Studying work practices: a key factor in understanding accidents on the level triggered by a balance disturbance

Analysis method for revealing human and organisational factors of occupational accidents with movement disturbance (OAMDs)

Slips, trips and other movement disturbances account for 20 to 30% of recorded occupational accidents (OAs). The causal representations of these accidents hamper their prevention. An analysis method dedicated to occupational accidents with movement disturbance (OAMDs) has been developed to change these representations. In France, the causal tree method (CTM) is very commonly used for analysing OAs. An initial version of an OAMD analysis method, which overcomes the problems encountered when analysing these accidents using the CTM, has been developed. This OAMD analysis method was reviewed by six targeted prevention officers and as a result some proposals have been discarded and this initial version has been transformed into three additional CTM modules. The purpose of these modules is to identify human and organisational factors and provide a formal representation of damage caused, beyond bodily injuries. Practitioner summary: A method for analysing occupational accidents triggered by a slip, a trip or any other movement disturbance has been developed in consideration of the practices and constraints in companies. In particular, this method allows us to highlight the human and organisational factors involved in the accident situation. Abbreviations: OA: occupational accident; OAMD: occupational accident with movement disturbance; CTM: causal tree method.

Work-related injuries within a large urban public school system in the Mid-Western United States

BACKGROUND

More than 13 million employees are working in the public education sector which includes more than just teachers in the United States. This industry sector also employs custodians, maintenance, and administration. To date, there is very limited information about the type and frequency of injuries for these employees.

OBJECTIVE

To identify injury trends related to frequency and severity for different occupational injuries in a large urban school district.

METHODS

Between 2014-2015, school district employees reported a total of 598 occupational injuries. Initial analysis of the data provided the frequency of injuries overall and for individual occupational categories. The Severity Index provides a score for job category and injury type based on severity and frequency.

RESULTS

Overall, the Slip, Trip and Fall category had the highest frequency, followed by Combative Situations, and Over-exertion. Teacher and Para-professional workers experienced the greatest number of injuries with violence being the most frequent cause. Based on the Severity Index, Over-exertion was identified as the primary exposure concern for Custodians, while Slip, Trip and Fall category had the greatest impact on Building Engineers.

CONCLUSIONS

With the diversity of negative outcomes, the administration will need targeted interventions for the various professions represented in the school systems. The injury severity profile indicates non-teachers should be a high priority for interventions with over-exertion and slips, trips and falls leading the risk.

Noise and neurotoxic chemical exposure relationship to workplace traumatic injuries: A review

INTRODUCTION

More than 5,000 fatalities and eight million injuries occurred in the workplace in 2007 at a cost of $6 billion and $186 billion, respectively. Neurotoxic chemicals are known to affect central nervous system functions among workers, which include balance and hearing disorders. However, it is not known if there is an association between exposure to noise and solvents and acute injuries.

METHOD

A thorough review was conducted of the literature on the relationship between noise or solvent exposures and hearing loss with various health outcomes.

RESULTS

The search resulted in 41 studies. Health outcomes included: hearing loss, workplace injuries, absence from work due to sickness, fatalities, hospital admissions due to workplace accidents, traffic accidents, hypertension, balance, slip, trips, or falls, cognitive measures, or disability retirement. Important covariates in these studies were age of employee, type of industry or occupation, or length of employment.

DISCUSSION

Most authors that evaluated noise exposure concluded that higher exposure to noise resulted in more of the chosen health effect but the relationship is not well understood. Studies that evaluated hearing loss found that hearing loss was related to occupational injury, disability retirement, or traffic accidents. Studies that assessed both noise exposure and hearing loss as risk factors for occupational injuries reported that hearing loss was related to occupational injuries as much or more than noise exposure. Evidence suggests that solvent exposure is likely to be related to accidents or other health consequences such balance disorders.

CONCLUSIONS

Many authors reported that noise exposures and hearing loss, respectively, are likely to be related to occupational accidents. Practical applications: The potential significance of the study is that findings could be used by managers to reduce injuries and the costs associated with those injures.

A comparison of the burden and resultant risk associated with occupational falls from a height and on the same level in Australia

Occupational falls are one of the leading causes of occupational injury and death internationally. This study described the nature of occupational falls following an analysis of workers compensation data in Western Australia. Frequencies, proportions and incidence rates were calculated following mechanism, gender, age and industry stratification. The natures of injury and bodily locations affected were compared between mechanisms of fall. Industry incidence rates were ranked and their corresponding proportions reported. Cost and lost time were described and risk scores for each burden type (incapacity, cost and lost time) were calculated and compared between fall mechanisms. Of all occupational falls, the proportion, incidence rates and risk scores of falls on same level were consistently greater compared to falls from a height. Gender, age and industry groups that appear to be at highest risk vary with the measure used and mechanism of incident. This study translates epidemiological information into a risk score that can aid in prioritisation. Practitioner Summary: This paper presents an in-depth analysis of Worker's Compensation claims for falls in Western Australia. Calculated proportion, incidence rates and formulated risk scores for falls on the level were consistently greater compared to falls from a height. Limitations associated with the analysis of large-scale data-sets are described.

State of science: occupational slips, trips and falls on the same level

Occupational slips, trips and falls on the same level (STFL) result in substantial injuries worldwide. This paper summarises the state of science regarding STFL, outlining relevant aspects of epidemiology, biomechanics, psychophysics, tribology, organisational influences and injury prevention. This review reaffirms that STFL remain a major cause of workplace injury and STFL prevention is a complex problem, requiring multi-disciplinary, multi-faceted approaches. Despite progress in recent decades in understanding the mechanisms involved in STFL, especially slipping, research leading to evidence-based prevention practices remains insufficient, given the problem scale. It is concluded that there is a pressing need to develop better fall prevention strategies using systems approaches conceptualising and addressing the factors involved in STFL, with considerations of the full range of factors and their interactions. There is also an urgent need for field trials of various fall prevention strategies to assess the effectiveness of different intervention components and their interactions. Practitioner Summary: Work-related slipping, tripping and falls on the same level are a major source of occupational injury. The causes are broadly understood, although more attention is needed from a systems perspective. Research has shown preventative action to be effective, but further studies are required to understand which aspects are most beneficial.

A better way of fitting clips? A comparative study with respect to physical workload

The clip fitting task is a frequently encountered assembly operation in the car industry. It can cause upper limb pain. During task laboratory simulations, upper limb muscular activity and external force were compared for 4 clip fitting methods: with the bare hand, with an unpowered tool commonly used at a company and with unpowered and powered prototype tools. None of the 4 fitting methods studied induced a lower overall workload than the other three. Muscle activity was lower at the dominant limb when using the unpowered tools and at the non-dominant limb with the bare hand or with the powered tool. Fitting clips with the bare hand required a higher external force than fitting with the three tools. Evaluation of physical workload was different depending on whether external force or muscle activity results were considered. Measuring external force only, as recommended in several standards, is insufficient for evaluating physical workload.

Similarities between work related musculoskeletal disorders and slips, trips and falls

Most occupational risks manifest themselves through movements performed at work, for example musculoskeletal disorders, slips, trips and falls. Research focusing on such risks often differentiates diseases from accidents. All these risks prove to be diffuse, widespread, emergent and devoid of an external harmful hazard, when analysed through their common vector, i.e. through the movements manifesting them. These characteristics have a strong impact on risk perception and on approaches necessary to ensure sustainable prevention. A participative search for local solutions to preventing these risks, integrating shared risk representation and several analysis levels, would seem helpful. A balance between defended and resilience-based conceptions of health and safety should be established. Research should also be extended to enhance in-depth understanding of controls impacting worker movements when performing a task, while safeguarding health and safety.

Stimulated recall methodology for assessing work system barriers and facilitators in family-centered rounds in a pediatric hospital

Human factors and ergonomics methods are needed to redesign healthcare processes and support patient-centered care, in particular for vulnerable patients such as hospitalized children. We implemented and evaluated a stimulated recall methodology for collective confrontation in the context of family-centered rounds. Five parents and five healthcare team members reviewed video records of their bedside rounds, and were then interviewed using the stimulated recall methodology to identify work system barriers and facilitators in family-centered rounds. The evaluation of the methodology was based on a survey of the participants, and a qualitative analysis of interview data in light of the work system model of Smith and Carayon (1989, 2001). Positive survey feedback from the participants was received. The stimulated recall methodology identified barriers and facilitators in all work system elements. Participatory ergonomics methods such as the stimulated recall methodology allow a range of participants, including parents and children, to participate in healthcare process improvement.

Extracting recurrent scenarios from narrative texts using a Bayesian network: application to serious occupational accidents with movement disturbance

A probabilistic approach has been developed to extract recurrent serious Occupational Accident with Movement Disturbance (OAMD) scenarios from narrative texts within a prevention framework. Relevant data extracted from 143 accounts was initially coded as logical combinations of generic accident factors. A Bayesian Network (BN)-based model was then built for OAMDs using these data and expert knowledge. A data clustering process was subsequently performed to group the OAMDs into similar classes from generic factor occurrence and pattern standpoints. Finally, the Most Probable Explanation (MPE) was evaluated and identified as the associated recurrent scenario for each class. Using this approach, 8 scenarios were extracted to describe 143 OAMDs in the construction and metallurgy sectors. Their recurrent nature is discussed. Probable generic factor combinations provide a fair representation of particularly serious OAMDs, as described in narrative texts. This work represents a real contribution to raising company awareness of the variety of circumstances, in which these accidents occur, to progressing in the prevention of such accidents and to developing an analysis framework dedicated to this kind of accident.

Organisational factors of occupational accidents with movement disturbance (OAMD) and prevention

Workplace design and upkeep, or human factors, are frequently advanced for explaining so-called Occupational Slip, Trip and Fall Accidents (OSTFAs). Despite scientific progress, these accidents, and more broadly Occupational Accidents with Movement Disturbance (OAMDs), are also commonly considered to be "simple". This paper aims to stimulate changes in such perceptions by focusing on organisational factors that often combine with other accident factors to cause movement disturbance and injury in work situations. These factors frequently lead to arbitration between production and safety, which involves implementation of controls by workers. These controls can lead to greater worker exposure to OAMD risk. We propose a model that focuses on such controls to account specifically for the need to confront production and safety logics within a company and to enhance the potential for appropriate prevention action. These are then integrated into the set of controls highlighted by work organisation model developed by the NIOSH.

The famous five factors in teamwork: a case study of fratricide

The purpose of this paper is to propose foundations for a theory of errors in teamwork based upon analysis of a case study of fratricide alongside a review of the existing literature. This approach may help to promote a better understanding of interactions within complex systems and help in the formulation of hypotheses and predictions concerning errors in teamwork, particularly incidents of fratricide. It is proposed that a fusion of concepts drawn from error models, with common causal categories taken from teamwork models, could allow for an in-depth exploration of incidents of fratricide. It is argued that such a model has the potential to explore the core causal categories identified as present in an incident of fratricide. This view marks fratricide as a process of errors occurring throughout the military system as a whole, particularly due to problems in teamwork within this complex system. Implications of this viewpoint for the development of a new theory of fratricide are offered. STATEMENT OF RELEVANCE: This article provides an insight into the fusion of existing error and teamwork models for the analysis of an incident of fratricide. Within this paper, a number of commonalities among models of teamwork have been identified allowing for the development of a model.

Occupational and environmental risk factors for falls among workers in the healthcare sector

Falls are a leading cause of occupational injury for workers in healthcare, yet the risk factors of falls in this sector are understudied. Falls resulting in workers' compensation for time-loss from work from 2004-2007 for healthcare workers in British Columbia (BC) were extracted from a standardised incident-reporting database. Productive hours were derived from payroll data for the denominator to produce injury rates; relative risks were derived through Poisson regression modelling. A total of 411 falls were accepted for time-loss compensation. Compared to registered nurses, facility support workers (risk ratio (95% CI) = 6.29 (4.56-8.69)) and community health workers (6.58 (3.76-11.50)) were at high risk for falls. Falls predominantly occurred outdoors, in patients' rooms and kitchens depending on occupation and sub-sector. Slippery surfaces due to icy conditions or liquid contaminants were a leading contributing factor. Falls were more frequent in the colder months (January-March). The risk of falls varies by nature of work, location and worker demographics. The findings of this research will be useful for developing evidence-based interventions. STATEMENT OF RELEVANCE: Falls are a major cause of occupational injury for healthcare workers. This study examined risk factors including occupation type, workplace design, work setting, work organisation and environmental conditions in a large healthcare worker population in BC, Canada. The findings of this research should contribute towards developing evidence-based interventions.