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.

Thermal burn and electrical injuries among electric utility workers, 1995-2004.

This study describes the occurrence of work-related injuries from thermal-, electrical- and chemical-burns among electric utility workers. We describe injury trends by occupation, body part injured, age, sex, and circumstances surrounding the injury. This analysis includes all thermal, electric, and chemical injuries included in the Electric Power Research Institute (EPRI) Occupational Health and Safety Database (OHSD). There were a total of 872 thermal burn and electric shock injuries representing 3.7% of all injuries, but accounting for nearly 13% of all medical claim costs, second only to the medical costs associated with sprain- and strain-related injuries (38% of all injuries). The majority of burns involved less than 1 day off of work. The head, hands, and other upper extremities were the body parts most frequently injured by burns or electric shocks. For this industry, electric-related burns accounted for the largest percentage of burn injuries, 399 injuries (45.8%), followed by thermal/heat burns, 345 injuries (39.6%), and chemical burns, 51 injuries (5.8%). These injuries also represented a disproportionate number of fatalities; of the 24 deaths recorded in the database, contact with electric current or with temperature extremes was the source of seven of the fatalities. High-risk occupations included welders, line workers, electricians, meter readers, mechanics, maintenance workers, and plant and equipment operators.

Clinical assessment and management of patients with implanted cardioverter-defibrillators presenting to nonelectrophysiologists.

All physicians increasingly will encounter patients who have implanted cardioverter-defibrillators (ICDs) for protection from ventricular arrhythmias. This advisory provides a concise summary relevant to the assessment and management of patients with ICDs, including those who present to primary care or emergency department physicians with symptoms suggesting arrhythmia or ICD malfunction and those who require cardiac or surgical procedures.

Just shocking!

Electrical shock injuries can be fatal. Rescues of electrical shock victims also can be fatal if not handled correctly. Using "best practices" at work (and at home) will reduce the risk of an event from ever occurring and prevent the injury. Do not attempt to touch someone in contact with an electrical source. Shut off the power first, then attempt the rescue. Immediately call for emergency assistance. Always look for life-threatening conditions first, then treat any wounds. Always look for two external wounds and cover with dry dressing. Continue to monitor the patient for breathing and heart rate. Transport the patient to a medical facility as soon as possible. Each of us has the ability to choose how we perform an assigned task. You do have control over your work environment. Exercise that control and choose wisely to stay alive!