Steven M. Thygerson

Effectiveness of a worksite wellness program on health behaviors and personal health.

Objective: To evaluate the effectiveness of a worksite wellness program at improving health behavior and personal health. Methods: Analyses are based on 472 (71% men and 29% women) workers employed in 2009 through 2010. Results: Participants showed significant improvement in frequency of exercise, consumption of whole grains, vegetables and fruits, restful sleep, and seat belt use. Life satisfaction and perceived health also significantly increased, but job satisfaction significantly decreased and there was no change in smoking or body mass index. In addition, the percentage with borderline/high blood pressure significantly decreased. Conclusions: Participation in well-structured worksite wellness programs, such as the one evaluated in this study, may increase health and life satisfaction for employees. This type of wellness program appears to help employees develop and maintain healthy behaviors.

Identifying Work-Related Motor Vehicle Crashes in Multiple Databases

Objective: To compare and estimate the magnitude of work-related motor vehicle crashes in Utah using 2 probabilistically linked statewide databases. Methods: Data from 2006 and 2007 motor vehicle crash and hospital databases were joined through probabilistic linkage. Summary statistics and capture–recapture were used to describe occupants injured in work-related motor vehicle crashes and estimate the size of this population. Results: There were 1597 occupants in the motor vehicle crash database and 1673 patients in the hospital database identified as being in a work-related motor vehicle crash. We identified 1443 occupants with at least one record from either the motor vehicle crash or hospital database indicating work-relatedness that linked to any record in the opposing database. We found that 38.7 percent of occupants injured in work-related motor vehicle crashes identified in the motor vehicle crash database did not have a primary payer code of workers’ compensation in the hospital database and 40.0 percent of patients injured in work-related motor vehicle crashes identified in the hospital database did not meet our definition of a work-related motor vehicle crash in the motor vehicle crash database. Depending on how occupants injured in work-related motor crashes are identified, we estimate the population to be between 1852 and 8492 in Utah for the years 2006 and 2007. Conclusions: Research on single databases may lead to biased interpretations of work-related motor vehicle crashes. Combining 2 population based databases may still result in an underestimate of the magnitude of work-related motor vehicle crashes. Improved coding of work-related incidents is needed in current databases.

Comparison of factors influencing emergency department visits and hospitalization among drivers in work and nonwork-related motor vehicle crashes in Utah, 1999-2005

This study identified contributing factors in the occurrence of motor vehicle crashes (MVCs) and the severity of crashes according to work-related status in Utah. Analyses were based on probabilistically linked data involving police crash reports and hospital inpatient and emergency department (ED) records for the years 1999-2005. Of 643,647 drivers involved in crashes, 73,437 (11.4%) went to the emergency department (ED) and 4989 (0.8%) were hospitalized. Of the drivers in crashes visiting the ED, 2330 (3.2%) were working at the time of the crash and of drivers in crashes who were hospitalized, 235 (4.7%) were working at the time of the crash. There was no significant difference between those working versus not working at the time of the crash in safety belt use (82% [53,947/66,188] for ED cases and 60% [2,489/4,176] for hospitalized cases) or fatigue (4% [2,697/70,536] for ED cases and 9% [450/4,824] for hospitalized cases) among drivers in crashes, but there was a significant difference with respect to alcohol drinking between workers versus nonworkers (ED: 1% [31/2,237] vs. 5% [3,455/68,299], P<0.001; hospitalized: 3% [7/228] vs. 15% [673/4,596], P<0.001). Of those attending the ED because of a crash, workers were significantly more likely to have broken bones, bleeding wounds, or to die. Of those hospitalized because of a crash, workers were significantly less likely to have caused the crash (65% [145/223] vs. 73% [3,315/4,566], P<0.001). Yet although those drivers who were working at the time of the crash compared with those not working were less likely to have alcohol involved or to have caused the crash, there remains room for improvement among workers with respect to these factors, as well as safety belt use and fatigue.

Graduated driver licensing provisions: an analysis of state policies and what works.

Objective: To compare and contrast how specific graduated driver licensing (GDL) components have been implemented in different states and explore how the policies currently in place have affected state-level teen crash and mortality outcomes. Methods: The study design involved a policy analysis using methodology set forth by Teitelbaum and Wilensky (2007). Eight states were selected, 2 each from 4 different regions in the United States. Each pair of states was similar in terms of geography and vehicle miles driven per capita but differed in the relative strength of their GDL legislation. Teen fatality and crash rates in 2010 as well as specific GDL components were the variables used for analysis. A weighted decision matrix was created to reflect the comparative impact of each variable. Results: In every region, the state with the stronger GDL policy scored higher on the decision matrix than the state with the weaker GDL policy. The Eastern states (Maryland and Vermont) scored the best overall (123.9); the Southern states (Mississippi and Georgia) scored the poorest overall (−55.7). Conclusions: Consistent with other GDL research, states with stronger GDL policies had more favorable teen crash and mortality outcomes than states with weaker ones. Analysis showed that the policies in strong states shared several common themes: more required practice hours, ban on all teen passengers, and night driving restrictions for 12+ months. Implications for state policy makers are provided.

Epidemiology of Motor Vehicle Crashes in Utah

Objectives: This study describes the frequency and pattern of vehicle crashes and safety belt use in Utah; the proportion of vehicle crashes involving safety belt use, alcohol, and fatigue; and the influence these factors and others have on emergency room visits or hospital admissions and on the severity of the outcome. Methods: Data were obtained from the Utah Department of Transportation, Division of Traffic and Safety, from 1999 through 2005. Motor vehicle crash (MVC) data were linked to statewide hospital admission (inpatient) and emergency department (ED) records. Results: The trend in rates of crashes significantly decreased for both males and females, with rates of crashes involving alcohol decreasing for males but increasing for females and rates of crashes involving fatigue remaining constant for males and females over the study period. Drivers not wearing a safety belt or intoxicated or fatigued were significantly more likely to have contributed to the crash, visit the emergency room, be admitted to the hospital, and experience severe injury or death. Drivers in crashes who were intoxicated or fatigued were significantly less likely to be wearing a safety belt. When a safety belt was worn at the time of the crash, sitting in the front seat was safer than in the second or third seats, and sitting on the left side of the vehicle was safer than on the right side or in the middle. However, when a safety belt was not worn at the time of the crash, sitting in the front seat was more likely associated with injury or death than in the second or third seats or sitting in the middle seat. Conclusion: Drivers in crashes who were intoxicated or fatigued were less likely to be wearing a safety belt and more likely to have contributed to the crash and experience serious injury or death. Severity of injury related to seat placement is moderated by safety belt use.

Boarding Injuries: The Long and the Short of It

As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P < 0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P < 0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

iPhone Apps for First Aid: A Content Analysis

The present study examines the content of current iPhone apps to determine whether the apps adhere to accepted first aid guidelines and if adherence to first aid guidelines between paid apps and free apps is significantly different. This study involved a content analysis of 65 iPhone apps related to first aid. Adherence scores are presented including a list of apps with the best adherence scores. Apps developed by nationally recognized first aid organizations should be considered the best apps to download because of adherence to evidence-based first aid guidelines.

Occupational and Environmental Health Hazards in the Brick ManufacturingIndustry in Kathmandu Valley, Nepal

The ever expanding traditional brick industry in Nepal is a labour intensive, low technology activity found in the Kathmandu Valley and Terai regions of Nepal. Various studies have characterized the environmental pollutants associated with brick making, few studies have focused on the effects of these pollutants on the workers themselves. This review attempts to summarize recent evidences characterizing the occupational hazards associated with the brick industry and provide evidences for control of these hazards.

iPhone Apps for Cardiopulmonary Resuscitation (CPR): A Content Analysis

This study examined the content of current iPhone cardiopulmonary resuscitation (CPR) apps to determine their adherence to 2010 American Heart Association (AHA) CPR Guidelines. Fifty apps were reviewed to determine presence and absence of individual guidelines. Data were statistically analyzed to determine app adherence to AHA guidelines related to cost and consumer ratings as well as which guidelines were most frequently missed. A one-way analysis of variance (ANOVA) showed statistically significant variation in app adherence along the price continuum. An additional ANOVA comparing consumer ratings and app adherence reported statistically significant differences in app content along the consumer rating scale. These findings have important implications for public health professionals and potential areas for further study and improvement will be discussed.

Exposure to respirable silica among clay brick workers in Kathmandu valley, Nepal

ABSTRACT Previous studies report high respirable silica exposures among clay brick workers globally; however, there are little data on exposures among workers in fixed chimney Bulls trench kilns, the predominant kiln type in Kathmandu valley, Nepal. We investigated respirable silica exposures among workers (N = 46) in five similar exposure groups (SEGs). Mean exposures were highest for red brick loading/carrying (331 μg/m3), followed by green brick stacking (223 μg/m3), fireman (102 μg/m3), coal crushing/carrying (92 μg/m3), and green brick molding (71 μg/m3). The average free silica content (13.8%) in the respirable dust fraction was similar to levels reported for clay brick workers employed in other types of kilns. Dust control measures and respiratory protection are recommended, with priority given to workers assigned to red brick loading and stacking and green brick stacking and carrying.