Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States.

Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.

Analytical observational study of nonfatal motor vehicle collisions and incidents in a light-vehicle sales and service fleet.

Motor vehicle crashes (MVCs) are a significant cause of lost-workday injuries, and consistently the leading cause of work-related fatalities in the United States for all industries combined. Prevention research has focused mainly on collisions fatal to the drivers of large trucks. This analytical observational study addresses gaps in the literature by: conducting a descriptive analysis of motor vehicle claim events involving light-vehicle drivers in a large health care industry fleet; identifying risk factors for work-related MVCs and injuries based on vehicle miles traveled; and providing details on circumstances of these events. The study examined 8068 motor vehicle events resulting in vehicle damage, property damage, or injury reported by 6680 U.S.-based drivers in a light-vehicle sales and service fleet operated by a health care company over a 4 ½-year period (January 2010 through June 2014). Thirty-three percent (n = 2660) of the events were collisions. Collisions were segmented as recoverable or non-recoverable according to whether the company could recover costs from another party, and mileage-based collision and injury rates were calculated by gender, age, tenure, and vehicle type. Differences in collision and injury rates between groups of interest (for example, tenure and age categories) were assessed with Poisson regression techniques adjusted using generalized estimating equations (GEE) for repeated observations on the same employee over time. Age, gender, and job tenure were significant collision risk factors, and risk patterns for recoverable and non-recoverable collisions were similar to those for total collisions. Collisions per million miles (CPMM) were significantly higher for drivers 21-24.9 years of age compared to drivers age 25-54.9 years (9.58 CPMM vs 4.96 CPMM, p = .025), drivers employed for less than 2 years compared to those employed 2 or more years (6.22 CPMM vs 4.82 CPMM, p < .001), for female drivers compared to male drivers (6.37 CPMM vs 4.16 CPMM, p < .001), and for drivers of passenger cars compared to all other vehicles (5.27 CPMM vs 4.48 CPMM, p < .001). Among collisions between the employee's vehicle and another vehicle in transport, those where the front of one vehicle hit another vehicle at an angle were the most likely to result in injury to the employee driver or another party (26%), followed by rear-end collisions (25%). Special attention should be given to preventing collisions among newly-hired employees, and to preventing angle and rear-end collisions, which were the most common types of collisions and also were most likely to result in injury than all other collisions combined.