Health-Related Exposures and Conditions among US Fishermen.

Commercial fishing is a high-risk occupation, yet there is a lack of surveillance documenting health conditions, health behaviors, and health care coverage among US fishermen. We used publicly available data sources to identify exposures and health outcomes common among fishermen. We utilized the National Institute for Occupational Safety and Health-Worker Health Charts to estimate the prevalence of general exposures, psychosocial exposures, health behaviors, and health conditions from the national surveys National Health Interview Survey - Occupational Health Supplement (NHIS-OHS, 2015) and Behavioral Risk Factor Surveillance System (BRFSS) (2013-2015). We compared fishing workers with both agricultural workers and all-workers. Fishermen commonly reported general exposures, psychosocial exposures, non-standard work arrangements, frequent night shifts, and shift work. The prevalence of musculoskeletal conditions such as carpal tunnel syndrome (33%) and severe low-back pain (27%) was also high. Smoking (45%) and second-hand smoke exposure (25%) were widespread, and 21% reported no health care coverage. National household surveys such as NHIS-OHS, and BRFSS can be utilized to describe the health status of fishermen. This workforce would benefit from increased access to health care and health promotion programs. More comprehensive evaluations of existing data can help to identify occupation-specific health challenges.

Efficacy of text messaging apprentices to reinforce ergonomics and safety voice training.

INTRODUCTION: Injuries and work-related musculoskeletal disorders (MSDs) are common among masons. SAfety Voice for Ergonomics (SAVE) integrates training in ergonomic and safety problem-solving skills into masonry apprenticeship training. The purpose of this study was to assess the efficacy of text messaging to reinforce SAVE program content. METHOD: SAVE effectiveness was evaluated at masonry apprenticeship training centers across the United States by comparing three experimental groups: (1) Ergonomics training, (2) Ergonomics and Safety Voice training, and a (3) Control. Apprentices received SAVE training with their standard instruction. To reinforce classroom training, refresher training was implemented by sending weekly text messages for six months. Half of the text messages required a response, which tested knowledge or assessed behavior, while the remaining reiterated knowledge. Apprentices (n = 119) received SAVE text messages. Response rates and percentage of correct responses were compared with chi-square tests and independent group t-tests. Multivariable logistic regression analysis predicted apprentice response with selected demographic and work experience variables. Finally, feedback on of the use of text messaging was obtained. RESULT: Of 119 participants, 61% (n = 72) responded to at least one text message. Logistic regression revealed that being a high school graduate and a brick and block mason significantly affected the odds of responding. Sixty-nine percent of apprentices agreed that text messages reinforced SAVE content. CONCLUSION: Even though there was no training center requirement to respond, the high response rate suggests that text messaging can effectively be used to reinforce ergonomics and safety voice training for both knowledge and behavior. Practical Application: The prevalent use of text messaging creates opportunities to reinforce health and safety training and engage workers, especially for populations that may be at various locations over time such as construction sites. Instructors and practitioners should consider the utility of text messaging for supporting their training and safety programs.

Prevalence of work-related musculoskeletal pain in masonry apprentices.

The construction industry, specifically masonry, reports more work-related musculoskeletal disorders (WMSD) rates than the general industry. Masonry apprentices are assumed to be healthy, yet may have WMSDs. The purpose of this study was to evaluate the prevalence of musculoskeletal symptoms (MSS), time loss, and healthcare use among apprentices. 183 brick and block masonry apprentices completed surveys on demographics, work history, MSS, and functional well-being. The prevalence of MSS was calculated by body region, time loss, and healthcare use. The relationship between MSS, and perceived global physical and mental health was assessed. Approximately 78% of apprentices reported MSS, most in several body regions. Low back and wrists/hands were most prevalent, although few missed work or sought healthcare. Lower functional health and well-being was reported. Apprentices reported MSS comparable to previous studies of journey-level masons. Apprenticeship programmes could integrate ergonomics education to help apprentices develop safety culture early in their careers. Practitioner Summary: New masonry workers (apprentices) are assumed to be healthy yet work-related musculoskeletal symptoms (MSS) may be common early in their career. The prevalence of MSS was assessed among apprentices. Approximately 78% of apprentices reported MSS, most in several body regions, comparable to journey-level masons. Abbreviations: WMSD: work-related musculoskeletal disorders; MSS: musculoskeletal symptoms; SAVE: SAfety voice for ergonomics; MNQ: modified nordic questionnaire; FTE: full-time equivalent; SF-12: short from-12v2.

Emergency Medical Training for the Commercial Fishing Industry: An Expanded Role for Wilderness Medicine.

This article describes the conception, implementation, and evaluation of a wilderness medicine-based first aid class for the commercial fishing industry. Commercial fishing is a dangerous occupation in the United States. Currently, commercial fishermen often only have access to basic first aid classes. Because of its focus on austere environments, hazardous conditions, and distance from definitive medical care-hallmarks of commercial fisheries-wilderness medicine offers a more appropriate approach to decreasing morbidity and mortality in the industry. A 2-d, 16-h pilot wilderness medicine course for commercial fishermen, Fishermen First Aid and Safety Training (FFAST), conducted for Dungeness crab fishermen, was effective and well received, based on pre- and postcourse knowledge, skill, and attitude surveys. FFAST has been approved by the Coast Guard and is being made more widely available to commercial fishermen in the Pacific Northwest. The FFAST program offers an example of how wilderness medicine can improve safety and emergency medical response for a wide variety of austere environments not traditionally linked to the backcountry.

Non-Fatal Injuries and Injury Treatment in the West Coast Dungeness Crab Fishery.

Objectives: Non-fatal injuries in the high risk US Dungeness crab fishery have been under-documented, despite their potential for lost work time and income, long-term disability, and early unwanted retirement. The Fishermen Led Injury Prevention Program (FLIPP) characterized injuries in this fishery, in order to identify work hazards and inform injury control measures.Methods: The FLIPP injury survey was completed by 426 fishermen in 23 Washington, Oregon, and California fishing ports prior to the 2015-2016 Dungeness crab season; 413 (97%) provided injury information for this analysis. Participants indicated whether they had been injured in the previous 12 months, described the injury, any treatments received, and whether the injury limited their ability to work.Results: Participants were mostly male (98%), more than half (56.6%) worked as deckhands, and reported considerable fishing experience (median = 14 years, interquartile range 5-27). Eighty-nine fishermen (21.5%) reported an injury incident in the past year, of which 49 (55.1%) were limiting. The 89 incidents yielded 102 injuries, of which nearly two-thirds were sprains/strains (23, 22.5%), surface wounds/bruises (17, 15.0%), cuts (18, 17.6%), or punctures (11, 10.8%). More severe injuries, including eight fractures, were rare. The majority of injuries received either no treatment (27, 26.5%) or first aid (35, 34.3%); clinical care was less common (22, 21.6%), and emergency care rare (3, 2.9%).Conclusion: One in five Dungeness crab fishermen reported an injury incident in the previous year. Most injuries were not severe and did not result in clinical care, but approximately half were work-limiting. Control measures must account for the remote and resource-limited workplace in commercial fishing.

Dungeness crab fishermen perceptions of injury causation and factors in staying safe.

BACKGROUND: Commercial fishing is a hazardous occupation in the United States (US). Injury surveillance data relies heavily on US Coast Guard reports, which capture injuries severe enough to require reporting. The reports do not incorporate the fishermen's perspective on contributing factors to injuries and staying safe while fishing. MATERIALS AND METHODS: We conducted a pre-season survey of Dungeness crab fishermen during 2015 to 2016. Community researchers administered surveys to fishermen. Respondents reported their opinions about factors contributing to injuries and staying safe, which were grouped into similar themes by consen- sus. Descriptive statistics were calculated to explore the number of injuries, crew position, age, and years of experience. Chi-square tests compared perceptions of injury causation, staying safe, and other factors. RESULTS: Four hundred twenty-six surveys were completed. Injury causation perceptions were sorted into 17 categories, and staying safe perceptions were sorted into 13 categories. The most frequently cited causes of injury were heavy workload (86, 21.9%), poor mental focus (78, 19.9%), and inexperience (56, 14.3%). The most frequently cited factors in staying safe while fishing were awareness (142, 36.1%), good and well-maintained fishing gear/vessel (41, 10.4%), and best marine practices (39, 9.9%). Opinions were not significantly associated with experiencing an injury in the past while fishing, but some opinions were significantly associated with crew position, age, and years of experience. CONCLUSIONS: The perceptions of fishermen can be evaluated further and incorporated into training or intervention development. The fishermen-led approach of this project lends itself to developing injury pre- vention strategies that are effective, realistic and suitable. The resources available at FLIPPresources.org, such as informational sheets for new fishermen, sample crew agreements, and first aid kit resources, supply workers in this fishery with real solutions for issues they identified through their survey responses.

Injury and illness among onshore workers in Alaska's seafood processing industry: Analysis of workers' compensation claims, 2014-2015.

BACKGROUND: Alaska's onshore seafood processing industry is economically vital and hazardous. METHODS: Accepted Alaska workers' compensation claims data from 2014 to 2015 were manually reviewed and coded with the Occupational Injury and Illness Classification System and associated work activity. Workforce data were utilized to calculate rates. RESULTS: 2,889 claims of nonfatal injuries/illnesses were accepted for compensation. The average annual claim rate was 63 per 1000 workers. This was significantly higher than Alaska's all-industry rate of 44 claims per 1000 workers (RR = 1.42, 95%CI = 1.37-1.48). The most frequently occurring injuries/illnesses, were by nature, sprains/strains/tears (n = 993, 36%); by body part, upper limbs (1212, 43%); and by event, contact with objects/equipment (1020, 37%) and overexertion/bodily reaction (933, 34%). Incidents associated with seafood processing/canning/freezing (n = 818) frequently involved: repetitive motion; overexertion while handling pans, fish, and buckets; and contact with fish, pans, and machinery. CONCLUSIONS: Ergonomic and safety solutions should be implemented to prevent musculoskeletal injuries/illnesses in seafood processing.

Silicone wristbands compared with traditional polycyclic aromatic hydrocarbon exposure assessment methods.

Currently there is a lack of inexpensive, easy-to-use technology to evaluate human exposure to environmental chemicals, including polycyclic aromatic hydrocarbons (PAHs). This is the first study in which silicone wristbands were deployed alongside two traditional personal PAH exposure assessment methods: active air monitoring with samplers (i.e., polyurethane foam (PUF) and filter) housed in backpacks, and biological sampling with urine. We demonstrate that wristbands worn for 48 h in a non-occupational setting recover semivolatile PAHs, and we compare levels of PAHs in wristbands to PAHs in PUFs-filters and to hydroxy-PAH (OH-PAH) biomarkers in urine. We deployed all samplers simultaneously for 48 h on 22 pregnant women in an established urban birth cohort. Each woman provided one spot urine sample at the end of the 48-h period. Wristbands recovered PAHs with similar detection frequencies to PUFs-filters. Of the 62 PAHs tested for in the 22 wristbands, 51 PAHs were detected in at least one wristband. In this cohort of pregnant women, we found more significant correlations between OH-PAHs and PAHs in wristbands than between OH-PAHs and PAHs in PUFs-filters. Only two comparisons between PAHs in PUFs-filters and OH-PAHs correlated significantly (rs = 0.53 and p = 0.01; rs = 0.44 and p = 0.04), whereas six comparisons between PAHs in wristbands and OH-PAHs correlated significantly (rs = 0.44 to 0.76 and p = 0.04 to <0.0001). These results support the utility of wristbands as a biologically relevant exposure assessment tool which can be easily integrated into environmental health studies. Graphical abstract PAHs detected in samples collected from urban pregnant women.

Safety voice for ergonomics (SAVE) project: protocol for a workplace cluster-randomized controlled trial to reduce musculoskeletal disorders in masonry apprentices.

BACKGROUND: Masons have the highest rate of overexertion injuries among all construction trades and rank second for occupational back injuries in the United States. Identified ergonomic solutions are the primary method of reducing exposure to risk factors associated with musculoskeletal disorders. However, many construction workers lack knowledge about these solutions, as well as basic ergonomic principles. Construction apprentices, as they embark on their careers, are greatly in need of ergonomics training to minimize the cumulative exposure that leads to musculoskeletal disorders. Apprentices receive safety training; however, ergonomics training is often limited or non-existent. In addition, apprenticeship programs often lack "soft skills" training on how to appropriately respond to work environments and practices that are unsafe. The SAVE program - SAfety Voice for Ergonomics - strives to integrate evidence-based health and safety training strategies into masonry apprenticeship skills training to teach ergonomics, problem solving, and speaking up to communicate solutions that reduce musculoskeletal injury risk. The central hypothesis is that the combination of ergonomics training and safety voice promotion will be more effective than no training or either ergonomics training alone or safety voice training alone. METHODS/DESIGN: Following the development and pilot testing of the SAVE intervention, SAVE will be evaluated in a cluster-randomized controlled trial at 12 masonry training centers across the U.S. Clusters of apprentices within centers will be assigned at random to one of four intervention groups (n = 24 per group): (1) ergonomics training only, (2) safety voice training only, (3) combined ergonomics and safety voice training, or (4) control group with no additional training intervention. Outcomes assessed at baseline, at the conclusion of training, and then at six and 12 months post training will include: musculoskeletal symptoms, general health perceptions, knowledge of ergonomic and safety voice principles, and perception and attitudes about ergonomic and safety voice issues. DISCUSSION: Masons continue to have a high rate of musculoskeletal disorders. The trade has an expected increase of 40 % in the number of workers by 2020. Therefore, a vetted intervention for apprentices entering the trade, such as SAVE, could reduce the burden of musculoskeletal disorders currently plaguing the trade. TRIAL REGISTRATION: ClinicalTrials.gov Identifier: NCT02676635 , 2 February 2016.

Utility of a Work Process Classification System for characterizing non-fatal injuries in the Alaskan commercial fishing industry.

BACKGROUND: The US commercial fishing industry is hazardous, as measured by mortality data. However, research on non-fatal injuries is limited. Non-fatal injuries constitute the majority of occupational injuries and can result in workers' lowered productivity and wages, lost quality of life, and disability. In the United States, a Work Process Classification System (WPCS) has previously been applied in Alaskan freezer-trawl and freezer-longline fleets to identify causes of injuries and specific hazards, but not to other fishing fleets. OBJECTIVES: This descriptive epidemiologic study aimed to explore the application and modification of the WPCS in multiple Alaskan fleets, characterize non-fatal occupational injuries in these fleets, and identify work processes that could be targeted for further investigation and future injury prevention efforts. DESIGN: Traumatic, non-fatal injuries on-board Alaskan commercial fishing vessels were identified through United States Coast Guard investigative reports. Characteristics of injuries, as well as worker characteristics, were analysed. Injuries were coded using the WPCS. RESULTS: We successfully utilized the WPCS to code non-fatal injury cases (n = 136). The most frequent main work processes associated with non-fatal injuries included: on-board trawlers, handling frozen fish and processing the catch; on-board vessels using pot/trap gear, handling the gear and shooting/setting the gear; on-board longliners, traffic on board and hauling the gear; and on-board processor vessels, processing the catch, other work with the catch, and handling frozen fish. CONCLUSIONS: The study confirmed that a WPCS can be applied to multiple Alaskan fleets to identify hazardous tasks. Hazards were unique for each vessel gear type. Future injury prevention efforts should target work processes associated with the most frequent and most severe injuries. Future studies should establish time estimates for work processes in order to determine risk estimates. Efforts to improve non-fatal injury reporting, especially on smaller commercial fishing vessels, should be undertaken.

Work-related traumatic injuries onboard freezer-trawlers and freezer-longliners operating in Alaskan waters during 2001-2012.

BACKGROUND: Workers onboard freezer-trawl (FT) and freezer-longline (FL) vessels in Alaska may be at high risk for fatal and non-fatal injuries. METHODS: Traumatic occupational injuries onboard vessels in the FT and FL fleets were identified through two government data sources. RESULTS: The annual risk of fatal injuries was 125 per 100,000 FTEs in the FT fleet, and 63 per 100,000 FTEs in the FL fleet. The annual risk of non-fatal injuries was 43 per 1,000 FTEs in the FT fleet and 35 per 1,000 FTEs in the FL fleet. The majority of injuries in the FT fleet occurred in the factories and freezer holds, whereas the most common injuries in the FL fleet occurred on deck while working the fishing gear. CONCLUSIONS: The findings confirmed that workers in those fleets were at high risk for work-related injuries. Injury prevention should focus on removing hazards in the work processes injuring the most workers.

Silicone wristbands as personal passive samplers.

Active-sampling approaches are commonly used for personal monitoring, but are limited by energy usage and data that may not represent an individual's exposure or bioavailable concentrations. Current passive techniques often involve extensive preparation, or are developed for only a small number of targeted compounds. In this work, we present a novel application for measuring bioavailable exposure with silicone wristbands as personal passive samplers. Laboratory methodology affecting precleaning, infusion, and extraction were developed from commercially available silicone, and chromatographic background interference was reduced after solvent cleanup with good extraction efficiency (>96%). After finalizing laboratory methods, 49 compounds were sequestered during an ambient deployment which encompassed a diverse set of compounds including polycyclic aromatic hydrocarbons (PAHs), consumer products, personal care products, pesticides, phthalates, and other industrial compounds ranging in log K(ow) from -0.07 (caffeine) to 9.49 (tris(2-ethylhexyl) phosphate). In two hot asphalt occupational settings, silicone personal samplers sequestered 25 PAHs during 8- and 40-h exposures, as well as 2 oxygenated-PAHs (benzofluorenone and fluorenone) suggesting temporal sensitivity over a single work day or week (p < 0.05, power =0.85). Additionally, the amount of PAH sequestered differed between worksites (p < 0.05, power = 0.99), suggesting spatial sensitivity using this novel application.

Occupational injuries to Oregon workers 24 years and younger: An analysis of workers' compensation claims, 2000-2007.

BACKGROUND: Occupational injuries to adolescents and young adults are a known public health problem. We sought to describe and estimate rates of occupational injuries to workers younger than 25 years of age in Oregon during an 8-year period. METHODS: Oregon workers' compensation disabling claims data (n = 23,325) and one commercial insurance carrier's non-disabling claims data (n = 16,153) were analyzed. Total employment from the Local Employment Dynamics of the U.S. Census Bureau and the Oregon Labor Market Information System was used as a denominator for rates. RESULTS: Injuries were more frequent among 22-24 year olds and among males, though females accounted for a higher proportion of claims in the youngest age group. The most common injury type was a sprain or strain, but lacerations and burns were more frequently reported in the 14-18 year olds. When non-disabling claims were included, the rate of injury for 14-18 year olds doubled. The overall rate of injury was 122.7/10,000 workers, but was higher in the construction, manufacturing, and transportation sectors, and in the agriculture, forestry, fishing, and hunting sector for older teens and young adults. CONCLUSIONS: Young workers continue to be at risk for occupational injuries. Our results show that specific interventions may be needed for older teen and young adult workers to reduce their rate of injury.

The impact of drywall handling tools on the low back.

Carpenters and other construction workers who install drywall have high rates of strains and sprains to the low back and shoulder. Drywall is heavy and awkward to handle resulting in increased risk of injury. The purpose of this study was to evaluate several low-cost coupling tools that have the potential to reduce awkward postures in drywall installers. Five coupling tools were evaluated using the Lumbar Motion Monitor that measures trunk kinematics and predicts probability of low back disorder group membership risk (LBD risk). Workers answered surveys about their comfort while using each tool. The results indicate that use of the 2-person manual lift and the J-handle provide the best reduction in awkward postures, motions, low back sagittal moment, and LBD risk. The two-person manual lift appears to be the safest method of lifting and moving drywall, though using the two-person J-handle also significantly reduces injury risk. Given that carpenters are skeptical about using equipment that can get in the way or get lost, a practical recommendation is promotion of two-person manual lifting. For single-person lifts, the Old Man tool is a viable option to decrease risk of MSDs.

Comparison of three single-person manual patient techniques for bed-to-wheelchair transfers.

The uniqueness of the home environment still requires home health clinicians to lift and transfer patients manually, tasks that are known to cause back injuries. Three manual patient transfers were evaluated to establish the technique with the least risk to the low back. Patient and worker perceptions as well as preferences, exposure duration, and a biomechanical low back evaluation are presented, together with transfer technique recommendations.

Injury trends for adolescents with early childhood lead exposure.

This pilot study investigated adolescents with well-documented childhood lead burdens to determine the relationship between lead and unintentional injury. Adolescents completed a self-administered injury questionnaire. Results demonstrated that elevated childhood blood lead concentrations were significantly related to injury variables. Further study is necessary to understand adolescent health and safety implications.

Postural sway measurements: a potential safety monitoring technique for workers wearing personal protective equipment.

This study investigated the use of postural sway measurements as a potential safety monitoring technique. Sixteen healthy male volunteers (age: 41.8+/-9.3 years) participated in this study. The level of neurophysiological strain and the ability to maintain upright balance for workers wearing personal protective equipment (PPE) were investigated. Three levels of PPE, the United States Environmental Protection Agency (USEPA)-defined levels A, B, and C, were worn in random order while performing two randomly ordered tasks, resting and a workload. After the workload task, the perceived exertion and discomfort were recorded. Postural sway, measured using a microprocessor-based force platform system, was assessed after each task. The variables of sway area and sway length were calculated from stabilograms. These measurements were taken for three sway tests: 1) Eyes open (EO), 2) Eyes closed on a four-inch foam (FC), and 3) a dynamic test with the subject reaching for a weight placed in front, lifting it to his or her chest, and lowering back to the shelf four times (RE). The heart rate was significantly higher for the workload task (p < 0.05), and the levels A and B PPE demonstrated significantly higher perceived exertion results than level C PPE (p < 0.05). The heart rate and perceived exertion were not significantly correlated with the sway measurements. Level A produced significant self-reported discomfort results for the upper back, lower back, and thighs. The sway variables showed significant differences with the PPE levels and the task. The workload task produced significantly higher sway length than the resting task (p < 0.05) for all test conditions. The PPE level B produced significantly higher sway length than PPE level A (p < 0.05) in the FC test condition. These results indicate that postural stability is altered with PPE use and with fatigued postural muscles. In summary, postural sway measurements may be used as a potential safety monitoring technique.