Fall-related occupational injuries on farms

We assessed risk factors for fall-related farm injuries in a population-based, case-control study. Cases had to reside in a defined geographic region served by a single medical center. Multiple sources reported cases, and a special farm census enabled random selection of controls. The annual risk of farm fall injury was 7.5 (95% CI: 5.7, 10.0) per 1,000 person-years. The crude incidence rate was higher in men, while the rate based on hours of farmwork was higher in women. In a multivariate analysis of risk factors, three factors were significantly associated with the risk. The risk of fall injury increased 2% (95% CI: 1%, 4%) per hour worked. Residents of farms with some farm workers not living on the farm had a fall injury rate 2.5 (95% CI: 1.0, 6.2) times greater than residents of other farms. Residents of farms with registered cows had one-third (95% CI: 0.14, 0.93) the risk of residents of other farms. To identify environmental hazards for fall injuries, researchers from several disciplines may need to collaborate in the design and conduct of studies that include injury site investigations. © 1996 Wiley-Liss, Inc.     

Proposal to reimburse occupational medicine disease and injury claims through third party health insurance

The current system of compensation for the medical costs of occupational illnesses and injuries, a component of health insurance coverage for most workers in the United States, has recently come under scrutiny in the national health care reform debate. The cost of treatment of these conditions is significant, and there exist numerous disincentives for physicians and patients to use the workers' compensation system. Physicians who treat workers with occupationally related diseases may find compensation for a condition is disputed at the same time that it is excluded from payment by third party insurance coverage, leaving the patient selectively uninsured for at least some medical care services. In addition, most workers' compensation programs have been designed in a way that discourages efficient resource use by providers and claimants. We propose allowing health care providers to bill third party health insurers for all care, including work-related diseases and injuries. Insurers, in turn, would bill workers' compensation programs for associated treatment costs. The potential advantages of such a system include reductions in inefficiency and unfair burdens placed on providers and patients, in reporting bias, and in administrative costs balanced against the risks of insurers excluding workers in high risk occupations from obtaining low cost health insurance and shifting away from employers the administrative burden for workers' compensation.     

Work-related injuries to Massachusetts teens, 1987–1990

This study uses workers' compensation data to describe the work-related injury experience of Massachusetts teens, ages 14–17, from 1987 to 1990. During this period, 2,551 injuries were reported to the workers' compensation system. Injuries were more frequent among 16–17 year-olds and among males. Sprains and strains, followed by lacerations, were the most frequent type of injury. Four industries—grocery stores, restaurants, health services, and department stores—accounted for over half of all injuries. The overall injury rate was 1.9/100 full-time equivalents (FTEs), but was higher in the construction, manufacturing, and wholesale trade sectors. Teens working in apparel manufacturing and nursing homes sustained the highest rate of injuries. Geographical analysis indicated that teens living in the southeast region of the state had the highest injury rates. This study adds to the existing evidence that work-related injuries to teens are a substantial public health problem. © 1996 Wiley-Liss, Inc.     

Surveillance for nonfatal work-related injuries in Alaska, 1991–1995

Historically, Alaska has had an occupational fatality rate five times greater than that for the United States. This article reports recent surveillance results for hospitalized nonfatal work-related injuries in Alaska, using the population-based Alaska Trauma Registry (ATR) from 1991 through 1995. The fishing, construction, and logging industries led with the highest number of reported cases in the ATR. Workers in the logging, water transportation, and wood product manufacturing industries had the highest injury rates. Cause, severity, type, and body region of injury were examined for each target industry. For industries with the highest numbers and rates of injuries, in most cases, falls were identified as a common cause of injuries. A fractured bone was the most common type of injury, and the extremities were the most common body region affected. The ATR has proved to be a reliable tool for work-related injury surveillance and will be helpful in planning research priorities and targeting injury prevention efforts. Am. J. Ind. Med. 34:493–498, 1998. © 1998 Wiley-Liss, Inc.     

Injury and illness in the American workplace: A comparison of data sources

Setting priorities for workplace health and safety research depends upon accurate and reliable injury and illness data. All occupational health databases have limitations when used to summarize the national scope of workplace hazards. The comparison of data from multiple sources may produce more credible estimates of the leading occupational injuries and illnesses. The purpose of this paper is to describe the strengths and weaknesses of six data collection systems that record occupational injuries and illnesses on a national level and to compare the leading estimates from these systems for 1990. The six systems are: 1) National Traumatic Occupational Fatalities database, 2) the Bureau of Labor Statistics Census of Fatal Occupational Injuries, 3) The Bureau of Labor Statistics Annual Survey data, 4) a large workers' compensation database, 5) the National Council on Compensation Insurance data, and 6) The National Electronic Injury Surveillance System. Occupational injuries, as defined herein, predominate over illnesses in terms of the number of cases and the overall costs. Databases that provide information on the antecedents of injuries suggest how these injuries may be prevented and warrant more attention and refinement. © 1996 Wiley-Liss, Inc.     

Work-related Injuries and Illnesses in Botswana

Abstract

In Botswana over 1,000 work-related accidents resulting in more than three days' absence from work are reported annually, including about 60 fatalities. Hardly any work-related diseases are reported, despite suspicion that they are prevalent. An analysis of 498 cases in Gaborone district for the year 2000 indicates that road traffic accidents accounted for about 80% of all workrelated fatalities, and that the majority of the victims of fatal accidents were government employees. Most accidents occurred in places of employment not regulated by any legislation enforcing occupational safety and health. There is a need for Botswana to put in place performance-based legislation requiring all employers to identify and control hazards. Employers should be encouraged to implement occupational safety and health management systems to improve their safety performances al1d enhance productivity.     

Differences in injury rates in child motor vehicle passengers in rural and urban areas in New South Wales, July 2000 to June 2004

OBJECTIVES: To investigate whether the pattern of hospitalised injuries in injured child motor vehicle passengers involved in traffic crashes differs in rural and urban residents of New South Wales (NSW). METHODS: This study compared injuries of hospitalised child motor vehicle passengers resident in rural areas with those from urban areas. The NSW Inpatient Statistics Collection (ISC), a population-based dataset, was used to select cases for the period of July 2000 to June 2004. The hospitalised injury rate was calculated according to urban/rural status using Poisson regression. Injury rate ratios (IRR) comparing rural and urban children were computed overall and for specific injury types. RESULTS: Overall, 1,286 children (aged 0-15 years) residing in NSW were identified from the NSW ISC internally linked datasets as being separated from hospital for injuries resulting from a motor vehicle crash. The overall hospitalised injury incidence rates for child motor vehicle passengers resident in rural and urban NSW areas were 46.75 (95% CI 36.63-59.66) and 20.13 (95% CI 17.94-22.58) per 100,000 children respectively. The rural/urban IRR for comparing the incidence of hospitalisation was significantly elevated (IRR=2.10, 95% CI 1.78-2.48). The IRR was also significantly elevated across most injury types. The largest risk disparity between rural and urban children was in 9-12 year-olds (IRR=2.33, 95% CI 1.73-3.13). CONCLUSION AND IMPLICATIONS: There is an elevated injury incidence rate in rural resident children, compared with their urban counterparts. This differential should be addressed in future road safety initiatives.     

Follow-back study of oldest workers with emergency department-treated injuries

The aging of the U.S. workforce highlights the need to address issues affecting older workers specifically. Telephone surveys were conducted with injured workers identified through a surveillance system based in a sample of emergency departments in the United States. The 176 interviewed cases correspond to a national estimate of 8.263 (s.e. = 1,258) injuries to workers aged 63 years and older during May 15-September 30, 1993. Five percent reported limitations in the types or amount of work they could perform prior to the injury. Ninety-four percent reported familiarity with the task resulting in injury. Fifty-one percent returned to work without missing any workdays, however, 69% required return visits to a health care provider. Thirty-four percent reported receiving training in injury prevention. Twenty percent of the injured workers were self-employed and 43% worked for small businesses. Data from this study provide insight into routinely collected statistics and have implications for future research and intervention efforts. Am. J. Ind. Med. 31:609–618, 1997. © 1997 Wiley-Liss, Inc.

1 This article is a US Government work and, as such, is in the public domain in the United States of America.

     

Gliomas and Farm Pesticide Exposure in Men: The Upper Midwest Health Study

The National Institute for Occupational Safety and Health evaluated farm pesticide exposure and glioma risk in a study that included 457 glioma cases and 648 population-based controls, all adult men (18–80 yr old) and nonmetropolitan residents of Iowa, Michigan, Minnesota, and Wisconsin. Multiple logistic regressions were used to control for farm residence, age, age group, education, and exposure to other pesticides. No associations were found between glioma and 12 specific pesticides. We estimated adjusted odds ratios (ORs) and 95% confidence intervals (Cls) and found reduced glioma risk for insecticides (OR = 0.53, Cl = 0.37–0.77), fumigants (OR = 0.57, Cl = 0.34–0.95), and organochlorines (OR = 0.66, Cl = 0.47–0.94). In analyses excluding proxy respondents (47% of cases) most Cls included 1.0. No positive association of farm pesticide exposure and glioma was found. Other farm exposures may explain the excess brain cancer risk seen in previous studies.     

绍兴市社区居民伤害现况和疾病负担调查

目的　调查绍兴市居民伤害的发生现况和疾病负担。方法　采取随机分层整群抽样入户调查的方法 ,选择城区、郊区、平原和山区 4类不同地区 116 4 0名社区居民 ,对其伤害发生情况进行回顾性调查。结果　 8种伤害的总发生率为 12 .5 4 % ,标化率为 12 .5 1% ,居发生率前三位的伤害依次为跌伤、钝 /锐器伤和车祸。不同年龄组的伤害发生率差异有显著性 (χ2 =15 8.92 ,P <0 .0 1)。男性高于女性 (χ2 =13.0 1,P <0 .0 1) ;不同地区居民的伤害发生率差异有显著性(χ2 =75 .37,P <0 .0 1) ,依次为郊区 15 .95 %、平原 14 .0 7%、城市 10 .16 %、山区 9.6 1%。平均每例伤者休息 9.11d ,医疗费用 6 2 1.6 2元。结论　绍兴市居民伤害发生率较高 ,并导致较重的疾病负担 ,应加强伤害的预防和控制工作。