Jennifer L. Bell

An evaluation of a "best practices" musculoskeletal injury prevention program in nursing homes.

Objective: To conduct an intervention trial of a “best practices” musculoskeletal injury prevention program designed to safely lift physically dependent nursing home residents. Design: A pre-post intervention trial and cost benefit analysis at six nursing homes from January 1995 through December 2000. The intervention was established in January 1998 and injury rates, injury related costs and benefits, and severity are compared for 36 months pre-intervention and 36 months post-intervention. Participants: A dynamic cohort of all nursing staff (n = 1728) in six nursing homes during a six year study period. Intervention: “Best practices” musculoskeletal injury prevention program consisting of mechanical lifts and repositioning aids, a zero lift policy, and employee training on lift usage. Main outcome measures: Injury incidence rates, workers’ compensation costs, lost work day injury rates, restricted work day rates, and resident assaults on caregivers, annually from January 1995 through December 2000. Results: There was a significant reduction in resident handling injury incidence, workers’ compensation costs, and lost workday injuries after the intervention. Adjusted rate ratios were 0.39 (95% confidence interval (CI) 0.29 to 0.55) for workers’ compensation claims, 0.54 (95% CI 0.40 to 0.73) for Occupational Safety and Health Administration (OSHA) 200 logs, and 0.65 (95% CI 0.50 to 0.86) for first reports of employee injury. The initial investment of

Changes in logging injury rates associated with use of feller-bunchers in West Virginia

158 556 for lifting equipment and worker training was recovered in less than three years based on post-intervention savings of

The epidemiology of fatal occupational traumatic brain injury in the U.S.

55 000 annually in workers’ compensation costs. The rate of post-intervention assaults on caregivers during resident transfers was down 72%, 50%, and 30% based on workers’ compensation, OSHA, and first reports of injury data, respectively. Conclusions: The “best practices” prevention program significantly reduced injuries for full time and part time nurses in all age groups, all lengths of experience in all study sites.

Occupational injuries in the mining industry and their association with statewide cold ambient temperatures in the USA.

PROBLEM It is well documented that logging is one of the most dangerous occupations and industries in which to work, and trees fellers are at greatest risk of injury. The objective of this study was to determine whether West Virginia (WV) logging companies experienced a reduction in injuries after beginning to use feller-bunchers (tree cutting machines, which replace some of the work done with a chainsaw) during harvesting operations. METHODS WV workers compensation claims and employment data from 1995 to 2000 were used to calculate injury rates. Injury trends in the rest of the WV logging industry, not using feller-bunchers, were also assessed. RESULTS For 11 companies, the pre-feller-buncher injury claims rate was 19.4 per 100 workers and the post-feller-buncher rate was 5.2 per 100 workers. This was a significant difference, with an adjusted rate ratio of 2.8 (95% CI: 1.8-4.5) of pre to post claims. Struck by injuries also showed significant decline, with the pre-feller-buncher injury rate being 3.8 (95% CI: 1.8-8.2) times as great as post-feller-buncher rate. During the time of the study, the injury rate rose in the rest of the WV logging industry. The average cost of a workers compensation claim in the WV logging industry during the time of the study was approximately

Logging injuries for a 10-year period in Jilin Province of the People's Republic of China

10,400. IMPACT ON INDUSTRY As mechanization of logging tasks becomes more widespread, the WV logging industry as a whole may see substantial injury declines and a reduction in the total cost of injury claims. Struck by injuries, the most common and potentially fatal of logging injury types, appear to be particularly affected. However, logging operations in areas of very steep terrain where it is not possible to use these machines may need to rely on strategies other than feller-bunchers to reduce injuries.

Assessing safety awareness and knowledge and behavioral change among West Virginia loggers

BACKGROUND Although traumatic brain injury (TBI) is one of the leading causes of death and disability in the U.S., work-related TBI has not been well documented. PURPOSE The aim of this study was to describe the epidemiologic characteristics and temporal trends of fatal occupational TBI in the U.S between 2003 and 2008. METHODS A cross-sectional analysis of the Census of Fatal Occupational Injury database was performed. Both the Occupational Injury and Illness Classification System nature of injury codes and body part codes were used to define TBIs. Fatality rates were calculated using denominators derived from the Current Population Survey. Fatality rates were compared among industries, cause of death, and demographics with rate ratios (RRs) and 95% CIs. Poisson regression was used to assess trends in fatality rates. Data were analyzed in 2009-2010. RESULTS Nearly 7300 occupational TBI deaths occurred between 2003 and 2008, for an average fatality rate of 0.8 per 100,000 workers per year. The leading causes of occupational TBI death were as follows: motor vehicle (31%); falls (29%); assaults and violent acts (20%); and contact with objects/equipment (18%). Fatality rates were 15 times higher in men compared with women (RR=15, 95% CI=13.7, 16.3). Workers aged ≥65 years experienced the highest TBI fatality rate of all age groups (2.5 per 100,000 per year). Construction, transportation, and agriculture/forestry/fishing industries recorded nearly half of all TBI fatalities (n=1828, n=825, n=761, respectively). Occupational TBI death rates declined 23% over the 6-year period (p<0.0001). CONCLUSIONS This study provides the first national profile of fatal TBIs occurring in the U.S. workplace. Prevention efforts should be directed at those industries with the highest frequency and/or highest risk. The construction industry had the highest number of TBIs, and the agriculture, forestry, and fishing industry had the highest rates. Additionally, workers aged >65 years in all industries would be a good target for future prevention efforts.

Slip and fall-related injuries in relation to environmental cold and work location in above-ground coal mining operations.

BACKGROUND Relatively few occupational epidemiological studies have been conducted concerning the association between cold ambient temperatures and cold exposure injuries, and fewer still of traumatic occupational injuries and cold ambient temperatures. METHODS The association of ambient temperature and wind data from the National Climatic Data Center with injury data from mines reported to the Mine Safety and Health Administration (MSHA) was evaluated over a 6 year period from 1985-1990; 72,716 injuries from the seven states with the most numerous injuries were included. Temperature and wind data from each states metropolitan weather stations were averaged for each day of the 6 year period. A weighted linear regression tested the relationship of ungrouped daily temperature and injury rate for all injury classes. For cold exposure injuries and fall injuries, relative incidence rates for grouped temperature data were fit with Poisson regression. RESULTS As temperatures decreased, injury rates increased for both cold exposure injuries and slip and fall injuries. The association of slip and fall injuries with temperature was inverse but not strictly linear. The strongest association appeared with temperatures 29 degrees F and below. The injury rates for other accident categories increased with increasing ambient temperatures. CONCLUSIONS This study suggests that statewide average ambient temperature reflects the expected association between the thermal environment and cold exposure injuries for workers, but more importantly, documents an association between ambient temperatures and occupational slip and fall injuries.

The Epidemiology of Slips, Trips, and Falls in a Helicopter Manufacturing Plant

PROBLEM Logging continues to be a major source of injuries in northeast China. This paper describes logging-related injuries in the Jilin Province of the Peoples Republic of China. METHODS Logging fatalities and nonfatal injuries were summarized from 1981 to 1990 in Jilin. Injury data from 1991 for the entire forestry sector in China were also analyzed. RESULTS Fatalities were mainly from of head injuries and were caused by being struck by an object. Nonfatal injuries were most often to the lower extremities and the head and were normally caused by being struck by an object or a fall or slip. The majority of both fatal and nonfatal logging injuries occurred to workers with less than 1 year of employment and those under 35 years old. Most injuries occurred November through March in Jilin. IMPACT ON INDUSTRY Patterns of logging injury in Jilin of China were similar, but not identical, to those described in other studies of logging injuries worldwide. Methods found to be effective in reducing logging-related injuries in other parts of the world might be used in China to reduce the injuries associated with logging.

Hand lacerations and job design characteristics in line-paced assembly.

Objective: To determine if a video used during logger training influences safety attitude, knowledge, and workplace habits. Method: From April 2002 to October 2003, loggers receiving training through the West Virginia Division of Forestry were given a new safety module. This consisted of a pre-training survey, viewing video, brief introduction to field safety guide, and an immediate post-training survey. Six months after training, loggers were contacted by telephone to assess workplace behavioral changes. Results: 1197 loggers attended 80 training sessions and completed surveys; 21% were contacted at follow up. Pre-training surveys indicated that half said “accidents” were part of the job and had experienced a “close call” in their work. An overwhelming majority felt that safety management and periodic meetings were important. Over 75% indicated they would not take risks in order to make a profit. Several statistically significant improvements were noted in safety knowledge after viewing the video: logger’s location in relation to the tree stump during fatal incidents and the pictorial identification of an overloaded truck and the safest cutting notch. At follow up, many of the loggers said they related to the real life victim stories portrayed in the video. Further, the field guide served as a quick and easy reference and taught them valuable tips on safe cutting and felling. Conclusions: Significant changes in safety knowledge and attitude among certified loggers resulted from viewing the video during training. Subsequent use of the video and field guide at the worksite encouraged positive change in self reported work habits and practices.

Evaluation of an in-vehicle monitoring system (IVMS) to reduce risky driving behaviors in commercial drivers: Comparison of in-cab warning lights and supervisory coaching with videos of driving behavior

BACKGROUND The association between slip and fall-related injuries and environmental temperature was examined for mostly enclosed (inside vehicles, machinery, or buildings), outdoor (outside, not enclosed), and enclosed/outdoor jobs in the coal mining industry to see if differences existed among the three work locations that had varying exposure to cold temperatures. METHODS Temperature data from the National Climatic Data Center and injury data from the Mine Safety and Health Administration were evaluated from 1985-1990 for seven states. Proportionate methods were used to examine the relationship between slips and falls and temperature. RESULTS Proportionate injury ratios of slips and fall-related injuries increased as temperature declined for all three work locations. Proportion of slips and fall-related injuries that occurred while running/walking increased with declining temperature, with the ground outside as the most common source of these injuries. CONCLUSIONS Outside movement becomes a greater hazard at freezing temperatures for workers in all locations, not just outdoor workers. Any intervention methods geared toward reducing injury incidents facilitated by cold weather must also be directed toward workers who spend time in more enclosed locations.