Fuzzy approach for reducing subjectivity in estimating occupational accident severity.

Quantifying or, more generally, estimating the severity of the possible consequences of occupational accidents is a decisive step in any occupational risk assessment process. Because of the lack of historic information (accident data collection and recording are incipient and insufficient, particularly in construction) and the lack of practical tools in the construction industry, the estimation/quantification of occupational accident severity is a notably arbitrary process rather than a systematic and rigorous assessment. This work proposes several severity functions (based on a safety risk assessment) to represent biomechanical knowledge with the aim of determining the severity level of occupational accidents in the construction industry and, consequently, improving occupational risk assessment quality. We follow a fuzzy approach because it makes it possible to capture and represent imprecise knowledge in a simple and understandable way for users and specialists.

Intensity and localization of trauma in non-fatal electrical injuries.

BACKGROUND: Electrical injuries currently remain a worldwide problem. In Turkey, burns are relatively small in number among injuries overall, but they continue to be a major public health problem. Electrical injuries may occur due to high- or low-voltage contact. Injuries due to low voltage usually occur at home. High-voltage injuries are usually work-related and result from a shorter contact, but may cause serious tissue destruction and secondary injuries. METHODS: The objective of this study was to review a medical institution's experience with electrical injuries between 1997-2005. The institution admitted 55 electrical injury cases throughout this period. A computerized burns registry was used for data collection and analysis. RESULTS: The burn causes differed among age groups and between the sexes, with males constituting 89.1% of the electrical burn patients. Forty-one of the injuries were due to high voltage whereas 14 injuries were due to low voltage. Complications were most common in the high-voltage group. Mean length of stay was longest in this group, at 33.69+/-21.13 days, and the patients in this group also required the most operations. CONCLUSION: Work-related activity was responsible for the majority of these high-voltage injuries, with the most common occupations being linemen and electricians. These patients tended to be younger men in the prime of their working lives. Our study underlines the need for stronger efforts aimed at prevention, such as better public education and strict regulations regarding the distribution and use of electricity.

Etiology of work-related electrical injuries: a narrative analysis of workers' compensation claims.

The purpose of this study was to provide new insight into the etiology of primarily nonfatal, work-related electrical injuries. We developed a multistage, case-selection algorithm to identify electrical-related injuries from workers' compensation claims and a customized coding taxonomy to identify pre-injury circumstances. Workers' compensation claims routinely collected over a 1-year period from a large U.S. insurance provider were used to identify electrical-related injuries using an algorithm that evaluated: coded injury cause information, nature of injury, "accident" description, and injury description narratives. Concurrently, a customized coding taxonomy for these narratives was developed to abstract the activity, source, initiating process, mechanism, vector, and voltage. Among the 586,567 reported claims during 2002, electrical-related injuries accounted for 1283 (0.22%) of nonfatal claims and 15 fatalities (1.2% of electrical). Most (72.3%) were male, average age of 36, working in services (33.4%), manufacturing (24.7%), retail trade (17.3%), and construction (7.2%). Body part(s) injured most often were the hands, fingers, or wrist (34.9%); multiple body parts/systems (25.0%); lower/upper arm; elbow; shoulder, and upper extremities (19.2%). The leading activities were conducting manual tasks (55.1%); working with machinery, appliances, or equipment; working with electrical wire; and operating powered or nonpowered hand tools. Primary injury sources were appliances and office equipment (24.4%); wires, cables/cords (18.0%); machines and other equipment (11.8%); fixtures, bulbs, and switches (10.4%); and lightning (4.3%). No vector was identified in 85% of cases. and the work process was initiated by others in less than 1% of cases. Injury narratives provide valuable information to overcome some of the limitations of precoded data, more specially for identifying additional injury cases and in supplementing traditional epidemiologic data for further understanding the etiology of work-related electrical injuries that may lead to further prevention opportunities.

Safety and injury profile of conducted electrical weapons used by law enforcement officers against criminal suspects.

STUDY OBJECTIVE: Conducted electrical weapons such as the Taser are commonly used by law enforcement agencies. The safety of these weapons has been the subject of scrutiny and controversy; previous controlled studies in animals and healthy humans may not accurately reflect the risks of conducted electrical weapons used in actual conditions. We seek to determine the safety and injury profile of conducted electrical weapons used against criminal suspects in a field setting. METHODS: This prospective, multicenter, observational trial tracked a consecutive case series of all conducted electrical weapon uses against criminal suspects at 6 US law enforcement agencies. Mandatory review of each conducted electrical weapon use incorporated physician review of police and medical records. Injuries were classified as mild, moderate, or severe according to a priori definitions. The primary outcome was a composite of moderate and severe injuries, termed significant injuries. RESULTS: Conducted electrical weapons were used against 1,201 subjects during 36 months. One thousand one hundred twenty-five subjects (94%) were men; the median age was 30 years (range 13 to 80 years). Mild or no injuries were observed after conducted electrical weapon use in 1,198 subjects (99.75%; 95% confidence interval 99.3% to 99.9%). Of mild injuries, 83% were superficial puncture wounds from conducted electrical weapon probes. Significant injuries occurred in 3 subjects (0.25%; 95% confidence interval 0.07% to 0.7%), including 2 intracranial injuries from falls and 1 case of rhabdomyolysis. Two subjects died in police custody; medical examiners did not find conducted electrical weapon use to be causal or contributory in either case. CONCLUSION: To our knowledge, these findings represent the first large, independent, multicenter study of conducted electrical weapon injury epidemiology and suggest that more than 99% of subjects do not experience significant injuries after conducted electrical weapon use.

Diffuse electrical injury: a study of 89 subjects reporting long-term symptomatology that is remote to the theoretical current pathway.

Historically, tissue damage from electrical contact was thought to arise from resistive heating of tissues along the current pathway. The modern view has accepted that tissue damage can result from cellular rupture (electroporation) induced by the presence of an electric field. There remain electrical injuries that defy explanation by either theory. In rare electrical contacts, diffuse symptomatology arises that is neither proportionate to the electrical contact nor does it occur along the theoretical linear pathway of the current from entry point to exit point. Disproportionate, remote electrical injury is most notable when the contact voltage is low (120 and 240 V). Symptoms occur, absent diagnostic evidence, that defy explanation as organic injury. A Web-based interactive survey was used to locate and query individuals suffering from rarely occurring responses to electrical contact. The results of the study suggest that there is a common symptomatology that is neither linked to voltage nor loss of consciousness at the time of contact.

[Fatal electric arc accidents due to high voltage]. / Tödliche Störlichtbogenunfälle im Hochspannungsbereich.

The frequency of electric arc accidents has been successfully reduced owing to preventive measures taken by the professional association. However, the risk of accidents has continued to exist in private setting. Three fatal electric arc accidents caused by high voltage are reported with reference to the autopsy findings.

Development of an occupational illness and injury surveillance database for the electric energy sector.

Currently available occupational injury and illness data for electric energy companies provide only overall summary rates. Specific information about types of injury or illnesses, rates by occupational or work environments, and injury costs and severity are generally not readily available. Relevant data such as personnel and claims information are frequently not integrated into a comprehensive health and safety surveillance system suitable for epidemiologic and health and safety research purposes. Epidemiological methods are valuable for identifying key risk factors for work-related injuries and illnesses and assessing their magnitude, as well establishing priorities for health and safety research. Application of such methods can result in long-term reductions in injury and illness rates and their attendant costs. Aggregation of relevant health and safety data across companies improves statistical power for the assessment of rare (yet costly) injuries or illness or specific at-risk subgroups within the electric energy sector. A pilot occupational injury and illness database has been developed that can incorporate and standardize data across a spectrum of companies of differing sizes and configurations. In illustrative data analyses, injury trends were summarized by company size, occupation, and demographic factors, among others. Trends observed in these illustrative analyses were consistent with results previously reported in the epidemiological literature, however, results are considered preliminary pending development of the full database. This study shows that development of a standardized surveillance occupational injury and illness database across companies with different database configurations is feasible. This database will ultimately provide a stable and accurate occupational health and safety assessment tool not currently available for this sector.

Classification of fatal occupational electrocutions.

The objective of this study was to describe fatal occupational electrocutions that occurred in Quebec between 1981 and 1988 and propose a classification suitable for setting up a prevention agenda. Of 63 fatalities, an investigation report was available in 57 (90.5%). They all occurred among males, 70.2% of whom were under the age of 35; 49.1% were performing a task related to the construction sector. A principal factor analysis allowed classification of 90.2% of the fatalities in two categories: victims assigned to electrical tasks indoors and those assigned to non-electrical tasks outdoors. The first group (56.5% of the cases) were electrocuted by direct contact with voltage less than 10 Kvolts and the second by the intermediary of a vector with voltage above 10 Kvolts. The identification of the two patterns of electrocutions provided an additional argument for shifting recommendations for prevention from educating the workers, to reducing the electrical hazards at the source.

Lightning injuries.

Lightning kills or injures thousands of people in the United States each year. Injuries are caused by the effects of electrical, thermal and mechanical energy, and a wide range of clinical results, involving multiple body systems, is possible. Important differences exist between lightning victims and patients injured by fire or by other forms of electricity. In lightning victims, successful resuscitation is highly likely, even among patients with conventional signs of brain death. With proper management, long-term physical and psychologic sequelae of lightning injury are rare.

Electric shock.

The problems of electrical phenomena striking the human body have been with us since early man observed the effect of lightning. The first generator was invented in the early 19th century, and commercial electricity generation began in 1849. By the early 1900s death from electric shock had been well described and its effect was thought to be irreversible. During the 1960s studies began to show that with prolonged resuscitation survival is possible.

Electrical injuries, with special reference to the upper extremities. A review of 182 cases.

A twenty year experience in the management of 182 patients with electrical injuries has been reviewed. Males predominate. The average age is thirty-six years. Bodily contact with high tension wires by linemen constituted the most common accidents. High voltage injuries were sustained by 67% of patients. Burns were sustained by 74% of our cases and of these, 71% involved the upper extremities. Complications developed in three fourths of patients, and one third of patients suffered some degree of permanent disability. Mortality (2.1%) was largely due to septicemia, pneumonia, and renal failure. The wide variety of injuries necessitates individualization in treatment. Prevention offers greatest hope in management.