Fatal injuries in the construction industry in Washington State

Two hundred thirty-one deaths occurred in the construction industry in Washington State between 1973 and 1983, an average annual mortality rate of 27.5 per 100,000 workers. Falls, cave-ins, and electrocutions resulting from heavy equipment (boom type) contacting overhead power lines together accounted for 45.4% of the fatalities. Heavy construction had a death rate twice that of the other two construction subgroups (building and special trades construction). There was a significant trend towards increasing mortality with decreasing company size (p = 0.03). Drilling machine operators, welders, flamecutters, reinforcing-iron workers, and heavy-equipment operators had the highest proportionate mortality ratios (PMRs). PMRs for workers generally increased with age. Many of these fatal construction injuries would not have occurred had existing safety regulations been observed.     

Fatal occupational injuries in the construction sector in Kocaeli, Turkey, 1990--2001

In Turkey, the construction sector is responsible for the largest number of work-related fatalities among all industries. This study's objective is to determine the characteristics of the fatalities in the construction sector in Kocaeli Province. The study was carried out retrospectively by investigating the records of occupational deaths between 1990 and 2001 in the Kocaeli District of Turkey. Fatal occupational injuries in the construction sector were investigated in detail by evaluating the records. The analysis was based on data from 153 deaths. The incidence of occupational injuries was found overall to be 4.5% in Kocaeli, while the annual mortality rate was 60.4 in Kocaeli and 79.0 in Turkey per 100,000 workers over the entire time period. On the other hand, the fatality rate of occupational injuries was found to be 12.0 per 1,000 in Turkey and 6.4 per 1,000 in Kocaeli. The evaluation of the type of injuries in construction sector has revealed that in 69 of cases (45.1%) fell down from high altitude, in 22 cases (14.4%) vehicle accident, and in 22 (14.4%) electrocution were the cause of death. The leading causes of death have been found to be blunt-force trauma (37.9%) and head trauma (25.5%). Fourty one percent of those who had occupational accidents have had less than one year work experience. Only in 7.8% of deaths, the cause was determined through an autopsy.     

Fatal harmful substances or environmental exposures in agriculture, 1992 to 1996.

Data from the Census of Fatal Occupational Injuries surveillance system from 1992 through 1996 were analyzed to allow a better understanding of exposures to harmful substances or environments that resulted in agricultural work fatalities. There were 357 fatalities as a result of these exposures in the agriculture production and agriculture services sectors, representing 10% of all work-related deaths that occurred in these industry sectors during this period. Contact with electric current represented 52.9% of these fatalities. Agricultural services reported 87 electrocutions, 50 of which occurred among tree trimmers. The events most likely to result in fatalities were contact with overhead power lines (26.3%) and drowning (17.1%). The overall fatality rate was 2.1 deaths per 100,000 workers. The development of appropriate hazard-awareness training for workers, such as that for electrical and drowning-related hazards, may help prevent future deaths in these industry sectors.     

Fatal work-related injuries in the U.S. chemical industry 1984–89

Several mortality studies of the chemical industry have examined fatal injuries, but most of these studies have been of employees of large chemical firms and have not separated work-related from non-work-related injuries. We examined all U.S. Occupational Safety and Health Administration (OSHA) investigation files in 1984-89 in 47 U.S. states of fatal injuries in the chemical industry, Standard Industrial Classification (SIC) 2800–2899. OSHA investigates all reported deaths over which it has jurisdiction; this includes most causes of work-related death except for homicide and motor vehicle crashes. For the 6 year period, there were 234 fatalities in the chemical industry, for a work-related fatality rate of 0.55 per 10,000 workers/year. The largest category of deaths was from explosions, with 99 (42%), followed by fire & burns, with 32 (14%), poisoning, with 31 (13%), and falls, with 18 (8%). Of the 99 deaths from explosions, 45 (45%) involved manufacture or handling of fireworks or other explosives. The fatality rate at firms with fewer than 50 employees was more than twice that of larger firms (P < 0.05) and employees at small firms were less likely to have been covered by a union contract (P < 0.05). OSHA issued citations for safety violations in 73% of the deaths. While regulatory authorities and the media often focus attention on large, multinational chemical corporations, the highest worker fatality rates are found at the smallest chemical firms.     

Identification and characterization of Kentucky self-employed occupational injury fatalities using multiple sources, 1995-2004

BACKGROUND: Identification and characterization of occupational injury fatalities in self-employed workers typically relies on a single data source and thus may miss some cases. METHODS: Kentucky self-employed worker injury fatalities were identified using Fatality Assessment and Control Evaluation (FACE) program data (1995-2004) and compared to non self-employed worker data. Occupations and industries listed on death certificates were compared to those in which the decedent was actually engaged. RESULTS: Of 1,281 Kentucky worker injury deaths, 28% were self-employed. Death certificates failed to identify 31% of these deaths as work-related; industry and occupation were incorrectly identified in 27% and 16%, respectively. Fifty-seven percent of the deaths were in agriculture, primarily tractor-related. For Kentucky, the self-employed crude death rate was higher (27.6/100,000) than the non self-employed worker (5.4/100,000) rate or the US (11.5/100,000) self-employed rate. CONCLUSIONS: Multiple information sources improve identification of self-employed status in work-related injury fatalities. Effective prevention requires accurate surveillance and examination of contributing factors. Self-employed worker injuries in high-risk industries should be more fully examined for development of effective injury prevention programs.     

Fatal occupational injuries in a new development area in the People's Republic of China

Fatal occupational injuries in a new development region in Shanghai in east China are described. All occupational deaths in the East Pujiang New Area during the period 1991 through 1997 were abstracted from multiple, overlapping source documents. There were 426 deaths and a crude mortality rate of 9.1 per 100,000 workers. The death rate was highest in 1995 (14.6%), when expansion in the area was most rapid. The construction sector accounted for 55% of the deaths, followed by manufacturing (23%) and transport, storage, and telecommunications (11%). Falls, collisions, struck by/against incidents, and electrocutions accounted for 80% of all deaths. Falls led all other causes of deaths (33%) and were particularly prevalent in the construction industry (46% of all deaths in construction). The development of ongoing, comprehensive injury surveillance systems in the People's Republic of China will be essential to target and evaluate injury prevention activities in the future.     

Occupational accidents and injuries in Thailand

The Workers' Compensation Fund (WCF) represents only a limited fraction of work-related injuries in the Thai workforce. This cross-sectional study examined 258,986 records from the Thai National Injury Surveillance (NIS) system collected during 2001-2004, focusing on 17,538 injuries coded as work-related. NIS records provided information generally not represented in WCF statistics, such as construction and agriculture. The reported mechanisms in 129 work-related fatalities were particularly informative, including electrical current (27%), transport accidents (20%), and falls (15%). Mortality in transport accidents was dramatically higher when seat belts or motorcycle helmets were not used, whether work-related or not. The findings emphasize the need to use multiple sources of information for a complete picture of work-related injuries in Thailand, and possibly in other countries. The mechanisms of fatal injury indicate areas where focused efforts are warranted.     

Fatal occupational injury rates: Quebec, 1981 through 1988.

OBJECTIVES. The purpose of the study was to estimate the death rates from occupational injuries in the province of Quebec for the period 1981 through 1988. METHODS. Worker's compensation files were used to ascertain numbers of deaths, which were used as the numerators in figuring the rates (it was estimated that these files reported 83% of the true number of deaths among men). Annual average estimates of the labor force were used as denominators. RESULTS. From 1981 through 1988, compensation was awarded for 1227 fatal work injuries. Among men (96% of the victims), rates declined from 1981 to 1988 (from 12.7 to 8.1 per 100,000); women's rates were stable (< or = 1.0 per 100,000). Compared with men, women had excess mortality from violent acts. Motor vehicle crashes accounted for 36% of all fatal injuries in 1984 and 1985 and declined thereafter. Fatal injury rates in forestry and mining rose to a 1987 maximum of 67.6 per 100,000. The construction sector had the largest number of deaths, despite a decline in rates from 1981 to 1988 (from 27.8 to 15.9 per 100,000). CONCLUSIONS. Except for construction and agriculture, reported fatal occupational injury rates in Quebec were similar to those in the United States. Motor vehicle crashes, falls, violent acts, and farming-related injuries were the most frequent causes of death.     

Utilizing United States Coast Guard data to calculate incidence rates and identify risk factors for occupational fishing injuries in New Jersey

Commercial fishing has high rates of work-related injury and death and needs preventive strategies. Work-related fatal and nonfatal injury rates for New Jersey (NJ) commercial fishermen who suffered unintentional traumatic injuries from 2001 to 2007 are calculated using data from the United States Coast Guard (USCG) Marine Safety and Pollution Database and estimated denominator data. Fatalities were compared to those ascertained by the NJ Fatality Assessment Control and Evaluation (FACE) surveillance system. For the study years, 225 nonfatal injuries and 31 fatal injuries were reported. Among nonfatal injuries, the causes by frequency were fall onto surface, crushed between objects, struck by moving object, line handling/caught in lines, collision with fixed objects, fall into water, and other noncontact injuries. The distribution of fatal injuries differed, with the most frequent cause as crushed between objects. Falls into water and several noncontact injuries accounted for most of the other fatalities. The large majority (96%) of nonfatal injuries were contact injuries, whereas only 68% of fatalities were classified as contact. The overall incidence rate of nonfatal injuries was 1188 per 100,000 full-time equivalents (FTEs) per year. The rate varied considerably by year, from a low of 286 per 100,000 FTEs in 2001 and 2007 to 3806 per 100,000 FTEs in 2003. The overall occupational fatality rate over the period 2001-2007 was 164 per 100,000 FTEs per year. These results can aid in targeting the commercial fishing industry for injury prevention strategies and interventions, especially for falls, crushing injuries, and drownings.     

Work-related fatalities in west virginia. A summary of surveillance, investigation, and prevention activities, july 1996-DECEMBER 1999

PURPOSE: From 1990-95, West Virginia (WV) had a work-related death (WRD) rate of 8.9 deaths per 100,000-the fifth highest rate among all states and twice the national rate. As a result, a Fatality Assessment and Control Evaluation (WV FACE) program was established to identify all WRDs, define workers at high risk for fatal injury, investgate selected causes, and formulate and disseminate prevention strategies.METHODS: Surveillance and investigation data were used to describe trends and rates and identify hazardous conditions, unsafe work practices, and management-leadership problems through the use of the traditional epidemiologic model and the Haddon temporal matrix. Prevention strategies were developed and disseminated utilizing various written media.RESULTS: From 7/1996-12/1999, 191 persons died from work-related injuries. The WRD rate was 7.6 per 100,000 compared to 4.7 for the U.S. (1996-98). 94% of the victims were male and all Caucasian. Mean age at death was 43 years. Leading external causes of death: motor vehicle (48), struck by object (38), machinery-related (24), fall from elevation (15), and homicide (10). WRDs occurred most often in the trans/public utilities (37; truckers-22), manufacturing (32; loggers-24), mining (28), construction (26), and services (25) industry sectors. 19 on-site investigations were conducted (10 logging, 5 machine-related, and 4 fall from elevation); no company safety programs, inadequate training, lack of oversight were consistently noted. Summary reports were prepared for employers, Fatal Incident Alerts written for workers, and a scientific article was published.CONCLUSIONS: FACE has contributed to a better understanding of fatal occupational injuries within WV and the importance of coordinated efforts by employees, employers, and safety and public health specialists to reduce the frequency and societal impact of these injuries.     

我国车祸的流行病学特征及影响因素分析

本研究的目的在于分析1951～1994年我国车祸的流行病学特征及其影响因素，为车祸的预防和控制提供依据。43年中我国车祸发生数增加了42倍，死亡人数增加了77倍。1984～1994年车祸年死亡率由2．43／10万人上升到5．56／10万人，平均年增长率为12．9％。广东、浙江、辽宁、四川和江苏是车祸最多的省份，5省的车祸发生数占全国总发生数45％，死亡人数占38％。1994年30个省市区的车祸死亡率以北京市为最低（3．41／10万人），浙江省最高（12．09／10万人），广东省的升幅最大。致死性车祸多发生于天气晴朗时的平直路段，以20～50岁的农民和职工居多，死者2／3为行人、骑自行车者和乘车者。各类事故的原因中驾驶员责任、无证开车、骑自行车人责任和行人过失等人的因素占90％。驾驶员肇事原因主要是违章行车、判断错误或疏忽大意。车辆增加、运输繁忙和道路不足、交通条件欠完善是导致车祸的主要因素。预防和控制车祸的根本措施在于改善交通环境和加强交通安全教育。     

Scientific Method Questioned

Abstract

The Workers' Compensation Fund (WCF) represents only a limited fraction of work-related injuries in the Thai workforce. This cross-sectional study examined 258,986 records from the Thai National Injury Surveillance (NIS) system collected during 2001-2004, focusing on 17,538 injuries coded as work-related. NIS records provided information generally not represented in WCF statistics, such as construction and agriculture. The reported mechanisms in 129 work-related fatalities were particularly informative, including electrical current (27%), transport accidents (20%), and falls (15%). Mortality in transport accidents was dramatically higher when seat belts or motorcycle helmets were not used, whether work-related or not. The findings emphasize the need to use multiple sources of information for a complete picture of work-related injuries in Thailand, and possibly in other countries. The mechanisms of fatal injury indicate areas where focused efforts are warranted.     

Alcohol and fatal injuries: temporal patterns

Although alcohol use has been established as a risk factor for injuries associated with motor vehicle crashes, the role of alcohol for other unintentional and intentional injuries is less defined. A review of 102,401 deaths investigated by North Carolina medical examiners in the period 1973-1983 characterized the temporal patterns of ethyl alcohol in unintentional injury fatalities, suicides, homicides, and persons who died of natural or unknown causes. Victims of homicides (85.9%) and suicides (77.7%) were tested for alcohol more frequently than were fatalities resulting from unintentional injury (67.5%) or natural causes (61.6%). Alcohol was present in 62.8% of homicide victims, 48.6% of unintentional injury fatalities, 35.3% of suicides, and 14.4% of deaths from natural causes. The percentage of alcohol-associated deaths for each manner of death showed little yearly or seasonal variation. Alcohol was most frequently detected in persons fatally injured on the weekend and from 6 PM to 6 AM. This study highlights the magnitude of alcohol's role in intentional and unintentional injuries, especially for persons injured at night and on weekends.     

Work-related electrical fatalities in Australia, 1982-1984.

Work-related electrical fatalities were studied as part of a larger investigation into all work-related fatalities in Australia in the period 1982-1984. The 95 electrical fatalities (all men) represented an incidence of 0.49 per 100,000 persons (0.79/100,000 men) in the employed civilian labor force during the study period. Electricity was the fifth highest cause of work-related fatalities in Australia and resulted in 10% of all workplace deaths. Ninety-four percent of the workers were performing their usual tasks at the time of their death, and 38% of them were doing work of an electrical nature at the time. The greatest number of deaths occurred on farms and nonconstruction industrial sites, with overhead powerlines as the main source of current. Better placement of overhead powerlines, improved worker awareness of electrical hazards, and the use of residual current devices would probably have prevented most of the deaths.     

Fatal occupational injuries among electric power company workers

Surveillance data suggest high rates of electrocutions and fatal falls among workers in electric utility companies, who may be exposed to electric current, heights, flammable agents, and frequent motor vehicle travel. To characterize the occurrence of fatal injuries among electric utility workers, we studied workers in five electric power companies in the United States. A cohort of 127,129 men hired between 1950 and 1986 was followed through 1988. Injuries at work were identified through manual review of death certificates. The occurrence of occupational injuries was analyzed with directly adjusted rates and Poisson regression. The overall rate of fatal occupational injuries was 13.20 per 100,000 person‐years (n = 192), with 76% due to electric current, homicide, and falls from heights. Deaths were concentrated in a few groups with elevated injury rates, notably linemen (rate ratio (RR) 3.33), electricians (RR 2.79), and painters (RR 3.27). Occupations requiring daily work on elevations or frequent, direct contact with energized electrical equipment experienced markedly higher rates of fatal injury from falls and electrocutions with rate ratios of 21.8 (95% confidence interval (CI) 11.4–41.5) and 16.7 (95% CI 6.6–42.6), respectively, independent of worker age and seniority. Although fatal injury rates in this industry have declined in recent decades, significant numbers of deaths still occur. Based on the premise that all injuries are preventable, a need for continued vigilance and efforts at prevention is indicated. Am. J. Ind. Med. 35:302–309, 1999. © 1999 Wiley‐Liss, Inc.     

The use of sentinel injury deaths to evaluate the quality of multiple source reporting for occupational injuries

PURPOSE: This study sought to develop an efficient method for evaluating the validity and completeness of routinely available sources of occupational injury fatality data. METHODS: Deaths due to falls from elevations, machinery, and electrocutions were selected as sentinel injuries likely to have occurred at work. Deaths from these injuries were identified from Maryland vital statistics over 7 years. The work-relatedness of these injuries and sensitivity of reporting were determined from death certificates, medical examiner reports, the National Traumatic Occupational Fatality System (NTOF), the Maryland Occupational Safety and Health Administration (MOSH), and Workers' Compensation (WC) data. RESULTS: A total of 527 deaths were identified for ages 16 and above, of which, 45% were work-related. Identification of work-related deaths varied by source: medical examiner (100%), death certificates (89%), NTOF (68%), MOSH (59%), and WC (44%). Reporting differed by age, cause of injury, year, occupation, and industry. CONCLUSIONS: Examination of work-relatedness for deaths from certain causes is an efficient means of evaluating the quality of occupational injury reporting source data. These sentinel injuries uncovered significant underreporting in sources used by national surveillance systems, resulted in improved NTOF reporting, and suggest the need to make more use of medical examiner data when available.     

某经济开发区建筑业1991～1997年工伤死亡调查分析

对某经济开发区建筑业１９９１～１９９７年发生的１６岁以上年龄的２３５名工伤罹难者进行了分析研究,此期间建筑业工伤死亡数占该区工伤亡总数的５５％,建筑业工伤粗死亡率为５９．８／１０万。坠落,碰撞,物体打击,触电和坍塌是主要的事故类别,占总死亡数的９３．６％。而最常见的多人工伤死亡事故是坠落,碰撞,中毒和火灾。提示在制订工伤防制计划时应重视这些事故类别。此外,改善工伤监测报告制度,包括计算机报告系统,     

某经济开发区1991～1997年工伤死亡调查分析

对某开发区1991－1997年发生的426例工伤罹难者进行了调查分析,主要涉及死者人口学资料,环境危险因素如致害设备、事故类型及伤害方式等。在该调查期间,工伤粗死亡率为9．1／10∧5。坠落、起重伤害、触电、物体打击、坍塌、机械和企业内车辆伤害等占全部工伤死亡的88％。其企业类型特征如下：坠落、起重伤害、坍塌、触电和物体打击在建筑行业最常见;触电、起重伤害、机械伤害和坠落在制造业常见;车辆伤害则最常发生在运输、仓储和邮电业。15％的工伤死亡属于多人（2人及以上）死亡事故,最常见的多人死亡事故是因坠落、化学中毒、金属工件和垆理伤害等。涉及的设备主要是工作面、在建建筑物、起重设备和车辆等。     

Women in the U.S. construction industry: An analysis of fatal occupational injury experience, 1980 to 1992

Analysis of 139 deaths to U.S. female construction workers identified from a death certificate-based surveillance system during 1980–1992 showed that female workers in transportation and material moving had 59 and 85% higher mortality rates than male construction workers in the same occupation from motor vehicles (the leading cause of occupational injury death for women, 43.2%) and machinery (the second leading cause of occupational injury death for women, 15.8%), respectively. Female handlers, equipment cleaners, helpers, and laborers had 73% higher mortality rates than their male counterparts from motor vehicles. Two-thirds of women in construction killed by motor vehicles were pedestrians, compared with an average of 19.2% of women in all industries. Half the female pedestrian decedents in construction were flaggers, compared with 3.4% of construction men killed by motor vehicles. Construction women had higher cause-specific years of potential life lost (to age 65 years) than construction men from motor vehicles (33 vs. 24.8), machinery (29 vs. 24.8), homicide (26.1 vs. 24.6), and falls (31.9 vs. 24.7). Over half (53.2%) the female fatalities occurred before age 35 years, compared with 46% for males. The average fatality rate of 1.80 per 100,000 workers for female construction workers was higher than the rate for women in any other industry. The average rate per 100,000 workers for all industries was 0.77. Further studies are required to explore factors contributing to differences in leading causes of death between female and male construction workers. Development and evaluation of prevention measures, such as effective traffic control in highway construction work zones, fall protection training, and machinery-operation training, could reduce the risks for fatal occupational injuries for construction workers, regardless of gender. Am. J. Ind. Med. 33:256–262, 1998. © 1998 Wiley-Liss, Inc.     

Fatal traumatic brain injury, West Virginia, 1989-1998

OBJECTIVE: The objective of this study was to describe fatal cases of traumatic brain injury (TBI) among West Virginia residents. METHODS: The authors analyzed data from the National Center for Health Statistics Multiple Cause of Death tapes for the period 1989-1998. They compared West Virginia's annualized average TBI death rate with the rates of other states and with the rate among U.S. residents for the same period. U.S. Bureau of Census population estimates were used as denominators. RESULTS: A total of 4,416 TBI deaths occurred in West Virginia in 1989-1998, for an annual average death rate of 23.6 per 100,000 population. From 1989 to 1998, TBI death rates declined 5% (p=0.4042). Seventy-five percent (n=3,315) of fatalities occurred among men. Adults > or =65 years of age accounted for the highest percentage of fatal injuries (n=1,135). The leading external causes of fatal TBI were: firearm-related (39% of reported fatalities), motor vehicles-related (34%), and fall-related (10%). Firearm-related TBI became the leading cause of TBI fatalities in 1991, surpassing motor vehicle-related TBI. Seventy-five percent of firearm-related TBI deaths were suicides (n=1,302). West Virginia's TBI death rate (23.6 per 100,000) was higher than the national rate (20.6 per 100,000). In 23 states, the average TBI death rates over the 10-year period were higher than West Virginia's. Whereas modest declines in TBI death rates occurred for motor vehicle-related and firearm-related causes in West Virginia, a concomitant 38% increase occurred in the fall-related TBI death rate during the decade. CONCLUSION: Data presented in this report can be used to develop targeted prevention programs in West Virginia.