The association between safety climate and noncombat injury events among United States Air Force workers.

INTRODUCTION: Work-related injuries are a common lagging safety indicator whereas safety climate assessments can help identify constructs serving as leading indicators. The National Institute for Occupational Safety and Health (NIOSH) partnered with the U.S. Department of the Air Force (DAF) Safety Center to examine the association between perceptions of safety climate survey constructs and the number of injury events within the DAF workforce. METHODS: The DAF administers voluntary, anonymous, occupation-specific safety climate surveys to DAF workers using the internal Air Force Combined Mishap Reduction System (AFCMRS). Survey responses from 2014 to 2018 provided by DAF workers and injury events in maintenance, support, and operations occupations were shared with NIOSH. Exploratory Factor Analysis revealed five constructs: Leadership and Communication; Organizational Safety Priority; Error Management; Resource Adequacy; and Deployment/Official Travel Impact. Squadron-level analysis included bivariate correlations and estimated Rate Ratios (RRs). RESULTS: 1,547 squadrons administered the survey, averaging 144 workers and 15.8 reportable injuries per squadron. Higher (more favorable) squadron-level construct scores were consistently correlated with fewer reported injuries (p < 0.001). Controlling for the number of workers, RRs revealed significant reductions in injury rates with each one-unit increase in responses: Leadership and Communication RR = 0.40 (95%CI: 0.32-0.48); Organizational Safety Priority RR = 0.50 (95%CI: 0.40-0.64); Error Management RR = 0.37 (95%CI: 0.30-0.47); Deployment/Official Travel Impact RR = 0.36 (95%CI: 0.29-0.45). Resource Adequacy revealed a non-significant lower injury rate RR = 0.87 (95%CI: 0.73-1.04). CONCLUSIONS: This unique study quantified safety climate and the association with injuries across a multi-year period. While safety climate measurements may be limited by frequent turnover and the self-reported, voluntary, anonymous nature of AFCMRS, the strength of this study is in the census of injuries. PRACTICAL APPLICATIONS: Future research should include longitudinal analyses to examine the impact on injuries when squadron leaders are provided feedback on safety climate survey results.

Comparison of Finger, Hand, and Wrist Injuries in the US Air Force to US Workers.

OBJECTIVE: Fingers, hands, and wrists (FHW) are the most frequently injured body parts in work-related injuries. This study described and compared FHW injuries among enlisted, officer, and civilian US Air Force (USAF) personnel to those in the US workforce. METHODS: All work-related, noncombat FHW injuries (≥1 lost workday) and demographics among USAF personnel and US workforce (2008-2018) were included. The USAF FHW injury rates were age adjusted to the US employment and compared by sex, source, event, and nature of the injuries. RESULTS: Finger, hand, and wrist injuries were significantly lower among the USAF personnel and among females. In both populations, FHW injuries from falls were higher and increased with age group among females. Males had higher overall FHW injuries from contact with objects and equipment. CONCLUSIONS: Prevention efforts should focus on understanding risk factors and sharing successful prevention activities.

Resistance-Related Injuries Among Law Enforcement Officers: Addressing the Empirical Gap.

INTRODUCTION: Officers can be unintentionally injured during officer-suspect interactions, and these injuries are often not coded as assaults. This article defines and enumerates injuries that officers sustain while chasing, detaining, arresting, or pursuing suspects. These are termed resistance-related injuries. METHODS: Data on law enforcement officer injuries treated in U.S. emergency departments were obtained from the National Electronic Injury Surveillance System-Occupational Supplement from 2012 to 2017. Resistance-related injuries were defined using the Bureau of Labor Statistics Occupational Injury and Illness Classification System, version 2.01. Injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2019. RESULTS: Between 2012 and 2017, an estimated 303,500 officers were treated in U.S. emergency departments for nonfatal injuries for an overall injury rate of 568 per 10,000 full-time equivalents. Emergency department-treated injuries significantly decreased by 3.8% annually during this time period (p<0.0001). The leading causes of injury were assaults and violent acts (48%), transportation incidents (11%), and falls (11%). Of the total injuries, more than half were resistance-related (53%). A total of 88% of violence-related injuries, nearly 50% of falls, and 31% of overexertion injuries were considered resistance related. CONCLUSIONS: More than half of officers' nonfatal injuries occurred when they were interacting, detaining, or pursuing a suspect. This highlights the need to code nonfatal injuries in a consistent and meaningful way that informs police policy and practice.

The impact of a crash prevention program in a large law enforcement agency.

BACKGROUND: Motor vehicle crashes (MVCs) remain a leading cause of death for US law enforcement officers. One large agency implemented a crash prevention program with standard operating policy changes, increased training, and a marketing campaign. This was a scientific evaluation of that crash prevention program. METHODS: MVC and motor vehicle injury (MVI) data for law enforcement officers were compared using an autoregressive integrated moving average (ARIMA) model. Two law enforcement agencies who had not implemented a crash prevention program were controls. RESULTS: After program implementation, overall, MVC rates significantly decreased 14% from 2.2 MVCs per 100 000 miles driven to 1.9 (P = .008). MVC rates did not decrease in the control agencies. Overall, MVI rates significantly decreased 31% from 3.4 per 100 officers to 2.1 (P = .0002). MVC rates did not decrease in the control agencies. MVC rates for patrol officers significantly decreased 21% from 3.1 per 100 000 miles to 2.4. MVI rates for patrol officers significantly decreased 48% from 3.2 per 100 officers to 1.6 (P < .0001). CONCLUSIONS: Crash and injury rates can be reduced after implementation of a crash prevention program and the largest impacts were seen in patrol officers.

Identifying high-risk areas for nonfatal opioid overdose: a spatial case-control study using EMS run data.

PURPOSE: The objective of our study was to incorporate stricter probable nonfatal opioid overdose case criteria, and advanced epidemiologic approaches to more reliably detect local clustering in nonfatal opioid overdose activity in EMS runs data. METHODS: Data were obtained using emsCharts for our study area in southwestern Pennsylvania from 2007 to 2018. Cases were identified as emergency medical service (EMS) responses where naloxone was administered, and improvement was noted in patient records between initial and final Glasgow Coma Score. A subsample of all-cause EMS responses sites were used as controls and exact matched to cases on sex and 10-year-age category. Clustering was assessed using difference in Ripley's K function for cases and controls and Kulldorff scan statistics. RESULTS: Difference in K functions indicated no significant difference in probable nonfatal overdose EMS runs across the study area compared to all-cause EMS runs. However, scan statistics did identify significant local clustering of probable nonfatal overdose EMS runs (maximum likelihood = 16.40, P = 0.0003). CONCLUSIONS: Results highlight relevance of EMS data to detect community-level overdose activity and promote reliable use through stricter case definition criteria and advanced methodological approaches. Techniques examined have the potential to improve targeted delivery of neighborhood-level public health response activities using a near real-time data source.

Nonfatal Injuries to Firefighters Treated in U.S. Emergency Departments, 2003-2014.

INTRODUCTION: Several studies of nonfatal firefighter injuries have been conducted but are limited by the inclusion criteria used and coverage. The aim of this study was to enhance current knowledge by providing national estimates of nonfatal injuries to firefighters treated in U.S. emergency departments. METHODS: Nonfatal injuries from 2003 through 2014 were extracted from the National Electronic Injury Surveillance System occupational supplement (NEISS-Work). NEISS-Work captures nonfatal occupational injuries, illnesses, and exposures treated in a sample of U.S. emergency departments. Nonfatal injury rates were calculated based on NEISS-Work counts (numerator) and counts from the National Fire Protection Association (denominator). Data were analyzed from 2016 through 2017. RESULTS: Between 2003 and 2014, an estimated 351,800 firefighters were treated in emergency departments for nonfatal injuries. The overall rate was 260 injuries per 10,000 firefighters. Career firefighters had an annual rate of 699 injuries per 10,000 firefighters; volunteers had a rate of 39 injuries per 10,000 firefighters. Leading injury events were fires and explosions (36%) and overexertion and bodily reactions (20%). A majority (38%) of injuries occurred during firefighting activities, 7% occurred during training, and 7% occurred during patient care. Sprains and strains accounted for the largest proportion of injuries in all three of these activities: 28% firefighting activities, 32% training, and 36% patient care. CONCLUSIONS: The results demonstrate that nonfatal injuries for firefighters remained high throughout the study period. The predominance of sprains and strains in all firefighting activities suggests the need for additional research and prevention needs in areas of improved fitness, safer body postures and movements, and situational awareness.

Nonfatal Injuries to Law Enforcement Officers: A Rise in Assaults.

INTRODUCTION: Limited studies exist that describe nonfatal work-related injuries to law enforcement officers. The aim of this study is to provide national estimates and trends of nonfatal injuries to law enforcement officers from 2003 through 2014. METHODS: Nonfatal injuries were obtained from the National Electronic Injury Surveillance System-Occupational Supplement. Data were obtained for injuries treated in U.S. emergency departments from 2003 to 2014. Nonfatal injury rates were calculated using denominators from the Current Population Survey. Negative binomial regression was used to analyze temporal trends. Data were analyzed in 2016-2017. RESULTS: Between 2003 and 2014, an estimated 669,100 law enforcement officers were treated in U.S. emergency departments for nonfatal injuries. The overall rate of 635 per 10,000 full-time equivalents was three times higher than all other U.S. workers rate (213 per 10,000 full-time equivalents). The three leading injury events were assaults and violent acts (35%), bodily reactions and exertion (15%), and transportation incidents (14%). Injury rates were highest for the youngest officers, aged 21-24 years. Male and female law enforcement officers had similar nonfatal injury rates. Rates for most injuries remained stable; however, rates for assault-related injuries grew among law enforcement officers between 2003 and 2011. CONCLUSIONS: National Electronic Injury Surveillance System-Occupational Supplement data demonstrate a significant upward trend in assault injuries among U.S. law enforcement officers and this warrants further investigation. Police-citizen interactions are dynamic social encounters and evidence-based policing is vital to the health and safety of both police and civilians. The law enforcement community should energize efforts toward the study of how policing tactics impact both officer and citizen injuries.