella, and tilt the umbrella into the wind. Policy-makers should educate the public about the potential dangers of beach and patio umbrellas.     

大客车侧翻过程中约束系统对乘客安全影响*

为研究约束系统对客车侧翻过程中乘客安全的影响,在经过试验验证的某客车侧翻碰撞有限元模型上截取部分车身截段,建立“车身截段-约束系统-乘员”侧翻仿真模型,开展不同约束条件下乘员运动响应和损伤的综合分析及评价。结果表明:满足《客车上部结构强度要求及试验方法》（GB 17578—2013）法规要求的客车在侧翻过程中仍然可能对乘员造成较严重的头部损伤风险;主动预紧安全带能够在侧翻碰撞过程中,有效缓解乘员的头部和颈部损伤程度;胸部损伤值受不同约束系统影响较小。     

Crash-Pulse Recorders in Real-Life Accidents: Influence of Change of Velocity and Mean and Peak Acceleration on Injury Risk in Frontal Impacts

Several parameters based on acceleration levels, such as mean or peak acceleration, may correlate with injury risk, or may together with change of velocity, explain the risk of injury, and thus may form the risk function for different kind of injuries. The aim was to study the influence on injury risk for mean and peak acceleration and change of velocity as well as how these correlate with each other. The results from 144 crash-pulse recorders and the diagnoses from driver injuries in real-life frontal impacts were analysed. Change of velocity and mean and peak acceleration were calculated from each recorded crash-pulse. The results and conclusions were that Δv, mean and peak accelerations influence the injury risk, where either high Δv, high mean or high peak acceleration may lead to severe injuries. Mean and peak accelerations together may explain the risk of injury in the studied impacts. When these parameters were combined, a limit could be drawn, above which there was an 89% risk of receiving a moderate or severe injury, while the risk was only 5.5% below that line. The different combinations of impact severity parameters shown in this study are helpful when crash pulses are created for crash tests and computer simulations.     

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.     

Fall from equipment injuries in U.S. mining: Identification of specific research areas for future investigation

Introduction

The objective of this study was to evaluate the circumstances leading to fall from equipment injuries in the mining industry.

Method

The 2006 and 2007 Mine Safety and Health Administration annual injury databases were utilized for this study whereby the injury narrative, nature of injury, body part injured, mine type, age at injury, and days lost were evaluated for each injury.

Results

The majority of injuries occurred at surface mining facilities (∼ 60%) with fractures and sprains/strains being the most common injuries occurring to the major joints of the body. Nearly 50% of injuries occurred during ingress/egress, predominately during egress, and approximately 25% of injuries occurred during maintenance tasks. The majority of injuries occurred in relation to large trucks, wheel loaders, dozers, and conveyors/belts. The severity of injury was independent of age and the median days lost was seven days; however, there was a large range in severity.

Impact on industry

From the data obtained in this study, several different research areas have been identified for future work, which include balance and stability control when descending ladders and equipment design for maintenance tasks.     

Estimated Injury Risk for Specific Injuries and Body Regions in Frontal Motor Vehicle Crashes

Objective: Injury risk curves estimate motor vehicle crash (MVC) occupant injury risk from vehicle, crash, and/or occupant factors. Many vehicles are equipped with event data recorders (EDRs) that collect data including the crash speed and restraint status during a MVC. This study's goal was to use regulation-required data elements for EDRs to compute occupant injury risk for (1) specific injuries and (2) specific body regions in frontal MVCs from weighted NASS-CDS data.

Methods: Logistic regression analysis of NASS-CDS single-impact frontal MVCs involving front seat occupants with frontal airbag deployment was used to produce 23 risk curves for specific injuries and 17 risk curves for Abbreviated Injury Scale (AIS) 2+ to 5+ body region injuries. Risk curves were produced for the following body regions: head and thorax (AIS 2+, 3+, 4+, 5+), face (AIS 2+), abdomen, spine, upper extremity, and lower extremity (AIS 2+, 3+). Injury risk with 95% confidence intervals was estimated for 15–105 km/h longitudinal delta-Vs and belt status was adjusted for as a covariate.

Results: Overall, belted occupants had lower estimated risks compared to unbelted occupants and the risk of injury increased as longitudinal delta-V increased. Belt status was a significant predictor for 13 specific injuries and all body region injuries with the exception of AIS 2+ and 3+ spine injuries. Specific injuries and body region injuries that occurred more frequently in NASS-CDS also tended to carry higher risks when evaluated at a 56 km/h longitudinal delta-V. In the belted population, injury risks that ranked in the top 33% included 4 upper extremity fractures (ulna, radius, clavicle, carpus/metacarpus), 2 lower extremity fractures (fibula, metatarsal/tarsal), and a knee sprain (2.4–4.6% risk). Unbelted injury risks ranked in the top 33% included 4 lower extremity fractures (femur, fibula, metatarsal/tarsal, patella), 2 head injuries with less than one hour or unspecified prior unconsciousness, and a lung contusion (4.6–9.9% risk). The 6 body region curves with the highest risks were for AIS 2+ lower extremity, upper extremity, thorax, and head injury and AIS 3+ lower extremity and thorax injury (15.9–43.8% risk).

Conclusions: These injury risk curves can be implemented into advanced automatic crash notification (AACN) algorithms that utilize vehicle EDR measurements to predict occupant injury immediately following a MVC. Through integration with AACN, these injury risk curves can provide emergency medical services (EMS) and other patient care providers with information on suspected occupant injuries to improve injury detection and patient triage.     

Substance exposure and helmet use in all-terrain vehicle accidents: Nine years of experience at a level 1 trauma center

IntroductionThe surging popularity of all-terrain vehicles (ATV) in the United States has caused an “epidemic of injuries and mortality.” The U.S. Consumer Product Safety Commission reported 99,600 injuries and 426 fatalities from ATV accidents in 2013. The aim of this study was to examine the relationship between helmet use and positive toxicology screenings on outcomes in ATV accident victims.MethodsThis is a retrospective study of patients admitted to a Level 1 Trauma Center in southwestern West Virginia following an ATV accident between 2005 and 2013. Data were obtained from the institution's Trauma Registry.ResultsA total of 1,857 patients were admitted during the study period with 39 (1.9%) reported deaths. Positive serum alcohol and/or urine drug screens were obtained in 66.4% of the patients tested (n = 1,293). Those with positive screenings were 9.5% less likely to utilize a helmet (13.2% vs. 22.7%, p < 0.001); and the lack of helmet use was associated with an increase in traumatic brain injury (57.1% vs. 41.7%, p < 0.001). Positivity for substances or the lack of helmet use was significantly associated with higher morbidity. Lack of helmet use resulted in a 3.94-fold increase in the risk of discharge in a vegetative state or death.ConclusionsDrugs and alcohol use may predispose riders to be less likely to wear helmets and significantly increase the risk of a poor clinical outcome following an ATV accident. Rigorous efforts should be made to enhance safety measures through educational endeavors and amendment of current regulations to promote safe and responsible use of ATVs.Practical applicationsModification of regulatory requirements should be considered in order to mandate the wearing of helmets during ATV operation. In addition, expansion of safety programs should be considered in an effort to improve availability, affordability and awareness of safe ATV practices.     

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

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

Hand tool injuries at work: A surveillance perspective

This paper reports results of a surveillance study of work injuries caused by power and nonpower hand tools. Analyzing 129,399 case reports of hand tool injury compensation claims from the 1983 Supplementary Data System of the Bureau of Labor Statistics, the authors determined that nonpower hand tool injury rates were highest in agriculture, followed by construction, mining, and retail trades. For power hand tool injury rates, the order was: construction, agriculture, manufacturing, and mining. Among nonpower hand tools, hand knives were prominent, causing large proportions of injuries to workers in the food preparation occupations and farm laborers. Power hand tool injuries were most often associated with saws, which accounted for large proportions of injuries to lumbermen, carpenters, and miscellaneous laborers. Most injuries could be described as acute trauma involving upper extremities, but musculoskeletal injuries were also documented in substantial numbers. The authors provide suggestions for focused investigations to follow the surveillance effort reported here.     

Characteristics of bicycle crashes among children and the effect of bicycle helmets

Abstract

Objective: Focusing on children (0–17?years), this study aimed to investigate injury and accident characteristics for bicyclists and to evaluate the use and protective effect of bicycle helmets.

Method: This nationwide Swedish study included children who had visited an emergency care center due to injuries from a bicycle crash. In order to investigate the causes of bicycle crashes, data from 2014 to 2016 were analyzed thoroughly (n?=?7967). The causes of the crashes were analyzed and categorized, focusing on 3 subgroups: children 0–6, 7–12, and 13–17?years of age. To assess helmet effectiveness, the induced exposure approach was applied using data from 2006 to 2016 (n?=?24,623). In order to control for crash severity, only bicyclists who had sustained at least one Abbreviated Injury Scale (AIS) 2+ injury (moderate injury or more severe) in body regions other than the head were included.

Results: In 82% of the cases the children were injured in a single-bicycle crash, and the proportion decreased with age (0–6: 91%, 7–12: 84%, 13–17: 77%). Of AIS 2+ injuries, 8% were head injuries and 85% were injuries to the extremities (73% upper extremities and 13% lower extremities). Helmet use was relatively high up to the age of 10 (90%), after which it dropped. Helmets were much less frequently used by teenagers (14%), especially girls. Consistently, the share of head injuries increased as the children got older. Bicycle helmets were found to reduce all head injuries by 61% (95% confidence interval [CI], 10: +/? 10%) and AIS 2+ head injuries by 68% (95% CI, 12: +/? 12%). The effectiveness in reducing face injuries was lower (45% CI +/? 10% for all injuries and 54% CI +/? 32% for AIS2+ injuries).

Conclusions: This study indicated that bicycle helmets effectively reduce injuries to the head and face. The results thus point to the need for actions aimed at increasing helmet use, especially among teenagers. Protective measures are necessary to further reduce injuries, especially to the upper extremities.     

A 6-year survey of road traffic accidents in Southwest China: Emphasis on traumatic brain injury

Background: The objective of this study is to provide an up-to-date overview of the patterns of injuries, especially traumatic brain injury (TBI) caused by RTAs and to discuss some of the public health consequences. Methods: A scientific team was established to collect road traffic accidents occurring between 2013 and 2018 in Chongqing, Southwest China. For each accident, the environment-, vehicle-, and person- variables were analyzed and determined. The overall injury distribution and TBI patterns of four types of road users (driver, passenger, motorcyclist and pedestrian) were compared. The environmental and time distribution of accidents with TBI were shown by bar and pie chart. The risks of severe brain injury whether motorcyclist wearing helmets or not were compared and the risk factors of severe TBI in pedestrian were determined by odds ratio analysis. Results: This study enrolled 2131 accidents with 2741 persons of all kind of traffic participants, 1149 of them suffered AIS1+ head injury and 1598(58%) died in 7 days. The most common cause of deaths is due to head injury with 714(85%) and 1266(79%) persons died within 2 hours. Among 423 persons suffered both skull fracture and intracranial injury, 102 (24.1%) have an intracranial injury but no skull fractures, while none of the skull fractures without intracranial injury was found. Besides, motorcyclists without a helmet were at higher risks for all the brain injury categories. The risk of pedestrian suffering severe TBI at an impact speed of more than 70 km/h is 100 times higher than that with an impact speed of less than 40 km/h. Conclusion: It is urgently needed to develop a more reliable brain injury evaluation criterion for better protection of the road users. We believe that strengthening the emergency care to head injury at the scene is the most effective way to reduce traffic fatality.     

Incidence rates and risk factors for injury events in high school students in Lijin County, China

PROBLEM: Most investigations of injuries among Chinese populations are focused on urban or better developed areas, fewer on rural or poor areas. METHODS: From September 21 to 27, 2002, an epidemiological investigation of eight kinds of injury-related events was carried out among 1,944 students in 39 classes randomly sampled from middle schools in Lijin County, a rural area. The eight kinds of events were: (a) traffic accidents, (b) poisoning, (c) fall, (d) burn or scald, (e) blunt or sharp tools contact, (f) electrical contact, (g) animal or insect bites, and (h) non-fatal drowning. RESULTS: The total incidence rate of eight kinds of injuries in the previous year was 21.1%. The incidence rate among boys was 24.2%, while that among girls was 17.4%, which was significant (chi-square=13.4, P<0.05). The incidence rate among junior high school students was 23.1%, while that among senior high school students was 15.5%, which was also significant (chi-square=13.2, P<0.05). A case-control study of 410 students with at least one of eight kinds of injury events indicated that students' gender and their mothers' health status were related to their injuries. CONCLUSION: The injury incidence rate in a rural area was less than other results in urban or developed areas. Students' gender and mothers' health status were important factors associated with the occurrence of injury. IMPACT ON INDUSTRY: In order to improve the surroundings of the growing population of adolescents, some preventive measures should be put forward, especially to the high-risk students of injury.     

Motor vehicle restraint system use and risk of spine injury

OBJECTIVE: Motor vehicle collision (MVC)-related spinal injury is a severe and often permanently disabling injury. In addition, strain injuries have been reported as a common outcome of MVCs. Although advances in automobile crashworthiness have reduced both fatalities and severe injuries, the impact of varying occupant restraint systems (seatbelts and airbags) on thoracolumbar spine injuries is unknown. This study examined the relationship between the occurrence of mild to severe cervical and thoracolumbar spine injury and occupant restraint systems among front seat occupants involved in frontal MVCs. METHODS: A retrospective cohort study was conducted among subjects obtained from the 1995-2004 National Automotive Sampling System. Cases were identified based on having sustained a spine injury of >/=1 on the Abbreviated Injury Scale (AIS), 1990 Revision. Risk risks (RRs) and 95% confidence intervals (CIs) were computed comparing occupant restraint systems with unrestrained occupants. RESULTS: We found an overall incidence of AIS1 cervical (11.8%) and thoracolumbar (3.7%) spinal injury. Seatbelt only restraints were associated with increased cervical AIS1 injury (RR = 1.40, 95% CI 1.04-1.88). However, seatbelt only restraints showed the greatest risk reduction for AIS2 spinal injuries. Airbag only restraints reduced thoracolumbar AIS1 injuries (RR = 0.29, 95% CI 0.08-1.04). Seatbelt combined with airbag use was protective for cervical AIS3+ injury overall (RR = 0.29, 95% CI 0.14-0.58), cervical neurological injury (RR = 0.19, 95% CI 0.05-0.81), and thoracolumbar AIS3+ injury overall (RR = 0.20, 95% CI 0.05-0.70). CONCLUSIONS: The results of this study suggest that seatbelts alone or in combination with an airbag increased the incidence of AIS1 spinal injuries, but provide protection against more severe injury to all regions of the spine. Airbag deployment without seatbelt use did not show increased protection relative to unrestrained occupants.     

Ecology of player-to-player contact in boys' youth soccer play

INTRODUCTION: Youth soccer (football) injuries occur for a wide range of reasons, but the most frequent cause of injury is via player-to-player contact. This study was designed to study the ecology of collisions between players during youth soccer play. METHOD: Six teams of 11- and 12-year-old male players were followed over the course of a full season. Games were videotaped and reviewed to address three primary questions: how frequently do player-to-player collisions occur; when and where on the field do those collisions occur; and what is the rate of falls and injuries as a result of player-to-player contact. RESULTS: A total of 1,279 player-to-player collisions was observed, or an average of 65.59 collisions per game. Nearly half of the observed collisions resulted in one or both players falling to the ground, and about one-tenth resulted in the referee calling a foul, but very few of the collisions (less than 1%) resulted in an injury. Collisions occurred relatively consistently throughout the games, no matter what the score was. They occurred most frequently in the midfield area, when the ball was on or near the ground, and when players were attempting to retrieve a loose, uncontrolled ball. CONCLUSIONS: Results are discussed with respect to implications for injury prevention.