Epidemiology of occupational acute traumatic hand injuries: a literature review

The purpose of this review was to summarize the literature on occupational, acute, traumatic hand injury and suggest directions for future research. In 1996, the leading occupational injury treated in United States' hospital emergency departments was an acute hand injury (e.g. laceration, crush or fracture). These injuries affected 30% of an estimated 3.3 million injured workers (990,000). Cuts and lacerations of the fingers ranked third after back and leg strains in the number of lost workday cases in the USA in 1994. The incidence rate of hand injuries studied in seven manufacturing environments around the world ranged from 4 to 11 per 100 workers per year. Workers aged 24 years or less had the highest risk of hand injury. Men had higher rates of severe hand injury than women.Despite the high frequency and significant amount of lost work time associated with these injuries, they are poorly understood from an etiological perspective. There is only one case-control study of occupational hand injury in the literature. That study suggested an important role for both fixed (age) and transient risk factors (doing an unusual task) at the time of the injury. More analytic epidemiological research is needed to identify potentially modifiable risk or protective factors (e.g. glove use) for acute hand injuries. In this regard, the case-crossover design, a relatively new epidemiological approach using cases as their own controls, could prove an efficient method for determining transient, modifiable risk factors for acute, occupational hand injury.     

Leading and lagging: Process safety climate–incident relationships at one year

In order to evaluate the leading and lagging effects of process safety climate on incidents, we correlated safety climate survey data with organizational safety records from before and after the survey time period. We obtained data from a large, multinational organization with manufacturing operations involving a number of complex processes, chemicals, and hazardous substances. A total of 7728 employees from 62 sites responded to a safety climate survey in 2007. Individual responses were aggregated to the site-level and matched to site-level organizational records of process safety incidents 1 year before and 1 year after survey administration. Employees’ perceptions of good routine housekeeping were significantly related to environmental impact incidents as both a leading and a lagging indicator, as well as fires/explosions and property damage outcomes. Employees’ perceptions of systems to prevent backlogs and the extent to which health and safety problems are promptly corrected were also related to environmental releases and fires/explosions. Implications for process safety climate research, organizational survey strategies, and organizational climate change are discussed.     

Comparing the usability and reliability of a generic and a domain-specific medical error taxonomy

Medical error taxonomies are used to report and analyse patient safety incidents. Medical error taxonomies can be generic or domain-specific. In comparing generic and domain-specific medical error taxonomies, the literature compares the information both type of taxonomies classify. There is little evidence the taxonomies have been compared in terms of usability and reliability. Twenty nurses and 21 pharmacists participated in a study comparing the usability and reliability of a generic medical error taxonomy and a medication error taxonomy. The medical error taxonomies utilized were the Patient Safety Event Taxonomy and the NCC MERP Taxonomy of Medication Error. The study found no significant difference in the usability ratings of both taxonomies. The taxonomies required different amount of time to classify patient safety incidents and had significantly different reliability levels. The reliability of the NCC MERP Taxonomy of Medication Error was significantly different when used by nurses and pharmacists. The taxonomy was also preferred by the majority of participants. Some recommendations are made about the design of future medical error taxonomies.     

Twenty-five years of HAZOPs

The HAZOP or hazard and operability study was developed by ICI over 25 years ago and is in wide use today throughout the world. The technique is intended to review, in a formalized manner, the design of a system such as a chemical process production plant to detect potential problems in the operation of the system. The system has been extended for use on all types of production, storage and distribution units. Experience in the use of hazard studies has lead to the development of a phased approach with three distinct design phases.     

Motorcycle conspicuity: An evaluation and synthesis of influential factors

Motorcycles are overrepresented in fatal motor vehicle accidents: The death rate for motorcycle riders of about 35 per 100,000,000 miles of travel compares with an overall vehicle death rate of 2.57 per 100,000,000 miles. In the attempt to reduce the frequency of automobile-motorcycle collisions, numerous studies have manipulated motorcycle and motorcyclist characteristics to enhance conspicuity. In this paper, we give a review of studies that examined the effectiveness of these measures. Subsequently, we take a critical look at the methods used in these studies to evaluate the effectiveness of conspicuity treatments. Furthermore, we identify factors yet to be considered in the empirical research in this area that may contribute to collisions with motorcycles. These include information-processing failures at the identification and decision stage, as well as more or less permanent factors potentially responsible for different information-processing failures. Transient factors related to the failure to detect motorcycles might include alcohol, fatigue/lack of sleep, inattention, and information overload, whereas more permanent factors might include “cognitive” conspicuity and fi eld dependence.     

Organisational learning and continuous improvement of health and safety in certified manufacturers

Certified management systems have increasingly been applied by firms in recent decades and now cover the management of health and safety, principally through the OHSAS 18001 standard. In order to become certified, firms must not only observe the relevant legislation, but also improve performance and raise goals within health and safety on a continuous basis. The article examines how certified occupational and health management systems influence this process to evaluate how far they hinder or support learning. It presents a model with which it is possible to identify and analyse improvement processes. The model is applied to five cases from a qualitative study of Danish manufacturers with certified health and safety management systems. The cases illustrate the wide variation in health and safety management among certified firms.Certification is found to support lower levels of continuous improvement performance in handling health and safety issues. However, more advanced improvement practices are shown to be connected to the integration of health and safety in other managerial areas, as well as to the employment of similar advanced improvement processes within firms. The article argues that certified health and safety management does not obstruct learning, and can support advanced learning. Improvement practices with regard to health and safety are mainly dependent upon the firm’s overall organisational processes and do not automatically arise from the standard alone.     

The measurement of job control

Subjective or perceived control over job-related activities or events is a frequently measured construct in organizational stress research. Karasek (1985) assessed perceived control as both decision authority and skill discretion at work (job decision latitude). Ganster (1989b; Dwyer and Ganster, 1991) developed a multidimensional or general measure of worker control, as well as a specific measure of work predictability. Because little published psychometric data exist for these scales, we investigated the item-level measurement properties of Karasek's and Ganster's measures. We hypothesized two separate, two-factor solutions, decision authority and skill discretion, for the job decision latitude scale, and general control and predictability, for the work control scale. The dimensionality of both measures was assessed in multiple, independent samples using confirmatory factor analyses (LISREL) with maximum likelihood estimation. Simultaneous solutions across samples were used to determine the fit of the factor models to the data. The hypothesized two-factor solutions were confirmed for both Karasek's and Ganster's scales, although item refinement is indicated. We also investigated the relative independence between Karasek's and Ganster's scales and found a lack of independence between the general control and decision authority items in one sample. © 1997 John Wiley & Sons, Ltd.     

Coding ATC incident data using HFACS: Inter-coder consensus

Reliability studies for coding contributing factors of incident reports in high hazard industries are rarely conducted and reported. Although the Human Factors Analysis and Classification System (HFACS) appears to have a larger number of such studies completed than most other systems doubt exists as the accuracy and comparability of results between studies due to aspects of methodology and reporting. This paper reports on a trial conducted on HFACS to determine its reliability in the context of military air traffic control (ATC). Two groups participated in the trial: one group comprised of specialists in the field of human factors and the other group comprised air traffic controllers. All participants were given standardised training via a self-paced workbook and then read 14 incident reports and coded the associated findings. The results show similarly low consensus for both groups of participants. Several reasons for the results are proposed associated with the HFACS model, the context within which incident reporting occurs in real organisations and the conduct of the studies.