Is inadequate play area in schools associated with overweight among students in Addis Ababa, Ethiopia? A comparative cross-sectional study

OBJECTIVES

The prevalence of childhood obesity has more than doubled since it was formally recognized as a global epidemic in 1997. With the increasingly dwindling space for private schools in Ethiopia, unresolved concerns exist among the public regarding the possible effect of limited play areas in schools on overweight/obesity. This study intended to determine and compare the levels of overweight/obesity among adolescents in private schools with and without adequate play area in Addis Ababa, Ethiopia.

METHODS

A school-based comparative cross-sectional study was conducted among 1,276 adolescents. Twenty private schools were grouped into 2 groups based on the size of the play area. Data were collected using a pre-tested questionnaire and anthropometric measurements and analyzed using descriptive statistical tests and logistic regression.

RESULTS

The magnitude of overweight/obesity was significantly higher in schools with inadequate play area (19.4%; 95% confidence interval [CI], 16.4 to 22.7) than in schools with adequate play area (14.6%; 95% CI, 11.9 to17.5). Inadequacy of the play area was also positively associated with overweight/obesity in the multiple logistic regression analysis (odds ratio [OR], 1.62; 95% CI, 1.05 to 2.51). Using private car transportation to and from school (OR, 2.27; 95% CI, 1.13 to 4.57), father's educational status (secondary school and above: OR, 2.54; 95% CI, 1.14 to 5.62), and middle wealth quintile (OR, 2.54; 95% CI, 1.50 to 4.33) were other factors significantly associated with overweight/obesity.

CONCLUSIONS

Inadequate play area in schools was an important contributor to overweight/obesity. Sedentary behavior was also significantly associated with overweight/obesity.

Consumers fueling outpatient construction

Construction leaders continue to see their biggest opportunities in outpatient care, but providers still face challenges delivering levels of customer service that patients have come to expect.

Basic Characteristics and Spatial Patterns of Pseudo-Settlements--Taking Dalian as An Example

A person’s living behavior patterns are closely related to three types of settlements: real-life settlements, imagined settlements, and pseudo-settlements. The term “pseudo-settlement” (PS) refers to the places that are selectively recorded and represented after the mass media chose and restructure the residence information. As the mass media rapidly develops and people’s way of obtaining information gradually change, PS has already become one of the main ways for people to recognize and understand real-life settlements, as well as describe their impressions of imagined settlements. PS also has a profound impact on tourism, employment, investment, migration, real estate development, etc. Thus, the study of PSs has important theoretical and practical significance. This paper proposes to put forward residential quarters where the mass media is displayed as the object of study and establishes the pseudo-settlement index system of Dalian in and elaborate analysis of the concept of PSs. From three aspects, including pseudo-buildings, pseudo-districts and pseudo-culture, this paper uses the ArcGIS 10.0 kernel density (spacial analyst) to analyze and interpret the basic characteristics and spatial patterns of 14 elements of the PS in Dalian. Through systemic clustering analysis, it identifies eight major types of PSs in Dalian. Then it systematically elaborates current situations and characteristics of the spatial pattern of PSs in Dalian, namely: regionally concentrated, widely scattered and blank spaces without pseudo-settlements. Finally, this paper discusses the mechanism of formation of PSs in Dalian.

[Sustainability and hygiene of building: future perspectives]

OBJECTIVES

Multiple factors influence individuals' health status. Their impact is difficult to quantify as it is their interaction. Aim of the current work is to develop guidelines to support designers to promote health in the residential environment and to apply them through an evaluation system to certify the level of health performance.

DESIGN

Politecnico di Milano, in collaboration with the Local Health Authorities of Milan and Empoli through analysis of needs performance and numerous multidisciplinary meetings, has produced a design guide (Healthy Design Guide - HeDe) and an evaluation system to certify the level of health performance. This system was tested on the Milan metropolitan area.

SETTING

The experiment was carried out on a sample of 30 private residences, with an overall floor area ranging between 90 and 150 square meters, new or recently renovated.

RESULTS

The tool works but at the same time it also shows that too often design choices are made for aesthetic or economic reasons rather than a real need for health and wellness.

CONCLUSIONS

It is becoming increasingly important to strengthen synergies and multidisciplinary collaborations to achieve shared performance indications and to make a systematic review of the regulatory tools to protect public health.

A review on removing pharmaceutical contaminants from wastewater by constructed wetlands: design, performance and mechanism

This paper presents a comprehensive review of the current state of research activities on the application of constructed wetlands for removing pharmaceutical contaminants from wastewater. The focus of the review was placed on the application of constructed wetlands as an alternative secondary wastewater treatment system or as a wastewater polishing treatment system. The design parameters of the reported constructed wetlands including the physical configuration, hydraulic mode, vegetation species, and targeting pharmaceuticals were summarized. The removal efficiencies of pharmaceuticals under different conditions in the wetlands were evaluated at the macroscopic level. In addition, the importance of the three main components of constructed wetlands (substrate, plants and microbes) for pharmaceutical removal was analyzed to elucidate the possible removal mechanisms involved. There is a general consensus among many researchers that constructed wetlands hold great potential of being used as an alternative secondary wastewater treatment system or as a wastewater polishing treatment system for the removal of pharmaceuticals, but relevant reported studies are scarce and are not conclusive in their findings. Current knowledge is limited on the removal efficiencies of pharmaceuticals in constructed wetlands, the removal mechanisms involved, the toxicity to constructed wetlands caused by pharmaceuticals, and the influences of certain important parameters (configuration design, hydraulic mode, temperature and seasonality, pH, oxygen and redox potential, etc.). This review promotes further research on these issues to provide more and better convincing evidences for the function and performance of larger laboratory-scale, pilot-scale or full-scale constructed wetlands.

Is renovation riskier than new construction?: an observational comparison of risk factors for stepladder-related falls

BACKGROUND

Stepladder-related injuries at construction sites have increased in recent years. We aimed to quantify the prevalence of stepladder-related fall hazards in general construction and to compare the risks on renovation worksites to new construction build sites.

METHODS

Eighteen worksites were visited, resulting in the observation of 771 stepladders. Eight of the sites were new builds and ten were renovation projects.

RESULTS

High compliance with best practices was not observed for several factors, including having hands free while climbing (46%) and using minimum forces (72%). There was a notable trend toward more hazards on renovation build projects than on new construction sites; however, these differences were not statistically significant.

CONCLUSIONS

There was not sufficient evidence to show that stepladder fall hazards are more prevalent on renovation projects than on new build projects. Having hands free while climbing and using minimum forces were two practices needing more wide-scale adoption regardless of construction job type.

Evaluation of environmental management resources (ISO 14001) at civil engineering construction worksites: a case study of the community of Madrid

In recent years, significant advances have been made in business organization and management. The growing demands of clients as well as the globalization of world markets are among the many factors that have led to the establishment of systems of quality control and environmental management as a competitive strategy for businesses. When compared to other professional sectors, the construction sector has been slower to respond to environmental problems and to adopt Environmental Management Systems (EMS). In the world today the ISO 14001 standard is currently the main frame of reference used by construction companies to implement this type of management system. This article presents the results of a general study regarding the evaluation of the application of the ISO 14001 standard at civil engineering construction worksites in the Community of Madrid (Spain), specifically pertaining to requirement 4.4.1, Resources, roles, responsibilities, and authority. According to requirement 4.4.1, company executives should appoint people responsible for implementing the EMS and also specify their responsibilities and functions. The personnel designated for supervising environmental work should also have sufficient authority to establish and maintain the EMS. The results obtained were the following: - EMS supervisors did not generally possess adequate training and solid experience in construction work and in the environment. Furthermore, supervisors were usually forced to combine their environmental work with other tasks, which made their job even more difficult. - Generally speaking, supervisors were not given sufficient authority and autonomy because productivity at the construction site had priority over environmental management. This was due to the fact that the company management did not have a respectful attitude toward the environment, nor was the management actively involved in the establishment of the EMS. - Insufficient resources were allocated to the Environmental Management Unit. As a result, the application of EMSs in construction projects often appeared to be more of a formality, which was merely a way of maintaining the certification of the Environmental Management System. It was more a means of meeting the requirements for submitting a tender to contracting organisms rather than an indicator of any real commitment to improving the environmental performance of construction companies.

The NIOSH Construction Program: research to practice, impact, and developing a National Construction Agenda

The U.S. National Institute for Occupational Safety and Health (NIOSH) conducts research to improve and protect the health and safety of workers. This paper describes the experience of the NIOSH Construction Program with two recent program planning initiatives intended to improve the program: (a) an independent external review of work over the past decade and (b) the development of strategic goals organized into a "National Construction Agenda" to guide a decade of future work. These goals, developed with input from construction industry stakeholders and researchers, are a part of the NIOSH National Occupational Research Agenda (NORA) initiative. The NORA goals are intended to provide an ambitious set of goals for all construction stakeholders to work together on. Both efforts relate to insuring the relevance and impact of research, reflecting an emerging policy perspective that research programs should be judged not just by the quality and quantity of science produced, but by the industry impact and tangible benefit resulting from the research. This paper describes how views on research planning have evolved to incorporate lessons learned about how research leads to improved safety and health for workers. It also describes the process used to develop the goals and the resulting strategic and intermediate goals that comprise the National Construction Agenda.

Evaluation of guardrail systems for preventing falls through roof and floor holes

INTRODUCTION

Fall-related occupational injuries and fatalities are serious problems in the U.S. construction industry, especially incidents related to unguarded holes. The National Institute for Occupational Safety and Health, Division of Safety Research, Morgantown, WV conducted a project to evaluate the effectiveness of guardrail systems to prevent falls through roof and floor holes.

METHODS

Two commercial edge-protection products were evaluated when used as perimeter guarding around a roof hole. Installations of the commercial products were compared to job-built guardrails constructed of 2('')x4('') construction-grade lumber. Occupational Safety and Health Administration (OSHA) regulations require that "a force of at least 200 pounds" must be supported by the top rail of a guardrail system "in any outward or downward direction at any point along the top edge." A laboratory testing system was developed to evaluate this requirement. A dynamic 200-lb force was generated against the top rail using a weighted manikin mounted on a hinged steel frame. Nine construction workers, who served as test subjects, each built five different guardrail configurations.

RESULTS

All 45 configurations met the 200-lb OSHA requirement. Installation time for one commercial product was 32% quicker than the job-built configuration (25.6 min vs. 37.9 min).

IMPACT ON INDUSTRY

This study: (a) indicates that the two edge-protection products can be used as perimeter guarding; (b) highlights the importance of using proper materials and fasteners to construct guardrails to protect workers from falling into unguarded roof and floor holes; and (c) discusses an overall-strength-testing methodology that can be used by fall-protection researchers.

[Comprehensive evaluation of county-level construction land intensive utility in Guangdong province: a case study for Zijin County]

Based on the weights and membership values of evaluation indices, a measurement model of construction land intensive utility in Zijin County of Guangdong Province was established, and the basic principles of the greatest compatible class were adopted to classify the intensive utility levels of the construction land based on fuzzy recognition. Additionally, the intensive utility potential of construction land in Zijin County in 2005 was calculated by comparing the per capita construction land in towns, independent industrial and mining areas, and rural residential areas with the latest national land use standards for planning of town launched in 2007. The predicted value of the model was 0.421, suggesting that the construction land utility in Zijin County was still low- effective and extensive. Theoretically, the construction land area could be decreased by 555.69-2197.69 hm2, which meant there was a great potential in the intensive utility of construction land in the county.

Utilization and physical activity levels at renovated and unrenovated school playgrounds

OBJECTIVE

This study examined utilization and physical activity levels at renovated compared to unrenovated school playgrounds.

METHODS

Ten unrenovated and ten renovated school playgrounds (renovated at least a year prior) in Cleveland, OH were matched on school and neighborhood characteristics. Using direct observation (SOPLAY), the number of persons attending each playground and their physical activity levels were recorded using separate counts for girls, boys, men and women. Each school was observed ten times for 90 min each time outside of school hours in 2005. Paired t-tests, Wilcoxon Signed Ranks tests, and regression analyses were completed to examine differences across school pairs.

RESULTS

More persons overall including adults and children utilized the renovated playgrounds compared to the unrenovated playgrounds. The proportion moderately-to-vigorously active was not different between renovated and unrenovated playgrounds although the proportion of children, in particular boys, who were vigorously active was greater at the renovated playgrounds. Although utilization was higher at the renovated playgrounds, absolute utilization was low across all playgrounds.

CONCLUSIONS

This study suggests that playgrounds renovations may have the potential to increase the number of children utilizing the playground outside of school hours and may increase the proportion of children, especially boys, who are vigorously active.

Safety assessment in plant layout design using indexing approach: implementing inherent safety perspective. Part 2-Domino Hazard Index and case study

The design of layout plans requires adequate assessment tools for the quantification of safety performance. The general focus of the present work is to introduce an inherent safety perspective at different points of the layout design process. In particular, index approaches for safety assessment and decision-making in the early stages of layout design are developed and discussed in this two-part contribution. Part 1 (accompanying paper) of the current work presents an integrated index approach for safety assessment of early plant layout. In the present paper (Part 2), an index for evaluation of the hazard related to the potential of domino effects is developed. The index considers the actual consequences of possible escalation scenarios and scores or ranks the subsequent accident propagation potential. The effects of inherent and passive protection measures are also assessed. The result is a rapid quantification of domino hazard potential that can provide substantial support for choices in the early stages of layout design. Additionally, a case study concerning selection among various layout options is presented and analyzed. The case study demonstrates the use and applicability of the indices developed in both parts of the current work and highlights the value of introducing inherent safety features early in layout design.

[Injury rates and severity during the construction of High Speed Train Track Torino-Novara: which are the expected risks?]

BACKGROUND

Construction of the Torino-Novara High Speed Train Track (TAV) provided a unique opportunity to describe the magnitude of accidents on a major construction project for which complete data were available for 123 companies with over 10,000 employees.

OBJECTIVES

To describe the rate and severity of accidents during the construction of TAV and to compare this with national indexes. The limits and critical points of the national surveillance system are discussed and solutions for responding to public occupational safety and health service needs are proposed.

METHODS

1,691 injuries with more than 3 lost work days were recorded between 2003 and 2005 by the TAV Surveillance System (Orme-TAV). Accident rate and severity indexes (Orme indexes) by year and occupation, were compared with indexes for Piedmont and Italy for the period 2002-04 provided by INAIL (National Institute for Insurance against Occupational Accidents and Diseases) for the Construction sector and the Road and Railway Construction sub-sector. A comparison with the accident rate of the same 123 firms calculated for all construction yards in Italy in 2003-04 (national indexes) was also made.

RESULTS

Accident rates decreased from 152 in 2003 to 72 in 2005 per 1,000 workers, but were higher than the national indexes (the Orme indexes/national indexes ratio was 1.75 in 2003 and 1.67 in 2004). Accident severity indexes were lower than the national figures.

DISCUSSION

Complete reporting, facilitated by the existence of a Surveillance System, yielded accident rates that were more reliable than those previously reported. Data suggest that the discrepancy is due to both underreporting and exposed worker assessment difficulties. The burden of on-site work-related accidents in the construction sector appears to be higher and more costly than what has been desumed from national data.

[Passive-house schools--a tool for improving indoor air quality in schools?]

In Germany, some schools have already been built according to the passive-house standard as an answer to the discussion of climate change and energy saving. For European passive construction, a prerequisite is an annual heating requirement of less than 15 kWh/(m2a) (4755 Btu/ft2/yr). Efficient heat recovery from exhaust air using an air-to-air heat exchanger reduces energy consumption and is considered to improve indoor air quality as well. However, data on indoor air quality have been lacking up to now. Here, the data on indoor air quality in a passive house school are presented.

MATERIAL AND METHODS

In the passive-house school in Frankfurt/M in summer time ventilation is performed by opening the windows. In winter time a mechanical ventilation system provides air at 14-16 m3/person h, with the incoming air being heated by an air-to-air heat exchanger. CO2 levels were obtained during 3 school days in one classroom in summer time, and during 5 days in two classrooms in winter time. In 5-minute intervals a continuous documentation of the number of persons present in the room, their activity and ventilation was done parallel to the measurements.

RESULTS

Mean CO2 levels in summer time were 1127 ppm, and 946 ppm in winter time. Regarding only those measurements with people present in the classroom, the air quality standard of 1000 ppm (Pettenkofer's level) was exceeded in two thirds of the measurements in summer and in winter, with 5% (summer) and 10% (winter) of the levels exceeding the guideline value (DIN 1946) of 1500 ppm. Considering the guideline values of the "new" DIN EN 13779, 9-21% of the measurements exceeded 1400 ppm, i.e., "low air quality".

DISCUSSION

Mean CO2 levels in the passive-house school were comparable to those in conventionally ventilated schools, i.e., ventilation via opening the windows, whereas maximal levels were lower in the passive-house school than in other schools. The guideline value of 1500 ppm was exceeded on 33% of the measurement days, the level of 1400 ppm was exceeded in 92% of the days. According to these data, indoor air quality should be improved not only in conventionally ventilated schools but also in passive-house schools. In addition to the mechanical ventilation, ventilation by opening the windows during breaks is necessary. Therefore, sufficient capacity for opening the windows should be available. This is mandatory not only for summer time ventilation but also in case of problems with the mechanical ventilation system. As a result air quality should be an important issue in passive houses as well, in addition to the focus on energy saving.

Is the apparent decrease in injury and illness rates in construction the result of changes in reporting?

Injury rates in all industries and in construction in particular have been declining. Inconsistencies in the information suggest some of the apparent decrease may be due to changes in the ways injuries are treated, misclassification of employees, or underreporting. Lost-time injury rates for the largest construction employers declined by as much as 92% between 1988 and 1999. Yet the rate for cases with restricted work activity actually increased from 0.7 to 1.2 per 100 full-time workers between 1990 and 2000, and fatalities among construction workers remain high. In Massachusetts, at least 14% of construction employers misclassified workers as independent contractors, with the effect that injuries to these workers are not recordable. Studies that compare OSHA logs with other data sources find that the OSHA logs do not include a significant proportion of injuries and illnesses identified elsewhere.

"Cooking the books"--behavior-based safety at the San Francisco Bay Bridge

Practitioners of Behavior-Based Safety (BBS) claim dramatic reductions in worker injuries and illnesses through modifying workers' "unsafe behaviors." This case study of a BBS program implemented by KFM, a giant construction consortium rebuilding the eastern span of the San Francisco Bay Bridge in California, documents how BBS was used to suppress reporting of worker injuries and illnesses on site. The key elements of KFM's BBS "injury prevention" strategy included: 1) cash incentives to workers and supervisors who do not report injuries; 2) reprisals and threats of reprisals against those employees who do report injuries; 3) selection and use of employer friendly occupational health clinics and workers compensation insurance administrators; 4) strict limits on the activities of contract industrial hygiene consultants; and 5) a secretive management committee that decides whether reported injuries and illnesses are legitimate and recordable. KFM reported injury and illness rates 55% to 72% lower than other bridge builders in the Bay Area, but the California Division of Occupational Safety and Health (Cal/OSHA) issued Willful citations to the consortium in June 2006 for failing to record 13 worker injuries on its "OSHA Log 300," as required by law.

Occupation, work environment, and disability pension: a prospective study of construction workers

AIMS

This study investigated the importance of occupation and work environment for the risk of disability pension among construction workers in Sweden.

METHODS

The data include around 389,000 construction workers who participated in health examinations from 1971 to 1992. During that period 68,000 participants received disability pension in some form. Between 1985 and 1992 questionnaires were used to collect data regarding hazards in the work environment. Some 87,000 participants answered that questionnaire, and almost 6,000 of these were in receipt of a disability pension. To analyse the risk of disability pension in different occupations, incidence rates (SIR) were calculated according to the person-year method. Logistic regression was used to calculate age-controlled odds ratios according to physical and psychosocial work environment factors.

RESULTS

The results show considerable variation in risk for disability pension between different occupations within the construction industry. Furthermore, analysis of work environment factors indicated associations with physical, ergonomic, and psychosocial work environment factors.

DISCUSSION

A considerable variation between occupations indicates that characteristics in the work situation are important when explaining the risk of disability pension. The results from this study indicate that improvements in working conditions are an important area of intervention in order to facilitate and prolong labour market participation among elderly people.

The effectiveness of hearing protection among construction workers

Effective hearing conservation programs in the construction industry are rare. Where programs are present, they often rely on workers' use of hearing protection devices (HPDs) rather than on exposure controls to reduce noise exposure levels. Dependence on HPDs for protection from high noise is problematic, as the protection provided by the HPD depends on both the HPD's attenuation level and the time the HPD is used. This article presents an analysis of data on noise exposure and hearing protection among construction workers drawn from several large datasets covering nine construction trades. A unique combination of 1-min dosimetry noise exposure levels and simultaneous self-reported use of HPDs was evaluated, as were occupational and nonoccupational HPD use data collected by questionnaire as part of a longitudinal study of noise exposure and hearing loss among apprentices. Direct measurements of HPD attenuation were also made on workers at their work site. The workers assessed in this study were found to use hearing protection less than one-quarter of the time that they were exposed above 85 dBA. Workers who reported always using HPDs in high noise on questionnaires were found to wear them only one-third of the time their exposures exceeded 85 dBA. Workers' self-reported use of HPDs during most noisy nonoccupational activities was also found to be low. Direct attenuation measurements found that workers were able to achieve more than 50% of the rated attenuation of their HPD on average, but that the variability in achieved attenuation was large. When the measured HPD attenuation levels and use time data were combined, the effective protection afforded by HPDs was less than 3 dB, a negligible amount given the high exposure levels associated with construction work. However, there was substantial variation in effective protection among the different trades assessed. These results demonstrate the need for better hearing conservation programs and expanded noise control efforts in the construction industry.

Effect of ice surface size on collision rates and head impacts at the World Junior Hockey Championships, 2002 to 2004

OBJECTIVE

To determine if collision rates and head impacts in elite junior hockey differed between games played on the small North American ice surface (85 ft wide), an intermediate-size Finnish ice surface (94 ft wide), and the large standard international ice surface (100 ft wide).

DESIGN

Videotape analysis of all games involving Team Canada from the 2002 (large ice, Czech Republic), 2003 (small ice, Canada), and 2004 (intermediate ice, Finland) World Junior Championships. All collisions were counted and separated into various categories (volitional player/player bodychecks, into boards or open ice, plus accidental/incidental player/boards, player/ice, head/stick, head/puck). Further subdivisions included collisions involving the head directly or indirectly and notably severe head impacts.

RESULTS

Small, intermediate, and large ice surface mean collisions/game, respectively, were 295, 258, 222, total collisions; 251, 220, 181, volitional bodychecks; 126, 115, 88, into boards; 125, 106, 93, open ice; 71, 52, 44, total head; 44, 36, 30, indirect head; 26, 16, 13, direct head; and 1.3, 0.5, 0.3, severe head (P < 0.05 for small-intermediate ice and intermediate-large ice differences in total collisions; P < 0.005 for small-large ice difference; P < 0.05 for small-intermediate ice differences in head impacts; P < 0.01 for small-large ice differences in total and severe head impacts).

CONCLUSIONS

There is a significant inverse correlation between ice size and collision rates in elite hockey, including direct, indirect, and severe head impacts. These findings suggest that uniform usage of the larger international rinks could reduce the risk of injury, and specifically, concussions in elite hockey by decreasing the occurrence of collisions and head impacts.

Apparative Diagnostik im Schockraum

Opinions vary with regard to the equipment and structural furnishings required for adequate management of the trauma patient in the dedicated shock suite. In order to assess the current situation in Germany, we conducted a survey of the 76 centers participating in the Polytrauma Registry of the DGU. Fifty-one questionnaires were returned by centers representing all levels of care. Responses revealed, for example, that not all centers possess capabilities for conventional radiography in the shock suite (7/51). Only 20 centers had a fixed table; the remaining 24 hospitals used either an image converter or a mobile X-ray unit. A dedicated ultrasound scanner was provided for the shock suite in 39 of 51 centers responding. Dedicated computed tomography scanners were provided for the shock suite in only eight centers (one dedicated trauma center, three level 3 centers, four university hospitals). All eight scanners use helical CT technology; at least three of the units are 8- or 16-slice. Of 51 shock suites, 12 are air-conditioned in compliance with sterile criteria (and are officially designated as surgical suites), while the remaining 39 are not. In acute cases, emergency surgeries can be performed in the shock suite in 37 centers, but not in the remaining 14 shock suites. According to the survey, slightly less than half of the hospitals responding are un-satisfied with the shock suite infrastructure ( n=24) and, of these, 13 centers are actively planning changes (the necessary financial resources have been guaranteed in 10 centers). Fourteen centers desire changes but do not currently have the required money. Information provided by Philips and Siemens suggests that the cost of furnishing a new shock suite ranges between 1.4 and 1.7 million euros. Responses to our survey show that a large gap remains between wishes and reality in the technical infrastructure in many shock suites in Germany.

Disabling and fatal occupational claim rates, risks, and costs in the Oregon construction industry 1990-1997

This study estimated injury and illness rates, risk factors, and costs associated with construction work in Oregon from 1990-1997 using all accepted workers' compensation claims by Oregon construction employees (N = 20,680). Claim rates and risk estimates were estimated using a baseline calculated from Current Population Survey data of the Oregon workforce. The average annual rate of lost-time claims was 3.5 per 100 workers. More than 50% of claims were by workers under 35 years and with less than 1 year of tenure. The majority of claimants (96.1%) were male. There were 52 total fatalities reported over the period examined, representing an average annual death rate of 8.5 per 100,000 construction workers. Average claim cost was $10,084 and mean indemnity time was 57.3 days. Structural metal workers had the highest average days of indemnity of all workers (72. 1), highest average costs per claim ($16,472), and highest odds ratio of injury of all occupations examined. Sprains were the most frequently reported injury type, constituting 46.4% of all claims. The greatest accident risk occurred during the third hour of work. Training interventions should be extensively utilized for inexperienced workers, and prework exercises could potentially reduce injury frequency and severity.

Fatal injuries to teenage construction workers in the US

BACKGROUND

The construction industry is second only to agriculture in the annual number of fatal injuries in workers less than 18 years of age. We examined fatal injury reports for youth and adult workers to determine risk factors for injury and applicability of existing child labor regulations.

METHODS

The US Occupational Safety & Health Administration (OSHA) investigation data for fatal work injuries from 1984 through 1998 were reviewed with respect to type of event, employer characteristics, and apparent violations of existing child labor laws under the Fair Labor Standards Act (FLSA). We also examined whether the employer met exemption criteria for federal enforcement of child labor or OSHA regulations.

RESULTS

The fatality rate for teenage construction workers age 19 and younger was 12.1 per 100,000 per year, slightly less than for adult workers. Teenage workers who were fatally injured were more likely than adults to have been employed at non-union construction firms (odds ratio (OR) = 4.96, P < 0.05), firms with fewer than 11 employees (OR = 1.72, P < 0.05), and their employers were more likely to have been cited by OSHA for safety violations (OR = 1.66, P < 0.05) than for firms which were investigated because of a fatality in an adult worker. Fatalities in teenagers were more likely to occur in special construction trades such as roofing. Among fatalities in workers less than 18 years of age, approximately one-half (49%) of the 76 fatal injuries were in apparent violation of existing child labor regulations. We estimated that in 41 of the 76 cases (54%) the employer's gross annual income exceeded the $500,000 threshold for federal enforcement of child labor laws. Only 28 of 76 cases (37%) were at construction firms with 11 or more employees, which are subject to routine OSHA inspections.

CONCLUSIONS

Fatal injuries in teenage construction workers differed from those in adults in that they were more likely to be at small, non-union firms of which a substantial proportion were exempt from federal enforcement of child labor laws and from routine OSHA inspections. Safety programs for young construction workers should include small, non-union construction firms and those in special construction trades such as roofing. We did not identify specific areas for new regulation but the number of fatalities reviewed was small.

Construction work practices and conditions improved after 2-years' participation in the HomeSafe pilot program

This study reevaluated changes in job-site safety audit scores for a cohort of residential construction workers that had protracted exposure to the HomeSafe pilot program for 2(1/2) years. The investigation was a repeated measure of a cohort study underway in the six-county metro area of Denver, Colo. The larger study was a longitudinal, quasi-experimental design with a cohort of residential construction workers within the HomeSafe strategic partnership between Occupational Safety and Health Administration Region VIII and the Home Builders Association of Metropolitan Denver (HBA). Audits were conducted on residential construction sites. Study subjects were construction workers employed by partner or control companies within the study. Repeated measures of 41 companies showed significant improvement (p=.01) in audit scores, increasing from 71.8 to 76.8 after 2(1/2) years in the program. HomeSafe companies out-performed controls (p=.01) for both the retest group and previously unaudited HomeSafe companies. Prolonged exposure in the HomeSafe pilot program resulted in improved audit scores for companies within the program for at least 2 years.

Better, not bigger. Construction costs soar on wings of patient demand, construction & design survey finds

Even though the number of construction projects remained flat in 1998, overall spending jumped 29% to nearly $15 billion, according to this year's Construction & Design Survey. Outpatient facilities remained in strong demand, increasing 17% compared with last year's survey.

Accessibility of primary care physicians' offices for people with disabilities. An analysis of compliance with the Americans With Disabilities Act

OBJECTIVE

To determine if primary care physicians are in compliance with the Americans With Disabilities Act of 1990 (ADA) and to what extent offices of primary care physicians are usable for persons with disabilities.

DESIGN

Cross-sectional survey.

SETTING

Members listed in the Harris County (Texas) Medical Society roster.

SUBJECTS

Sixty-two general practitioners, family practitioners, internists, and obstetrician-gynecologists.

MAIN OUTCOME MEASURE

A 15-page questionnaire with 57 items and 136 variables.

RESULTS

Eleven (18%) of the primary care physicians in this study were unable to serve their patients with disabilities in the last year for reasons that could be interpreted as noncompliant with the ADA. Two physicians (3%) had offices that patients with disabilities could not enter because of physical barriers, and 1 physician (2%) had inaccessible equipment. Fourteen physicians (22%) were improperly referring patients with disabilities although they generally treat such patients. In measuring the level of compliance with regard to structural features that enhance the accessibility of the physicians' offices, only 8 (13%) had a low level of compliance. Thirty-nine (63%) of the physicians supplied auxiliary aids and services to their patients with disabilities. The most common aid was printed materials.

CONCLUSIONS

A substantial portion of primary care physicians' offices are not in compliance with the ADA, and some informational tools will be required to inform physicians about the nondiscriminatory requirements of the statute.

1998 construction design survey

Healthcare construction and design firms are discovering new worlds of opportunity--some domestic, some international and some unconventional. Emergency room renovation and construction work is drawing more attention, as are overseas projects and facilities designed with alternative medicine in mind. The number of projects rose 11% in 1997, but the overall cost of completed projects stayed flat compared with the previous year.

Health sciences library building projects, 1996-1997 survey

Nine building projects are briefly described, including four new libraries, two renovations, and three combined renovations and additions. The libraries range in size from 657 square feet to 136,832 square feet, with seating varying from 14 to 635. Three hospital libraries and four academic health sciences libraries are described in more detail. In each case an important consideration was the provision for computer access. Two of the libraries expanded their space for historical collections. Three of the libraries added mobile shelving as a way of storing print materials while providing space for other activities.

Sociocultural dilemma of Japanese steeplejacks

Japanese steeplejacks are good at working in high places as construction workers, and they have been called tobi for a longtime. They now play an important role in completing modern civil engineering projects and in the construction of high-rise buildings; however, their lifestyle is considered by most to be quaint but outdated. Originally, they were unskilled workmen at construction sites. In the 18th century, they were engaged in repairing houses or setting up scaffolding, helping carpenters, but they worked as firefighters whenever fires broke out. Their traditional work system did not change throughout the Meiji era, although Japanese society became greatly modernized. After World War II, the industrialization of Japanese society required highly developed technology in civil engineering and architecture. This provided an opportunity for them to establish their positions as trained professional workers. However, the number of skilled tobi professionals has continued to decrease because the younger generation does not consider this profession desirable career. Improving not only the professional skills but also the way of living to the extent as a modern high-tech society demands will be the key for the tobi's work system to become attractive.

1997 construction & design survey

Managed care might seem to be putting a damper on healthcare construction, but in fact it's one of several industry changes creating opportunities for architectural and design firms. One example of a trend toward making surroundings as pleasant as possible is the west campus expansion at East Texas Medical Center in Tyler (left). Designed and built by Ellerbe Becket and completed in 1995, the project, including a nine-story medical office building, features artwork and rooftop gardens.

Smoking patterns and mortality attributable to smoking in a cohort of 3528 construction workers

This study describes the smoking patterns of 3528 construction workers as reported at occupational health examinations, in four occupational health centres located in the South of Germany, conducted between August 1986 and December 1988. Subjects were aged 20 to 59 years and were working as plumbers, carpenters, painters or varnishers, plasterers, bricklayers, unskilled workers or white collar employees. Overall smoking prevalence was 53.5%. It was considerably higher than in a representative population sample of the same age groups. Active follow up was carried out to ascertain vital status between October 1992 and July 1994. The effect of smoking on all cause mortality was assessed using the cox proportional hazard model. The relative risk of current smoking was 2.5 (95% CI 1.4-4.4) after adjustment for age, profession, self reported alcohol consumption, body mass index, nationality, and company size. 60% of the deaths among smokers and 34% of deaths in the whole cohort were attributable to smoking. These findings underline the need for comprehensive efforts to reduce smoking and its negative consequences in the occupational group.