Using data linkage to assess the impact of motorized recreational vehicle-related injuries in Ohio

Problem

Motorized recreational vehicle (MRV)-related injuries can result in severe medical and financial consequences. The objective of this study was to describe the epidemiology, and clinical and financial impact of MRV-related injuries in Ohio.

Method

Probabilistically linked statewide Emergency Medical Services (EMS) and hospital (inpatient and emergency department) data for 2003 and 2004 were examined. Record pairs with a MRV-related E-code (E821-E823, E825) were included in this study.

Results

There were 2,893 patients with MRV-related injuries, who had linked EMS and hospital records, resulting in more than $15 million in hospital charges and 1,921 inpatient days of hospitalization. The male-to-female ratio was nearly 4:1, and 19% were younger than 16. Almost 82% of cases were not wearing a helmet; there was a trend of decreasing helmet use with increasing age. Mean (SE) inpatient hospital charges and length of stay (LOS) were $22,218 ($1,290) and 3.8 (0.2) days, respectively. The mean (SE) Injury Severity Score (ISS) for inpatients was 9.2 (0.4). Individuals injured on a street/highway were 3.20 times more likely to sustain an ISS ≥ 16 (95% CI: 1.03, 9.88; p = 0.044) and 3.05 times more likely to sustain a traumatic brain injury (TBI) (95% CI: 1.17, 7.94; p = 0.024) than those who were injured at a place designated for sport or recreation. Children aged 12 to 15 and young adults aged 16 to 25 were 2.47 and 2.14 times more likely, respectively, to sustain a TBI than adults aged 36 or older (aged 12 to 15: 95% CI: 1.13, 5.38; p = 0.024; aged 16 to 25: 95% CI: 1.26, 3.64; p = 0.005). Higher ISS was associated with both higher total charges (p < 0.001) and longer LOS (p < 0.001).

Discussion

This study demonstrates that MRV-related injuries are an important public health problem in Ohio, with a substantial clinical and financial impact.

Impact on Industry

Enactment and enforcement of statewide MRV safety legislation and training of MRV users offer valuable opportunities to prevent these costly injuries.     

Coverage of motor vehicle crashes with injuries in U.S. newspapers, 1999-2002

Problem

The aims of the study were to evaluate information on motor-vehicle crashes with injuries provided in newspaper reports and to assess the frequency of thematic and episodic reporting of motor-vehicle crashes.

Method

The study used Fatal Analysis Reporting System (FARS) derived variables to code a nationally representative sample of U.S. newspaper reports of motor-vehicle crashes from 1999-2002. A total of 473 newspaper reports of motor-vehicle crashes with injuries were included. Information on the crash event, people involved, and vehicles was extracted. The reports were coded for episodic and thematic news framing.

Results

A majority of newspaper reports used episodic framing. The majority of reports included information on the type of crash, but characteristics about people and vehicles were rarely reported.

Discussion

Lack of information in newspapers makes them an incomplete source from which to influence public perceptions and attitudes.

Impact on industry

This provides an opportunity for news print media to improve public health content.

Impact on industry

Newspapers represent an important source of public information; they are, however, an incomplete source [Voight, B., Lapidus, G., Zavoski, R., & Banco, L. (1998). Injury reporting in Connecticut newspapers. Injury Prevention, 4, 292-294.; Baullinger, J., Quan, L., Bennett, E., Cummings, P., & Williams, K. (2001). Use of Washington state newspaper for submersion injury surveillance. Injury Prevention, 7, 339-342]. To increase the accuracy of information provided to the public through media sources, there is a need for increased communication between public health professionals and reporters.The results of this study raise concerns about the contents of motor-vehicle crash information provided in newspapers and suggest that newspapers do not provide information to allow public perception to be in accord with the importance of motor-vehicle crash injuries and health promoting actions to reduce risk of injury. More balanced and detailed information in newspapers would provide an opportunity for news print media to improve public health programs and public perception about the impact of motor-vehicle crashes on safety for all.     

Tracking the prevalence of rollover protective structures on U.S. farm tractors: 1993, 2001, and 2004

Problem

Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.

Methods

ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.

Results

In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.

Summary

The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.

Impact on Industry

The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.     

Evaluation of a healthcare safety climate measurement tool

Problem

Psychometrically validated measurement tools are needed to evaluate an organization's safety climate. In 2000, Gershon and colleagues published a new healthcare safety climate measurement tool to determine its relationship to safe work behavior (Gershon, R., Karkashian, C., Grosch, J., Murphy, L., Escamilla-Cejudo, A., Flanagan, P., et al. (2000). Hospital safety climate and its relationship with safe work practices and workplace exposure incidents. American Journal of Infection Control, 28, 211-21). The present study evaluated the psychometric properties of the Gershon tool when modified to address respiratory rather than bloodborne pathogen exposures.

Method

Medical practitioners, nurses, and nurse aides (n = 460) were surveyed using the modified Gershon tool. Data were analyzed by factor analysis and psychometric properties of the tool evaluated.

Results

Eight safety climate dimensions were extracted from 25 items (Cronbach's alpha range: 0.62 - 0.88). Factor extractions and psychometric properties were reasonably consistent with those of the Gershon tool.

Impact on Industry

The Gershon safety climate tool appears to have sufficient reliability and validity for use by healthcare decision makers as an indicator of employee perceptions of safety in their institution.     

When workplace safety depends on behavior change: Topics for behavioral safety research

Introduction

Comprehensive interventions that address public-health concerns invariably include behavior-change strategies. In occupational safety and health, behavioral safety is an approach designed to improve safety performance directly through peer observations of safe behaviors, goal setting, performance feedback, and celebrations or incentives for reaching safety goals. Although the basic components of behavioral safety processes have been studied and widely documented, the current safety literature reveals several gaps in knowledge. These gaps are associated mostly with wide practice variations among the common process elements and uncertainty about the influence of organizational and other external factors.

Impact to Industry

A major objective of this paper was to highlight not only key topic areas that warrant further research, but also to propose a list of research questions that are tied to uncertainties about various intervention practices. If only a portion of these topic areas and research questions are addressed through systematic reviews, field interventions, surveys, and laboratory-based studies, then the knowledge gained will significantly improve the delivery and effectiveness of behavioral safety interventions and thus their impact on worker health and safety.     

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.     

A Strategic Project Appraisal framework for ecologically sustainable urban infrastructure

Actors in the built environment are progressively considering environmental and social issues alongside functional and economic aspects of development projects. Infrastructure projects represent major investment and construction initiatives with attendant environmental, economic and societal impacts across multiple scales. To date, while sustainability strategies and frameworks have focused on wider national aspirations and strategic objectives, they are noticeably weak in addressing micro-level integrated decision making in the built environment, particularly for infrastructure projects. The proposed approach of this paper is based on the principal that early intervention is the most cost-effective and efficient means of mitigating the environmental effects of development projects, particularly macro infrastructure developments. A strategic overview of the various project alternatives, taking account for stakeholder and expert input, could effectively reduce project impacts/risks at low cost to the project developers but provide significant benefit to wider communities, including communities of future stakeholders. This paper is the first exploratory step in developing a more systematic framework for evaluating strategic alternatives for major metropolitan infrastructure projects, based on key sustainability principles. The developed Strategic Project Appraisal (SPA) framework, grounded in the theory of Strategic Environmental Assessment (SEA), provides a means of practically appraising project impacts and alternatives in terms of quantified ecological limits; addresses the neglected topic of metropolitan infrastructure as a means of delivering sustainability outcomes in the urban context and more broadly, seeks to open a debate on the potential for SEA methodology to be more extensively applied to address sustainability challenges in the built environment. Practically applied and timed appropriately, the SPA framework can enable better decision-making and more efficient resource allocation ensuring low impact infrastructure development.     

Predatory insects as bioindicators of heavy metal pollution

Heavy metal concentrations of different predatory insects were studied near by a steel factory and from control sites. Waterstriders (Gerridae), dragon fly larvae (Odonata), antlion larvae (Myrmeleontidae) and ants (Formicidae) were analyzed by AAS. In most cases the metal concentrations were higher near the factory, but e.g. waterstriders had higher cadmium concentrations in control area. Discriminant analysis clearly reveals that all these insect groups can be used as heavy metal indicators. However, the commonly used ants were the least effective in indicating the differences between the factory and control sites. Waterstriders are good in detecting differences in iron and manganese, but seem to be poor in accumulating nickel and lead. Antlions are efficient in detecting differences in iron. Antlions and ants are effective in accumulating manganese; as well antlions are efficient in accumulating cadmium. Waterstriders are poor in accumulating lead, but antlions and ants are effective.     

Influence of a chlor-alkali plant on the mercury contents of fungi

Significantly higher contents of mercury were found in fungi growing in the vicinity of a large Finnish chlor-alkali plant than in a control area. The highest concentrations (72–200 ppm dry wt) were found in $\text{Agaricus}$-species. The mercury contents in mycorrhizal fungi did not generally exceed the Finnish safety limit of 0.8 ppm.     

A constant-volume rapid exhaust dilution system for motor vehicle particulate matter number and mass measurements

An improved version of the constant volume sampling (CVS) methodology that overcomes a number of obstacles that exist with the current CVS dilution tunnel system used in most diesel and gasoline vehicle emissions test facilities is presented. The key feature of the new sampling system is the introduction of dilution air immediately at the vehicle tailpipe. In the present implementation, this is done concentrically through a cylindrical air filter. Elimination of the transfer hose conventionally used to connect the tailpipe to the dilution tunnel significantly reduces the hydrocarbon and particulate matter (PM) storage release artifacts that can lead to wildly incorrect particle number counts and to erroneous filter-collected PM mass. It provides accurate representations of particle size distributions for diesel vehicles by avoiding the particle coagulation that occurs in the transfer hose. Furthermore, it removes the variable delay time that otherwise exists between the time that emissions exit the tailpipe and when they are detected in the dilution tunnel. The performance of the improved CVS system is examined with respect to diesel, gasoline, and compressed natural gas vehicles.