Knowledge, attitudes and practices regarding respirable silica exposure and personal protective equipment use among brick kiln workers in Nepal.

OBJECTIVES: Brick kiln workers in Nepal are a neglected population who are exposed to high respirable silica concentrations, and few use interventions to reduce exposure. We aimed to characterise the prevalence of respiratory personal protective equipment (PPE) use, understand knowledge and attitudes towards kiln dust and respiratory PPE and identify factors associated with respiratory PPE use. METHODS: We conducted a cross-sectional study in Bhaktapur, Nepal. We used simple random selection to identify 10 out of 64 total kilns and stratified random sampling of 30 households to enrol workers aged ≥14 years within selected kilns. Field workers surveyed participants using structured questionnaires. Our primary outcome was to characterise the prevalence of current respiratory PPE use and secondary outcomes were summaries of knowledge, attitudes and practice of PPE use. RESULTS: We surveyed 83 workers (mean age 30.8 years, 77.1% male). Of these, 28.9% reported current respiratory PPE use at work, 3.6% heard of silicosis prior to the survey and 24.1% correctly identified the best respiratory PPE (N95, compared with surgical masks and barrier face coverings) for reducing dust exposure. Respiratory PPE users had higher income (mean monthly household income US$206 vs US$145; p=0.04) and education levels (25% vs 5.1% completed more than primary school; p=0.02) compared with non-users. CONCLUSIONS: Respiratory PPE use was low. Workers had poor knowledge of kiln dust health effects and proper respiratory PPE. We highlight important barriers to PPE use, particularly knowledge gaps, which can guide future investigations to reduce the silicosis burden among brick kiln workers.

Brick kiln pollution and its impact on health: A systematic review and meta-analysis.

Brick kiln emissions adversely affect air pollution and the health of workers and individuals living near the kilns; however, evidence of their impacts remains limited. We conducted a systematic review of brick kiln pollution (emissions, source contributions and personal exposures) and its effects on health. We extracted articles from electronic databases and through manual citation searching. We estimated pooled, sample-size-weighted means and standard deviations for personal exposures by job type; computed mean emission factors and pollutant concentrations by brick kiln design; and meta-analyzed differences in means or proportions for health outcomes between brick kiln workers and controls or for participants living near or far away from kilns. We identified 104 studies; 74 were conducted in South Asia. The most evaluated pollutants were particulate matter (PM; n = 48), sulfur dioxide (SO2; n = 24) and carbon monoxide (CO; n = 22), and the most evaluated health outcomes were respiratory health (n = 34) and musculoskeletal disorders (n = 9). PM and CO emissions were higher among traditional than improved brick kilns. Mean respirable silica exposures were only measured in 4 (4%) studies and were as high as 620 µg/m3, exceeding the NIOSH recommended exposure limit by a factor of over 12. Brick kiln workers had consistently worse lung function, more respiratory symptoms, more musculoskeletal complaints, and more inflammation when compared to unexposed participants across studies; however, most studies had a small sample size and did not fully describe methods used for sampling or data collection. On average, brick kiln workers had worse health outcomes when compared to unexposed controls but study quality supporting the evidence was low. Few studies reported silica concentrations or personal exposures, but the few that did suggest that exposures are high. Further research is needed to better understand the relationship between brick kiln pollution and health among workers, and to evaluate exposure mitigation strategies.

Development of a job-exposure matrix-like exposure assessment method for the US general population based on Occupational Information Network (O*NET) job tasks.

BACKGROUND: Job-exposure matrices (JEMs) are often used for exposure assessment in occupational exposure and epidemiology studies. However, general population JEMs are difficult to find and access for workers in the United States of America. OBJECTIVE: We aimed to use publicly available information to develop a JEM-like exposure assessment method to determine exposure to a wide range of occupational agents in a wide range of occupations for US general population studies. METHODS: We used information from the US Department of Labor's Occupational Information Network database (O*NET) for 19,636 job tasks and 974 civilian occupations. We used automated keyword searches to identify 1,804 job tasks that involved exposure to 50 occupational agents. We had 2 reviewers determine whether each identified job task actually involved exposure to the 50 occupational agents. We had a third reviewer, a certified industrial hygienist, assess any job task and exposure for which the first 2 reviewers disagreed. For each U.S. Census 2010 occupation code, we used this information to derive 3 exposure variables for each occupational agent: ever exposure, number of job tasks of exposure, and frequency of exposure. RESULTS: Our keyword searches identified a median of 10 (interquartile range [IQR]: 43.75) job tasks for each occupational agent, and the maximum was 308. We determined job tasks actually involved exposure to 45 occupational agents, including solvents, air pollution, pesticides, radiation, metals, etc. We derived the 3 exposure variables for these 45 occupational agents for 516 U.S. Census 2010 occupation codes. The median percentage for ever exposure to individual occupational agents was 1.16% (IQR: 1.74%), and the maximum was 11.43%. CONCLUSIONS: Our JEM-like exposure assessment method based on O*NET information can be used to determine exposure to a wide range of occupational agents in a wide range of occupations for the US general population.

Non-Fatal Occupational Injury Prevalence and Associated Factors in an Integrated Large-Scale Textile Industry in Addis Ababa, Ethiopia.

Occupational injuries disproportionately impact workers of the textile industry in low-income countries. The present study investigates the prevalence of non-occupational injury and its associated factors among workers in an integrated textile industry in Addis Ababa, Ethiopia. A cross-sectional study was conducted from 17-26 May 2021. A total of 311 workers were eligible for participation. The information was collected through an interview-administered questionnaire. The findings were presented with descriptive statistics and the relationship among variables was assessed with multi-variable analyses. A total of 291 (93.6%) participants were interviewed. The prevalence of non-fatal occupational injury was 11% [95% CI: 7.7-15.5] in the past 12 months. The hands and fingers were the most affected body parts. Male gender [AOR: 3.40; 95% CI (1.13-10.5)], the age group of 18-29 years [AOR: 6.69; 95% CI (1.35-32.7)], sleeping less than seven hours in a night [AOR: 2.67; 95% CI (1.03-6.97)], machine-based jobs [AOR: 3.59; 95% CI (1.02-12.6)], the workplace housekeeping [AOR: 5.87; 95% CI (1.45-23.8)], and inadequate empowerment to prevent injury accident [AOR: 4.6; 95% CI (1.01-20.9)] were associated factors with occupational injury. The prevalence of non-fatal occupational injuries is lower than the previous studies among textile workers. As a result, improving workplace safety, changing sleeping habits, and empowering workers to participate in injury prevention should be a priority in intervention.

Occupational safety and health guidelines in relation to COVID-19 risk, death risk, and case-fatality proportion: An international, ecological study.

Background: Coronavirus disease 2019 (COVID-19) began in 2019 with several unknown factors. The World Health Organization (WHO) subsequently developed COVID-19 occupational safety and health (OSH) guidelines to reduce occupational COVID-19 transmission. Many countries also developed their own COVID-19 OSH guidelines, but whether these guidelines included WHO's guidelines and whether including WHO's guidelines in countries' COVID-19 OSH guidelines reduced COVID-19 transmission is unknown. Objectives: The objectives of our study were to (1) compare the COVID-19 OSH guidelines of several countries to WHO's OSH guidelines, (2) estimate associations between characteristics of countries and their OSH guidelines and the number of WHO's OSH guidelines included in countries' OSH guidelines, and (3) estimate associations between WHO's OSH guidelines included in countries' OSH guidelines and COVID-19 risk, death risk, and case-fatality proportion. Methods: This study represents international, ecological research of 36 countries from all six world health regions. Countries' COVID-19 OSH guidelines were compared with WHO's OSH guidelines. Linear regression models adjusted for potential confounders were used to estimate associations of interest. Results: The median number of WHO's 15 COVID-19 OSH guidelines included in countries' COVID-19 OSH guidelines was eight. Countries' COVID-19 OSH guidelines focused on workers included significantly more of WHO's COVID-19 OSH guidelines than countries' COVID-19 OSH guidelines focused on general populations. Including "provide personal protective equipment for workers" and "create workplace policy for wearing personal protective equipment" in countries' COVID-19 OSH guidelines were significantly related to decreased COVID-19 risk, death risk, and/or case-fatality proportion. Conclusions: Countries' COVID-19 OSH guidelines should include WHO's guidelines, focus on workers, and include "provide personal protective equipment for workers" and "create workplace policy for wearing personal protective equipment."

Gaseous Air Pollutants and Respirable Crystalline Silica Inside and Outside Homes at Brick Kilns in Bhaktapur, Kathmandu Valley, Nepal.

Household and ambient air pollution remain public health problems in much of the world. Brick kiln employees in Nepal may be particularly at risk of high air pollution exposures and resulting health effects due to high levels of outdoor air pollution, substandard housing, and indoor biomass cooking. We conducted a cross-sectional study of indoor and outdoor air pollution concentrations at workers' homes at four fixed chimney Bull's trench brick kilns in Bhaktapur, Kathmandu Valley, Nepal. We measured air concentrations of carbon monoxide (CO), carbon dioxide (CO2), nitrogen dioxide (NO2), sulfur dioxide (SO2), and respirable crystalline silica (SiO2; cristobalite, quartz, tridymite) using established methods and conducted a survey about characteristics of homes or samples that may be associated with air pollution concentrations. Geometric mean concentrations of CO, CO2, and SiO2 (quartz) were 0.84 ppm, 1447.34 ppm, and 6.22 µg/m3, respectively, whereas concentrations of all other air pollutants measured below lower detection limits. Most characteristics of homes or samples were not associated with air pollution concentrations. We found a positive association between the variable how long lived in house and SiO2 (quartz) concentrations, which may reflect sustained take-home exposure to SiO2 (quartz) over time. Interventions should focus on administrative controls to reduce take-home exposure to SiO2 (quartz) in this population.

Workplace stress and associated factors among vehicle repair workers in Hawassa City, Southern Ethiopia.

INTRODUCTION: Workplace stress is a public health problem worldwide. Studies focusing on work-related stress among vehicle repair workers are scarce in African countries. The current study aimed to determine the prevalence of self-reported workplace stress and associated factors among vehicle repair workers in Hawassa City, South Ethiopia. METHODS AND FINDINGS: A cross-sectional study design was employed among 347 vehicle repair workers from January 25 to February 22, 2019. Questionnaires were administered using interviews. Additional tools were used for weight and height measurements. The main findings were analyzed using descriptive statistics, bivariable, and multivariable logistic regression. The strength of association of variables was presented by odds ratio along with its 95% CI. The statistical assessments were considered significant at p<0.05. A total of 344 workers participated in the study. The prevalence of workplace stress among participants was 41.6% with 95% CI: (36.3-47.1). Factors associated with workplace stress were more than 10 years of work experience [AOR: 2.40; 95% CI (1.29-4.50)], work-related musculoskeletal disorder [AOR: 3.39; 95% CI (1.99-5.78)], squatting and lying work posture [AOR: 4.63; 95% CI (1.61-13.3)] and servicing large vehicles [AOR: 1.96; 95% CI (1.14-3.38)]. CONCLUSION AND RECOMMENDATIONS: This study showed that the overall prevalence of work-related stress was substantially high. The independently associated factors were workers' service years, symptoms of body pain, and the work environment. Preventive measures need to be implemented in vehicle repair workshops by focusing on work environment improvements.

Unintentional Injuries and Sociodemographic Factors among Households in Ethiopia.

Background: Unintentional injuries are a public health problem throughout the world including Africa. Most of the injury studies in Ethiopia are from the healthcare facility or workplace that does not reflect the problem at the community level. Therefore, this study aimed to assess the unintentional injuries and sociodemographic factors among households in Ethiopia. Methods: This study was done from the Ethiopian Demographic and Health Survey conducted in 2016. The survey collected information about unintentional injuries and injury mechanisms in the past 12 months among 16,650 households. The selection of households was from nine regions and two city administrations of Ethiopia using a stratified cluster sampling procedure. Descriptive statistics were used to characterize the data and the chi-square test was applied as a test of significance and a p value of <0.05 was considered statistically significant. Result: Of the 16,650 households that participated in the study, 394 (2.4%) reported that at least one household member suffered from an unintentional injury in the past 12 months. The leading mechanisms of injury were unintentional falls (152 falls, 33.2%) and road traffic incidents (96 incidents, 21.0%). Among household members who were injured, 84.3% survived and 15.7% died because of the injury. Divorce marital status of the household head [AOR: 2.12, 95% CI (1.12-4.41)] and family size of the household ≥ 6 [AOR:1.65, 95% CI (1.21-2.26)] were associated with high likelihood of occurrence of an injury, while lowest household wealth index [AOR: 0.69, 95% CI (0.50-0.95)] was protective against injuries. Conclusion: A low prevalence of unintentional injury was found from the community in this survey, which might be due to the tendency of the community to report severe injuries. Fall and road traffic accidents were the leading mechanisms of selected sociodemographic factors of the households that were associated with unintentional injuries. Injury prevention efforts should focus on falls and transportation injuries with special attention to the sociodemographic context of the communities.

Musculoskeletal Disorders and Associated Factors among Vehicle Repair Workers in Hawassa City, Southern Ethiopia.

Background: Vehicle repair work is one of the highest risk professions for work-related musculoskeletal disorders. Globally, only a few published studies have examined the prevalence and determinants of work-related musculoskeletal disorders among vehicle repair workers. Related studies in Ethiopia are even fewer. This study aimed to determine the prevalence of self-reported work-related musculoskeletal disorders and associated factors among vehicle repair workers in Hawassa city, South Ethiopia, 2019. Methods: An institution-based cross-sectional study was conducted among 344 vehicle repair workers in the Hawassa city. The Nordic Musculoskeletal Questionnaire-Extended (NMQ-E) was used to assess work-related musculoskeletal disorders on nine body regions. Descriptive statistics and multivariable analyses were used to characterize the data and identify factors associated with work-related musculoskeletal disorders. Result: The twelve-month prevalence of work-related musculoskeletal disorders among this working group was 47.7% with 95% CI (42.7-53.2). Jobs continuously requiring repetitive motions (AOR: 4.29, 95% CI (1.78-10.2)), not having professional training (AOR: 2.04, 95% CI (1.09-3.81)), force exertion when using tools (AOR: 2.40, 95% CI (1.24-4.62)), job stress (AOR:4.54, 95% CI (2.44-8.46)), and regularly lifting, pushing, and pulling loads greater than 20 kg (AOR:4.85, 95% CI (2.65-8.87)) were identified as associated factors. Conclusion: This study showed a 47.7% prevalence of work-related musculoskeletal disorders. Force exertion, repetitive tasks, manual handling of heavy loads, stress, and lack of training were the identified factors. Ergonomic awareness among workers should be increased through training. In addition, owners should investigate methods to reduce or eliminate risk factors leading to musculoskeletal disorders found among these workers. Automation of high-risk tasks should also be investigated.

Cross-Sectional Survey of Musculoskeletal Disorders in Workers Practicing Traditional Methods of Underground Coal Mining.

Background: In subcontinental underground mines, coal mining is carried out manually and requires many laborers to practice traditional means of coal excavation. Each task of this occupation disturbs workers' musculoskeletal order. In order to propose and practice possible ergonomic interventions, it is necessary to know what tasks (drilling and blasting, coal cutting, dumping, transporting, timbering and supporting, loading and unloading) cause disorder in either upper limbs, lower limbs, or both. Methods: To this end, R-programming, version R 3.1.2 and SPSS, software 20, were used to calculate data obtained by studying 260 workers (working at different tasks of coal mining) from 20 mines of four districts of Punjab, Pakistan. In addition, a Standard Nordic Musculoskeletal Questionnaire (SNMQ) and Rapid Upper Limb Assessment (RULA) sheet were used to collect data and to analyze postures respectively. Results: In multi regression models, significance of the five tasks for upper and lower limb disorder is 0.00, which means that task based prevalence of upper and lower limb disorders are common in underground coal mines. The results of the multiple bar chart showed that 96 coal cutters got upper limb disorders and 82 got lower limb disorders. The task of timbering and supporting was shown to be dangerous for the lower limbs and relatively less dangerous for the upper limbs, with 25 workers reporting pain in their lower limbs, and 19 workers reporting pain in their upper limbs. Documented on the RULA sheet, all tasks got the maximum possible score (7), meaning that each of these tasks pose a threat to the posture of 100% of workers. The majority of participants (182) fell in the age group of 26 to 35 years. Of those workers, 131 reported pain in the lower limbs and slight discomfort (128) in the upper limbs. The significance value of age was 0.00 for upper limb disorder and was 0.012 for lower limb disorder. Frequency graphs show age in direct proportion to severity of pain while in inverse proportion with number of repetitions performed per min. Conclusions: All findings infer that each task of underground coal mining inflicts different levels of disorder in a workers' musculoskeletal structure of the upper and lower limbs. It highlighted the need for urgent intervention in postural aspects of each task.

Risk Factors Associated with the Prevalence of Upper and Lower Back Pain in Male Underground Coal Miners in Punjab, Pakistan.

There is not enough data available on occupational health and safety issues of underground coal miners in Pakistan. This study focuses on spinal disorders in association with personal and occupational factors. The Nordic Musculoskeletal Questionnaire was used for a cross-sectional study of 260 workers of 20 mines located in four districts of Punjab, Pakistan. Regression models were created for upper back pain and lower back pain of workers whose mean age is 19.8 years (±SD 1.47). Results identify the coal cutting as the most harmful work with odds ratios (ORs) 13.06 (95% confidence interval (CI) 13.7-21.5) for lower back pain and 11.2 (95% CI 3.5-19.4) for upper back pain in participants. Those with greater years of work experience had higher odds of upper back pain (2.4, 95% CI 1.4-3.5) and lower back pain (3.3, 95% CI 1.1-4.4). Number of repetitions (mean value 25.85/minute with ±SD 9.48) are also significant for spinal disorder with ORs of 4.3 (95% CI 3.2-7.4) for lower back and 1.3 (95% CI 1.0-2.4) for upper back. Many other occupational and personal factors are positively associated with the back pain in underground coal mines workers, requiring immediate ergonomic intervention.

Air-Quality Assessment of On-Site Brick-Kiln Worker Housing in Bhaktapur, Nepal: Chemical Speciation of Indoor and Outdoor PM2.5 Pollution.

Brick workers and their families in Nepal generally live in poorly ventilated on-site housing at the brick kiln, and may be at higher risk for non-occupational exposure to fine particulate matter air pollution and subsequent respiratory diseases due to indoor and outdoor sources. This study characterized non-occupational exposure to PM2.5 by comparing overall concentrations and specific chemical components of PM2.5 inside and outside of brick workers' on-site housing. For all samples, the geometric mean PM2.5 concentration was 184.65 µg/m3 (95% confidence interval: 134.70, 253.12 µg/m3). PM2.5 concentrations differed by kiln number (p = 0.009). Kiln number was significantly associated with 16 of 29 (55%) air pollutant, temperature, or relative humidity variables. There was not a significant interaction between kiln number and location of sample for PM2.5 (p = 0.16), but there was for relative humidity (p = 0.02) and temperature (p = 0.01). Results were qualitatively similar when we repeated analyses using indoor samples only. There was no difference in the chemical makeup of indoor and outdoor PM2.5 in this study, suggesting that outdoor PM2.5 air pollution easily infiltrates into on-site brick worker housing. Outdoor and indoor PM2.5 concentrations found in this study far exceed recommended levels. These findings warrant future interventions targeted to this vulnerable population.

Exposure to respirable silica among clay brick workers in Kathmandu valley, Nepal.

Previous studies report high respirable silica exposures among clay brick workers globally; however, there are little data on exposures among workers in fixed chimney Bull's trench kilns, the predominant kiln type in Kathmandu valley, Nepal. We investigated respirable silica exposures among workers (N = 46) in five similar exposure groups (SEGs). Mean exposures were highest for red brick loading/carrying (331 µg/m3), followed by green brick stacking (223 µg/m3), fireman (102 µg/m3), coal crushing/carrying (92 µg/m3), and green brick molding (71 µg/m3). The average free silica content (13.8%) in the respirable dust fraction was similar to levels reported for clay brick workers employed in other types of kilns. Dust control measures and respiratory protection are recommended, with priority given to workers assigned to red brick loading and stacking and green brick stacking and carrying.

Respiratory symptoms and illnesses related to the concentration of airborne particulate matter among brick kiln workers in Kathmandu valley, Nepal.

BACKGROUND: Bricks have been manufactured in Nepal for hundreds of years and are seen as a component of Nepalese sculpture and architecture. Large quantities of hazardous materials including high concentrations of particulate matter are emitted on a daily basis from brick kilns. Exposure to these hazardous materials can lead to adverse consequences on the environment and human health. This study was conducted to  estimate the prevalence of respiratory symptoms/illnesses and the magnitude of respirable and total dust exposures among Nepalese brick kiln workers. METHODS: Respiratory symptoms/illnesses were evaluated by questionnaire among brickfield workers (n = 400) and a referent group of grocery workers (n = 400) in Kathmandu valley. Work zones (WZs): green brick molding (GBM), green brick stacking/carrying (GBS/C), red brick loading/carrying (RBL/C), coal preparation (CP) and firemen (FM) were the similar exposure groups (SEGs) from where personal air samples and interviews were taken. Among brickfield workers, personal monitoring was conducted across SEGs for total (n = 89) and respirable (n = 72) dust during February-March 2015 and March-April 2016. Applying multi-stage probability proportionate to size sampling technique, 16 kilns and 400 brick workers for interview were selected. Proportions, means, medians and ranges were calculated for the demographics, samples and respiratory symptoms/illnesses. One-way ANOVA was applied to compare the significance differences of the level of particulate matter among SEGs. Bivariate and multivariate logistic regression analysis were performed to evaluate association between respiratory symptoms/illnesses and participants groups, and SEGs among brick kiln workers at 0.05 level. Statistical analyses were performed using IBM SPSS Statistics 21. RESULTS: Chronic cough (14.3%), phlegm (16.6%) and bronchitis (19.0%) were higher (P < 0.05) among brickfield compared with grocery workers (6.8, 5.8 and 10.8%). Mean respirable (5.888 mg/m3) and total (20.657 mg/m3) dust exposures were highest for red brick loading tasks. The prevalence of chronic cough, chronic phlegm, chronic bronchitis, wheezing and asthma were significantly higher for other WZs workers (p < 0.05) compared with CP; for GBM: 22.9, 34.6, 15.0 and 7.5%; for GBS/C: 13.5, 15.8, 10.0, 8.8 and 7.5%; for RBL/C: 11.1, 17.1, 27.4, 19.0 and 11.9%; for FM: 18.4, 12.5, 28.4, 4.9 and 0.0%; and for CP: 4.9, 6.3, 13.3, 9.3 and 4.0% respectively. CONCLUSION: High dust exposures identified in this study may explain the increased prevalence of respiratory symptoms/illnesses among Nepalese brickfield workers, warranting action to reduce exposures.

Graduated driver licensing provisions: an analysis of state policies and what works.

OBJECTIVE: To compare and contrast how specific graduated driver licensing (GDL) components have been implemented in different states and explore how the policies currently in place have affected state-level teen crash and mortality outcomes. METHODS: The study design involved a policy analysis using methodology set forth by Teitelbaum and Wilensky (2007). Eight states were selected, 2 each from 4 different regions in the United States. Each pair of states was similar in terms of geography and vehicle miles driven per capita but differed in the relative strength of their GDL legislation. Teen fatality and crash rates in 2010 as well as specific GDL components were the variables used for analysis. A weighted decision matrix was created to reflect the comparative impact of each variable. RESULTS: In every region, the state with the stronger GDL policy scored higher on the decision matrix than the state with the weaker GDL policy. The Eastern states (Maryland and Vermont) scored the best overall (123.9); the Southern states (Mississippi and Georgia) scored the poorest overall (-55.7). CONCLUSIONS: Consistent with other GDL research, states with stronger GDL policies had more favorable teen crash and mortality outcomes than states with weaker ones. Analysis showed that the policies in strong states shared several common themes: more required practice hours, ban on all teen passengers, and night driving restrictions for 12+ months. Implications for state policy makers are provided.

Boarding injuries: the long and the short of it.

As the popularity of longboarding increases, trauma centers are treating an increased number of high severity injuries. Current literature lacks descriptions of the types of injuries experienced by longboarders, a distinct subset of the skateboarding culture. A retrospective review of longboarding and skateboarding injury cases was conducted at a level II trauma center from January 1, 2006, through December 31, 2011. Specific injuries in addition to high injury severity factors (hospital and intensive care unit (ICU) length of stay (LOS), Injury Severity Score (ISS), patient treatment options, disposition, and outcome) were calculated to compare longboarder to skateboarder injuries. A total of 824 patients met the inclusion criteria. Skull fractures, traumatic brain injuries (TBI), and intracranial hemorrhage (ICH) were significantly more common among longboard patients than skateboarders (P < 0.0001). All patients with an ISS above 15 were longboarders. Hospital and ICU LOS in days was also significantly greater for longboarders compared with skateboarders (P < 0.0001). Of the three patients that died, each was a longboarder and each experienced a head injury. Longboard injuries account for a higher incidence rate of severe head injuries compared to skateboard injuries. Our data show that further, prospective investigation into the longboarding population demographics and injury patterns is necessary to contribute to effective injury prevention in this population.

Risk factors for work-related injuries among university student employees.

This study identified contributing risk factors in the occurrence of work-related injuries among university students employed at a single university. Four hundred seventy-six student employees completed the survey in March 2010. The majority of respondents were female (66%) and the average age of all respondents was 20.7 yr. A pre-validated survey instrument was taken from the Youth Employment and School Study (YESS) and contained scales for the risk factors of interest. Results show significant differences in the amount of work-school conflict, boredom, workplace hazards, and workload between injured and non-injured groups. Odds ratios show that physical hazards and heavy workload have a significant two-fold increase on the likelihood of 1-3 injuries (OR=1.80, 1.09-3.00; OR=1.72, 1.12-2.60), and a 2 to 3 fold increase in 4 or more injuries (OR=2.94, 1.65-5.24; OR=2.34,1.51-3.64). Good supervisor relations appear to reduce injury risk (OR=0.48, 0.25-0.91; OR=0.59, 0.32-1.09). Reducing workload stress, teaching students how to manage the workload, reducing exposure to physical hazards, and providing examples of standard work practices may reduce the number of injuries seen in the population.

Identifying work-related motor vehicle crashes in multiple databases.

OBJECTIVE: To compare and estimate the magnitude of work-related motor vehicle crashes in Utah using 2 probabilistically linked statewide databases. METHODS: Data from 2006 and 2007 motor vehicle crash and hospital databases were joined through probabilistic linkage. Summary statistics and capture-recapture were used to describe occupants injured in work-related motor vehicle crashes and estimate the size of this population. RESULTS: There were 1597 occupants in the motor vehicle crash database and 1673 patients in the hospital database identified as being in a work-related motor vehicle crash. We identified 1443 occupants with at least one record from either the motor vehicle crash or hospital database indicating work-relatedness that linked to any record in the opposing database. We found that 38.7 percent of occupants injured in work-related motor vehicle crashes identified in the motor vehicle crash database did not have a primary payer code of workers' compensation in the hospital database and 40.0 percent of patients injured in work-related motor vehicle crashes identified in the hospital database did not meet our definition of a work-related motor vehicle crash in the motor vehicle crash database. Depending on how occupants injured in work-related motor crashes are identified, we estimate the population to be between 1852 and 8492 in Utah for the years 2006 and 2007. CONCLUSIONS: Research on single databases may lead to biased interpretations of work-related motor vehicle crashes. Combining 2 population based databases may still result in an underestimate of the magnitude of work-related motor vehicle crashes. Improved coding of work-related incidents is needed in current databases.

Effectiveness of a worksite wellness program on health behaviors and personal health.

OBJECTIVE: To evaluate the effectiveness of a worksite wellness program at improving health behavior and personal health. METHODS: Analyses are based on 472 (71% men and 29% women) workers employed in 2009 through 2010. RESULTS: Participants showed significant improvement in frequency of exercise, consumption of whole grains, vegetables and fruits, restful sleep, and seat belt use. Life satisfaction and perceived health also significantly increased, but job satisfaction significantly decreased and there was no change in smoking or body mass index. In addition, the percentage with borderline/high blood pressure significantly decreased. CONCLUSIONS: Participation in well-structured worksite wellness programs, such as the one evaluated in this study, may increase health and life satisfaction for employees. This type of wellness program appears to help employees develop and maintain healthy behaviors.

Comparison of factors influencing emergency department visits and hospitalization among drivers in work and nonwork-related motor vehicle crashes in Utah, 1999-2005.

This study identified contributing factors in the occurrence of motor vehicle crashes (MVCs) and the severity of crashes according to work-related status in Utah. Analyses were based on probabilistically linked data involving police crash reports and hospital inpatient and emergency department (ED) records for the years 1999-2005. Of 643,647 drivers involved in crashes, 73,437 (11.4%) went to the emergency department (ED) and 4989 (0.8%) were hospitalized. Of the drivers in crashes visiting the ED, 2330 (3.2%) were working at the time of the crash and of drivers in crashes who were hospitalized, 235 (4.7%) were working at the time of the crash. There was no significant difference between those working versus not working at the time of the crash in safety belt use (82% [53,947/66,188] for ED cases and 60% [2,489/4,176] for hospitalized cases) or fatigue (4% [2,697/70,536] for ED cases and 9% [450/4,824] for hospitalized cases) among drivers in crashes, but there was a significant difference with respect to alcohol drinking between workers versus nonworkers (ED: 1% [31/2,237] vs. 5% [3,455/68,299], P<0.001; hospitalized: 3% [7/228] vs. 15% [673/4,596], P<0.001). Of those attending the ED because of a crash, workers were significantly more likely to have broken bones, bleeding wounds, or to die. Of those hospitalized because of a crash, workers were significantly less likely to have caused the crash (65% [145/223] vs. 73% [3,315/4,566], P<0.001). Yet although those drivers who were working at the time of the crash compared with those not working were less likely to have alcohol involved or to have caused the crash, there remains room for improvement among workers with respect to these factors, as well as safety belt use and fatigue.