Stephanie G. Pratt

Occupational fatalities among older workers in the United States: 1980-1991

Workers aged 65 and older had a workplace fatality rate of 2.6 times that of workers aged 16 to 64 for 1980 through 1991 (14.1 per 100,000 vs 5.4), according to National Traumatic Occupational Fatalities (NTOF) data. The highest rates were in mining, agriculture, and construction. Compared with younger workers, older men were at an elevated risk for fatalities caused by machines, and older women for fatal falls and homicide. Prevention efforts should focus on older workers in agricultural settings, as well as those at increased risk of workplace falls or violence.

Machinery-related occupational fatalities in the United States, 1980 to 1989

The National Traumatic Occupational Fatalities surveillance system identified machinery-related incidents as the second leading cause of traumatic occupational fatalities in the United States between 1980 and 1989. These incidents resulted in 8,505 civilian worker deaths and an average annual fatality rate of .80 per 100,000 workers. Workers aged 65 years and older had 5.8 times the fatality rate of workers aged 16 to 64 years (4.06 vs. 70). The highest industry-specific rate was noted in agriculture, forestry, and fishing (7.47). Tractors and other agricultural machinery were associated with nearly 9 of every 10 fatal machinery-related incidents involving workers aged 65 or older. Although numerous studies of agricultural machinery-related fatalities are found in the literature, detailed analyses of machinery-related fatalities in the construction industry as well as analyses of work situations and risk factors associated with fatal injuries are needed.

Machinery-related fatalities in the construction industry.

The National Traumatic Occupational Fatalities (NTOF) surveillance system identified machinery-related incidents as the fourth leading cause of traumatic occupational fatalities in the U.S. construction industry between 1980 and 1992, resulting in 1,901 deaths and 2.13 deaths per 100,000 workers. Fatality rates declined 50% over the study period. Workers in three occupation divisions-precision production, craft, and repair; transportation and material moving; and handlers, equipment cleaners, helpers, and laborers-had both the highest frequency and rate of fatalities. Cranes, excavating machinery, and tractors were the machines most frequently involved. The most common incident types were: struck by a mobile machine; overturn; and struck by a boom. Further delineation of groups at highest risk for machinery-related injuries is complicated by a lack of data on exposure to machinery. The findings suggest that injury prevention programs should focus not only on machine operators, but on those who work on foot around machines.

The use of electronic pharmacy data to investigate prescribed medications and fatal motor vehicle crashes in a military population, 2002-2006

The authors examined the association between prescribed medications and fatal motor vehicle crashes (MVCs) in an active duty military population between 2002 and 2006. Using a case-control design, MVC deaths were ascertained using a military mortality registry, and an integrated health system database provided information on health system eligibility, pharmacy transactions, and medical encounters. Cases and controls were matched on comparable observation time outside periods of deployment. Among selected categories, only one, antidepressant medications, was an independent predictor of fatal MVC (odds ratio, 3.19; 95% confidence interval, 1.01-10.07). Male gender, Black race, enlisted rank, service branch (Navy and Marine Corps), and selected co-morbidities were also independent predictors. Unexpectedly, the odds of younger age quartiles (< 27 years) and history of deployment were reduced for MVC cases. Although results need to be considered in the context of data limitations, the association between prescribed antidepressants and fatal MVC may reflect unmeasured co-morbidities, such as combined effects of prescribed and over-the-counter medications and/or alcohol or other substance abuse. Younger individuals, representing new military accessions in training or returning from deployment with serious injuries, may have fewer opportunities to operate vehicles, or targeted efforts to reduce MVC following deployment may be showing a positive effect.