Comparing Data from the Poisons Information Centre with Employers' Accident Reports Reveal Under-Recognized Hazards at the Workplace

Significant increase in the number of occupational exposures reported to the Dutch Poisons Information Centre (2016-2022): the importance of poison centre data in health surveillance

INTRODUCTION

Exposure to hazardous substances in the workplace can result in injuries and fatalities. This study aimed to investigate the characteristics and trend of occupational exposures reported to the Dutch Poisons Information Centre and to investigate whether the COVID-19 pandemic had an impact on the trend.

METHODS

A retrospective analysis of all acute occupational exposures reported to the Dutch Poisons Information Centre between 1 January 2016 and 31 December 2022 was performed. Data on patient and exposure characteristics, symptoms and treatment recommendations were analyzed.

RESULTS

Between 2016 and 2022, the Dutch Poisons Information Centre received 5,508 calls regarding acute occupational exposures. The annual number of calls on acute occupational exposures almost doubled over the years studied (from 475 in 2016 to 936 in 2022). During and after the COVID-19 pandemic (March 2020-December 2022), the number of calls stabilized, but the upward trend was not significantly affected. There were an estimated 0.20 calls per 1,000 human exposure calls per month (95 per cent confidence interval: -0.14; 0.53). Victims were often exposed through multiple routes, with inhalation being the most common route (44 per cent), followed by ocular (32 per cent) and dermal contact (30 per cent). Acids (1,138 exposures) and alkalis (912 exposures) were often involved. The Dutch Poisons Information Centre had information on 6,334 patients, although the total number of exposed patients was not known as some victims did not seek medical assistance, or were treated by healthcare professionals who did not consult our Centre. At the time of contact, 13 per cent (n = 795) of the patients reported no symptoms, 76 per cent (n = 4,805) reported mild to moderate symptoms and 3 per cent (n = 183) reported potentially severe symptoms. Information on symptoms was missing for 9 per cent (n = 551) of the patients. Hospital observation and treatment were recommended for 5 per cent (n = 325) of the patients.

DISCUSSION

This study highlights the necessity for poisoning prevention strategies to reduce the number of work-related incidents involving hazardous substances.

CONCLUSION

The continuing increase in the number of workplace incidents involving hazardous substances is of concern. A comprehensive and multidisciplinary approach should be taken to gain a full understanding of occupational exposure to hazardous substances and to identify risk factors.

Causal factors of work-related chemical eye injuries reported to the Dutch Poisons Information Center

This study investigated the circumstances of chemical occupational eye exposures reported to the Dutch Poisons Information Center. During a 1-year prospective study, data were collected through a telephone survey of 132 victims of acute occupational eye exposure. Victims were often exposed to industrial products (35%) or cleaning products (27%). Most patients developed no or mild symptoms. Organizational factors (such as lack of work instructions (52%)), and personal factors (such as time pressure and fatigue (50%), and not adequately using personal protective equipment (PPE, 14%), were the main causes of occupational eye exposures. Exposure often occurred during cleaning activities (34%) and personal factors were reported more often during cleaning (67%) than during other work activities (41%). Data from Poison Control Centers are a valuable source of information, enabling the identification of risk factors for chemical occupational eye exposure. This study shows that personal factors like time pressure and fatigue play a significant role, although personal factors may be related to organizational issues such as poor communication. Therefore, risk mitigation strategies should focus on technical, organizational, and personal factors. The need to follow work instructions and proper use of PPE should also have a prominent place in the education and training of workers.

Acute occupational exposures reported to the Dutch Poisons Information Center: a prospective study on the root causes of incidents at the workplace

BACKGROUND

Hazardous substances at the workplace can cause a wide variety of occupational incidents. This study aimed to investigate the nature and circumstances of acute occupational intoxications reported to the Dutch Poisons Information Center.

METHODS

During a one-year prospective study, data on the circumstances and causes of the incident, the exposure(s) and clinical course, were collected by a telephone survey with victims of an acute occupational intoxication.

RESULTS

We interviewed 310 patients. Most incidents occurred in industry (25%), building and installation industry (14%) and agriculture (10%). Patients were often exposed via multiple routes. Inhalation was the most common route of exposure (62%), followed by ocular (40%) and dermal contact (33%). Acids and alkalis were often involved. Exposure often occurred during cleaning activities (33%). The main root causes of these accidents were: technical factors such as damaged packaging (24%) and defective apparatus (10%), organizational factors such as lack of work instructions (44%) and poor communication or planning (31%), and personal factors such as disregarding work instructions (13%), not (adequately) using personal protective equipment (12%) and personal circumstances (50%) such as inaccuracy, time pressure or fatigue. The majority of the patients only reported mild health effects and recovered quickly (77% within 1 week).

CONCLUSIONS

Poison Center data on occupational exposures provide an additional source of knowledge and an important basis for poisoning prevention strategies related to hazardous substances at the workplace. These data are useful in deciding which risk mitigation measures are most needed in preventing future workplace injuries.

OUP accepted manuscript

Using data from the Swedish Products Register, hosted by the Swedish Chemicals Agency (KemI), national occupational injury and disease statistics, and call records from the Swedish Poisons Information Centre (PIC) we characterize health hazards of marketed cleaning products and recorded injuries, disease, and incidents linked to cleaning or disinfection agents. The results show that cleaning agents pose many kinds of health hazards, although corrosion and irritation hazards dominate, in particular for the eyes (54% of all included products). Few products were recognized as inhalation hazards. The nature of the health hazards is reflected in the occupational disease and injury statistics and PIC records for eyes and skin but not for the respiratory tract. Among occupational disease cases attributed to cleaning or disinfection agents, 61% concern skin and 26% the respiratory tract. Among occupational injury cases 64% concern chemical burns. However, only a small part (<0.5%) of all reported diseases and injuries were explicitly attributed to cleaning or disinfection agents. On average, there were 11 cases of disease attributed to cleaning or disinfection agents per million workers and year. For occupational injuries the corresponding number was 8. The data concern a broad range of sectors and occupations, but notable sectors were healthcare, accommodation and food service, and manufacturing. Women were more likely to suffer from disease, men and women equally likely to suffer from injury. PIC cases were evenly distributed between men and women, but the clear risk cases more frequently involved men. Occupational diseases increased many-fold in 2020 while injuries decreased, which could be due to COVID-19 changing use patterns of cleaning and disinfection agents at work. We conclude that cleaning agents pose a variety of risks to a large part of the workforce, although particular attention for preventive efforts may need to be directed to the healthcare, accommodation and food service, and manufacturing sectors.

The Causes of Occupational Accidents and Injuries in Romanian Firms: An Application of the Johansen Cointegration and Granger Causality Test

Organizational risks are present in any activity, so it is important to manage them properly. The jobs are dynamic and involve a series of processes and activities. The entire human resource is exposed to several risks. If these risks are approached correctly, the organizational capacity to achieve its objectives and vision will increase considerably. This paper aims to investigate the relationships between work accidents (fatal and non-fatal) and the causes that contribute to their occurrence (causes dependent on the executor, causes dependent on the means of production, workload-dependent causes, and work-dependent causes—the work environment). The augmented Dickey–Fuller (ADF) test is employed to check the data stationarity series, while the Johansen test determines the cointegration relation of variables. The data have been collected from Romanian organizations. The vector error correction model (VECM) and Granger causality test are applied for speed of adjustment, nature, and direction of variables’ relationship. This research demonstrated that both data series are free from the unit-root problem at first difference. The lag length criterions select the third lag for model fitness, and Johansen cointegration declares that variables are cointegrated for the long term. The vector error correction model shows the speed of adjustment from the short to the long run is 83.35% and 42.60% for work and fatal accidents. The study results show that fatal accidents have a series relationship with selected cases for the short run and have a long-run relationship with the means of production. Fatal accidents are directly related to means of production. Fatal accidents are not designed by executors, workload-dependent causes, or work environments in the short run. Fatal accidents are directly related to the means of production and sudden incidents happening in the long run. Fatal accidents are considered by executors, workload-dependent causes, or work environments in the short run. In the long run, fatal accidents are directly related to the means of production and sudden incidents happening.

Risk Profiling from the European Statistics on Accidents at Work (ESAW) Accidents' Databases: A Case Study in Construction Sites

The number of accidents and victims in the construction sector has not decreased significantly despite the increasingly stricter laws and regulations. The analysis of accidents, as well as their root causes and determinants can certainly contribute to the development of more effective preventive interventions. The present study proposes a methodology for the analysis and synthesis of data provided by accidents statistics with the goal of defining specific risk profiles based on the accidents determinants, their variables, and how they interact with one another in influencing the occurrence of an accident. For this purpose, a procedure capable of extracting this type of information from the European Statistics on Accidents at Work (ESAW) database was developed. In particular, data processing and aggregation are performed by means of the synergic use of the Matrix of Descriptors (MoD) and cluster analysis. To validate such a procedure, the analysis of fatalities due to electrical shocks was carried out. The results achieved allowed us to elicit valuable information for both safety managers and decision makers. The proposed methodology can facilitate a systemic analysis of accidents databases reducing the difficulties in managing reports and accident statistics.

Calls made to the Poisons Information Centre reveal need for improved risk management of cleaning agents in the workplace

Purpose. This study aimed to investigate chemical injuries caused by cleaning agents and disinfectants by reviewing poison control data. Methods. We performed a 5-year retrospective analysis of calls to the Swedish Poisons Information Centre (PIC) concerning occupational use of cleaning agents and disinfectants. In addition, callers for 17 new cases were interviewed. Results. Out of 8240 occupationally related cases handled by the PIC during 2010-2014, 24% concerned cleaning agents and disinfectants (N = 1983). Of these, one-third were classified as major risk cases, generally due to potential for corrosive eye and skin injuries. The most frequent type of workplace was restaurants and caterers. However, information about occupation was only identifiable for 30% of the cases. Follow-up interviews exemplify how limited awareness of safety data sheets and disregard of protective equipment may contribute to health-related outcomes such as absence at work. Conclusions. Management and prevention strategies for cleaning agents should be improved. PIC records hold relevant information both for designing interventions and for future research on occupational health and safety management. We suggest that systematic collection by the PIC of information on occupation and age would further improve the usefulness for occupational injury surveillance purposes.