Bridging the gap: bringing together intentional and unintentional injury prevention efforts to improve health and well being

PROBLEM: Intentional and unintentional injury prevention efforts have traditionally been independent and non-integrated. Fostering collaboration between the sub-fields would enhance work within both sub-fields and advance injury prevention work as a whole. METHOD: A systematic assessment of similarities and differences between the sub-fields was performed, including an examination of relevant definitions and norms, research methods and findings, key risk and resiliency factors, and prevention strategies that would promote collaboration and better advance current prevention efforts. RESULTS/SUMMARY: Several areas exist in which injury prevention efforts could be coordinated or ideas and practices could be cross-applied, including training of practitioners, data collection and analysis, application of tools and methodologies, examination of risk and resiliency factors, and identification of funding sources and partners. IMPACT ON INDUSTRY: This paper delineates how intentional and unintentional injury prevention practitioners can more effectively collaborate to promote safer environments and further reduce incidence of injury. An integrated injury prevention approach could significantly impact the underlying contributors to both types of injury, allowing practitioners within both sub-fields to achieve greater outcomes through increased credibility, reduced duplication of efforts, more efficient use of resources, and unified injury prevention messages.     

矿井风流温度预测分析研究

随着煤矿机械化程度不断提高,特别是随着开采深度逐渐增加,矿井热害问题日益突显,高温环境不仅影响生产效率而且严重危害着工作人员的健康。为了更好地降低高温矿井开采时期巷道风流温度,确定合理的巷道布置方案和矿井通风系统,提出矿井巷道风流温度预测方法。以矿井通风和热力学为基础,结合网络解算,对矿井风流温度分布进行研究,总结各种类型巷道风流温度的计算方法,提出多点风流混合温度计算模型。结合具体矿井进行实际预测分析,预测结果中显示风流温度可能超限的巷道,对通风系统进行优化设计。     

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.     

工伤保险在社保制度中的排序变化及其内涵

目前我国常见的社会保险制度排序是养老保险、医疗保险、失业保险、工伤保险和生育保险,工伤保险制度位列第四位;而在计划经济时期的劳动保险制度系列中,工伤待遇规定曾位居第一位,尔后才是医疗待遇规定、养老待遇规定和生育待遇规定。上述排序变化的出现不会是立法者的偶然随意之为,而是以实行市场经济体制改革后我国劳动者-企业-国家之"三方关系"出现的根本性变化为背景原因的,与制度本身从一种面向牺牲了个人安全和健康的建设功臣们实施的国家慰谢待遇向以分散风险、损失共担为机理的保险制度发生的转化密切相关。针对近年来极端劳资纠纷事件增多的趋势,我国的劳动安全管理及工伤保险立法决策还应更加注重向弱势劳动者的倾斜。     

建筑施工中临边高处坠落危险源影响空间建模

将建筑施工中临边坠落的特性模型化,对于预防建筑施工中伤亡事故具有重要的意义。在分析人或物临边高处坠落事故特点的基础上,给出施工工作面内外2种危险源影响空间范围的定义及其数学表达函数,构建相应的危险源影响空间中危害能量分布的数学模型,提出它对人体不同部位伤害程度的评估分析思路,并在大面积碰撞和小面积碰撞2种情况下,建立该危害能量对人体头枕部伤害程度的评估分析方法。通过上海某个6层框架结构教学楼案例,对上述数学模型和评估分析方法进行验证。这为在进行施工计划安排时,考虑危险源影响空间的影响,降低安全事故发生的可能性创造条件,也为安全事故事前预防提供新思路。     

The theory of planned behavior (TPB) and texting while driving behavior in college students

Objective: To examine the role of intent and other theory of planned behavior (TPB) constructs in predicting college students' willingness to text while driving (TWD).

Methods: This was a cross-sectional study. 243 male and female college students enrolled in the 2013–2014 academic year in the College of Health, Human Services & Nursing completed a survey on TWD. Inclusion criteria: All races and ethnicities, ≥18 years of age, cell phone owner, and licensed driver.

Results: Over 70% of the sample (n = 243) reported talking on a cell phone and sending and receiving text messages “at least a few times” while driving within the past week. However, only 27% reported being stopped by police. Of these, 22% reported being fined. Within the past 30 days, 26% reported reading or sending TWD and having to slam on the brakes to avoid hitting another car or pedestrian(s) as a result. In all, 47% of the variance in intention to send TWD was accounted for by the full TPB model. Intention, in turn, predicted willingness to TWD. Intention also mediated the relationship between perceived behavioral control and willingness to TWD.

Conclusion: Attitude was found to be the strongest predictor of intention. In addition, intention was found to mediate the relationship of willingness to TWD on perceived behavioral control. These findings highlight potential factors that could be targeted in behavioral change interventions seeking to prevent TWD.     

Orthopedic injury in electric bicycle-related collisions

Objective: Although electric bicycle-related injuries have become the most common reason for hospitalization due to a road crash in China, no study has comprehensively investigated electric bicycle collisions and their impact on orthopedic injuries; such a study may provide evidence to support a new road safety policy.

Methods: A retrospective review of orthopedic injuries from electric bicycle collisions was performed in an urban trauma center. We collected variables including age, gender, location of fracture, presence of open or closed fractures, concomitant vascular, and neurologic injuries.

Results: A total of 2,044 cases were involved in electric bicycle collisions. The orthopedic injury victims were predominantly male and middle aged. The most common orthopedic injury was a femur fracture. Open fractures frequently involved the forearm and tibia/fibula. Male patients were more likely to suffer from multiple fractures and associated injuries than female patients. Fewer patients age 60 years old or older wore helmets at the time of the accident compared to those in other age groups.

Conclusions: Orthopedic injuries from electric bicycle-related accidents cause patients substantial suffering that could lead to serious social consequences. Helmet use and protective clothing or similar safety gear, especially for electric bicycle users, should be required to provide greater protection.     

Health-related quality of life 24 months after sustaining a minor musculoskeletal injury in a road traffic crash: A prospective cohort study

Objectives: A better understanding of the long-term factors that independently predict poorer quality of life following mild to moderate musculoskeletal injuries is needed. We aimed to establish the predictors of quality of life (including sociodemographic, health, psychosocial, and pre-injury factors) 24 months after a noncatastrophic road traffic injury.

Methods: In a prospective cohort study of 252 participants with mild/moderate injury sustained in a road traffic crash, quality of life was measured 24 months following the baseline survey. A telephone-administered questionnaire obtained information on various potential explanatory variables. Health-related quality of life was measured using the European Quality of Life–5 Dimensions (EQ-5D) and Medical Outcomes Survey Short Form–12 (SF-12). Multivariable linear regression analyses determined the associations between explanatory variables and quality of life measures.

Results: Mean SF-12 physical component summary (PCS) and mental component summary (MCS) scores increased by 7.3 and 2.5 units, respectively, from baseline to 24-month follow-up. Each 10-year increase in baseline age was independently associated with 3.1-unit (P < .001) and 1.5-unit (P = .001) decrease in EQ Visual Analogue Scale (VAS) and SF-12 PCS scores at follow-up, respectively. Poor/fair compared to excellent pre-injury health was associated with a 0.16-, 21.3-, and 11.5-unit decrease in EQ-5D summary (P = .03), VAS scores (P = .001), and SF-12 PCS scores (P < .001), respectively. Baseline pain severity ratings and pain catastrophizing scores were inversely associated with 24-month EQ VAS scores (both P < .001). Each unit increase in baseline pain score (P = .001) and pain catastrophizing score (P = .02) was associated with a 1.0- and 4.6-unit decrease in SF-12 MCS scores at 24 months, respectively. Other observed predictors of quality of life measures (EQ-5D summary and/or VAS scores and/ or SF-12 MCS) included marital status, smoking, hospital admission, pre-injury health (anxiety/depression and chronic illness), and whiplash injury.

Conclusion: Sociodemographic indicators, pre-injury health, and biopsychosocial correlates were independently associated with health-related quality of life 24 months following a noncatastrophic road traffic crash injury.     

Airbag deployment–related eye injuries

Objective: We studied the correlation between airbag deployment and eye injuries using 2 different data sets.

Methods: The registry of the Finnish Road Accident (FRA) Investigation Teams was analyzed to study severe head- and eyewear-related injuries. All fatal passenger car or van accidents that occurred during the years 2009–2012 (4 years) were included (n = 734). Cases in which the driver's front airbag was deployed were subjected to analysis (n = 409). To determine the proportion of minor, potentially airbag-related eye injuries, the results were compared to the data for all new eye injury patients (n = 1,151) recorded at the Emergency Clinic of the Helsinki University Eye Hospital (HUEH) during one year, from May 1, 2011, to April 30, 2012.

Results: In the FRA data set, the unbelted drivers showed a significantly higher risk of death (odds ratio [OR] = 5.89, 95% confidence interval [CI], 3.33–10.9, P = 2.6E-12) or of sustaining head injuries (OR = 2.50, 95% CI, 1.59–3.97, P = 3.8E-5). Only 4 of the 1,151 HUEH patients were involved in a passenger car accident. In one of the crashes, the airbag operated, and the belted driver received 2 sutured eye lid wounds and showed conjunctival sugillation. No permanent eye injuries were recorded during the follow-up. The calculated annual airbag-related eye injury incidence was less than 1/1,000,000 people, 4/100,000 accidents, and 4/10,000 injured occupants.

Conclusions: Airbag-related eye injuries occurred very rarely in car accidents in cases where the occupant survived and the restraint system was appropriately used. Spectacle use did not appear to increase the risk of eye injury in restrained occupants.