Analysis of Falls from Height Variables in Occupational Accidents

Spine Injuries Sustained After Falls While Crossing the U.S.-Mexico Border

This study is to report the demographics, incidence, and patterns of spinal injuries associated with border crossings resulting from a fall from a significant height. A retrospective cohort study was performed at a Level I trauma center from January 2016 to December 2021 to identify all patients who fell from a significant height while traversing the U.S.-Mexico border and were subsequently admitted. A total of 448 patients were identified. Of the 448 patients, 117 (26.2%) had spine injuries and 39 (33.3%) underwent operative fixation. Females had a significantly higher incidence of spine injuries (60% vs. 40%; p < 0.00330). Patients with a spine fracture fell from a higher median fall height (6.1 vs. 4.6 m; p < 0.001), which resulted in longer median length of stay (LOS; 12 vs. 7 days; p < 0.001), greater median Injury Severity Score (ISS; 20 vs. 9; p < 0.001), and greater relative risk (RR) of ISS >15 (RR = 3.2; p < 0.001). Patients with operative spine injuries had significantly longer median intensive care unit (ICU) LOS than patients with non-operative spine injuries (4 vs. 2 days; p < 0.001). Patients with spinal cord injuries and ISS >15 sustained falls from a higher distance (median 6.1 vs. 5.5 m) and had a longer length of ICU stay (median 3 vs. 0 days). All patients with operative spine injuries had an ISS >15 relative to 50% of patients with non-operative spine injuries (median ISS 20 vs. 15; p < 0.001). Patients with spine trauma requiring surgery had a higher incidence of head (RR = 3.5; p 0.0353) and chest injuries (RR = 6.0; p = 0.0238), but a lower incidence of lower extremity injuries (RR = 0.5; p < 0.001). Thoracolumbar injuries occurred in 68.4% of all patients with spine injuries. Patients with operative spine injuries had a higher incidence of burst fracture (RR = 15.5; p < 0.001) and flexion-distraction injury (RR = 25.7; p = 0.0257). All patients with non-operative spine injuries had American Spinal Injury Association (ASIA) D or E presentations, and patients with operative spine injuries had a higher incidence of spinal cord injury: ASIA D or lower at time of presentation (RR = 6.3; p < 0.001). Falls from walls in border crossings result in significant injuries to the head, spine, long bones, and body, resulting in polytrauma casualties. Falls from higher height were associated with a higher frequency and severity of spinal injuries, greater ISS, and longer ICU length of stay. Operative spine injuries, compared with non-operative spine injuries, had longer ICU length of stay, greater ISS, and different fracture morphology. Spine surgeons and neurocritical care teams should be prepared to care for injuries associated with falls from height in this unique population.

Safety risk assessment of sustainable construction based on projection pursuit model optimized by multi-intelligent algorithm: a case study of new chemical projects

With the rapid development of urban and social economies, the safety accidents in the construction process of the new chemical plant have caused huge losses to the city. The purpose of this study is to evaluate the risks in the construction process of chemical projects and propose preventive measures. A novel risk assessment model based on multi-intelligence algorithm optimization projection pursuit was developed to assess the construction safety risk and determine the risk level. In this model, the best-worst method and the entropy weight method were used as subjective and objective evaluation methods, respectively. The theory based on the idea of the distance function was applied to the model to calculate the combined weight value. The results showed that the three evaluation objects with the highest risk value were the air compression station plant, regional control room, and hazardous and solid waste temporary repository. The risk values of these three buildings were 2.2557, 2.2160, and 2.1654, respectively, and the corresponding risk level was high. On-site safety managers should take immediate measures in these high-risk buildings to reduce the possibility of accidents. This study is a new attempt to consider the construction safety risk of the new chemical project.

Real-time monitoring unsafe behaviors of portable multi-position ladder worker using deep learning based on vision data

INTRODUCTION

Fatal fall from height accidents, especially on construction sites, persist, underscoring the importance of monitoring and managing worker behaviors to enhance safety. Deep learning showed the possibility of substituting the manual work of safety managers. However, applying detection results to determine compliance with safety regulations has limitations.

METHOD

This study estimated the actual working height depending on the height of the object detection bounding box by specifying the consistent hinge part as a target marker based on ladder manufacturing regulations. Furthermore, an attempt was made to improve the separation between workers, coworkers, and persons unconnected to ladder activities by applying an optimized loss function alongside an attention mechanism.

RESULTS

The experimental results showed that an average precision increased from 87.60% to 90.44%. The performance of the monitoring unsafe behavior of ladder worker following the Korea Occupational Safety and Health Agency (KOSHA) guide was evaluated by 91.40 F1-Score, which accumulated sorted according to the working height.

CONCLUSIONS

Experimental results show the feasibility of the real-time automate safety monitoring in ladder work.

PRACTICAL APPLICATIONS

By linking the estimated working height and deep learning multi-detection results to established safety regulations, the proposed method shows the potential to automatically monitoring unsafe behaviors in construction site.

Mapping the evidence on assessment of fitness to work at heights: a scoping review protocol

INTRODUCTION

Falls from height are a leading cause of serious injury and fatality globally. In South Africa, work at heights is regulated by occupational health and safety legislation, which places responsibility on employers to ensure their workers are fit for high-risk work. There is however no formal procedure or consensus on how fitness to work at heights should be assessed. This paper presents an a priori protocol for a scoping review that seeks to identify and map the current evidence base around the assessment of fitness to work at heights. It forms the initial phase of a PhD study aimed at developing an interdisciplinary consensus statement for assessing fitness to work at heights in the South African construction industry.

METHODS AND ANALYSIS

This scoping review will follow the Joanna Briggs Institute (JBI) scoping review framework and will be guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Extension for Scoping reviews (PRISMA-ScR) checklist. An iterative search will be conducted in a selection of multidisciplinary databases including, Proquest Central, PubMed, Scopus, Science Direct, Web of Science, PsychINFO and Google Scholar. Thereafter, searches for grey literature will be performed in Google.com and websites of various national and international agencies, governing bodies and professional organisations with an interest in occupational health and work at heights. Where appropriate, targeted requests for clarification for further information will be undertaken with information sources. A descriptive qualitative content analysis of the results will be conducted and a level of evidence rating will be assigned to each study using the JBI approach. This will allow us to provide some commentary on the rigour of the existing evidence base.

ETHICS AND DISSEMINATION

Ethics approval for the PhD study was granted by the Research Ethics Committee, Faculty of Health Sciences, University of Pretoria, ethics reference number, 486/2021. Results of the scoping review will be submitted to a scientific journal for publication.

TRIAL REGISTRATION NUMBER

This protocol is registered on the Open Science Framework at osf.io/yd5gw.

Border-fence falls versus domestic falls at a South Texas trauma center

Objectives

Falling from height may lead to significant injuries and time hospitalized; however, there are few studies comparing the specific mechanism of fall. The purpose of this study was to compare injuries from falls after attempting to cross the USA-Mexico border fence (intentional) with injuries from domestic falls (unintentional) of comparable height.

Methods

This retrospective cohort study included all patients admitted after a fall from a height of 15-30 ft to a level II trauma center between April 2014 and November 2019. Patient characteristics were compared by falls from the border fence with those who fell domestically. Fisher's exact test, χ² test and Wilcoxon Mann-Whitney U test were used as appropriate. A significance level of α<0.05 was used.

Results

Of the 124 patients included, 64 (52%) were falls from the border fence while 60 (48%) were domestic falls. Patients sustaining injuries from border falls were on average younger than patients who had domestic falls (32.6 (10) vs 40.0 (16), p=0.002), more likely males (58% vs 41%, p<0.001), fell from a significantly higher distance (20 (20-25) vs 16.5 (15-25), p<0.001), and had a significantly lower median injury severity score (ISS) (5 (4-10) vs 9 (5-16.5), p=0.001). Additionally, compared with domestic falls, border falls had fewer injuries to the head (3% vs 25%, p=0.004) and chest (5% vs 27%, p=0.007), yet more extremity injuries (73% vs 42%, p=0.003), and less had an intensive care unit (ICU) stay (30% vs 63%, p=0.002). No significant differences in mortality were found.

Conclusion

Patients sustaining injuries from border crossing falls were slightly younger, and although fell from higher, had a lower ISS, more extremity injuries, and fewer were admitted to the ICU compared with patients sustaining falls domestically. There was no difference in mortality between groups.

Level of evidence

Level III, retrospective study.

Study on Influencing Factors of Construction Workers' Unsafe Behavior Based on Text Mining

The unsafe behavior of construction workers is the key cause of safety accidents. The accident investigation report contains rich experience and lessons, which can be used to prevent and reduce the occurrence of safety accidents. In order to draw lessons from the accident and realize knowledge sharing and reuse, this paper uses text mining technology to analyze the data of 500 construction accident investigation reports in Shenzhen, China. Firstly, a Latent Dirichlet Allocation (LDA) topic model is used to identify the unsafe behavior of construction workers and its influencing factors. Then, with the help of Social Network Analysis, the importance of influencing factors and the relationship between them are identified. The results show that weak safety awareness, operating regulations, supervision dereliction of duty, equipment resources, and inadequate supervision of the construction party are the key and important factors. It is also found that there are correlations between weak safety awareness and supervision dereliction of duty, between equipment resources and poor construction environment, between organization and coordination and inadequate supervision of the construction party, and between operating regulations and hidden dangers investigation. This study not only helps to improve the theoretical system in the field of construction workers’ unsafe behavior but also helps managers to find the key control direction of construction safety, so as to effectively curb unsafe behavior of construction workers and improve the level of safety management.

An integrated DEMATEL-ANP approach for identification and prioritization of factors affecting falls from height accidents in construction industry

BACKGROUND

Decision Making Trial and Evaluation Laboratory (DEMATEL) technique, integrated with the Analytic Network Process (ANP) is used for determination and prioritization of cause-effect relationships among factors affecting construction falls.

METHODS

Considering the 135 fall accidents collected between 2013 and 2018 from fifteen residential construction projects, 70 factors and sub-factors affecting the occurrence of construction falls were determined based on the safety experts' opinions. Then, questionnaires based on the former and the latter were distributed among 10 occupational health and safety specialists to determine the effectiveness of the factors. The interactions and important degree of each factor are specified, using DEMATEL-ANP approach.

RESULTS

Findings showed that organizational factors and their sub-factors have the greatest impact on construction falls and were considered as causal variables (D-R>0), while individual and environmental factors were considered as the effect variables (D-R<0). The results of prioritization using the ANP method showed that the work platform altitude, psychological/occupational stresses, and interactions were ranked as the first through third priorities affecting the falls, respectively.

CONCLUSIONS

It is necessary to implement a systematic strategy to reduce the unsafe conditions in construction projects and to pay more attention to organizational factors.