Personal injury recovery cost of pedestrian–vehicle collisions in New South Wales,Australia

Background: There is a need for routine estimates of injury recovery costs from pedestrian collisions using hospital separation records for economic evaluations.

Objective: To estimate the cost of injury recovery following pedestrian–vehicle collisions using the personal injury recover cost (PIRC) equation using key demographic and injury characteristics.

Method: An estimation of the costs of on-road pedestrian–vehicle collisions involving individuals who were injured and hospitalized in New South Wales (NSW), Australia, from 2002 to 2011 using the PIRC equation. The PIRC estimates individual injury recovery costs and does not include costs associated with property damage, vehicle repair, or rescue services. Individual recovery costs associated with severe traumatic brain injury (TBI) were estimated. The injured individual's mean, median, and total injury recovery costs are described for key demographic, injury, and crash characteristics.

Results: There were 9,781 pedestrians who were injured, costing an estimated total of $2.4 billion in personal injury recovery costs, an annual cost of $243 million. Males had a total injury recovery cost 1.7 times higher than females. The median injury recovery cost decreased with increasing age. TBI ($248,491) and spinal cord and vertebral column injuries ($264,103) had the highest median injury recovery costs for the body region of the most severe injury. TBI accounted for 22.6% of the total injury recovery costs for the most severe injury sustained. Just over one third of pedestrians sustained 4 or more injuries, with a median cost of $243,992, which was 1.6 times higher than the cost for a pedestrian who sustained a single injury ($153,682).

Conclusions: Personal injury recovery costs following pedestrian–vehicle collisions where a pedestrian is injured are substantial in NSW. The PIRC equation enables the economic cost burden of road traffic injury to be calculated using hospital separation data. The PIRC enables comprehensive personal injury recovery costs to be estimated and would aid in economic evaluations of preventive strategies in road safety.     

The direct costs of fatal and non-fatal falls among older adults — United States

IntroductionThis study sought to estimate the incidence, average cost, and total direct medical costs for fatal and non-fatal fall injuries in hospital, ED, and out-patient settings among U.S. adults aged 65 or older in 2012, by sex and age group and to report total direct medical costs for falls inflated to 2015 dollars.MethodIncidence data came from the 2012 National Vital Statistics System, 2012 Healthcare Cost and Utilization Project-Nationwide Inpatient Sample, 2012 Health Care Utilization Program National Emergency Department Sample, and 2007 Medical Expenditure Panel Survey. Costs for fatal falls were derived from the Centers for Disease Control and Prevention's Web-based Injury Statistics Query and Reporting System; costs for non-fatal falls were based on claims from the 1998/1999 Medicare fee-for-service 5% Standard Analytical Files. Costs were inflated to 2015 estimates using the health care component of the Personal Consumption Expenditure index.ResultsIn 2012, there were 24,190 fatal and 3.2 million medically treated non-fatal fall related injuries. Direct medical costs totaled $616.5 million for fatal and $30.3 billion for non-fatal injuries in 2012 and rose to $637.5 million and $31.3 billion, respectively, in 2015. Fall incidence as well as total cost increased with age and were higher among women.ConclusionMedically treated falls among older adults, especially among older women, are associated with substantial economic costs.Practical applicationWidely implementing evidence-based interventions for fall prevention is essential to decrease the incidence and healthcare costs associated with these injuries.     

Fewer workers' compensation claims and lower claim costs if employers with high injury rates achieved the rates of their safer peers

Introduction: Employers engaged in similar business activities demonstrate a range of workers' compensation claim rates. Workplace injuries and illnesses could be prevented if employers with high claim rates achieved the claim rates of their safer peers. Methods: We used Washington workers' compensation claims data for years 2013–2015 to calculate rates of compensable claims (eligible for disability or time loss benefits, if unable to work four days after injury) and total accepted claims (compensable plus medical-aid only claims) for each employer. We estimated the number and cost of claims to occur if employers with high claim rates reduced them to the rates of employers at the 25th percentile, adjusted for insurance risk class, employer size, and injury type. To evaluate the impact of setting more or less ambitious goals, we also estimated reductions based on claim rates at the 10th and 50th percentiles. Results: Over 43% of claims and claim costs would be prevented if employers with higher claim rates lowered them to the 25th percentile using either total accepted or compensable claim rates as the benchmark outcome. The estimated claim cost savings from benchmarking to compensable claims was nearly as great as the estimate based on benchmarking to total accepted claims ($308.5 mil annually based on compensable claims vs. $332.4 mil based on total accepted claims). Restaurants and Taverns had the greatest number of potentially prevented compensable claims. Colleges and Universities and Wood Frame and Building Construction had the greatest potential reduction in compensable claim costs among larger and smaller employers, respectively. Conclusion: Substantial reductions in workers' compensation claims and costs are possible if employers achieve the injury rates experienced by their safer peers. Practical application: Evaluating the range of workplace injury rates among employers within industry groups identifies opportunities for injury prevention and offers another approach to resource allocation.     

An analysis of injury claims from low-seam coal mines

Introduction

The restricted workspace present in low-seam coal mines forces workers to adopt awkward working postures (kneeling and stooping), which place high physical demands on the knee and lower back.

Method

This article provides an analysis of injury claims for eight mining companies operating low-seam coal mines during calendar years 1996-2008. All cost data were normalized using data on the cost of medical care (MPI) as provided by the U.S. Bureau of Labor Statistics.

Results

Results of the analysis indicate that the knee was the body part that led in terms of claim cost ($4.2 million), followed by injuries to the lower back ($2.7 million). While the average cost per injury for these body parts was $13,100 and $14,400, respectively (close to the average cost of an injury overall), the high frequency of these injuries resulted in their pre-eminence in terms of cost. Analysis of data from individual mining companies suggest that knee and lower back injuries were a consistent problem across companies, as these injuries were each among the top five most costly part of body for seven out of eight companies studied.

Application/Impact

Results of this investigation suggest that efforts to reduce the frequency of knee and low back injuries in low-seam mines have the potential to create substantial cost savings.     

A procedure for annually estimating wage losses due to accidents in the U.S.

The demand for accident cost information has increased in recent times as safety professionals seek to compare accident costs with other societal problems. Addressing one component of accident costs, this study proposes a procedure for estimating the cost of lost wages due to accidents with separate estimates generated for motor vehicle, work, home, and public accidents, as well as the overall total. Estimates were developed from data that can be updated annually so that cost estimates can be kept current. Deaths, permanent disabilities, and temporary disabilities of workers were included as part of the framework. In addition, the value of homemaker services lost due to accidents was estimated. The procedure utilized the ‘human capital’ approach, whereby the discounted present value of lost future earnings is taken as the appropriate measure of the productivity loss to society due to accidents. Other cost estimating approaches were discussed. Using this procedure, it was estimated that accidental injuries resulted in $31.1 billion in wage losses in 1985, about 1.6% of all wages and salaries paid in that year.     

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.     

危险品运输网络中运输方式和路径优化研究

在危险品运输网络中,往往有多种运输方式和多条运输路径。不同运输方式在不同路径上发生事故所造成的损失不同,不同运输方式的单位运输成本也不同。本文研究了在给定运输起点和终点的情况下,在综合考虑事故所造成的损失最小和运输成本最小的情况下,运输方式和运输路径的选择方法。通过一个仿真例子说明了模型的求解方法和实际效果,并与单一运输方式的方案进行了对比。结果表明考虑运输方式的组合,在一定程度上可以降低危险品运输过程中的社会总期望损失和运输成本。     

Potential effects of lowering the BAC limit on injuries,fatalities, and costs

IntroductionPotential health and cost impacts of lowering the BAC limit for U.S. drivers below .08% were explored through analyses of reductions in crash incidence, injury severity, and costs based on five scenarios with varying assumptions about how the change to a .05% BAC limit might affect alcohol-impaired driving.MethodsDistribution of crashes by injury level and highest driver or non-occupant BAC levels for 2010, together with unit crash costs provided a base for comparison. Scenario 1 assumed all alcohol-impaired driving ceased; scenario 2 assumed all drivers obeyed the law, and scenario 3 assumed decreases in driver BAC levels would be limited to those who had been driving near the legal limit before the change. Scenario 4 was based on changes in driver BAC levels associated with a 08% to .05% BAC limit change in Australia, and scenario 5 was based on changes in alcohol-related crashes associated with the change to the .08% BAC limit in the United States. The number of casualties prevented in each scenario was estimated using relative risks of crash involvement, and changes in societal costs were estimated using the unit costs.ResultsReductions ranging from 71% to 99% in fatalities, injuries, and costs related to alcohol-impaired driving were estimated in scenarios 1 and 2. Scenarios 3–5 produced smaller reductions ranging from 4% to 16% for alcohol-impaired fatalities, injuries, and costs.ConclusionThe wide difference between the outcomes of the two sets of scenarios reflects the sensitivity of BAC policy benefits to driver compliance behavior.Practical applicationThe quantification of the reduction in the number and costs of traffic crash casualties in the set of behavioral scenarios explored in this research can inform policymakers about the extent and limits of benefits achievable by lowering the BAC limits as they consider strategies to reduce alcohol-impaired driving.     

Injuries in special transportation services for elderly and disabled--a multi-methodology approach to estimate incidence and societal costs

OBJECTIVE: Previous research has shown that elderly and disabled travelers using Special Transportation Services (STS) are injured without being involved in a vehicle crash. In order to estimate the true costs for these vehicle-related injuries, the focus needs to be adjusted towards an incident/traveler-oriented perspective. The aim of the project was thus to utilize such a perspective, in order to make a best estimation of the true costs for injury incidents, related to STS in Sweden. METHODS: In order to address the chosen perspective, a mixed-method approach was used, involving quantitative as well as qualitative research methods applied on four different sets of data, the hospital-based material (n=32), two sets of STS material (n=127), and interview-based material (n=1,000). RESULTS: The results showed that the injury incidence rate in STS is considerable, i.e., 3.2 per 100,000 trips (ranging from 1.5-1.9 in STS taxis and 3.6-5.6 in STS special vehicles). However, this high incidence rate is not due to road traffic crashes, but to non-collision injury incidents involving elderly and frail passengers, easily sustaining injuries from minor to moderate external violence. Typically, this violence is affecting an older female STS user, while entering and exiting the vehicle. The true costs were estimated to be $35 million per annum or $2.6 per trip. CONCLUSION: Future injury prevention measures should thus focus on safety in entering and exiting procedures.     

The use of state workers' compensation administrative data to identify injury scenarios and quantify costs of work-related traumatic brain injuries

PROBLEM: Traumatic brain injury (TBI) is a public health problem but little is known about the nature of that problem in the working population. METHOD: The author used a national definition to identify cases in Washington State from workers' compensation (WC) hospital billing data, quantified the cost of WC insurance benefits using actuarial cost estimates, and identified high risk industries using ANSI Z16.2 typology. RESULTS: There were 928 cases of TBI with a lifetime claim cost of $159 million from the Washington State Fund (1994-2001). Sixty percent of injuries resulted in death or disability. The highest risks of TBI are concentrated in 16 industrial insurance risk classes and the highest costs in 19 North American Industry Classification codes. Injury scenarios were identified for nine industrial insurance risk classes. CONCLUSIONS: TBI is a disabling and costly workplace injury in the state of Washington, affecting even teenagers and seniors who are not generally considered to be part of the workforce. Injury typology codes provide useful information for improving workplace safety. IMPACT ON INDUSTRY: This research provides industry with quantitative information regarding the cost of work-related traumatic brain injury and the usefulness of using workers' compensation claims data to reduce the burden of workplace injury.     

Assessment of medical care costs of injuries due to alcohol-related motor vehicle crashes

The purpose of this study was to estimate the total medical care costs of individuals injured in motor vehicle crashes and in crashes where alcohol was involved. Crashes were studied that involved 2,728 vehicle occupants and 191 pedestrians with injuries as reported in 1979 by the National Accident Sampling System, a probability sample of all motor vehicle crashes occurring in the united States. Medical care costs were assigned by using Abbreviated Injury Scale codes in accordance with other published research. Determination of alcohol involvement was based on crash characteristics. Results indicate that 20.2 % of medical care costs for motor vehicle crash injuries may be due to crashes where alcohol was involved. It was estimated that alcohol-related motor vehicle crashes cost between $434 million and $483 million in medical care alone in the United States in 1979.     

The direct cost burden of 13 years of disabling workplace injuries in the U.S. (1998–2010): Findings from the Liberty Mutual Workplace Safety Index

Introduction: Although occupational injuries are among the leading causes of death and disability around the world, the burden due to occupational injuries has historically been under-recognized, obscuring the need to address a major public health problem. Methods: We established the Liberty Mutual Workplace Safety Index (LMWSI) to provide a reliable annual metric of the leading causes of the most serious workplace injuries in the United States based on direct workers compensation (WC) costs. Results: More than $600 billion in direct WC costs were spent on the most disabling compensable non-fatal injuries and illnesses in the United States from 1998 to 2010. The burden in 2010 remained similar to the burden in 1998 in real terms. The categories of overexertion ($13.6B, 2010) and fall on same level ($8.6B, 2010) were consistently ranked 1st and 2nd. Practical application: The LMWSI was created to establish the relative burdens of events leading to work-related injury so they could be better recognized and prioritized. Such a ranking might be used to develop research goals and interventions to reduce the burden of workplace injury in the United States.     

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

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

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.     

The impact of a standard enforcement safety belt law on fatalities and hospital charges in Ohio

Introduction

The purpose of this study was to analyze linked crash and hospital data to determine the effect that enactment of a standard enforcement safety belt law in Ohio would have on hospital charges and direct medical costs due to motor-vehicle crashes, focusing on the impact to the state's Medicaid system.

Method

The linkage and analysis was conducted as part of the Ohio Crash Outcome Data Evaluation System (CODES) program. Current safety belt usage in Ohio stands at 82% with its secondary enforcement safety belt law.

Results

Assuming an increase in usage to 92% through standard enforcement, over $15.3 million in medical costs to Medicaid for injuries that occur in a single year could be prevented over a 10-year period. Cumulative savings could reach more than $91.2 million during the 10-year period. In addition, 161 fatalities could have been prevented in one year had all unbelted occupants who sustained a fatal injury instead chosen to wear their safety belt.

Summary and Impact on Industry

Clearly, substantial progress can be made in reducing the number of deaths and injuries, as well as medical costs associated with motor-vehicle crashes, by strengthening safety belt laws and increasing safety belt usage in Ohio.     

Time of day effects on railroad roadway worker injury risk

IntroductionThe purpose of this study is to examine how time of day affects injury risk of railroad maintenance of way employees and signalmen (roadway workers). Railroads reported 15,654 serious roadway worker injuries between 1997 and 2014. Roadway workers primarily work outdoors on or near railroad tracks and frequently encounter hazardous conditions. To avoid closing an active rail line during peak hours, railroads sometimes require roadway workers to work at night. Previous studies of roadway worker injury have not adequately accounted for exposure to time of day effects, nor have they investigated the human factors issues contributing to roadway worker injury.MethodThe Federal Railroad Administration (FRA) database of injury reports provided data for circadian rhythm models of the odds of fatal and nonfatal injuries. The FRA database and fatal injury investigation reports also permitted an analysis of the circumstances and the human factors issues associated with injuries that occur at different times of day.ResultsOdds of injury increased during nighttime work. The odds of nonfatal injury for both roadway worker crafts rose above 9:1 in the early morning hours. The relative odds of a fatal injury also increased significantly at night. A human factors analysis suggested that during all three shifts most nonfatal injuries involve workload, but workload was not identified as a factor in fatal injuries.ConclusionsNighttime work is more hazardous for roadway workers than daytime work. Several factors related to fatigue and other conditions appear to increase the risk of injury during the outdoor, nighttime work required of roadway workers.Practical applicationFor practical reasons, nighttime roadway work is sometimes unavoidable. Therefore, new practices for nighttime work must be developed to adequately address fatigue and protect roadway workers from harm.     

Characteristics of worker accidents on NYSDOT construction projects

INTRODUCTION: This paper aims at providing cost-effective safety measures to protect construction workers in highway work zones, based on real data. Two types of accidents that occur in work zones were: (a) construction work area accidents, and (b) traffic accidents involving construction worker(s). METHODOLOGY/RESULTS: A detailed analysis of work zone accidents involving 36 fatalities and 3,055 severe injuries to construction workers on New York State Department of Transportation (NYSDOT) construction projects from 1990 to 2001 established that five accident types: (a) Struck/Pinned by Large Equipment, (b) Trip or Fall (elevated), (c) Contact w/Electrical or Gas Utility, (d) Struck-by Moving/Falling Load, and (e) Crane/Lift Device Failure accounted for nearly 96% of the fatal accidents, nearly 63% of the hospital-level injury accidents, and nearly 91% of the total costs. These construction work area accidents had a total cost of $133.8 million. Traffic accidents that involve contractors' employees were also examined. Statistical analyses of the traffic accidents established that five traffic accident types: (a) Work Space Intrusion, (b) Worker Struck-by Vehicle Inside Work Space, (c) Flagger Struck-by Vehicle, (d) Worker Struck-by Vehicle Entering/Exiting Work Space, and (e) Construction Equipment Struck-by Vehicle Inside Work Space accounted for nearly 86% of the fatal, nearly 70% of the hospital-level injury and minor injury traffic accidents, and $45.4 million (79.4%) of the total traffic accident costs. CONCLUSIONS: The results of this paper provide real statistics on construction worker related accidents reported on construction work zones. Potential preventions based on real statistics have also been suggested. IMPACT ON INDUSTRY: The ranking of accident types, both within the work area as well as in traffic, will guide the heavy highway contractor and owner agencies in identifying the most cost effective safety preventions.     

Physical,psychological and economic burden of two-wheel users after a road traffic injury: Evidence from intensive care units of three EU countries

Introduction: This study aimed to assess the physical, psychological, and economic burden shouldered by severely injured two-wheel users in three European countries as well as the cost resulting from their hospitalization. Methods: A total of seven public hospitals were involved in three countries: Greece, Italy, and Germany. Participants enrolled during a 12-month period starting in April 2013. Eligibility criteria included an injury sustained at Road Traffic Crashes (RTC) irrespective of the type of vehicle, hospitalization 1 day in the Intensive Care Unit (ICU) or sub-ICU, and age 18 years or over. Patients were interviewed at 1, 6, and 12 months upon admission. The study used widely recommended classifications for injury severity (Abbreviated Injury Severity [AIS]; Maximum Abbreviated Injury Severity [MAIS]) and standardized measures such as the Disability Assessment Schedule II (WHODAS 2.0), “Impact of Event Scale” (IES-R), Center for Epidemiological Studies Depression Scale (CES-D Scale). Health Care Expenditure was assessed through the Monash University Accident Research Centre (MUARC's) framework, which included measures of ‘Direct’ and ‘Indirect’ costs. Diagnosis-related groups (DRGs) were used to estimate hospitalization costs. Results: A total of 54 two-wheel users enrolled in the study in all the countries and 32 completed all follow-up questionnaires. Physical disability increased over 12 months following the injury. Post Traumatic Stress Disorder (PTSD) symptoms of avoidance remained at high levels over the study period. PTSD symptoms of intrusion improved significantly during the second half of the year under investigation. The total annual cost of injury for the two-wheel users who were hospitalized in the selected ICU of all the partner countries for severe injury in 2013/2014, was estimated at €714,491 made up of €123,457 direct and €591,034 indirect costs. Men, aged 50–64 years and those who sustained slight injuries primarily at the lower extremities presented higher indirect costs per person. A total of €1032.092 was spent on hospitalization payments. Women, aged 65 + and those who sustained severe injuries at the central body region presented higher direct costs per person. Women, aged 50–64 years, those with severe injuries and a major injury at the central body and the upper body region presented the highest hospitalization costs per person. Conclusions: There is a need for effective strategies to early detect and treat groups at risk of being confronted with prolonged psychosocial and economic consequences. Practical implications: A holistic understanding of the impact of injury on individuals is important in order to achieve effective treatment of psychological co-morbidities in a timely manner.     

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review

IntroductionMore than 5,000 fatalities and eight million injuries occurred in the workplace in 2007 at a cost of $6 billion and $186 billion, respectively. Neurotoxic chemicals are known to affect central nervous system functions among workers, which include balance and hearing disorders. However, it is not known if there is an association between exposure to noise and solvents and acute injuries. Method: A thorough review was conducted of the literature on the relationship between noise or solvent exposures and hearing loss with various health outcomes. Results: The search resulted in 41 studies. Health outcomes included: hearing loss, workplace injuries, absence from work due to sickness, fatalities, hospital admissions due to workplace accidents, traffic accidents, hypertension, balance, slip, trips, or falls, cognitive measures, or disability retirement. Important covariates in these studies were age of employee, type of industry or occupation, or length of employment. Discussion: Most authors that evaluated noise exposure concluded that higher exposure to noise resulted in more of the chosen health effect but the relationship is not well understood. Studies that evaluated hearing loss found that hearing loss was related to occupational injury, disability retirement, or traffic accidents. Studies that assessed both noise exposure and hearing loss as risk factors for occupational injuries reported that hearing loss was related to occupational injuries as much or more than noise exposure. Evidence suggests that solvent exposure is likely to be related to accidents or other health consequences such balance disorders. Conclusions: Many authors reported that noise exposures and hearing loss, respectively, are likely to be related to occupational accidents. Practical applications: The potential significance of the study is that findings could be used by managers to reduce injuries and the costs associated with those injures.     

The effectiveness of the revised scaffold safety standard in the construction industry

The purpose of this study was to examine the effectiveness of the revised scaffold safety standard in the construction industry and to evaluate time trend analyses on scaffold-related fatalities and injuries, as well as inspections conducted and cited violations of the scaffold safety standard set forth in Title 29 of the Code of Federal Regulations Part 1926, Subpart L. Data on scaffold-related fatalities, injuries, and lost workdays, as well as cited violations of scaffold safety, were assembled from sources such as the US Department of Labor's Occupational Safety and Health Administration (OSHA) Integrated Management Information System, and Bureau of Labor Statistics. Data for the period prior to the revision of the standard were compared with data from the period after the revision. We used autoregressive analyses to evaluate the percentage of change in the mean scaffold-related fatalities, injuries and lost workdays and in the OSHA inspections and cited violations of scaffold safety. Effectiveness analysis was conducted to assess the effectiveness of the revised scaffold safety standard in preventing fatal or nonfatal injuries in the construction industry. Complying with the revised scaffold safety standard would prevent approximately 4.6 fatalities, 404 nonfatal injuries, and 2896 lost workdays per year. A total cost savings associated with compliance was estimated at $5.8 million (2001 US$) per year. Compliance with the revised scaffold safety standard would provide a safer workplace and generate a significant cost saving in the construction industry.