Determinants of accident proneness: a case-control study in railway workers

Management Perspectives on Musculoskeletal Disorder Risk Factors and Protective Safety Resources within the Stone, Sand, and Gravel Mining Industry

BACKGROUND

Musculoskeletal disorders (MSD) are problematic in many industries, including stone, sand, and gravel mining (SSGM). This research aimed to delineate MSD risk factors and to identify protective safety resources that reduce MSD within these operations.

METHODS

A deductive content analysis of recorded transcripts from a focus group, which included professionals working in SSGM organizations, was completed.

FINDINGS

Results suggested demographic and personal factors associated with MSD included age, lack of experience, low levels of physical fitness, and attitudes toward risks. Work factors and job demands included excessive lifting, performing additional job duties, production-focused operations, lack of resources, and work related to maintenance and equipment operation. Suggested safety resources included a focus on worker fitness, resource adequacy, pay and benefits, the SLAM (Stop, Look, Analyze, and Manage) process and positive safety culture.

CONCLUSION

This qualitative research project utilized mine experts to identify demographic, personal, work, and job demand factors they perceive or know to be associated with MSD. Safety programs suggested by these same experts to reduce MSD were also presented.

APPLICATION TO PRACTICE

Occupational health and safety practitioners and mine administrators should focus on the identified factors in their work to prevent MSD within SSGM operations. Safety efforts need to include integrated programs that promote health and fitness as well. These efforts should be implemented along with recommended programs such as SLAM and the provision of appropriate safety resources to minimize risks. These efforts should promote the importance of safety and will help with bolstering a positive safety culture.

Association of perceived work pace and physical work demands with occupational accidents: a cross-sectional study of ageing male construction workers in Denmark

BACKGROUND

Occupational accidents continue to be a significant public health challenge worldwide. Construction workers in particular are at high risk of occupational accidents, and thus it is of major importance to identify possible predictors of occupational accidents among construction workers. We aimed to investigate the association between self-reported work pace and physical work demands and occupational accidents among ageing male construction workers in Denmark.

METHODS

Data on perceived work pace, physical work demands, and occupational accidents was acquired from questionnaires sent to ageing construction workers in Denmark in 2016 as part of the ALFA project (ALdring og Fysisk Arbejde; Ageing and Physical Work). A sample of 1270 Danish male construction workers above 50 years of age was included in the present study. Multiple logistic regression models were applied, with adjustments for age, smoking, body mass index, musculoskeletal disorders, occupation, work experience, and support at work.

RESULTS

Of 1270 construction workers, 166 (13.1%) reported an occupational accident within the last 12 months. There was no significant association between perceived work pace and occupational accidents, but physical work demands were associated with higher odds for occupational accidents, with an odds ratio of 2.27 (95% confidence interval 1.26-4.10) for medium physical work demands and 2.62 (95% confidence interval 1.50-4.57) for high physical work demands.

CONCLUSIONS

Ageing male construction workers with high physical work demands had statistically significant higher odds of having an occupational accident. By contrast, perceived work pace was not associated with occupational accidents in this large cross-sectional study.

Association between sleep disturbance and occupational injury among Korean employees

Background

Occupational injury has been a serious social problem steadily. Sleep disturbance is a risk factor for occupational injury. However, there were few researches studied on the linking between sleep disturbance and occupational injury in general working population of Korea. Therefore, we explored the association between sleep disturbance and occupational injury among Korean workers.

Methods

This study used data from the 5th Korean Working Conditions Survey. Occupational injury was assessed by asking work related injury for 12 months prior to the point of the survey. Sleep disturbance was assessed using the Minimal Insomnia Symptoms Scale (MISS). To analyze the association between sleep disturbance and occupational injury, multiple logistic regression analysis was conducted.

Results

The odds ratio (OR) of sleep disturbance group for occupational injury was 2.57 (95% confidence interval [CI]: 1.68–3.93) in the fully adjusted model. For the association between MISS score and occupational injury, it showed increasing trend that ORs increase from the 1st to the 4th quartiles. The OR of 2nd quartile was 1.10 (95% CI: 0.60–2.01), the OR of 3rd quartile was 2.27 (95% CI: 1.53–3.38) and the OR of 4th quartile was 2.80 (95% CI: 1.84–4.26).

Conclusions

Sleep disturbance was associated with occupational injury. In addition, increasing trend was observed between MISS score and occupational injury. These findings imply that developing of intervention programs to manage sleep disturbance and fatigue may be necessary to prevent occupational injury.

Assessment of confined space entry and rescue training for aircraft rescue and fire fighting (ARFF) members in the United States

INTRODUCTION

Fire and emergency service workers, including Aircraft Rescue and Fire Fighting members, may be called on to perform confined space entry and rescue operations. The purpose of the present study was to develop a comprehensive and valid understanding of the present state of confined space entry and rescue training effectiveness and resultant compliance or use of best practices among trained Aircraft Rescue and Fire Fighting personnel.

METHOD

The study used a convergent, parallel mixed-methods approach. Qualitative data (n = 20) were collected via semi-structured interviews at four locations. Data were coded, analyzed and super-ordinate and sub-ordinate themes were derived. Quantitative data (n = 158) from Aircraft Rescue and Fire Fighting members were analyzed.

RESULTS

Interviewees believed there is a lack of standardization in training, but believed training should not be completed in the same format every time. Several participants (50%) desired more realistic training. Other concerns were associated with staffing, personal readiness, and resource adequacy. With regard to survey outcomes, most respondents reported that their organizations completed confined space training (69.8%), but only 55.3% indicated this training was conducted as a full-scale exercise and nearly 40% indicated that rescue practice was not performed despite standards mandating annual rescue practice. Following training, 55.4% indicated training evaluation information was not presented.

CONCLUSIONS

Participants mostly agreed their training effectively addressed OSHA requirements, such as how to test the atmosphere, the need for and use of personal protective equipment, how to identify pertinent permit information and methods to retrieve victims in limited space. Some gaps exist between current training practices and established training requirements and standards.

PRACTICAL APPLICATIONS

Aircraft Rescue and Fire Fighting organizations need to bolster aspects of their training, particularly with regard to standardizing training efforts, practicing rescues, providing evaluation feedback and written materials and providing adequate resources.

Musculoskeletal disorders, personality traits, psychological distress, and accident proneness of Chinese coal miners

BACKGROUND

Human factors comprise one of the important reasons leading to the casualty accidents in coal mines.

OBJECTIVE

The aim of this study was to analyze the relationships among musculoskeletal disorders (MSDs), personality traits, psychological distress, and accident proneness of coal miners.

PARTICIPANTS

There were 1500 Chinese coal miners surveyed in this study. Among these miners, 992 valid samples were obtained.

METHODS

The study surveyed the MSDs, personality traits, psychological distress, and accident proneness of coal miners with MSDs Likert scale, Eysenck personality questionnaire, Symptom Checklist-90 (SCL-90) scale, and accident proneness questionnaire, respectively.

RESULTS

The highest MSDs level was found in the waist. The increasing working age of the miners was connected with increased MSDs and psychological distress. Significant differences in MSDs and psychological distress of miners from different types of work were observed. Coal miners with higher MSDs had higher accident proneness. Coal miners with higher neuroticism dimension of Eysenck personality and more serious psychological distress had higher accident proneness. Phobic anxiety, paranoid ideation and psychoticism dimension of psychological distress were the three most important indicators that had significant positive relationships with accident proneness.

CONCLUSION

The MSDs, neuroticism dimension, and psychological distress of the coal mine workers are important to work safety and require serious attention. Some implications concerning coal mine safety management in China were provided.

Perceived Risk of Low-Back Injury Among Four Occupations

OBJECTIVE

This study aimed to assess the perception of risk of low-back injury of individuals from four groups: office/administrative employees, dental workers (dentists/dental hygienists), firefighters, and undergraduate students.

BACKGROUND

The concept of worker's perception of injury risk has been used to set safe material-handling limits and to determine compliance with health and safety regulations but has not been used to identify perceptual differences among occupations or potential deficiencies in risk awareness.

METHOD

Participants (N = 232) were presented with eight images of different low-back postures/tasks and were required to rate their perceived magnitude of low-back risk on a scale from 0 (no risk) to 10 (extreme risk).

RESULTS

Office/administrative and dental workers rated postures higher than firefighters and students. Individuals from all groups perceived kyphotic postures as having a higher low-back risk than lordotic postures. Further, office and dental workers, compared to firefighters and students, perceived sitting postures to have a relatively higher level of risk, likely due to these postures being typically adopted by these individuals at work. No relationship between previous low-back pain and risk rating was observed in this study.

CONCLUSION

Low-back injury risk perception varies between occupations/groups and may be a result of different exposures.

APPLICATION

The results of this study can potentially be used to implement occupation-specific training programs to ensure that the scientific research regarding low-back injuries is being properly conveyed to employees across all sectors.

Workers' Risk Tolerance and Occupational Injuries

This study explores the relationship between individuals' risk tolerance and occupational injuries. We analyze data from a national representative survey of U.S. workers that includes information about injuries, risk tolerance, cognitive and noncognitive attributes, and risky behaviors. We measure risk tolerance through questions regarding individuals' willingness to gamble on their lifetime income. We estimate zero-inflated count models to assess the role played by such measures on workers' recurrent injuries. We discuss some implications of our results for future research and occupational safety policies. Our results highlight the concurrent and changing role played by individual, work, and environmental factors in explaining recurrent incidents. They show that risk tolerance affects recurrent injuries, although not in the direction that proponents of the concept of proneness would expect. Our measure of risk aversion shows that individuals who are somewhat more risk tolerant have fewer recurrent injuries than those who are risk averse. But the estimated relationship is U-shaped, not monotonic and, therefore, not easy to predict. At the same time, we find that individuals' "revealed risk preferences"-specific risky behaviors-are related to higher injury probabilities. Demanding working conditions, measures of socioeconomic status, health, and safety problems experienced by workers during their youth remain among the most important factors explaining the phenomena of recurrent injuries. So our results contribute also to the important debate about the relationship between health and socioeconomic status.

Insomnia symptoms and risk for unintentional fatal injuries--the HUNT Study

STUDY OBJECTIVES

To assess the association between insomnia symptoms and risk of fatal unintentional injuries.

DESIGN

Population-based prospective cohort study with a mean follow-up of 14 y, linking health survey data with information on insomnia symptoms to the National Cause of Death Registry.

SETTING

Nord-Trøndelag County, Norway.

PARTICIPANTS

A total of 54,399 men and women 20-89 y of age who participated in the Nord-Trøndelag Health Study between 1995 and 1997.

INTERVENTIONS

N/A.

MEASUREMENTS AND RESULTS

There were 277 unintentional fatal injuries, including 57 fatal motor vehicle injuries during follow-up. There was a dose-dependent association between the number of insomnia symptoms and risk of unintentional fatal injuries (P for trend 0.001) and fatal motor vehicle injuries (P for trend 0.023), respectively. The proportion of unintentional fatal injuries cases that could have been prevented in the absence of difficulties initiating sleep, difficulties maintaining sleep, and having a feeling of nonrestorative sleep were 8%, 9%, and 8%, respectively. The corresponding estimates for motor vehicle injuries were 34%, 11%, and 10%.

CONCLUSION

Insomnia is a major contributor to both unintentional fatal injuries in general as well as fatal motor vehicle injuries. Increasing public health awareness about insomnia and identifying persons with insomnia may be important in preventing unintentional fatal injuries.

Increased risk of unintentional injuries in adults with disabilities: a systematic review and meta-analysis

BACKGROUND

An increased risk of unintentional injuries among individuals with disability has been reported in many studies, yet quantitative syntheses of findings from previous studies have not been done.

OBJECTIVES

We conducted a systematic review and meta-analysis to characterize the relationship between pre-existing disability and unintentional injuries.

METHODS

We searched 14 electronic databases to identify original research published between Jan 1, 1990 and Feb 28, 2013. Included studies reported the odds ratio (OR) or relative risk (RR) of unintentional injuries in adults 18+ years of age with pre-existing disabilities compared with adults without disabilities. Twenty six eligible studies were included covering 54,586 individuals with disabilities. We conducted quality assessments and then analyzed the pooled effects using random-effect models.

RESULTS

The pooled OR of unintentional injuries was 1.77 (95% CI 1.51-2.07) for all studies in individuals with disabilities compared with individuals without disabilities. The pooled ORs were 1.87 (95% CI 1.52-2.30) for overall unintentional injuries, 1.64 (95% CI 1.39-1.94) for falls-related injuries, 1.62 (95% CI 1.24-2.13) for occupational injuries, and 1.91 (95% CI 1.59-2.30) for non-occupational injuries.

CONCLUSIONS

Compared with adults without disabilities, individuals with disabilities are at a significantly higher risk of unintentional injuries. Evidence about the association between cognitive disabilities and unintentional injuries is weak. Future researchers are encouraged to use International Classification of Functioning, Disability and Health (ICF) to classify disability and use rigorous evaluation methods to assess and implement the most appropriate injury prevention efforts to mitigate the risks identified.

Roles of age, length of service and job in work-related injury: a prospective study of 63,620 person-years in female workers

BACKGROUND

The roles of age, length of service and job in various work-related injury types are unknown and deserve investigations among female workers. This study assessed their roles in the occurrence of injury.

METHODS

Three-year prospective study of all 22,952 permanently employed women at the French national railway company: 63,620 person-years, 756 injuries with working days lost, coded using the company's injury classification derived from that of the French health insurance scheme. We investigated the incidence of four types of injury: fall on same level, fall to lower level, materials/equipment/objects handling, and other injuries. Data were analyzed using negative binomial regression.

RESULTS

Workers aged <25 were subject to a higher risk for all types of injuries. Older workers (45-55 years) were subject to a higher injury risk for fall on same level and fall to lower level. For fall on same level as for fall to lower level the relative risk decreased steadily with increasing length of service with the company, from 1.60 for 1 year to 0.50-0.60 for ≥30 years. For injuries due to materials/equipment/objects handling the relative risk decreased from 1.05 for one year to 0.49 for 5-9 years, and then increased to about 1.50 for 20-29 years and ≥30 years.

CONCLUSIONS

Younger and shorter lengths of service were at risk for various types of injuries. Higher length of service was at risk for injury due to materials/equipment/objects handling. Preventive measures should consider the respective risks associated with age, years of employment and job.

Self-reported work-related musculoskeletal injuries and isometric handgrip strength

BACKGROUND

Musculoskeletal injuries are common in car assembly workers, causing significant morbidity. There is evidence that increased muscle strength reduces musculoskeletal injury risk and that handgrip strength is a predictor of general muscle strength. Aims To investigate whether isometric handgrip strength (IHGS) is a predictor of increased musculoskeletal injury risk in automotive assembly workers.

METHODS

We measured IHGS in a cross-sectional survey of final assembly line workers in an automotive manufacturing plant. Weak handgrip was defined as two standard deviations below the normative mean value for age and gender. Self-reported musculoskeletal injury/accident data and recent musculoskeletal symptoms were recorded using a modified Nordic musculoskeletal questionnaire.

RESULTS

Of 445 final assembly line workers, 206 (46%) participated. Sixty participants (29%) reported a musculoskeletal injury/accident at work in the preceding 5 years. Mean IHGS in this population was lower than international normative values. Odds ratios for self-reported injury (adjusted for gender and recent musculoskeletal symptoms) were 0.62 (95% CI 0.28-1.35) for left weak handgrip and 0.57 (95% CI 0.31-1.1) for right weak handgrip.

CONCLUSIONS

In this study, weak handgrip did not predict increased risk of musculoskeletal injuries/accidents.

Obesity and occupational injury: a prospective cohort study of 69,515 public sector employees

Background

Obesity and overweight are suggested to increase the risk of occupational injury but longitudinal evidence to confirm this is rare. We sought to evaluate obesity and overweight as risk factors for occupational injuries.

Methodology/Principal Findings

A total of 69,515 public sector employees (80% women) responded to a survey in 2000–2002, 2004 or 2008. Body mass index (kg/m²) was derived from self-reported height and weight and was linked to records of subsequent occupational injuries obtained from national registers. Different injury types, locations and events or exposures (the manner in which the injury was produced or inflicted) were analyzed by body mass index category adjusting for baseline socio-demographic characteristics, work characteristics, health-risk behaviors, physical and mental health, insomnia symptoms, and sleep duration. During the mean follow-up of 7.8 years (SD = 3.2), 18% of the employees (N = 12,204) recorded at least one occupational injury. Obesity was associated with a higher overall risk of occupational injury; multivariable adjusted hazard ratio (HR) 1.21 (95% CI 1.14–1.27). A relationship was observed for bone fractures (HR = 1.37; 95% CI: 1.10–1.70), dislocations, sprains and strains (HR = 1.36; 95% CI: 1.25–1.49), concussions and internal injuries (HR = 1.26; 95% CI: 1.11–1.44), injuries to lower extremities (HR = 1.62; 95%: 1.46–1.79) and injuries to whole body or multiple sites (HR = 1.37; 95%: 1.10–1.70). Furthermore, obesity was associated with a higher risk of injuries caused by slipping, tripping, stumbling and falling (HR = 1.55; 95% CI: 1.40–1.73), sudden body movement with or without physical stress (HR = 1.24; 95% CI: 1.10–1.41) and shock, fright, violence, aggression, threat or unexpected presence (HR = 1.33; 95% CI: 1.03–1.72). The magnitude of the associations between overweight and injuries was smaller, but the associations were generally in the same direction as those of obesity.

Conclusions/Significance

Obese employees record more occupational injuries than those with recommended healthy weight.

Piecewise exponential models to assess the influence of job-specific experience on the hazard of acute injury for hourly factory workers

Background

An inverse relationship between experience and risk of injury has been observed in many occupations. Due to statistical challenges, however, it has been difficult to characterize the role of experience on the hazard of injury. In particular, because the time observed up to injury is equivalent to the amount of experience accumulated, the baseline hazard of injury becomes the main parameter of interest, excluding Cox proportional hazards models as applicable methods for consideration.

Methods

Using a data set of 81,301 hourly production workers of a global aluminum company at 207 US facilities, we compared competing parametric models for the baseline hazard to assess whether experience affected the hazard of injury at hire and after later job changes. Specific models considered included the exponential, Weibull, and two (a hypothesis-driven and a data-driven) two-piece exponential models to formally test the null hypothesis that experience does not impact the hazard of injury.

Results

We highlighted the advantages of our comparative approach and the interpretability of our selected model: a two-piece exponential model that allowed the baseline hazard of injury to change with experience. Our findings suggested a 30% increase in the hazard in the first year after job initiation and/or change.

Conclusions

Piecewise exponential models may be particularly useful in modeling risk of injury as a function of experience and have the additional benefit of interpretability over other similarly flexible models.

Risk factors for frequent work-related burn and cut injuries and low back pain among commercial kitchen workers in Japan

This study investigated risk factors for frequent work-related burn and cut injuries and low back pain (LBP) among kitchen workers including personal, work-related and environmental factors. Subjects were 991 kitchen workers in 103 schools, 17 hospitals and nursing homes, and 6 restaurants in central Japan. A cross-sectional survey was carried out using a structured self-administered questionnaire. Logistic regression models were used to examine associations between frequent injuries/LBP and risk factors. The effective response rate was 75.1% (n=744), the mean age was 40.7 (SD 11.7) and 77.2% were female. Burn injury was associated with a smaller kitchen (OR 1.94; 95%CI, 1.13-3.33), and gas kitchens rather than electric kitchens (OR 2.30; 95%CI, 1.17-4.52). LBP was associated with female gender (OR 2.46; 95%CI, 1.37-4.43), high body height (>160 cm) (OR 2.03; 95%CI, 1.22-3.36), and large number of meals produced per person (≥ 150 meals) (OR 1.83; 95%CI, 1.12-3.00). The results of this study suggest that securing adequate work space and introducing electric kitchen systems may reduce the risk to kitchen workers, as well as the importance of adequate height of cooking equipment and selecting an appropriate volume of meals to produce per person to prevent LBP in kitchen workers.

Accident occurrence and functional health patterns: a pilot study of relationships in a graduate population

PURPOSE

This pilot study sought to examine the relationship between functional health patterns and accident proneness.

METHODS

A quantitative-descriptive design was employed assessing accident proneness by collecting data on the occurrence of accidents among a sample of university graduates, and examining this in relation to biographical data and information collated using the Functional Health Pattern Assessment Screening Tool (FHPAST). Data were analyzed using descriptive and inferential statistics.

FINDINGS

One FHPAST factor predicted more frequent sports accidents. Age was also shown to be a significant predictor but in a counterintuitive way, with greater age predicting less accident proneness.

CONCLUSION

The FHPAST may have a role to play in accident prediction.

IMPLICATIONS FOR NURSING PRACTICE

Functional health pattern assessment may be useful for predicting accidents.

Insomnia, comorbidity, and risk of injury among insured Americans: results from the America Insomnia Survey

STUDY OBJECTIVES

To estimate associations of broadly defined insomnia (i.e., meeting inclusion criteria for International Classification of Diseases, Tenth Revision (ICD-10), Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), or Research Diagnostic Criteria/International Classification of Sleep Disorders, Second Edition (RDC/ICSD-2) diagnosis) with workplace/nonworkplace injuries controlling for comorbid conditions among workers in the America Insomnia Survey (AIS).

DESIGN/SETTING

Cross-sectional telephone survey.

PARTICIPANTS

National sample of 4,991 employed health plan subscribers (age 18 yr and older).

INTERVENTIONS

None.

MEASUREMENTS AND RESULTS

Broadly defined insomnia with duration of at least 12 mo was assessed with the Brief Insomnia Questionnaire (BIQ). Injuries in the 12 mo before interview were assessed with a standard self-report measure of injuries causing role impairment or requiring medical attention. Eighteen comorbid condition clusters were assessed with medical/pharmacy claims records and self-reports. Insomnia had significant gross associations (odds ratios, ORs) with both workplace and nonworkplace injuries (OR 2.0 and 1.5, respectively) in logistic regression analyses before controlling for comorbid conditions. The significant population attributable risk proportions (PARPs) of total injuries with insomnia was 4.6% after controlling for comorbid conditions. Only 2 other conditions had PARPs exceeding those of insomnia. The associations of insomnia with injuries did not vary significantly with worker age, sex, or education, but did vary significantly with comorbid conditions. Specifically, insomnia was significantly associated with workplace and nonworkplace injuries (OR 1.8 and 1.5, respectively) among workers having no comorbid conditions, with workplace but not nonworkplace injuries (OR 1.8 and 1.2, respectively) among workers having 1 comorbid condition, and with neither workplace nor nonworkplace injuries (OR 0.9 and 1.0, respectively) among workers having 2 or more comorbid conditions.

CONCLUSIONS

The associations of insomnia with injuries vary with comorbid conditions in ways that could have important implications for targeting workplace interventions.

Changes in Peak Flow value during immunotherapy administration

Nasal allergies are prevalent affecting a large percentage of the population. Not only the upper respiratory tract but the whole body is involved. Allergies produce morbidity (and even occasional mortality) as they can lead to asthma development, and increased number of accidents. Immunotherapy results can be evaluated by following symptom scores, medication use, and objective measurements. Using a Peak Flow Meter (PFM) to evaluate immunotherapy results, it became evident that patients with and without asthma exhibited an improvement in the Peak Flow (PF) value, suggesting that lower airway involvement in allergic patients could be more prevalent than assumed. A consecutive chart review was performed including patients of any age with nasal allergies (with or without asthma) treated with immunotherapy for at least 6 months that had at least 2 complete evaluations. When immunotherapy was successful, most patients exhibited an increase in the PF value regardless of asthma status. A very significant finding was that most allergy sufferers may have lower airway inflammation. The use of the PF value to assess immunotherapy results and the potential failure to diagnose asthma in allergy sufferers are discussed. A better diagnosis of lower airway inflammation could be substantial in the management of these patients.

[Epidemiology of insomnia in France]

BACKGROUND

Sleep is usually considered as a factor for good health and personal equilibrium. However, the epidemiology of insomnia, which is the most frequent of sleep disorders, is still unknown in France.

METHODS

All epidemiological studies concerning the prevalence of insomnia and its associated factors carried out in France and published between 1980 and 2009 have been extracted from Medline. Subsequently, a research of reports not indexed in Medline has been carried out in the national Public health Database. We also sought the presence of questions concerning sleep disorders in questionnaires and reports from health surveys in the general population.

RESULTS

In the general population, six specific studies had been undertaken between 1987 and 2003 while there had been eight occupational studies between 1980 and 2000. Surveys in schoolchildren and in students focused on the daytime tiredness due to lack of sleep but few studies investigated insomnia in children and teenagers. Methodological differences as well as the heterogeneity in the definition of the disorders yielded very diverse prevalences. Between 30 and 50% of adults in France declared the presence of at least one sleep disorder while the prevalence of insomnia using the DSM-IV criteria concerned between 15 and 20% of the population. Women reported sleep disorders more frequently than men. Sleep disorders were associated with work absenteeism. Comorbidity with anxiety and depressive disorders has also been highlighted in several studies.

CONCLUSION

Surveillance of sleep disorders appears as an important public health issue requiring prior standardization of questionnaires and survey methods.

[Emergency response management near the tracks of the public railway network: special aspects of missions connected with the German national railway system]

Emergency response management and rescue operations concerning the railway network in Germany need special attention and implementation in several ways. The emergency response concerning the German national railway network managed by Deutsche Bahn AG is subject to various rules and regulations which have to be followed precisely. Only by following these rules and procedures is the safety of all emergency staff at the scene ensured. The German national railway network (Deutsche Bahn AG) provides its own emergency response control center, which specializes in managing its response to emergencies and dispatches an emergency response manager to the scene. This person serves as the primary Deutsche Bahn AG representative at the scene and is the only person who is allowed to earth the railway electrical power lines. This article will discuss different emergency situations concerning railway accidents and the emergency medical response to them based on a near collision with a high speed train during a rescue mission close to the railway track. Injury to personnel could only be avoided by chance and luck. The dangers and risks for rescue staff are specified. Furthermore, the article details practical guidelines for rescue operations around the German national railway track system.

Relationship between job, lifestyle, age and occupational injuries

BACKGROUND

Physical job demands (PJD), age, disability and lifestyle may influence the risk of occupational injury.

AIM

To assess the relationships between PJD, lifestyle and injury in workers of various ages.

METHODS

A total of 2888 randomly selected workers from northeastern France, aged >or=15, completed a postal questionnaire. The PJD score was defined as the total number of the following reported job demands: using pneumatic tools, other vibrating hand tools, hammers, machine tools or vibrating platforms and exposure to manual handling tasks, awkward postures, high pace of work, high physical workload, work at heights, work in adverse climates or exposure to noise, cold or heat. Data were analysed using logistic regression.

RESULTS

Nine per cent of subjects reported an injury during the previous 2 years. The PJD score was related to the injury rate for workers aged >or=45: crude odds ratio (OR) 3.5 (95% confidence interval = 1.5-8.0) for PJD = 1, 5.0 (2.2-11.3) for PJD = 2-3 and 14.5 (6.5-32.2) for PJD >or=4, versus PJD = 0. Lower ORs were found for those aged <30 (1.4, 4.2 and 9.9, respectively) and 30-44 (1.5, 4.4 and 6.5, respectively). The differences between age groups remained when controlling for all factors studied. Obesity, smoking and musculoskeletal disorders were associated with injury risk in workers aged >or=45 (adjusted ORs 1.7-2.6). Smoking was also an injury risk factor for workers aged <30.

CONCLUSIONS

PJD and lifestyle have a higher impact on injury rates among older workers than among younger ones. Injury prevention should address reducing PJD and improving relevant lifestyle factors, especially for older workers.

Sleep disturbances as a predictor of occupational injuries among public sector workers

The association between disturbed sleep and increased risk of occupational injury has been observed in several cross-sectional and case-control studies, but prospective evidence is lacking. We examined prospectively whether sleep disturbances predicted occupational injuries in a large population of Finnish public sector employees. A total of 48 598 employees working in 10 municipalities and 21 hospitals in various parts of Finland were included. Sleep disturbances were assessed with the four-item Jenkins Sleep Problems Scale. Records of sickness absence due to occupational injury during the year following the survey were obtained from employers' registers. A proportion (9076; 22%) of participants reported disturbed sleep, and 978 (2.4%) had a recorded occupational injury. After adjustment for socio-demographic characteristics, the odds ratio (OR) for occupational injury was 1.38 [95% confidence interval (CI) 1.02-1.87] times higher for men with experiences of disturbed sleep than for those without sleep disturbances, but not significant for women. Of the sub-dimensions of sleep disturbances, the OR for occupational injury was 1.69 (95% CI 1.26-2.26) for women with difficulties initiating sleep, but not significant for men. These associations remained after additional adjustment for work stress, sleep length, obesity, alcohol use and mental health. This study suggests that sleep disturbances are a significant predictor of occupational injuries even after accounting for a range of covariates.

Smoking is a marker of risky behaviors independent of substance abuse in injured drivers

OBJECTIVE

Smoking has been linked to disease and injury. The purpose of this study is to investigate the smoking habits of motor vehicular driver trauma center patients and their association with previous injury history and risky behaviors.

METHODS

The studied population included 323 motor vehicular driver injury patients (123 smokers and 200 non-smokers) interviewed as part of a larger study of psychoactive substance use disorders at an adult Level I trauma center. Patients with head injuries, hospital stays of less than two days, and diminished cognition were excluded. Interviews included demographics (age, gender, race, marital status), socioeconomic status (SES; income, education, employment), risky behaviors (seatbelt non-use, drinking and driving, riding with drunk driver, binge drinking), and trauma history information (vehicular, assault, and other injuries). Substance abuse (alcohol and drug dependence) was evaluated in depth using DSM III-R criteria. Smokers and non-smokers were compared in relation to control and dependent variables using student's t test and chi-square (alpha = 0.05). Outcome variables included previous trauma history and risky behaviors. Multiple logistic regression models using step-down selection methods (alpha = 0.05) were constructed with risky behaviors and trauma history as dependent variables including demographics, SES and substance as independent variables.

RESULTS

Smokers represented 38 percent of the 323 patients studied. Smokers (n = 123) were younger (34 vs. 43 years), more likely to be male (72 percent vs. 50 percent), not married (72 percent vs. 56 percent), and had higher rates of alcohol (29 percent vs. 9 percent) and drug dependence (14 percent vs. 3 percent) than non-smokers (n = 200). Educational achievement (20 percent vs. 15 percent less than high school) and income level (24 percent vs. 23 percent with less than $15,000 of yearly income) were not different between smokers and non-smokers. Smokers were more likely than non-smokers to have a history of prior vehicular trauma (48 percent vs. 26 percent), assault (25 percent vs. 9 percent), or other injury (50 percent vs 37 percent). The following injury-prone behaviors were also more common among the smokers than non-smokers: seatbelt non-use (49 percent vs. 29 percent), drinking and driving (38 percent vs. 15 percent), riding with drunk driver (38 percent vs. 13 percent), and binge drinking (68 percent vs. 26 percent). In multiple logistic regression models adjusting for demographics, SES, and substance abuse, smoking revealed significantly higher odds ratios (OR) for the following dependent variables: seatbelt non-use (OR = 2.9), riding with drunk driver (OR = 2.2), binge drinking (OR = 2.4), previous vehicular (OR = 2.0), and assault injuries (OR = 2.5). Smoking did not reach significance for drinking and driving and other (non-vehicular and non-assault) injury.

CONCLUSION

Smoking is independently associated with risky behaviors and repeated history of vehicular or assault injury within the vehicular trauma population.

Relationships of physical job tasks and living conditions with occupational injuries in coal miners

This study assessed the relationships of job tasks and living conditions with occupational injuries among coal miners. The sample included randomly selected 516 underground workers. They completed a standardized self-administred questionnaire. The data were analyzed via logistic regression method. The rate of injuries in the past two years was 29.8%. The job tasks with significant crude relative risks were: power hammer, vibrating hand tools, pneumatic tools, bent trunk, awkward work posture, heat, standing about and walking, job tasks for trunk and upper/lower limbs, pain caused by work, and muscular tiredness. Logistic model shows a strong relationship between the number of job tasks (JT) and injuries (adjusted ORs vs. JT 0-1: 2.21, 95%CI 1.27-3.86 for JT 2-6 and 3.82, 2.14-6.82 for JT>or=7), and significant ORs>or=1.71 for face work, not-good-health-status, and psychotropic drug use. Musculoskeletal disorders and certain personality traits were also significant in univariate analysis. Therefore job tasks and living conditions strongly increase the injuries, and occupational physicians could help workers to find remedial measures.