Nonfatal work-related motor vehicle injuries treated in emergency departments in the United States, 1998-2002

Agricultural Injury Surveillance in the United States and Canada: A Systematic Literature Review

INTRODUCTION

Agricultural injuries remain a major concern in North America, with a fatal injury rate of 19.5 deaths per 100,000 workers in the United States. Numerous research efforts have sought to compile and analyze records of agricultural-related injuries and fatalities at a national level, utilizing resources, ranging from newspaper clippings and hospital records to Emergency Medical System (EMS) data, death certifications, surveys, and other multiple sources. Despite these extensive efforts, a comprehensive understanding of injury trends over extended time periods and across diverse types of data sources remains elusive, primarily due to the duration of data collection and the focus on specific subsets.

METHODS

This systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, consolidates and analyzes agricultural injury surveillance data from 48 eligible papers published between 1985 and 2022 to offer a holistic understanding of trends and challenges.

RESULTS

These papers, reporting an average of 25,000 injuries each, were analyzed by database source type, injury severity, nature of injury, body part, source of injury, event/exposure, and age. One key finding is that the top source of injury or event/exposure depends on the chosen surveillance system and injury severity, underscoring the need of diverse data sources for a nuanced understanding of agricultural injuries.

CONCLUSION

This study provides policymakers, researchers, and practitioners with crucial insights to bolster the development and analysis of surveillance systems in agricultural safety. The overarching aim is to address the pressing issue of agricultural injuries, contributing to a safer work environment and ultimately enhancing the overall well-being of individuals engaged in agriculture.

Applying a Health Equity Lens to Work-Related Motor Vehicle Safety in the United States

Motor vehicle crashes (MVCs) are the leading cause of fatal work-related injuries in the United States. Research assessing sociodemographic risk disparities for work-related MVCs is limited, yet structural and systemic inequities at work and during commutes likely contribute to disproportionate MVC risk. This paper summarizes the literature on risk disparities for work-related MVCs by sociodemographic and employment characteristics and identifies worker populations that have been largely excluded from previous research. The social-ecological model is used as a framework to identify potential causes of disparities at five levels-individual, interpersonal, organizational, community, and public policy. Expanded data collection and analyses of work-related MVCs are needed to understand and reduce disparities for pedestrian workers, workers from historically marginalized communities, workers with overlapping vulnerabilities, and workers not adequately covered by employer policies and safety regulations. In addition, there is a need for more data on commuting-related MVCs in the United States. Inadequate access to transportation, which disproportionately affects marginalized populations, may make travel to and from work less safe and limit individuals' access to employment. Identifying and remedying inequities in work-related MVCs, whether during the day or while commuting, will require the efforts of industry and multiple public sectors, including public health, transportation, and labor.

Temporal trends in occupational injuries treated in US emergency departments, 2012-2019

BACKGROUND

Evidence suggests that rates of occupational injuries in the US are decreasing. As several different occupational injury surveillance systems are used in the US, more detailed investigation of this trend is merited. Furthermore, studies of this decrease remain descriptive and do not use inferential statistics. The aim of this study was to provide both descriptive and inferential statistics of temporal trends of occupational injuries treated in US emergency departments (EDs) for 2012 to 2019.

METHODS

Monthly non-fatal occupational injury rates from 2012 to 2019 were estimated using the national electronic injury surveillance system-occupational supplement (NEISS-Work) dataset, a nationally representative sample of ED-treated occupational injuries. Rates were generated for all injuries and by injury event type using monthly full-time worker equivalent (FTE) data from the US Current Population Survey as a denominator. Seasonality indices were used to detect seasonal variation in monthly injury rates. Trend analysis using linear regression adjusted for seasonality was conducted to quantify changes in injury rates from 2012 to 2019.

RESULTS

Occupational injuries occurred at an average rate of 176.2 (95% CI =  ± 30.9) per 10,000 FTE during the study period. Rates were highest in 2012 and declined to their lowest level in 2019. All injury event types occurred at their highest rate in summer months (July or August) apart from falls, slips, and trips, which occurred at their highest rate in January. Trend analyses indicated that total injury rates decreased significantly throughout the study period (- 18.5%; 95% CI =  ± 14.5%). Significant decreases were also detected for injuries associated with contact with foreign object and equipment (- 26.9%; 95% CI =  ± 10.5%), transportation incidents (- 23.2%; 95% CI =  ± 14.7%), and falls, slips, and trips (- 18.1%; 95% CI =  ± 8.9%).

CONCLUSIONS

This study supports evidence that occupational injuries treated in US EDs have decreased since 2012. Potential contributors to this decrease include increased workplace mechanization and automation, as well as changing patterns in US employment and health insurance access.

Death on the job: The Great Recession and work-related traffic fatalities

In light of recent discussions about shifting employees from traditional workplaces to virtual employment, we are motivated by the question of whether this phenomenon will end up saving lives even in the absence of an infectious disease outbreak. Motor vehicle incidents are the leading cause of work-related fatalities in the US, killing more than 1200 workers each year, which make up about a quarter of all work-related deaths. Not only are motor vehicle crashes the top killer at work, but economic expansions can further increase occupational and traffic deaths as they both tend to be procyclical. In this paper, we examine the effects of business cycles on traffic fatalities in the US with a special focus on work-related deaths. Specifically, we implement a longitudinal design across all 50 states by compiling quarterly data for 2004-2012 and consider macroeconomic fluctuations around the Great Recession. Our findings show that traffic deaths during prosperous times are not solely due to an increase in risky behaviors such as drunk driving, but directly related to work. Given the highly preventable nature of traffic crashes, policy makers, public health advocates, and employers can develop effective strategies, including remote work arrangements, to improve both occupational and traffic safety.

Differences between occupational and non-occupational-related motor vehicle collisions in West Virginia: A cross-sectional and spatial analysis

BACKGROUND

Motor vehicle collisions comprise the majority of occupational-related fatalities in the United States and West Virginia has one of the highest occupational-related fatality rates in the nation. The purpose of this study was to compare work and non-work-related collisions, crash locations, and the characteristics of in-state and out-of-state drivers ≥18 years of age who were fatally injured in work-related collisions in West Virginia.

METHODOLOGY

Data were from the 2000-2017 Fatality Analysis Reporting System. Work and non-work-related crashes and characteristics in-state vs. out-of-state drivers were compared using binary and multivariable logistic regression analyses. Crash locations were compared via spatial analyses using kernel density estimations.

RESULTS

Among the 5,835 individuals fatally injured in crashes, 209 were designated 'at work'. The odds of being a work-related crash were 85% lower [Odds Ratio (OR) = 0.15; 95% confidence interval (CI): 0.04, 0.49] among those testing positive for alcohol, but 2.5 times greater (OR = 2.56; 95% CI: 1.16, 5.65) among those holding a commercial driver's license. The odds of being an in-state driver were 75% lower (OR = 0.25; 95% CI: 0.12, 0.53) among those wearing a safety belt, but 2.7 times greater among workers testing drug positive (OR = 2.67; 95% CI: 1.10, 6.52). In-state drivers were also less likely to be driving a large truck or be involved in single vehicle collisions and less likely to experience crashes on weekends, nights, or on highways. Spatial patterns of crash locations varied slightly between workers and non-workers.

CONCLUSIONS

Work-related crashes differed greatly from non-work-related crashes in West Virginia. Stark differences existed between in-state and out-of-state workers and their crashes. Various avenues for workplace safety interventions exist, including seatbelt initiatives and drug testing policies for non-commercial drivers, which could help mitigate West Virginia's elevated, occupational-related, traffic fatality rate.

Road casualties in work-related and private contexts: occupational medical impact. Results from the ESPARR cohort

BACKGROUND

Road accidents may impact victims' physical and/or mental health and socio-occupational life, notably including return to work.

OBJECTIVES

To assess whether the occupational medical consequences sustained by subjects injured in road accidents occurring in a work-related context differ from those associated with private accidents.

METHODS

778 adults who were in work or occupational training at the time of their accident were included. Two groups were distinguished: 354 (45.5%) injured in road accidents occurring in a work-related context (commuting or on duty) and 424 (54.5%) injured in a private accident. The groups were compared on medical and occupational factors assessed on prospective follow-up at 6 months and 1 and 3 years. Multivariate analysis explored for factors associated at 6 months and 1 year with sick leave following the accident and duration of sick leave.

RESULTS

There were no significant differences between groups for demographic data apart from a slightly higher injury severity in private accidents (32.5% of private accidents with MAIS3+(Maximum Abbreviated Injury Scale greater or equal to 3) vs. 23.7% for work-related accidents, p = 0.007). Victims of work-related accidents were more often on sick leave (OR = 1.8; 95% CI, 1.1-2.9). Although the length of sick leave is higher for work-related accidents that for private accidents, multivariate analysis showed that the injury severity and the post-traumatic stress disorder (PTSD) are significant factors to explain the time to return to work. There were no significant differences according to occupational impact during follow-up, notably including sick-leave duration, number of victims returning to work within 3 years and number of victims out of work due to incapacity.

CONCLUSIONS

In the ESPARR (follow-up study of a road-accident population in the Rhône administrative county: Etude de Suivi d'une Population d'Accidentés de la Route dans le Rhône) cohort, the fact that a road accident occurred in a work-related context did not affect the occupational consequences.

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.

Male perpetration of teen dating violence: associations with neighborhood violence involvement, gender attitudes, and perceived peer and neighborhood norms

This study aims to examine the link between male perpetration of teen dating violence (TDV) and neighborhood violence, as well as associations with gender attitudes and perceived peer and neighborhood norms related to violence among a sample of urban adolescent boys. Participants of this cross-sectional study (N = 275) were between the ages of 14 and 20 years and recruited from urban community health centers. Crude and adjusted logistic and linear regression models were used to examine TDV perpetration in relation to (a) neighborhood violence involvement, (b) perceptions of peer violence, (c) perceptions of neighborhood violence, and (d) gender attitudes. Slightly more than one in four (28%) boys reported at least one form of TDV perpetration; among boys who have ever had sex, almost half (45%) reported at least one form of TDV perpetration. In logistic and linear regression models adjusted for demographics, boys who reported TDV perpetration were more likely to report involvement in neighborhood violence (odds ratio (OR) = 3.1; 95% confidence interval (CI) = 1.7-5.5), beliefs that their friends have perpetrated TDV (OR = 2.7; 95%CI = 1.4-5.1), perceptions of violent activity within their neighborhood (OR = 3.0; 95%CI = 1.4-6.3), and greater support of traditional gender norms (β = 3.2, p = 0.002). The findings suggest that efforts are needed to address boys' behaviors related to the perpetration of multiple forms of violence and require explicit efforts to reduce perceived norms of violence perpetration as well as problematic gender attitudes (e.g., increasing support for gender equity) across boys' life contexts.