Commercial Fishing Fatalities and Injuries Described by Linked Vessel Incidents.

OBJECTIVES: The Risk Information System for Commercial Fishing (RISC Fishing) merged information on fishermen and vessel incident types from various databases. This descriptive study examined linked fisherman injury records (fatal and nonfatal) and vessel incident records in Oregon and Washington from 2000 to 2018 in the RISC Fishing database. The circumstances of incidents and any association with fishermen outcomes were explored to identify injury prevention opportunities. METHODS: The statistical analyses included a descriptive study of incidents related to the injury characteristics and frequency of outcomes by incident type. Further analyses included contingency tables and Pearson Chi-Square tests for selected variables to determine if there were associations between vessel incident outcomes (fatality, nonfatal injury, no injury). RESULTS: A total of 375 reported incidents with 93 cases of fatalities, 239 nonfatal injuries, and over 6,575 fishermen with no injury were described. Of fatalities, 90% were due to drowning, with only 2% of victims reported donning survival equipment. Deckhands experienced fatal and nonfatal injuries most frequently. The most common factors associated with nonfatal injuries included contact with objects (event), walking on vessel and hauling gear (work activities), and fractures and open wounds (nature). The most common final event leading to a vessel disaster with no injury being reported was sinking (76%). Distributions between the incident outcomes (fatality, nonfatal injury, and no injury) differed by vessel activity/type, fishery/gear, and event leading to the incident. CONCLUSION: Linked information of fishermen injury outcomes and vessel incident information showed that events and settings that involve fatalities are qualitatively different from incidents resulting in only nonfatal injuries or uninjured survivors. Vessel-level approaches for mitigating fatalities, such as ensuring vessel stability, improving navigation/operation decisions, and spotlighting survival equipment policies/rescue priorities could have a significant impact. Work task-specific prevention strategies for nonfatal injuries related to the larger vessels (catcher/processors and processors) and smaller vessels (with pot/trap gears) are paramount. The use of linked information provided in reports can provide a fuller incident picture to advance efforts to improve the working conditions of commercial fishermen.

Utilizing Haddon matrix to assess nonfatal commercial fishing injury factors in Oregon and Washington.

BACKGROUND: Commercial fishing is a precarious industry with high fatal and nonfatal injury rates. The Risk Information System of Commercial [RISC] Fishing project at Oregon State University has been tracking both fatal and nonfatal injuries among Oregon and Washington commercial fishermen. We examined the utility of the RISC dataset variables in highlighting injury factors and prevention opportunities. METHOD: We identified 245 nonfatal commercial fishing injuries in Oregon and Washington (2000-2018) and assessed the top three injury events (contact with objects or equipment, transportation incidents, and slips/trips/falls) using a cross-sectional design. We generated a Haddon matrix for each event type and populated the matrices with injury-associated factors following our a-priori matrix. RESULTS: We observed 108 nonfatal injuries due to contact with objects. Contact injuries occurred during fishing (40%) with fishing gears (40%), often while hauling the fishing gear (22%). Common injury mechanisms included getting caught in running equipment or machinery (19%) or compressed by shifting objects or equipment (18%). Of the 58 transportation injuries most occurred in catchers (93%) and smaller vessels (1 to 3 crew) (55%). Vessel casualties were common as several vessels struck rocks/bottom (29%) or experienced fire and explosion (19%). The crew was abandoned to water (38%), often due to no raft or raft malfunctions (19%). Slip/trip/fall injuries (n = 43) typically happened during onboard traffic (49%). Such events were largely experienced by the catcher-processors (44%) including large vessels with > 100 crew (28%). CONCLUSION: The Haddon matrix demonstrated the injury-event timeline and helped to identify potential injury-associated factors. Our injury-specific risk matrices will let commercial fishing stakeholders determine priorities and work with the experts on prevention efforts.

Traumatic injuries among Alaska's young workers: Linking cases from four data systems.

BACKGROUND: Young workers (aged 15-24 years) experience higher rates of job-related injury compared with workers aged 25-44 years in the United States. Young workers may have limited or no prior work experience or safety training, which can contribute to their injury risk. In 2018, Alaska had the second highest work-related fatality rate and 14th highest non-fatal injury rate in the United States. This study aimed to characterize nonfatal and fatal occupational injuries among young workers in Alaska. METHODS: To describe injury patterns among Alaska young workers from 2014-2018, we used data from four datasets: Alaska Workers' Compensation, Alaska Occupational Injury Surveillance System, Alaska Trauma Registry, and Alaska Fishermen's Fund. The datasets were merged two at a time and filtered by the worker characteristics (e.g., age and sex) and incident characteristics (e.g., date of injury). Duplicates were then manually identified between the datasets using the variables above. The injury narrative and Occupational Injury and Illness Classification System codes were used last to verify true duplicates. Descriptive analyses were performed after the duplicates were merged. RESULTS: During the 5-year study period 2014-2018, young workers experienced 20 fatal and 12,886 nonfatal injuries. Residents of Alaska comprised 85% of nonfatal and 70% of fatal injuries. The top three major occupation groups with the highest number of injuries were production (1,391, 14%), food preparation (1,225, 12%), and transportation/material moving (1,166, 11%). The most common events leading to injuries were struck by object or equipment (2,027, 21%), overexertion involving outside sources (1,385, 14%), and struck against object or equipment (905, 9%). The most common nature of injuries were sprains/strains/tears (3,024, 29%), cuts/lacerations (1,955, 19%), and bruises/contusions (1,592, 15%). CONCLUSION: Although progress has been made in reducing worker injuries, Alaskan young workers still experience injuries and fatalities frequently. Based on findings, there is a clear need for employers, researchers, public health professionals, parents, and young workers to prioritize young worker safety through an integrated approach, from education and training to adequate workplace supervision and support.

Workplace Injuries Caused by Commercial Fishing Winches-Alaska, 2000-2020.

OBJECTIVES: Deck machinery is a leading source of hospitalized injury for commercial fishing workers in Alaska. More detailed data are needed about the specific circumstances leading to injuries for developing targeted prevention efforts. METHODS: This study analyzed claims submitted to the Alaska Fisherman's Fund (AFF) to identify patterns among injuries in Alaska from commercial fishing winches. RESULTS: During January 1, 2000-November 1, 2020, 125 traumatic injuries from commercial fishing winches were identified, mainly occurring among males (94%), frequently among fishermen aged 30 years or younger (54%). Over 80% of winch injuries occurred in salmon fisheries. By gear type, 40% of injuries occurred on vessels using purse seine gear, 30% on vessels using drift gillnet gear, and 12% among set gillnet operators. Most injuries involved a fisherman having a body part caught in or compressed by a winch or cables attached to a winch (67%). Injuries mainly affected upper extremities including fingers (50% of cases) or hands/wrists (together 22% of cases). Injury severity was not formally assessed, but injuries ranged from contusions, sprains, and strains to finger or hand crushing injuries, upper limb amputation, skull fracture, spinal fracture, and chest trauma. Most cases involved fractures (23%), amputations (18%), lacerations (16%), and contusions (16%). Of all injuries, 51% were caused by anchor winches, 32% were caused by deck winches, 9% were caused by trailer winches, and 9% were caused by other types of winches. CONCLUSIONS: Practical solutions are needed for avoiding entanglement and struck-by hazards when operating fishing winches. Anchor winches warrant focused attention, having accounted for more than half of all winch injuries identified in this study. Engineering solutions, including emergency stop devices or other simple mechanical interventions depending on winch type, could help to avert potentially disabling injuries from winches. Administrative controls such as task-specific training for winches should be emphasized, especially for younger or less experienced commercial fishing crew, who may be at increased risk for injury.

Intracardiac thrombosis following intravenous zoledronate treatment in a child with steroid-induced osteoporosis.

OBJECTIVES: Bisphosphonates are used in childhood osteoporosis but can cause an acute phase reaction (APR) and hypocalcemia. We present a child with cardiac thrombosis following zoledronate, a previously unreported complication. CASE PRESENTATION: An 11-year-old with Duchenne muscular dystrophy and steroid-induced osteoporosis presented 48 h after first zoledronate infusion with fever, tachycardia, tachypnoea and hypoglycaemia. This was managed as acute adrenal crisis and possible sepsis. He also had hypocalcemia, hypophosphatemia, hyponatraemia and hypokalaemia. Echocardiography performed due to persistent chest pain and tachycardia revealed a left ventricular thrombus. CONCLUSIONS: Potential causes for intracardiac thrombosis in this patient include ventricular dysfunction due to acute adrenal crisis or electrolyte disturbance, and hypercoagulability due to the APR. Echocardiography should be considered in children with acute cardiovascular compromise following zoledronate. Stress-dose steroids to cover the APR and a reduced starting dose of zoledronate might have reduced the risk of this complication.

Have you met Angus? Development and evaluation of a social marketing intervention to improve personal flotation device use in commercial fishing.

INTRODUCTION: Drowning is the leading cause of death among commercial fishermen in the United States. Approximately 30% of all commercial fishing fatalities are attributed to falls overboard. One of the simplest and most affordable ways to prevent these fatalities is for crewmembers to wear personal flotation devices (PFDs) while on deck. An examination of over 200 fatal falls overboard in the U.S. fishing industry revealed that none of the victims were wearing PFDs when they died. PFDs are not required to be worn by commercial fishermen in the United States, so this study was designed to encourage behavior change using targeted health communication and social marketing. METHODS: This study developed, implemented, and evaluated a multi-media social marketing campaign featuring a fictitious, culturally-relevant spokesman designed to look, talk, and act like the target audience. The messages were crafted to address common barriers to PFD adoption and misconceptions about fleet-specific risks for fatalities from falls overboard. The campaign was evaluated over two seasons of fishing to look at message retention and intent toward action following exposure to the campaign materials. RESULTS: Survey respondents indicated overall positive opinions about the spokesman and the messages. Results also show a reported change in behavior related to using PFDs while working on deck. DISCUSSION: Targeted multi-media messaging can influence behavior of workers in high-risk occupations in remote locations. Safety message development should focus on occupational culture to create valid and authentic communication products for workers in high-risk industries.

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.

Prevalence of Adverse Health Behaviors and Conditions Among Maritime Workers, BRFSS 2014 to 2018, 38 States.

OBJECTIVE: To analyze health behaviors and conditions among maritime workers using Behavioral Risk Factor Surveillance System (BRSS). METHODS: BRFSS data from 2014 to 2018 were used to calculate weighted prevalence estimates and adjusted prevalence ratios (aPRs) for 10 health behaviors and conditions. Logistic regression was used to compare aPRs between maritime workers and all other US workers. RESULTS: Compared with other workers, maritime workers had higher weighted prevalence estimates for six of 10 health behaviors and conditions: binge drinking, smoking, obese/overweight, diabetes, cancer, and chronic obstructive pulmonary disease. Maritime workers had significantly higher aPRs for binge drinking (aPR = 1.28) and smoking cigarettes (aPR = 1.39) compared with all other US workers. CONCLUSIONS: This study uses BRFSS data to estimate the prevalence of adverse health conditions across maritime industries. This study can serve as the foundation for additional follow-on research.

Application of data linkage techniques to Pacific Northwest commercial fishing injury and fatality data.

BACKGROUND: Commercial fishing consistently has among the highest workforce injury and fatality rates in the United States. Data related to commercial fishing incidents are routinely collected by multiple organizations which do not currently coordinate or automatically link data. Each data set has the potential to generate a more complete picture to inform prevention efforts. Our objective was to examine the utility of using statistical data linkage methods to link commercial fishing incident data when personally identifiable information is not available. METHODS: In this feasibility study, we identified true matches and discrepancies between de-identified data sets using the Python Record Linkage Toolkit. Four commercial fishing data sets from Oregon and Washington were linked: the Commercial Fishing Incident Database, the Vessel Casualty Database, the Nonfatal Injuries Database, and the Oregon Trauma Registry. The data sets each covered different date ranges within 2000-2017, containing 458, 524, 184, and 11 cases respectively. Several data linkage classifiers were evaluated. RESULTS: The Naïve-Bayes classifier returned the highest number of true matches between these small data sets. A total of 41 true matches and 8 close matches were identified, of which 29 were determined to be duplicates. In addition, linkage highlighted 4 records that were not commercial fishing cases from Oregon and Washington. The optimum match parameters were the date, state, vessel official number, and number of people on board. CONCLUSIONS: Statistical data linkage enables accurate, routine matching for small de-identified injury and fatality data sets such as those in commercial fishing. It provides information needed to improve the accuracy of existing data records. It also enables expanding and sharpening details of individual incidents in support of occupational safety research.

Linking Datasets to Characterize Injury and Illness in Alaska's Fishing Industry.

Limited research has characterized nonfatal injury/illness in Alaska's hazardous fishing industry. This study aimed to determine (a) the utility of linking datasets to conduct surveillance, and (b) injury/illness patterns during 2012-2016. Data were obtained from the Alaska Trauma Registry (ATR), Fishermen's Fund (FF), and US Coast Guard (USCG). Datasets were coded to identify patterns in injury/illness characteristics and circumstances. Probabilistic linkage methods were utilized to identify unique incidents that appeared in more than one dataset. After linking datasets, 3,014 unique injury/illness cases were identified. By dataset, 2,365 cases appeared only in FF, 486 only in USCG, 110 only in ATR, 25 in ATR and FF, 15 in ATR and USCG, 10 in USCG and FF, and 3 in all datasets. FF mainly captured claims submitted by small, independently-owned vessels in Southcentral and Southeastern Alaska. In contrast, USCG mainly captured reports from large, company-owned vessels in Western Alaska. By nature, cases were most frequently sprains, strain, and tears (27%), cuts (15%), and fractures (11%). Across fleets, injuries/illnesses most frequently resulted from contact with objects and equipment (41%), overexertion and bodily reaction (27%), and slips, trips, and falls (20%). Work processes associated with traumatic injuries were most frequently hauling gear (18%) and walking, climbing, and descending (18%). Half of all injuries were of moderate severity (53%). Linking datasets, which capture different segments of Alaska's fishing industry, provides the most comprehensive understanding of nonfatal injury/illness to date. These results, stratified by fleet and severity, will inform prevention strategies.

Predicting commercial fishing vessel disasters through a novel application of the theory of man-made disasters.

INTRODUCTION: Vessel disasters (e.g., sinkings, capsizings) are a leading contributor to fatalities in the U.S. commercial fishing industry. Primary prevention strategies are needed to reduce the occurrence of vessel disasters, which can only be done by developing an understanding of their causes and risk factors. If less serious vessel casualties (e.g., loss of propulsion, fire, flooding) are predictors of future disasters, then reducing vessel casualties should in turn reduce vessel disasters and the accompanying loss of life. METHOD: This case-control study examined the association between vessel casualties and disasters using fishing vessels in Alaska during 2010-2015. RESULTS: The findings show that vessels that experienced casualties within a preceding 10-year period were at increased odds of disaster. Other significant predictors included safety decal status and hull material. Practical Applications: The results of this analysis emphasize the importance of implementing vessel-specific preventive maintenance plans. At an industry level, specific prevention policies should be developed focusing on high-risk fleets to identify and correct a wide range of safety deficits before they have catastrophic and fatal consequences.

Persistent and emerging hazards contributing to work-related fatalities in Alaska.

BACKGROUND: Workers in Alaska have an elevated risk of dying on the job compared to workers in the rest of the United States. The purpose of this study was to measure and describe the trend in fatalities during the 15-year period 2004 to 2018, and to identify lingering and emerging hazards that result in fatalities. METHODS: Data on fatal work-related injuries in Alaska during 2004 to 2018 were obtained from the Alaska Occupational Injury Surveillance System. Descriptive statistics were calculated to identify fatality characteristics. Fatality rates were expressed as the number of deaths per 100 000 workers, and Poisson regression was used to measure the trend during the study period. RESULTS: During 2004 to 2018, there were 517 work-related fatalities in Alaska. The average annual risk of fatalities during the 15-year period was 9.6 per 100 000 workers, with no significant trend. The leading events or exposures resulting in fatal injuries to workers in Alaska during 2004 to 2018 were water vehicle incidents (145, 28.0%), aircraft incidents (105, 20.3%), and suicides (46, 8.9%). The number of suicides and homicides at work increased substantially during the 15-year period. CONCLUSIONS: While deaths due to water vehicle incidents have substantially decreased, they still represent a major component of Alaska's work-related fatality profile. Aviation safety continues to be an area of concern in Alaska. Unintentional drug overdoses at work, as well as workplace violence in the form of suicides and homicides, represent emerging issues that need the attention of Alaskan occupational safety stakeholders. These findings can inform and direct fatality prevention research and practice.

Occupational traumatic injuries among offshore seafood processors in Alaska, 2010-2015.

INTRODUCTION: The U.S. Coast Guard and Federal Occupational Safety and Health Administration have identified the Alaskan offshore seafood processing industry as high-risk. This study used Coast Guard injury reports to describe patterns of traumatic injury among offshore seafood processors, as well as identify modifiable hazards. METHODS: From the reports, we manually reviewed and abstracted information on the incident circumstances, injury characteristics and circumstances, and vessel. Traumatic injury cases were coded using the Occupational Injury and Illness Classification System, and a Work Process Classification System. Descriptive statistics characterized worker demographics, injuries, and fleets. RESULTS: One fatal and 304 nonfatal injuries among processors were reported to the Coast Guard during 2010-2015 across multiple fleets of catcher-processor and mothership vessels. The most frequently occurring injuries were: by nature of injury, sprains/strains/tears (75, 25%), contusions (50, 16%), and fractures (45, 15%); by body part affected, upper extremities (121, 40%), and trunk (75, 25%); by event/exposure resulting in injury, contact with objects and equipment (150, 49%), and overexertion and bodily reaction (76, 25%); and by source of injury, processing equipment and machinery (85, 28%). The work processes most frequently associated with injuries were: processing seafood on the production line (68, 22%); stacking blocks/bags of frozen product (50, 17%); and repairing/maintaining/cleaning factory equipment (28, 9%). CONCLUSIONS: Preventing musculoskeletal injuries, particularly to workers' upper extremities and trunks, is paramount. Some injuries, such as serious back injuries, intracranial injuries, and finger crushing or amputations, had the potential to lead to disability. PRACTICAL APPLICATIONS: Safety professionals and researchers can use the study findings to inform future intervention efforts in this industry. Hazard control measures should target: (a) overexertion from lifting and lowering objects and equipment; (b) equipment and boxes falling and striking workers; (c) workers being caught in running machinery during regular operations; and (d) slips, trips, and falls.

Factors associated with crewmember survival of commercial fishing vessel sinkings in Alaska.

Occupational fatality surveillance has identified that fishing vessel disasters, such as sinkings and capsizings, continue to contribute to the most deaths among crewmembers in the US fishing industry. When a fishing vessel sinks at sea, crewmembers are at risk of immersion in water and subsequent drowning. This study examined survival factors for crewmembers following cold water immersion after the sinking of decked commercial fishing vessels in Alaskan waters during 2000-2014. Two immersion scenarios were considered separately: immersion for any length of time, and long-term immersion defined as immersion lasting over 30 minutes. Logistic regression was used to predict the odds of crewmember survival. Of the 617 crewmembers onboard 187 fishing vessels that sank in Alaska during 2000-2014, 557 (90.3%) survived and 60 died. For crewmembers immersed for any length of time, the significant adjusted predictors of survival were: entering a life-raft, sinking within three miles of shore, the sinking not being weather-related, and working as a deckhand. For crewmembers immersed for over 30 minutes, the significant adjusted predictors of survival were: wearing an immersion suit, entering a life-raft, working as a deckhand, and the sinking not being weather-related. The results of this analysis demonstrate that in situations where cold water immersion becomes inevitable, having access to well-maintained, serviceable lifesaving equipment and the knowledge and skills to use it properly are critical.

Fatal Falls Overboard in Commercial Fishing - United States, 2000-2016.

Commercial fishing is one of the most dangerous jobs in the United States, with a 2016 work-related fatality rate (86.0 deaths per 100,000 full-time equivalent workers) 23 times higher than that for all U.S. workers (3.6) (1). Sinking vessels cause the most fatalities in the industry; however, falling from a fishing vessel is a serious hazard responsible for the second highest number of commercial fishing-associated fatalities (2,3). CDC's National Institute for Occupational Safety and Health (NIOSH) analyzed data on unintentional fatal falls overboard in the U.S. commercial fishing industry to identify gaps in the use of primary, secondary, and tertiary prevention strategies. During 2000-2016, a total of 204 commercial fishermen died after unintentionally falling overboard. The majority of falls (121; 59.3%) were not witnessed, and 108 (89.3%) of these victims were not found. Among 83 witnessed falls overboard, 56 rescue attempts were made; 22 victims were recovered but were not successfully resuscitated. The circumstances, rescue attempts, and limited use of lifesaving and recovery equipment indicate that efforts to reduce these preventable fatalities are needed during pre-event, event, and post-event sequences of falls overboard. Vessel owners could consider strategies to prevent future fatalities, including lifeline tethers, line management, personal flotation devices (PFDs), man-overboard alarms, recovery devices, and rescue training.

Work-related nonfatal injuries in Alaska's aviation industry, 2000-2013.

Aviation is a critical component of life in Alaska, connecting communities off the road system across the state. Crash-related fatalities in the state are well understood and many intervention efforts have been aimed at reducing aircraft crashes and resulting fatalities; however, nonfatal injuries among workers who perform aviation-related duties have not been studied in Alaska. This study aimed to characterize hospitalized nonfatal injuries among these workers using data from the Alaska Trauma Registry. During 2000-2013, 28 crash-related and 89 non-crash injuries were identified, spanning various occupational groups. Falls were a major cause of injuries, accounting for over half of non-crash injuries. Based on the study findings, aviation stakeholders should review existing policies and procedures regarding aircraft restraint systems, fall protection, and other injury prevention strategies. To supplement these findings, further study describing injuries that did not result in hospitalization is recommended.

Work-related mortality in the US fishing industry during 2000-2014: New findings based on improved workforce exposure estimates.

BACKGROUND: Commercial fishing is a global industry that has been frequently classified as high-risk. The use of detailed surveillance data is critical in identifying hazards. METHODS: The purpose of this study was to provide updated statistics for the entire US fishing industry during 2010-2014, generate fleet-specific fatality rates using a revised calculation of full-time equivalent estimates, and examine changes in the patterns of fatalities and in risk over a 15-year period (2000-2014). RESULTS: During 2010-2014, 188 commercial fishing fatalities occurred in the United States. Vessel disasters and falls overboard remain leading contributors to commercial fishing deaths. The Atlantic scallop fleet stands out for achieving substantial declines in the risk of fatalities over the 15-year study period. However, fatality rates ranged from 21 to 147 deaths per 100 000 FTEs, many times higher than the rate for all US workers. CONCLUSIONS: Although the number of fatalities among commercial fishermen in the United States has generally declined since 2000, commercial fishing continues to have one of the highest occupational fatality rates in the United States. The sustainable seafood movement could assist in improving the health and safety of fishing industry workers if worker well-being was integrated into the definition of sustainable seafood.

Preventing fatal winch entanglements in the US southern shrimp fleet: A research to practice approach.

INTRODUCTION: During 2000-2011, 35 injuries (8 fatal) involving winches were reported to the Coast Guard in the Southern shrimp fleet. Injuries involving the main winch drums had a higher risk for fatal outcomes compared to injuries involving the winch cathead (RR=7.5; 1.1-53.7). The objective of this study was to design effective solutions to protect deckhands from entanglement hazards posed by winches found on the vessels in the Southern shrimp fleet. METHODS: Based on injury characteristics, site visit observations, and input from vessel owners, NIOSH determined that the design and implementation of effective main-winch guarding was a feasible first-step in mitigating the entanglement hazard. Design considerations for stationary guards favor systems that are simple, affordable, durable, unobtrusive, and will not interfere with normal fishing operations. In addition, an auxiliary-stop method was tested to prevent entanglements in try-net winches. RESULTS: Standardized passive guards were designed for three commonly found main winch models. Initial prototype guards have been sea-tested. The design of six additional guards is underway, for a total of three iterations for each winch model identified. These will incorporate features found to be valued by fishermen, will be more efficient, and will reduce the overall cost of fabrication and maintenance. Sea testing of these iterations continues. The auxiliary-stop circuit control prototype system was designed to prevent entanglements in the try-net winch and is currently being sea tested. DISCUSSION: NIOSH has completed initial designs for stationary-winch guards. Through collaborations with shrimper associations and safety groups, the successfully tested winch guard and auxiliary stop designs will be made available to qualified welders and craftsmen to use. This approach has proven effective in preventing other types of winch injuries. PRACTICAL APPLICATIONS: Injury epidemiologic methods and industry input are an effective way to identify workplace hazards and to design effective safety interventions to control hazards.

Population structure of invasive Streptococcus pneumoniae isolates among Alaskan children in the conjugate vaccine era, 2001 to 2013.

Here we describe the relationships between serotypes, genotypes, and antimicrobial susceptibility among isolates causing invasive pneumococcal disease in Alaskan children during the pneumococcal conjugate vaccine (PCV) era. From 2001 to 2013 we received 271 isolates representing 33 serotypes. The most common serotypes were 19A (29.5%, n= 80), 7F (12.5%, n= 34), 15B/C (6.3%, n= 17), and 22F (4.8%, n= 13). Multilocus sequence typing identified 11 clonal complexes (CC) and 45 singletons. Five CCs accounted for 52% (141/271) of the total: CC199 (21% [n= 57], serotypes 19A, 15B/C), CC191 (12.2% [n= 33], serotype 7F), CC172 (10.3% [n= 28], serotypes 19A, 23A, 23B), CC433 (4.4% [n= 12], serotype 22F), and CC100 (4.4% [n= 12], serotype 33F). The proportion of isolates nonsusceptible to erythromycin and tetracycline increased after 13-valent PCV use (14% [n= 30] versus 29% [n= 14]; P= 0.010) and (4% [n= 9] versus 22% [n= 11]; P< 0.001), respectively. The genetic diversity also increased after 13-valent PCV use (Simpson's diversity index =0.95 versus 0.91; P= 0.022).

A Longitudinal Hepatitis B Vaccine Cohort Demonstrates Long-lasting Hepatitis B Virus (HBV) Cellular Immunity Despite Loss of Antibody Against HBV Surface Antigen.

BACKGROUND: Long-lasting protection resulting from hepatitis B vaccine, despite loss of antibody against hepatitis B virus (HBV) surface antigen (anti-HBs), is undetermined. METHODS: We recruited persons from a cohort vaccinated with plasma-derived hepatitis B vaccine in 1981 who have been followed periodically since. We performed serological testing for anti-HBs and microRNA-155 and assessed HBV-specific T-cell responses by enzyme-linked immunospot and cytometric bead array. Study subgroups were defined 32 years after vaccination as having an anti-HBs level of either ≥10 mIU/mL (group 1; n = 13) or <10 mIU/mL (group 2; n = 31). RESULTS: All 44 participants, regardless of anti-HBs level, tested positive for tumor necrosis factor α, interleukin 10, or interleukin 6 production by HBV surface antigen-specific T cells. The frequency of natural killer T cells correlated with the level of anti-HBs (P = .008). The proportion of participants who demonstrated T-cell responses to HBV core antigen varied among the cytokines measured, suggesting some natural exposure to HBV in the study group. No participant had evidence of breakthrough HBV infection. CONCLUSIONS: Evidence of long-lasting cellular immunity, regardless of anti-HBs level, suggests that protection afforded by primary immunization with plasma-derived hepatitis B vaccine during childhood and adulthood lasts at least 32 years.