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PURPOSE: Current occupational recommendations limit fetal radiation dose to 1 mSv. With increased gender diversity in urology, understanding radiation exposure during pregnancy is crucial. The purpose of this study was to determine surgeon uterine radiation dose during percutaneous nephrolithotomy (PCNL) and compare effectiveness of several radiation reduction strategies in a cadaver model. MATERIALS AND METHODS: Two cadavers were used to simulate the surgeon and patient in a PCNL model. An ion chamber was placed behind the surgeon's anterior uterine wall to measure radiation dose. Three radiation reduction methods were compared: pulsed fluoroscopy (1, 4, 8, 15, 30 pps), low-dose (LD) fluoroscopy, and surgeon shielding (none, 0.35, 0.50, 0.70 mm lead equivalents). The average radiation dose/second was recorded for 20 trials per combination. Assuming 5 minutes of fluoroscopy per PCNL, the number of cases required to exceed the fetal occupational limit was determined. RESULTS: Decreasing pulse frequency from 30 to 1 pps reduced dose by 96% (p<0.001). The LD setting decreased dose by 56% (p<0.001). A 0.35 mm lead apron resulted in a 94% dose reduction (p<0.001), and the 0.50 and 0.70 mm lead aprons further reduced dose by 12% and 47%, respectively. At conventional fluoroscopy settings of automatic exposure control and 30 pps, a surgeon could perform 12 PCNLs using no lead or 189 PCNLs using a 0.35 mm lead apron before reaching the 1 mSv limit. In addition to shielding, employing 1 pps with LD further decreased radiation exposure, allowing over 6000 cases to be performed with <1 mSv uterine radiation exposure. CONCLUSIONS: Within the limitations of this cadaver study, these data support that high volume pregnant surgeons employing active radiation reduction techniques such as pulsed, LD fluoroscopy and appropriate shielding can maintain surgical volume with relatively low risk. Fetal dosimeter use with monthly monitoring is still encouraged to confirm safety throughout pregnancy.
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BACKGROUND: Medical personnel, particularly emergency department (ED) physicians, face a variety of occupational hazards. However, the current state of occupational injuries among ED physicians remains unknown. This study aimed to assess the occupational injury of Chinese ED physicians and to identify its associated factors. METHODS: From July to August 2018, a cross-sectional survey was conducted in Chinese emergency departments. A structured questionnaire covering sociodemographic characteristics, individual health behaviours, and work-related characteristics was completed by 10,457 ED physicians. Binary logistic regression was used to analyse the factors associated with occupational injuries. RESULTS: In this study, 81.13% of ED physicians reported occupational injuries in the previous 12 months. All participants who had experienced occupational injuries had suffered verbal violence. Among physicians who experienced at least one injury, 76.57% and 71.30% reported injuries sustained while moving patients and from falls, slips, and sprains during office visits, respectively. Occupational injuries were significantly associated with gender, education level, drinking behaviour, sleep quality, the frequency of night shifts per month, self-perceived physician shortage, and work-family conflict. Physicians who experienced effort-reward imbalance were at a higher risk of occupational injury. CONCLUSION: In China, occupational injuries are common among ED physicians. Individual factors as well as work-related factors are independently linked to occupational injuries. To reduce the rate of occupational injuries among ED physicians, health policymakers and healthcare facility managers should consider multi-injury interventions.
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Traumatismos Ocupacionais , Médicos , Humanos , Estudos Transversais , Traumatismos Ocupacionais/epidemiologia , Prevalência , Serviço Hospitalar de Emergência , Inquéritos e QuestionáriosRESUMO
BACKGROUND: Workplace injuries due to a slip, trip or fall on the level (STF) are often reported together, making the potential impact of targeted interventions, such as slip-resistant footwear, difficult to assess. The objective of this research was to review workplace non-fatal injuries reported as STFs under the Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013 to determine what proportion of staff STF injuries reported by the National Health Service (NHS) in Great Britain were caused specifically by a slip. METHODS: The free text descriptions of all 1004 STF injuries reported by NHS staff in summer 2018 and winter 2018/2019 were independently reviewed by two researchers to determine whether a slip was the primary cause or not. Where agreement could not be reached or the cause was unclear, an STF specialist reviewed the reports to establish the likely cause. The kappa statistic was used to measure inter-reviewer agreement, and the χ2 test was used to compare proportions across seasons. RESULTS: The reviewers agreed on the initiating event, slip or non-slip, for 917 (91.3%) of the incidents. The kappa statistic was 0.842 (95% CI 0.785 to 0.898) indicating strong agreement between reviewers. In total, 431 or 42.9% (95% CI 39.8% to 46.1%) of the STF incidents were slips. This percentage was greater in winter compared with summer (49.0% and 36.0%, respectively, p<0.001). CONCLUSION: The high proportion of slips among reported STF injuries implies that an effective intervention targeting workplace slips in the NHS could have a substantial impact on the number of injuries reported.
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INTRODUCTION: Determining industry of decedents and victim-perpetrator relationships is crucial to inform and evaluate occupational homicide prevention strategies. In this study, we examine occupational homicide rates in North Carolina (NC) by victim characteristics, industry and victim-perpetrator relationship from 1992 to 2017. METHODS: Occupational homicides were identified from records of the NC Office of the Chief Medical Examiner system and the NC death certificates. Sex, age, race, ethnicity, class of worker, manner of death, victim-perpetrator relationship and industry were abstracted. Crude and age-standardised homicide rates were calculated as the number of homicides that occurred at work divided by an estimate of worker-years (w-y). Rate ratios and 95% CIs were calculated, and trends over calendar time in occupational homicide rates were examined overall and by industry. RESULTS: 456 homicides over 111 573 049 w-y were observed. Occupational homicide rates decreased from 0.82 per 100 000 w-y for the period 1992-1995 to 0.21 per 100 000 w-y for the period 2011-2015, but increased to 0.32 per 100 000 w-y in the period 2016-2017. Fifty-five per cent (252) of homicides were perpetrated by strangers. Taxi drivers experienced an occupational homicide rate that was 110 times (95% CI 76.52 to 160.19) the overall occupational homicide rate in NC; however, this rate declined by 76.5% between 1992 and 2017. Disparities were observed among workers 65+ years old, racially and ethnically minoritised workers and self-employed workers. CONCLUSION: Our findings identify industries and worker demographics that experienced high occupational homicide fatality rates. Targeted and tailored mitigation strategies among vulnerable industries and workers are recommended.
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BACKGROUND: Given the high incidence and heavy burden of ankle sprains in recruits, large-scale, multifactorial investigations into potential risk factors are warranted. This study aimed to identify the incidence of ankle sprains and associated risk factors among new military recruits during their infantry training. METHODS: The study included 365 infantry recruits (aged 18-21 years), who were inducted into service in March 2022. These recruits were monitored for ankle sprains throughout their basicy and advanced infantry training by a physiotherapist. Preinduction smoking habits, physical fitness preparation and recurrent ankle sprains were recorded. Anthropometric measures, lower-extremity functional movement, Achilles tendon structure, perceived ankle instability, and mechanical ankle instability were assessed at the onset of both training periods. RESULTS: Ankle sprains were diagnosed in 109 trainees (29.9%) during both the basic and the advanced training periods. Preinduction recurrent ankle sprains were reported by 28.2% of the participants. The relative risk of a recruit with preinduction ankle sprains suffering a subsequent sprain during training was 1.66 (p=0.001). Logistic regression analysis indicated that reduced proprioception ability (OR=0.002), higher body mass index (OR=1.08), preinduction recurrent sprains (OR=1.95) and lack of physical fitness preparation (OR=3.12) were related to ankle sprains throughout the complete basic-and-advanced training period. Preinduction recurrent ankle sprains (OR=3.37) and reduced Achilles tendon quality (OR=1.30) were associated with ankle sprains during the advanced training period. CONCLUSIONS: Lower-extremity functional movement, body mass index, preinduction recurrent sprains, physical preparation and reduced Achilles tendon quality were associated with the risk of ankle sprains during training. These findings could contribute to developing prevention and intervention programmes for reducing ankle sprains in military trainees.
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OBJECTIVES: Occupational injuries pose a significant challenge to global health and development. This study aimed to quantify the international and regional burdens of occupational injuries from 1990 to 2019, stratified by specific causes. METHODS: We analysed global trends in deaths, disability-adjusted life years (DALYs), age-standardised mortality rates (ASMR) and age-standardised DALY rates (ASDR) related to occupational injuries. Specific injuries, including animal contact, drowning, mechanical forces, falls, fire, heat, hot substances, foreign bodies, poisoning and road injuries, were evaluated. Age-stratified and regional analyses were also performed. RESULTS: Globally, the number of deaths, DALYs, ASMR and ASDR related to occupational injuries declined from 1990 to 2019. The middle Socio-demographic Index (SDI) region exhibited the highest burden, whereas the high SDI region showed the least burden. China and India had the highest occupational injury-related death rates in 2019. Males, particularly those aged 25-44 years, were found to be more vulnerable. Road injuries were the leading cause of death in all age groups. Compared with 1990, mortality numbers and rates decreased significantly by 2019, with the highest burdens experienced in East Asia, South Asia and Southeast Asia. CONCLUSION: The global decline in occupational injuries is promising; however, certain regions and demographics remain disproportionately affected. Targeted interventions in high-burden areas are crucial to further reduce the impact of occupational injuries.
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OBJECTIVE: There are inconsistent reports of factors relating to injury, illness and tactical performance in law enforcement recruits. Our objectives were to: (1) report physical and psychological risk factors and protective factors for injury and illness and (2) report physical and psychological risk factors and protective factors for tactical performance success. DESIGN: Systematic epidemiological review. METHODS: Searches of six databases were conducted on 13 December 2022. We included cohorts that assessed physical and psychological factors for injury, illness and tactical performance success. Study quality was assessed using the Joanna Briggs Institute Quality Assessment Checklist for Prevalence Studies and certainty assessed using the Grading of Recommendations Assessment, Development and Evaluation. RESULTS: 30 studies were included, and quality assessment was performed. Very low certainty of evidence exists for physical variables related to injury risk, and we found no studies that investigated psychological variables as a risk factor for injury. Low-certainty evidence found older age, poorer performance with push-up reps to failure, poorer arm ergometer revolutions, poorer beep test, poorer 75-yard pursuit and the 1.5 miles run tests to be associated with reduced tactical performance. Very low certainty of evidence exists that the psychological variables of intelligence and anger are associated with tactical performance. CONCLUSIONS: We identified a lack of high-level evidence for factors associated with injury, illness and performance. Interventions based on this research will be suboptimal. We suggest context-specific factors related to injury, illness and performance in law enforcement populations are used to inform current practice while further, high-quality research into risk factors is performed. PROSPERO REGISTRATION NUMBER: CRD42022381973.
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BACKGROUND: Drowning is a major cause of death in Uganda, especially among young adults with water-based occupations and livelihoods. Information about drowning and other water-related deaths and injuries is limited. To address this gap in knowledge, study partners assessed knowledge, attitudes and beliefs about drowning and drowning prevention interventions in the Mayuge district of eastern Uganda. METHODS: This study consisted of a mixed-methods, cross-sectional community health assessment. Research was conducted in 10 landing sites of 6 subcounties within Mayuge district bordering Lake Victoria and focused on 505 head-of-household interviews, 15 key informant interviews, 10 landing site observations and 3 focus group discussions with 10 young adults each. RESULTS: While landing site observations revealed high lake use, households reported limited community drowning prevention knowledge and revealed risky behaviours and attitudes towards water safety. Less than one-third (30.9%) of participants reported that at least one family member can swim. 64.2% of all respondents reported no existing safety measures (eg, signage, fences) around the lake and 95.8% reported no aquatic emergency response system in their community. The majority of households (85.7%) had experienced a drowning incident in their area. Key informants and focus group participants were eager for community-based interventions and offered solutions that reflected international drowning prevention recommendations. CONCLUSIONS: The results reveal gaps in services, access and knowledge and highlight a need for water safety services and interventions in lakeside communities in Uganda and throughout the Lake Victoria Basin.
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INTRODUCTION: According to the 2018-2019 People Mobility Survey, work-related journeys (commuting and on-duty journeys) account for approximately 25% of all journeys. The use of non-motorised (nm) and motorised (m) personal mobility devices (PMDs) has steadily increased since their introduction into the French market in the last decade. OBJECTIVE: This study aimed to describe the characteristics of work-related road accidents and their evolution since the introduction of new PMDs in France and the increase in the use of scooters. MATERIALS AND METHODS: This was a retrospective, cross-sectional study using data from the Rhône Road Trauma Registry. Data were collected from 2015 to 2020. We included the data for the victims aged 18-70 years who were injured in work-related road accidents. RESULTS: We identified 11 296 individuals aged 18-70 years who experienced work-related road accidents. An injury report was provided for a total of 11 277 patients. A total of 546 passengers and 78 drivers of other motorised vehicles (buses/trams, construction equipment and tractors) were excluded from the analysis. Seven patients died at the time of the accident and seven died after hospitalisation. Of the 10 653 (94.4%) victims, there were pedestrians (5.1%) or riders of bicycles (16.9%), scooters (3.8%), other PMDs (roller blades, skateboards, monowheels, gyropods and hoverboards; 0.4%) and motorised two wheelers (21.4%), or drivers of car (45.3%), and truck (1.5%). More than half of the scooter riders and 80% of other PMD riders were men. More than 60% of other PMD riders and 53% of scooter riders were under 34 years of age. Most scooter road accidents occurred during commuting (95.6%). 65% of the scooter accidents and 50% of other PMD accidents did not have opponents. Overall, one-quarter of the victims experienced accidents without opponents. Most scooter riders had injuries to their upper limbs (59.2%), lower limbs (46.8%), face (21.2%) or head (17.9%). DISCUSSION: This original study on work-related road accidents allowed us to characterise the increase in work-related road accidents associated with new modes of travel, particularly scooters. The results observed for users of scooters and other PMDs in this study were generally consistent with those found in the scientific literature. Despite limited data, the results suggest that accidents involving scooters or other PMDs are of low severity. CONCLUSION: Many head injuries could be prevented with more widespread use of helmets, among scooter and other PMD users and bicycle users.
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BACKGROUND: The iron and steel industries are among the most dangerous workplaces in the world compared to other manufacturing industries. Workers are exposed to multiple occupational hazards, which predispose them to high risks of both fatal and non-fatal injuries. Currently, the data on the global prevalence and associated risk factors for occupational injuries in the iron and steel industries is fragmented and incomplete. This study was undertaken to address this issue by pooling data relating to the prevalence of occupational injuries and its associated factors among workers in iron and steel industries studies around the world. METHODS: The search was conducted systematically using PubMed, HINARI, EMBASE and Google Scholar for published studies in English that reported on occupational injuries and associated risk factors among workers in iron and steel industries. MetaXL version 5.3 software was used in the meta-analysis to estimate the pooled prevalence of occupational injuries and associated risk factors among workers in the iron and steel industries. The study protocol has been registered with PROSPERO, number CRD42022344258. RESULTS: Of the 447 articles identified, 15 studies from 9 countries met the inclusion criteria. The pooled prevalence estimate of occupational injury was 0.55 (95% CI: 0.15, 0.93). The pooled results indicated that the odds of having an occupational injury were 4.06 times higher among workers who did not use personal protective equipment compared to those who used such equipment. Likewise the odds of occupational injuries was increased by 1.65 among night shift workers compared to the counterpart. CONCLUSIONS: The global prevalence of occupational injuries in iron and steel industries was 55%. The results indicate that night work shift and the lack of use of personal protective equipment has a higher impact than other factors in the occurrence of occupational injuries in the iron and steel industries.
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Metalurgia , Traumatismos Ocupacionais , Humanos , Ferro , Metalurgia/estatística & dados numéricos , Traumatismos Ocupacionais/epidemiologia , Prevalência , Fatores de Risco , AçoRESUMO
INTRODUCTION: Fall injuries are the second leading cause of traumatic injury and death for all US workers and are a leading injury concern for the Department of the Air Force (DAF). Bundled interventions can improve the likelihood of injury reduction, especially in large, heterogeneous working populations. In 2013, the DAF implemented the "Air Force Fall Prevention Focus," a bundled intervention of prevention efforts designed to reduce occupational fall injury events among DAF members. The purpose of this study is to describe the burden and risk factors associated with fall injuries and evaluate the effectiveness of the Fall Prevention Focus in reducing the burden of fall injuries. METHODS: The National Institute for Occupational Safety and Health (NIOSH) partnered with the US Air Force Safety Center (AFSEC) to examine the impact of the Fall Prevention Focus as a bundled intervention. Injury events included a narrative description of the injury event, demographics, work environment, job tasks, and other structured details. Descriptive statistics and pre-post longitudinal modeling were used to evaluate changes in fall injury rates. RESULTS: The Fall Prevention Focus Implementation (2013-2018) resulted in an annual 10.4% (95% confidence interval [CI]: 8.5%, 12.2%) reduction, and a 6-year cumulative 48.3% (95% CI: 41.4%, 54.3%) reduction in fall injury event rates by 2018. DISCUSSION: Safety in the DAF involves a comprehensive approach. Documenting the impact of the Fall Prevention Focus may help translate these findings to improve fall prevention efforts in other sectors of the military and high fall-risk industries in the private sector, such as construction.
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BACKGROUND: Hospital patient-care workers have high occupational injury rates. While physical hazards within hospital work environments are established determinants of injury, social exposures may also contribute. This study examined how reports of unfair treatment at work, a dimension of work-related experiences of discrimination, were associated with injury among hospital-based patient-care workers. METHODS: We used data from the Boston Hospital Workers Health Study, a longitudinal cohort of nurses and nursing assistants at two Boston-area hospitals. In 2018, we conducted a worker survey asking about three types of unfair treatment at work and occupational injuries during the past year. We used mixed-effects logistic regression models to evaluate associations between specific types, total load, and high-frequency exposure of unfair treatment with injury, adjusting for age, gender, race and ethnicity, job title, and unit type. RESULTS: Among 1001 respondents, 21% reported being humiliated in front of others at work, 28% reported being watched more closely than other workers, and 47% reported having to work twice as hard as others for the same treatment. For each type of unfair treatment, we observed a monotonic relationship with occupational injury wherein increasing frequency of exposure was associated with increased odds of injury. We also observed monotonic relationships between total load and high-frequency exposure to unfair treatment and odds of injury. CONCLUSIONS: Work-related unfair treatment is associated with injury among hospital workers. Programs and policies that focus on preventing unfair treatment may lessen injury burden in hospital workers.
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Traumatismos Ocupacionais , Humanos , Masculino , Feminino , Adulto , Traumatismos Ocupacionais/epidemiologia , Pessoa de Meia-Idade , Boston/epidemiologia , Estudos Longitudinais , Inquéritos e Questionários , Recursos Humanos de Enfermagem Hospitalar/estatística & dados numéricos , Recursos Humanos de Enfermagem Hospitalar/psicologia , Assistentes de Enfermagem/estatística & dados numéricos , Preconceito , Local de Trabalho/estatística & dados numéricosRESUMO
INTRODUCTION: In 2014, the Federal Occupational Safety and Health Administration (OSHA) enacted a standard requiring employers to report work-related amputations to OSHA within 24 hours. We studied the characteristics of the injured workers and employer compliance with the regulation in Michigan. METHODS: Two independent data sets were used to compare work-related amputations from 2016 to 2018: employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS). We deterministically linked employer reports to OSHA with the MMSIISS by employee name, employer name, date, and type of amputation. RESULTS: We identified 1366 work-related amputations from 2016 to 2018; 575 were reported by employers to OSHA and 1153 were reported by hospitals to the MMSIISS. An overlap of 362 workers were reported in both systems, while 213 workers were only reported by employers to OSHA and 791 workers were only reported by hospitals. Employer compliance with the regulation was 42.1%. Employer compliance with reporting was significantly less in: agriculture, forestry, fishing, and hunting (14.6%); construction (27.4%); retail trade (20.7%); arts, entertainment, and recreation (7.7%); accommodation and food services (13.0%); and other services (27.0%). Large employers and unionized employers were significantly more likely (67.9% and 92.7%, respectively) and small employers were significantly less likely (18.2%) to comply with the reporting rule. Enforcement inspections at 327 workplaces resulted in 403 violations; of those, 179 (54.7%) employers had not corrected the amputation hazard before the time of inspection. DISCUSSION: Michigan employers reported less than half of the work-related amputations required by OSHA's reporting regulation. Noncompliance was greatest in small employers, and agriculture, forestry, fishing, and hunting; construction; arts, entertainment, and recreation; accommodation and food services; and retail and other service industries. Inspections found that over half of the employers had not corrected the hazard that caused the amputation at the time of the inspection's initial opening date; in these cases, abatement of any hazards identified would have occurred after the inspection. Improved compliance in employer reporting of work-related amputations will identify hazards posing a high risk of recurrence of injury to other workers from the same injury source. Greater compliance can also help target safety-related preventive and intervention efforts in industries that might otherwise be overlooked.
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Traumatismos Ocupacionais , Local de Trabalho , Estados Unidos , Humanos , United States Occupational Safety and Health Administration , Michigan/epidemiologia , Traumatismos Ocupacionais/epidemiologia , IndústriasRESUMO
PURPOSE: Based on the theoretical framework of the Model of Preventive Behaviours at Work, the aim of this study was to describe the the occupational rehabilitation strategies the literature reports that support workers who have suffered an occupational injury in adopting preventive behaviours. METHODS: To conduct this scoping review, we used a systematic methodology in 7 steps : (1) definition of the research question and inclusion/exclusion criteria; (2) scientific and gray literature search; (3) determination of manuscripts' eligibility; (4) extraction and charting of information; (5) quality assessment; (6) interpretation; and (7) knowledge synthesis. RESULTS: We selected 46 manuscripts of various types (e.g. randomized trials, qualitative studies, governmental documents). Manuscripts were mainly of good or high quality according to our quality assessment. The strategies for coaching, engaging, educating and collaborating were mostly reported in the literature to support the development of the six preventive behaviours during occupational rehabilitation. The results also suggest that heterogeneity exists regarding the specificity of the strategies reported in the literature, which may have hindered our ability to provide rich and detailed descriptions. Literature also mainly describes individually oriented behaviours and reports strategies requiring a low level of worker involvement, which represent issues to adress in future researh projects. CONCLUSION: The strategies described in this article reprensent concrete levers that occupational rehabilitation professionals can use to support workers in the adoption of preventive behaviours at work on return from having suffered an occupational injury.
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Tutoria , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/prevenção & controle , Fatores de RiscoRESUMO
BACKGROUND: Although occupational injuries among building construction workers are a major public health concern, limited studies have focused on the prevalence and factors associated with injuries among building construction workers in sub-Saharan Africa. Accordingly, this study investigates the prevalence and factors associated with occupational injuries among building construction workers in the Gambia. METHOD: Using a cross-sectional design, 504 building construction workers with more than 12 months of work experience in the construction industry and aged ≥18 years were recruited from 22 registered companies in the Kanifing Municipality of the Gambia. Data were collected using a structured questionnaire and an observational checklist. RESULTS: More than 56% of the building construction workers reported sustaining work-related injuries in the past 12 months. Majority of injuries reported were abrasions/lacerations (28.2%), followed by cuts (26.6%), backaches (23.8%) and piercing/punctured wounds (22.8%). Results of the multivariate logistic regression analysis showed that being male worker (adjusted OR (aOR), 3.06; 95% CI 1.31 to 7.19), had <8 hours of work daily (aOR 3.46, 95% CI 1.44 to 7.78), smoke tobacco (aOR 1.97; 95% CI 1.36 to 2.85) and consume alcohol (aOR 0.27; 95% CI 0.08 to 0.95) were significantly associated with injuries from building construction work. CONCLUSION: Our findings show that injuries among building construction workers are prevalent in the Gambia. Male gender, work hours, tobacco use and alcohol consumption were associated with occupational injuries in building construction. Introducing and enforcing workplace safety policies in the building construction industry may help reduce occupational injury among construction workers in the Gambia.
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Indústria da Construção , Traumatismos Ocupacionais , Humanos , Masculino , Adolescente , Adulto , Feminino , Traumatismos Ocupacionais/epidemiologia , Traumatismos Ocupacionais/prevenção & controle , Prevalência , Estudos Transversais , Gâmbia/epidemiologiaRESUMO
BACKGROUND: This study aimed to investigate the characteristics of occupational injuries based on fatality, sex, and classification of occupations among construction workers using workers' compensation (WC) insurance data in South Korea. METHODS: We collected WC insurance data from the Korea Workers' Compensation & Welfare Service for all construction workers between 2009 and 2018. Data from 158,947 accepted claims for occupational injury were extracted, and the demographic features, occupational injury types, and annual trends were analyzed for fatal and nonfatal cases. The annual incidence and mortality trends of occupational injury were estimated using negative binomial regression and Poisson regression models, for injury incidence and mortality respectively. RESULTS: Among a total of 158,947 occupational injury cases, there were 155,772 (98%) nonfatal injuries and 3175 (2%) fatal injuries. For all occupational injuries, Construction Elementary Workers (6th Korean Standard Classification of Occupations (KSCO) 910; 45.7%) was the most frequent occupation, followed by Construction-Related Technical Workers (6th KSCO 772; 39.2%). The most frequent injury type was a fracture, followed by ruptures or lacerations and contusions. The incidence of all occupational injuries increased from 700.36 per 100,000 persons in 2009 to 1,195.98 per 100,000 persons in 2018. Further, deaths from injuries at work followed a significantly increasing annual trend [mortality rate ratio 1.04 (95% CI: 1.03-1.05)] from 2009 to 2018. CONCLUSION: The over two-thirds increased incidence of occupational injuries and significantly increasing mortality trends for occupational injuries during the last 10 years indicate the need for aggressive intervention in occupational safety and health management within the Korean construction industry.
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Indústria da Construção , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/epidemiologia , Ocupações , República da Coreia/epidemiologia , Indenização aos Trabalhadores , Acidentes de TrabalhoRESUMO
BACKGROUND: The Occupational Safety and Health Administration (OSHA) implemented a new standard in 2014 requiring employers to report nearly all work-related inpatient hospitalizations within 24 h of the event. We examined the characteristics of the injured workers who were reported and the compliance of Michigan employers with the regulation. METHODS: From 2016 to 2018, we compared reports of acute nonmotor-vehicle work-related injuries and illnesses from two independent datasets, employer reports to OSHA and the Michigan Multi-Source Injury and Illness Surveillance System (MMSIISS) which collects injured worker hospital records from the 134 hospitals in Michigan. We matched records from employer reports to OSHA with the MMSIISS by employee's first and last name, company name, date of injury/illness, and type of injury/illness. RESULTS: We identified 2887 workers hospitalized with severe injuries/illnesses from 2016 to 2018 in Michigan; 1260 workers were reported by employers to OSHA and 2238 workers were reported by hospitals to the MMSIISS. There was an overlap of 611 workers reported in both systems, while 649 workers were only reported by employers to OSHA and 1627 workers were only reported by hospitals to the MMSIISS. Employer compliance with the regulation over the 3 years showed a nonsignificant increase; from 42.0% to 43.6% to 45.0%. Fractures were the most frequent type of injury (1238, 42.9%), then head injuries, including skull fractures (470, 16.3%). The median length of hospital stay was 3 days. Manufacturing (709, 25.5%) and construction (563, 20.3%), accounted for the greatest number of hospitalizations. Employer-reported cases to OSHA significantly undercounted hospitalized workers in agriculture, forestry, fishing, and hunting; construction; finance and insurance; real estate and rental and leasing; administrative and support and waste management and remediation services; arts, entertainment, and recreation; accommodation and food services; and other services except public administration. Companies with 250 or more employees were significantly more likely to comply and small companies with 10 or fewer employees were significantly less likely to comply with the reporting rule. Enforcement inspections at 465 of the workplaces where a hospitalization had occurred resulted in $1,017,835 in fines and identified 608 violations. Of the 465 inspections, 246 (52.9%) of the employers had not corrected the hazard before the inspection. CONCLUSIONS: This study identified that workers sustained severe injuries and illnesses on the job and that over half of the companies where a worker suffered an injury/illness leading to hospitalization were not in compliance with OSHA's reporting regulation. Furthermore, at the time of an inspection 1-5 months later, 50% of the companies had not corrected the hazard causing the hospitalization. Improvement in the reporting of work-related injuries/illnesses that result in hospitalization will identify more ongoing hazards in the workplace and improve where to focus preventive actions.
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Traumatismos Ocupacionais , Estados Unidos , Humanos , Traumatismos Ocupacionais/epidemiologia , United States Occupational Safety and Health Administration , Hospitalização , Local de Trabalho , Michigan/epidemiologiaRESUMO
Vigorous legislative activity both for and against paid sick leave has occurred over the last decade. Although a compelling body of evidence suggests that paid sick leave supports personal and public health goals, a notable barrier in opposition to paid sick leave is apprehension about the potential short-term and long-term harms to business. This review critically assesses the relationship between paid sick leave and favorable or unfavorable business conditions. Utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we systematically review six research databases between 2000 and November 2022. Of 2664 studies identified, 123 were considered potentially relevant and 43 were included in the review. In addition to absence from work, paid sick leave was associated with favorable business conditions such as increased job satisfaction; improved retention; and reductions in occupational injury, contagion, presenteeism, and death; as well as some measures of firm performance and labor market conditions. Overall, our review discovered more evidence supporting the relationship between paid sick leave and favorable business conditions as compared with evidence that supported unfavorable business conditions. Although more research is needed, these findings can be used to inform firm-level and public policy decisions about paid sick leave.
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Traumatismos Ocupacionais , Licença Médica , Humanos , Salários e Benefícios , Política Pública , PresenteísmoRESUMO
BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic greatly affected healthcare workers, both physically and psychologically, by increasing their workload and stress. This may also have increased their risk of occupational injuries. This study analyzed workers' compensation (WC) claims among California nursing care facility workers during 2019-2021, to assess the impact of the pandemic on occupational injury risk. METHODS: This study used data from the California Workers' Compensation Information System. WC claims in prepandemic and pandemic periods were described and compared between nursing care facilities and other settings. Nursing facility cases were described by demographic, job, and injury characteristics. RESULTS: In 2019-2021, we identified 41,134 claims as nursing facility cases in California. Annual claims increased by 64.6% from 2019 to 2020 and then decreased in 2021, returning to levels similar to pre-COVID. In contrast, non-healthcare settings had decreases in claims during the pandemic. COVID-related claims accounted for 50.5% of claims in nursing facilities in 2020-2021; this proportion was much higher compared with other healthcare (35.7%) or nonhealthcare settings (14.3%). Non-COVID claims decreased during the pandemic but mental disorder or stress claims increased in nursing facilities, particularly in 2020 (+42.5%). CONCLUSIONS: Our findings show that nursing care facilities were more severely affected by the pandemic than other settings. We did not find evidence of an increased risk of occupational injuries during the pandemic, except for increased claims for stress or mental disorders. Our findings indicate a clear need to address psychological stress and mental health among nursing facility workers during a pandemic.
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COVID-19 , Cuidados de Enfermagem , Traumatismos Ocupacionais , Humanos , Traumatismos Ocupacionais/epidemiologia , Indenização aos Trabalhadores , COVID-19/epidemiologia , California/epidemiologiaRESUMO
PURPOSE: Injured workers can experience adverse effects from work injury and claims processes.Workers may be treated unfairly by employers, compensation boards, and return-to-work coordinators; however,how workers respond to these challenges is unknown. This article describes how injured precarious workersresponded behaviourally and emotionally to procedural unfairness in work injury and claims processes, and whatworkers did next. METHODS: Interviews were conducted with thirty-six precariously employedinjured workers recruited in Ontario through social media, email, cold calling, word-of-mouth, and the "snowball"method. Thematic code summaries were analyzed to identify how precarious workers responded to procedural unfairness. RESULTS: Workers went through all or most of these five stages (not always linearly)when faced with procedural unfairness: (1) passive, (2) fought back, (3) quit pursuit of claim, (4) quit job, and (5)won or got further in fight. Feeling confused, angry, frustrated, unsupported, disappointed, determined, optimistic,and wary were common emotions. CONCLUSIONS: Identifying unfairness and its emotional,behavioral, and material effects on workers is important to understand implications for compensation systems.Understanding and recognizing unfairness can equip employers, legal representatives, compensation boards, andphysicians, to address and prevent it, and provide worker resources. Policy changes can ensure accountability andconsequences to unfairness initiators.