Fatal Animal Related Incidents on Australian Farms - a 20-Year Review.

Objectives To assess demographic and causal factors of fatal farm incidents involving animals in Australia. Methods Descriptive study of the National Coronial Information System for persons fatally injured by an animal on an Australian farm over the 2001-20 period. Data were analysed in relation to age, sex, state where incident occurred, work-relatedness and causal agents. Results There has been little change in the mean number of animal-related injury deaths across Australia in the 2001-20 period (mean 6.5), however this is a 35% reduction on an earlier 1989-92 assessment (mean 10). The majority of incidents (81%) involved horses (n = 75) and cattle (n = 31). Males were involved in 86 (66%) cases, with 54 female cases. People aged 60 years and over accounted for 46% of the cases, with more than half occurring during work. Of the decedents, 85% fell from or were struck by an animal at the time of the incident, with 40% resulting in a head injury. Conclusion While annualized case numbers have decreased slightly, the leading agents remain consistent with previous studies. The lack of genuine progress in addressing fatalities related to horses and cattle, along with the representation of older persons in the cohort, require attention drawing on the Hierarchy of Controls.

Under-reporting of non-fatal occupational injuries among precarious and non-precarious workers in Sweden.

BACKGROUND: Under-reporting of occupational injuries (OIs) among precariously employed workers in Sweden challenges effective surveillance of OIs and targeted preventive measures. OBJECTIVE: To estimate the magnitude of under-reporting of OIs among precarious and non-precarious workers in Sweden in 2013. METHODS: Capture-recapture methods were applied using the national OIs register and records from a labour market insurance company. Employed workers 18-65 resident in Sweden in 2013 were included in the study (n=82 949 OIs). Precarious employment was operationalised using the national labour market register, while injury severity was constructed from the National Patient Register. Under-reporting estimates were computed stratifying by OIs severity and by sociodemographic characteristics, occupations and precarious employment. RESULTS: Under-reporting of OIs followed a dose-response pattern according to the levels of precariousness (the higher the precarious level, the higher the under-reporting) being for the precarious group (22.6%, 95% CI 21.3% to 23.8%), followed by the borderline precarious (17.6%, 95% CI 17.1% to 18.2%) and lastly the non-precarious (15.0%, 95% CI 14.7% to 15.3%). Under-reporting of OIs, decreased as the injury severity increased and was higher with highest level of precariousness in all groups of severity. We also observed higher under-reporting estimates among all occupations in the precarious and borderline precarious groups as compared with the non-precarious ones. CONCLUSIONS: This is the first register-based study to empirically demonstrate in Sweden that under-reporting of OIs is 50% higher among precariously employed workers. OIs under-reporting may represent unrecognised injuries that especially burden precariously employed workers as financial, health and social consequences shift from the employer to the employee.

Organisational factors and under-reporting of occupational injuries in Sweden: a population-based study using capture-recapture methodology.

OBJECTIVE: To estimate the magnitude of under-reporting of non-fatal occupational injuries (OIs) by different organisational factors in Sweden for the year 2013. METHODS: Capture-recapture methods were applied using two data sources: (1) the national OI register and (2) records from a labour market insurance company. To assure comparability of data sources, the analysis was restricted to the public sector and private companies with at least 50 employees. OIs were matched using personal identification number and reported injury dates (±7 days). Organisational factors were obtained from the national labour market register and injury severity (no healthcare/only outpatient/hospitalised) from the National Patient Register. Total number of OIs and ascertainment by data sources were estimated assuming data source independence. RESULTS: There were an estimated 98 493 OIs in 2013. Completeness of reporting OIs to the national register and to the insurance company was estimated at 73% and 43%, respectively. No report to either source was estimated at 15 000 OIs (~15%). Under-reporting to the national register differed by selected organisational factors, being higher among organisations in the public sector, those with more females, with a younger workforce and with a higher proportion of immigrants. Overall under-reporting was more common in agriculture (19.7%), other services (19.3%), commerce and hospitality (19.1%), health (18.4%) and education (18.4%). Under-reporting decreased as injury severity increased, with little variations across sectors of economic activity. CONCLUSIONS: Results suggest considerable under-reporting of OIs in Sweden and differential under-reporting by organisational factors. Results are relevant for official estimates of burden and for setting priorities for workplace safety and prevention.

Occupational safety and health in traditional date palm works.

OBJECTIVE: Date palm is mostly cultivated in Western Asia and North Africa and is the main wealth for the people of these regions. Traditional date palm crown access via manual climbing, as the main activity in date fruit production, suffers from occupational hazards. Mitigation of these problems through interventions or new designs initially needs to complete knowledge of safety and health aspects and relationships between them and characters of date palm climbers. This study provided detailed information about this concern. METHODS: A questionnaire consisting of personal, operational, safety, satisfaction, financial and ergonomic demographics was used for data collection. 117 climbers participated in the study. Nonparametric correlations using Spearman's coefficient and logistic regressions investigated the linkage between characters obtained by the questionnaire. RESULTS: The annual mortality rate of falls from height was calculated by 3.4 per one thousand men. Fall was a major challenge in traditional date palm crown access and its rate was highly greater in comparison with the estimation of International Labor Office (ILO) about fatal agricultural injuries. Safety and health condition was the main contributing factor in the status of date palm climbing and was significantly linked to job satisfaction. Safety risk-taking and non-awareness of technology had a significant linkage with together (r = - 0.195, p = 0.035). Safety risk-taking, also, had significant correlations with discomfort in back (r = - 0.201, p = 0.030). Regressions showed heavier climbers (> 75 kg) were expected about 4.3 (1/0.230) times than more lightweight ones to have an upper leg discomfort with high severity relative to low severity (p = 0.018). CONCLUSION: Obesity, senescence, and awareness of technology as three personal characteristics of climbers need to be addressed. Future strategies are required to improve the safety condition of climbing and manage the workforces as well as governmental decision making to address the financial aspects of climbers for sustainable date production and reduction in reasons causing unemployment. Considering current status and modification of the present tool and equipment is recommended.

Effect of professional certification on employees' return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups.

BACKGROUND: One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work. METHODS: The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups. RESULTS: The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76). CONCLUSION: In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.

Return on Investment of Workplace Wellness: Evidence From a Long-Term Care Company.

BACKGROUND: Workplace wellness programs (WWPs) are increasingly promoted by businesses and governments as an important strategy to improve workers' overall health and well-being and to reduce health care and other organizational costs. Few studies have evaluated WWPs in small businesses to provide evidence on the potential return-on-investment (ROI) that WWPs might yield. This study aimed to fill this gap by presenting a quasi-experimental, ROI analysis of a WWP in a small company. METHODS: This observational quasi-experimental study evaluated economic outcomes of a multicomponent WWP implemented by a small long-term care company. The company provided approximately 2 years of de-identified, individualized data on its employees for 2013-2015. There were 116 WWP participants and 323 nonparticipants. Difference-in-differences models were used to evaluate the program using organizational costs and ROI estimates. FINDINGS: The estimated program cost was $132.692 (95% confidence interval [CI]: [$112.957, $156.101]) per participant and the estimated organizational costs savings were $210.342 (95% CI: [-4354.095, 2002.890]). The WWP achieved an ROI of $0.585 (95% CI: [-$35.095, $14.103]) per participant. Although not statistically significant, the results suggest that the WWP saved $1.585 for every $1 invested. CONCLUSIONS/APPLICATION TO PRACTICE: These results suggest that the evaluated WWP yielded a positive, although nonsignificant, ROI estimate. While ROI is still one of the most common evaluation metrics used in workplace wellness, few studies present ROI estimates of WWPs in small companies. Given policy efforts to promote WWPs in small businesses, there is a need to conduct high-quality ROI analyses for WWPs in smaller companies.

Effect of professional certification on employees' return-to-work rate after occupational injuries in Korea: focusing on vulnerable groups

BACKGROUND@#One effective way to improve return-to-work (RTW) performance may be to convince the employer that the worker has the necessary skills. The aim of this paper is to investigate the effect of having a professional certification among workers injured in occupational injuries on their return to work.@*METHODS@#The Panel Study of Workers' Compensation Insurance (PSWCI) targets workers who completed medical care in 2012 after an occupational injury. The study population (n = 2000) was stratified by gender, age, region, disability grade, and rehabilitation service use. A total of 1458 workers were finally selected for this study. The effect of having a certification on RTW status was calculated with an odds ratio and 95% confidence intervals using binomial and multinomial logistic regression analyses. In the binomial logistic regression analysis, the RTW group was made up as a combination of the return to original work and the reemployment groups.@*RESULTS@#The ORs of RTW among those with a certification compared to those without certification were 1.38 (1.16-1.65) in Model 1, 1.25 (1.05-1.50) in Model 2, and 1.22 (1.01-1.47) in Model 3. Among female workers with a certification, the OR of RTW was 4.60 (2.68-7.91), that of return to original work was 3.21 (1.74-5.91), and that of reemployment was 5.85 (3.34-10.27). Among daily workers with a certification, the OR of RTW was 1.32 (1.03-1.69) and that of reemployment was 1.37 (1.07-1.76).@*CONCLUSION@#In conclusion, injured workers with a certification generally had a higher RTW rate. In particular, the RTW rate was higher among female workers and daily workers with a certification than among those without.

Occupational injury and psychological distress among U.S. workers: The National Health Interview Survey, 2004-2016.

INTRODUCTION: Injuries at work may negatively influence mental health due to lost or reduced working hours and financial burden of treatment. Our objective was to investigate, in U.S. workers (a) the prevalence of serious psychological distress (SPD) by injury status (occupational, non-occupational, and no injury) and injury characteristics, and (b) the association between injury status and SPD. METHODS: Self-reported injuries within the previous three months were collected annually for 225,331 U.S. workers in the National Health Interview Survey (2004-2016). Psychological distress during the past 30 days was assessed using the Kessler 6 (K6) questions with Likert-type scale (0-4, total score range: 0-24). SPD was defined as K6 ≥ 13. Prevalence ratios (PR) from fitted logistic regression models were used to assess relationships between injury and SPD after controlling for covariates. RESULTS: The prevalence of SPD was 4.74%, 3.58%, and 1.56% in workers reporting occupational injury (OI), non-occupational injury (NOI), and no injury, respectively. Workers with head and neck injury had the highest prevalence of SPD (Prevalence: OI = 7.71%, NOI = 6.17%), followed by workers with scrape/bruise/burn/bite (6.32% for those with OI). Workers reporting OI were two times more likely to have SPD compared to those without injury (PR = 2.19, 95%CI: 1.62-2.96). However, there was no significant difference in SPD between workers with OI and workers with NOI (PR = 0.98, 95%CI: 0.65-1.48). CONCLUSION: The prevalence of SPD varied by injury status with the highest being among workers reporting OI. We found that the workers reporting OI were significantly more likely to have SPD than those without injury, but not more than those with NOI. Practical Applications: Mental health management programs by employers are necessary for workers who are injured in the workplace.

Animal-related injuries in veterinary services personnel, U.S. Army, 2001-2018.

Limited data exist on animal-related injuries in the U.S. Army veterinary service (VS). The purpose of this study was to determine the incidence of animalrelated injuries and the associated risk factors in VS personnel. A retrospective cohort study was conducted using military healthcare surveillance data on animal- related injuries in VS personnel from 2001-2018. Yearly incidence of medically diagnosed animal-related injuries ranged from 25-50 injuries per 1,000 person-years from 2001-2018. Linear regression showed no significant trend in the incidence rate per year over the study period (R2=0.005). Bites were the most common injury (86.5%), with dog bites (44.3%) being the most common injury type and dogs the most common species implicated. After controlling for sex, age group, race/ethnicity group, and occupation, adjusted incidence rate ratios (AIRRs) showed significantly elevated risk for animal-related injuries among females compared to males (AIRR=1.69; 95% confidence interval [CI]: 1.45-1.99), soldiers aged 17-29 compared to those aged 30 years or older (AIRR=2.55; 95% CI: 2.12-3.08), and technicians compared to veterinarians (AIRR=1.57; 95% CI: 1.30-1.89). Unlike the majority of published literature on veterinary occupational health and safety, this study showed a clear increased risk of diagnoses of injury among females compared to males.

Work-related injuries and illnesses and their association with hour of work: Analysis of the Oregon construction industry in the US using workers' compensation accepted disabling claims, 2007-2013.

OBJECTIVES: This study aimed to characterize injuries and illnesses among construction workers in the State of Oregon in the US and examine the association between injury frequency and severity with hour of work by using Workers' Compensation (WC) accepted disabling claims data in the construction industry from 2007 to 2013. METHODS: Injury frequency, rate, medical cost, and lost work days were analyzed by year, demographics, employment, injury nature, and temporal factors including hour of work. Multiple linear regression models were used to quantify adjusted associations between hour of work and medical cost and lost work days (indicating injury severity). RESULTS: There were a total of 12 222 disabling claims in the Oregon construction industry. The average annual injury rate was 2.21 per 100 workers. Both the count and rate of disabling claims decreased during the study period. Male workers and young workers had higher injury rates, while medical cost and lost work days increased for older workers. Injuries occurring at night were more severe. The distribution of claims frequency by hour of work was bimodal, with peaks in the 4th and 8th hour. Compared with the first hour of work, the 5th and 13th hours corresponded to significantly more severe injuries and illnesses. CONCLUSIONS: This study identified the burden and distribution of work-related injuries and illnesses in the Oregon construction industry. Continued intervention efforts should target certain subpopulations (eg, young workers) and certain working time periods (eg, mid- and end-shift) to protect construction workers' safety and health.

Factors related to turnover intentions and work-related injuries and accidents among professional caregivers: a cross-sectional questionnaire study.

BACKGROUND: The Japanese health and welfare industry has a shortage of professional caregivers, and work-related accidents and injuries among this group are therefore especially critical issues. This study aimed to examine the factors associated with turnover intentions and work-related injuries and accidents among professional caregivers in Japan. METHODS: Self-report questionnaires were distributed to care workers (N = 1396) at 26 geriatric-care facilities. The questionnaire addressed basic attributes, work and organizational characteristics, wage adequacy, and intrinsic motivations for work (e.g., "being suited to caring work"). Social-relational aspects of the work environment were assessed via three subscales of the Social Capital and Ethical Climate in the Workplace instrument (i.e., "Social Capital in the Workplace," "Exclusive Workplace Climate," and "Ethical Leadership"). Dependent variables were the experience of work-related accidents or injuries in the prior year and organizational and occupational turnover intentions. We used datasets of professional caregivers for analyses. RESULTS: The response rate was 68% (N = 949). Among the 667 professional caregivers, 63% were female. On multivariable logistic regression analysis for work-related accidents and injuries for each sex, those with higher scores for "being suited to caring work" were found to experience significantly fewer work-related accidents and injuries (odds ratio [OR] = 0.78, p < 0.01) among female caregivers. Male caregivers who perceived an exclusive workplace climate experienced more work-related accidents and injuries (OR = 1.61, p < 0.01). However, experience of work-related accidents and injuries did not show significant relationships with organizational and occupational turnover intentions. Additionally, "being suited to caring work" (OR = 0.73, p < 0.01) and ethical leadership (OR = 0.76, p < 0.05) were found to be negatively associated with organizational turnover intentions. "Being suited to caring work" (OR = 0.61, p < 0.01), inadequacy of wage (OR = 2.22, p < 0.05), and marital status (OR = 2.69, p < 0.01) were also associated with occupational turnover intentions of professional caregivers. CONCLUSIONS: These findings highlight the need to foster intrinsic motivations for work as well as providing a supportive and ethical work environment to reduce high turnover rates and work-related injuries and accidents among professional caregivers.

Workplace Safety: A Strategy for Enterprise Risk Management.

Background: Injury and illness incidence rates continue to be higher in healthcare facilities than in the manufacturing environment despite improvement efforts implemented by various organizations. The prevention of workplace injury and illness is a challenge for facilities due to reasons including exposure to body fluids, infectious diseases, and patient handling activities. The purpose of this project was to reduce workplace safety-related incidents and prevent employee injuries through leadership involvement in employment of preventive, directive, and corrective controls. Methods: A tertiary medical center in California experienced 114 accepted injury claims in 1 year. As a response to the problem, the medical center developed a safety management system consisting of a process for engagement between leadership and staff members/employees to increase accountability and reduce injury risks. Findings: The medical center achieved a 59% reduction from 114 to 67 injury claims over a period of 2 years and a two-point increase in engagement scores from both leaders and staff members. Conclusion/Application to Practice: The development of a safety culture starts with leadership behavior, establishment of clear safety processes, and hazard mitigation activities. Workplace safety is a shared responsibility between frontline staff managers and leadership within an organization. Senior leaders must serve as role models to promote a speak-up culture to support safe work practices.

Impact of workplace injury on opioid dependence, abuse, illicit use and overdose: a 36-month retrospective study of insurance claims.

OBJECTIVES: To examine the impact of workplace injury on opioid dependence, abuse and overdose (opioid-related morbidity) and if severity of injury increases the hazard of these health effects. METHODS: We used MarketScan databases to follow injured and propensity score matched non-injured workers, both without prior opioid-related diagnoses. Using a Cox proportional hazard model, we examined the impact of workplace injury on opioid-related morbidity. RESULTS: The hazard of opioid-related morbidity for injured workers was 1.79 times than that of matched non-injured workers (95% CI 1.89 to 3.60). For medical-only and lost-time injured workers, it was respectively 1.54 (95% CI 1.02 to 2.32) and 2.91 (95% CI 1.75 to 4.84) times that of non-injured workers. CONCLUSIONS: Reducing workplace injury or severity of workplace injury, as well as efforts to ensure appropriate opioid prescribing for injured workers, may help to reduce the societal costs of opioid use.

Unmasking social distant damage of developed regions' lifestyle: A decoupling analysis of the indecent labour footprint.

A fair path to achieve a sustainable world would imply reducing the eventual negative effects linked to the production process while increasing economic output, which is referred to in the literature as impact decoupling. This article aims to assess whether global consumption chains are currently on the decoupling path or not, from a social point of view. Specifically, we address the working conditions which developed societies' lifestyle sparked at a distance in global factory countries, focusing on the most harmful consequences of an indecent work. Additionally, we determine the kind of decoupling observed through the new concept of social footprints' elasticities with respect to final demand for each region. We employ a Multi-Regional Input-Output model and an own elaboration database of social impacts concerning undignified working conditions. Results indicate that most countries achieved the goal of decoupling occupational injuries -both fatal and non-fatal- from production, while results for forced labour show a slower and sometimes uncertain process of decoupling. European Union and United States' footprints have been reduced overtime for the three impacts. However, more than half of these footprints are still generated by imports, mainly from developing regions.

Work-related injury and illness in the Victorian healthcare sector: a retrospective analysis of workers' compensation claim records.

Objective Health and social care workers have a significantly higher rate of work-related injury and illness than workers in other industries. The objective of this study was to examine the rate and distribution of work-related injury and illness in the Victorian health and social care sector by demographic, occupation and injury characteristics. Methods A retrospective cohort analysis was conducted of population-level workers' compensation claim records, including 43910 claims from the Victorian health and social care over a 10-year period from 2006 to 2015. Negative binomial regression was used to compare claim rates between occupation categories. Results The 55-64 year age group had the highest injury rate compared with the 15-24 year age group (rate ratio 2.26; 95% confidence interval 1.91-2.68). Ambulance officers had the highest overall injury claim rates and had a fluctuating trend of musculoskeletal, psychological and neurological injury claims during the study period. Social workers had the second highest rate of psychological injury and up to threefold the risk of psychological injury compared with nurse professionals. Conclusions Although the greatest volume of claims was observed in nurses, ambulance officers and paramedics were at higher risk for injury, followed by social workers. The differential patterns of injury and illness among occupation groups suggests a need for primary and secondary prevention responses tailored by occupation. What is known about the topic? The health and social care industry is a large and diverse industry. Health and social care workers encounter unique occupational health risks, with exposure varying by occupation. What does this paper add? This study provides evidence of a high rate of work-related injury and illness among health and social care workers, with ambulance officers and social workers at highest risk. Notably, there are also high rates of psychological injury claims among these two occupations. What are the implications for policy makers? This study compares rates of compensable injury and illness in the Victorian health and social care sector by occupation. The study provides guidance on which occupations and which health conditions require greatest attention.

Occupational injury surveillance pyramid description and association of medical care utilization with low income among work-related injuries.

BACKGROUND: A more comprehensive characterization of total work-related injury burden would ideally include all levels of medical care. Additionally, studies have suggested differential utilization of medical care among various socioeconomic groups, and it is unclear how this translates to work-related injuries. METHODS: The 2004-2016 National Health Interview Survey data were used to estimate all levels of care utilized by the individual for each injury episode. A multivariable logistic regression model based on 2004-2014 data was developed to investigate the relationship of low income and level of medical care used by the injured worker. RESULTS: Around 53.1% of occupational injury were exclusively treated outside of a hospital setting and never captured by hospital/emergency department data systems, which comprises 40% (3.0 million) of total missed days of work and 44% ($452 million) of total cost of lost productivity among full-time workers. Patients with work-related injuries are less likely to stay overnight in hospital compared with those with nonwork-related injuries (adjusted odds ration [aOR]: 0.6, 95% confidence interval [CI]: 0.5-0.7), however among work-related injuries, low-income patients are more likely to use medical care in a hospital setting compared with patients with income higher than poverty threshold (hospitalization: aOR: 1.9, 95% CI: 1.1-3.3; emergency room: aOR: 1.5, 95% CI: 1.1-2.0). CONCLUSIONS: These "minor work-related injuries" exclusively treated outside hospital tend to be ignored when defining national injury prevention priorities, but this analysis indicates that such an approach fails to capture a large portion of injuries significant enough to result in missed days of work and cost of lost productivity.

The Cost of Managing Occupational Injuries Among Frontline Construction Workers in Ghana.

BACKGROUND: The cost burden of occupational injuries has significant effects on the social well-being of workers. Although there seems to be growing evidence on the cost burden on other public health issues, little is known about occupational injuries, especially in low- to middle-income countries including Ghana. OBJECTIVE: This study, therefore, sought to estimate the cost burden of managing occupational injuries among frontline construction workers. METHODS: A prevalence-based cost of illness approach was used to estimate the cost burden of construction injuries. A structured questionnaire was used to collect cost-related data from 640 frontline construction workers. Descriptive statistics were used to estimate direct and indirect cost of injuries using Microsoft Excel and STATA version 14. RESULTS: Overall, a worker spends an average of GHC 104.84 ($24.52) and GHC 180.89 ($42.31) as direct and indirect costs, respectively. Compared with other injuries, fracture had the highest average cost, GHS 343.33 ($80.30), and concussion and internal injury recorded the lowest cost. Also, compared with other trade specialties, carpenters had the highest average cost burden and laborers had the lowest burden. CONCLUSION: There is high direct and indirect cost for managing occupational injury among construction workers. Advocacy and awareness about workplace insurance and regulatory policies should adequately be strengthened and prioritized through periodic monitoring and evaluations.

Association between workers' compensation claim processing times and work disability duration: Analysis of population level claims data.

Delays in workers' compensation claim processing (CP) times have been associated with reduced recovery and delayed return-to-work. This study aimed to (1) determine the injury, worker, and workplace factors associated with CP delays and (2) investigate whether CP delays are associated with longer disability duration after adjusting for these factors. Retrospective cohort analysis of Australian workers' compensation claims was conducted from 1st July 2009 to 30th June 2016 for objective (1) and to 30th June 2014 for objective (2). CP times were derived by calculating differences in days between: injury and lodgement dates (lodgement); lodgement and decision dates (decision) and; injury and decision dates (total). All CP times were shorter for younger workers and those with fractures or traumatic injury, and longer for those with neurological or mental health conditions, and other diseases. Claims from self-insured employers had shorter decision times. With increasing lodgement, decision and total time there was significantly higher hazard of longer disability duration. Findings suggest the need for more efficient claims management to ensure fewer barriers to claim lodgement or approval. This in turn should reduce disability duration and ensure improved return-to-work outcomes.

Incidence and analysis of sharps injuries and splash exposures in a tertiary hospital in Southeast Asia: a ten-year review.

INTRODUCTION: We aimed to report the ten-year incidence and trend of sharps injuries and splash exposures (SISE), and analyse the causative instruments and risk factors leading to these injuries to identify potential areas of improvement. METHODS: A retrospective review of self-reported SISE incidents from 2005 to 2014 was conducted in Singapore General Hospital. Data was extracted from the electronic database of the Department of Infection Prevention and Control. Incidence of SISE was calculated per 1,000 healthcare workers (HCWs) per year. RESULTS: Over the ten-year period, a total of 1,901 SISE were reported. The average SISE incidence per year was 110.5 per 1,000 doctors and 22.8 per 1,000 nursing staff, with an overall incidence of 28.9 per 1,000 HCWs. The incidence of SISE decreased from 30.3 to 22.0 per 1,000 HCWs per year from 2005 to 2014, while that for splash exposures increased from 1.9 to 3.7 per 1,000 HCWs per year. Doctors reported the highest number of SISE (43.7%), followed by nurses (37.7%). Top mechanisms of injury were intraoperative procedures (22.8%), drawing blood (14.4%) and splash exposures (13.7%). CONCLUSION: Overall incidence of SISE decreased over the decade. Improved training and increasing use of safety devices, education and awareness could have contributed to the fall in incidence of sharps injuries; these measures should be reinforced and continued. However, the incidence of splash exposures increased over the same period. Preventive measures such as the use of protective goggles and face shields, together with personal protective equipment, should be emphasised and encouraged.