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The presumed high exposure to volatile organic compounds among construction workers has not been substantiated with biomonitoring evidence. This study found that construction occupation was associated with increased blood concentrations of toluene, ethylbenzene, o-xylene, and m-/p- xylene. The findings inform interventions for exposure reduction using engineering controls and personal protective equipment. Objective: This study aimed to examine blood benzene, toluene, ethylbenzene, o-xylene, and m-/p-xylene (BTEX) concentrations and their trends contrasting construction workers with workers in other occupations from 1999 to 2014 in the United States. Methods: Using data from the National Health and Nutrition Examination Survey, quantile regressions were performed to investigate associations between occupation and blood BTEX concentrations. Results: We found that high-risk and construction occupations were associated with increased blood concentrations of toluene, o-xylene, and m-/p-xylene at the 50–90th percentiles (P50–90), and ethylbenzene at P70–90. Moreover, although blood concentrations of ethylbenzene, o-xylene, and m-/p-xylene trended down among all US workers, no decreasing trend was observed for benzene and toluene among construction workers. Conclusions: Future studies are warranted to address questions about specific tasks to better assess VOC exposure from various trades. [ABSTRACT FROM AUTHOR]

This study updates the prevalence of operator fatigue as a causative factor in accidents investigated by the National Transportation Safety Board (NTSB) and the associated injury severity in fatigue-related accidents. In total, 394 investigations were analyzed and 12% of them identified fatigue. The prevalence of fatigue varied among the transportation modes, ranging from 28% of aviation to 7% of marine. Most fatigue-related accidents (48%) occurred during late night or morning. Compared to non-fatigued operators, fatigued operators were more involved in severe or fatal injuries (odds ratio [OR] 2.30; 95% confidence interval [CI] [1.66, 2.95]) and injuries to non-operators (OR 3.32; 95% CI [2.70, 3.95]). Obstructive sleep apnea (OSA) was identified as a probable cause, contributing cause or finding in 15% of fatigue-related accidents, and in 85.7% of these accidents the operator met OSA screening criteria. Thus, opportunities remain for preventing fatigue-related accidents, including through more systematic operator screening for OSA. [ABSTRACT FROM AUTHOR]

Children represent some of the most vulnerable and most valuable members of society. When acutely ill or injured, pediatric emergency departments (EDs) provide first line, specialized care for children and adolescents. Unique and unpredictable, the pediatric ED environment requires a wide range of health care professionals to care for children and their families and often includes hospital-employed security professionals and local law enforcement personnel to ensure safe and protective spaces paramount for optimal patient care. However, an active policing presence within environments designed to promote healing can paradoxically contribute to harm, particularly for Black and Brown patients. As health care systems pledge to dismantle structural racism and achieve health equity, efforts must include anti-racist reforms of threat management systems within clinical environments. We propose assessment and evaluation of current security and police encounters within pediatric EDs. We call for institution of policies that mitigate biases, address medical mistrust, distinguish clinical from criminal aggression, and minimize punitive contact with police. We outline a multitiered, patient-centered approach to disruptive and violent acts that prioritizes prevention, early intervention, and de-escalation strategies with a goal of reducing the perceived need for policing presence in pediatric EDs. [ABSTRACT FROM AUTHOR]

The findings from this study highlight significant disparities in the risk for occupational environmental heat injuries, including risk related to industry and occupation. These findings may be useful for identifying and developing interventions for high-risk populations. Objective: This study describes the characteristics of workers experiencing occupational heat-related injuries/illnesses in the United States and explores the associations between states' average annual temperatures and heat-related injury/illness rates. Methods: The number and rate of occupational environmental heat injuries/illnesses were calculated according to age group, gender, race/ethnicity, occupation group, and state from 2011 to 2019. Results: Injury/illness rates were higher among Black and Hispanic workers. Workers in farming, fishing, and forestry; installation, maintenance, and repair; and construction/extraction occupations had the highest rates. There was a positive correlation between states' average annual temperatures and heat-related injury/illness rates. Discussion: There are demographic and occupational disparities in occupational environmental heat-related injuries/illnesses in the United States and a correlation between these injuries/illnesses and state average annual temperatures. There is a need for policies and other interventions to protect workers from occupational environmental heat injuries/illnesses. [ABSTRACT FROM AUTHOR]

Construction is a hazardous industry with a high number of injuries. Prior research found that many industry injuries can be prevented by implementing an effective safety plan if prepared and maintained by qualified safety personnel. However, there are no specific guidelines on how to select qualified construction safety personnel and what criteria should be used to select an individual for a safety position in the United States (US) construction industry. To fill this gap in knowledge, the study goal was to identify the desired qualifications of safety personnel in the US construction industry. To achieve the study goal, the Delphi technique was used as the main methodology for determining the desired qualifications for construction safety personnel. As a result, a panel of 15 subject-matter experts was selected, and 4 rounds of surveys were carried out. The findings of the study led to the identification of the desired qualifications for three construction safety positions (safety entry, safety professional, and safety manager). The present study contributes to the body of theoretical knowledge on construction safety and presents practical guidelines to assist industry stakeholders select qualified safety personnel for their projects. The selection of qualified safety personnel is expected to improve workplace safety performance and positively reflect on other project outcomes. Construction stakeholders should pay attention to three key aspects (namely, education, experience, and certification) when determining the qualifications for a safety leadership position and take into consideration the type of position intended to be filled. This study fills the gap in knowledge by identifying the desired qualifications and criteria on how to select safety personnel in the US construction industry. [ABSTRACT FROM AUTHOR]

Background: There are continued concerns about holding large group gatherings with the ongoing COVID‐19 pandemic. The American Board of Pediatric Dentistry (ABPD) made the decision to cancel the Oral Clinical Examination (OCE) in 2020 with a goal to host the exam in 2021. This cancellation postponed the board certification of over 400 pediatric dentists. There is limited published data on safety protocols for in‐person examinations. Aim: To determine if safety protocols utilized in the administration of the 2021 ABPD Oral Clinical Examination (OCE) were reassuring to candidates and examiners, and effective at addressing prevention of COVID‐19 infection. Design: An electronic survey was emailed to candidates and examiners following completion of the board examination process. The candidate survey had 784 and the examiner survey had 108 eligible participants. Eight questions overlapped between the two surveys. Descriptive statistics were utilized. p‐values < 0.05 were considered significant. Results: Three hundred ninety‐four candidates (response rate = 50.3%) and 97 examiners (response rate = 89.8%) completed their respective surveys. The majority of candidates (86.8%) and examiners (94.8%) felt safe participating the OCE, and found COVID‐19 protocols reassuring, 69.3% and 89.7%. Conclusions: Participants agreed that safety protocols enacted by the ABPD kept everyone safe and led to a successful and safely conducted high‐stakes oral clinical examination during the COVID‐19 pandemic. [ABSTRACT FROM AUTHOR]

This research identified occupational and work-life demands due to the COVID-19 pandemic in fire-based first responders. These data empower clinicians to consider upstream primary prevention approaches to mitigate these demands and prevent secondary and tertiary outcomes that may occur if demands are not properly managed. Objective: The US fire service experienced increased demands due to COVID-19. This qualitative study explored the pandemic's impact on work-life balance and safety. Methods: Five interviews and 10 focus groups were conducted with 15 fire departments in the COVID-19 RAPID Mental Health Assessment. Coding and multilevel content analysis were conducted in NVivo. Results: Four department support themes were identified: emotional/social (33.1%), policy (28.4%), instrumental (22.9%), and informational (15.5%). Four work-life balance themes were identified: life (51.2%), children (18.1%), physiological (16.5%), and work (14.2%). We observed more departmental resources to help mitigate job demands within the work environment compared with those for work-life demands. Conclusions: Job resources are needed to mitigate demands and improve safety culture and mental well-being of the fire service under normal conditions, and for the next pandemic, natural disaster, or long-term emergency. [ABSTRACT FROM AUTHOR]

When organizational attributes like management commitment and communication are favorable, they are known to positively influence safety behaviors, morale, and well-being. Fire departments should focus on improving overall safety culture as a way to address the mental health burden of fire and rescue service work. Objective: This study aimed to examine the COVID-19 pandemic's impact on fire service safety culture, behavior and morale, levers of well-being, and well-being outcomes. Methods: Two samples (Stress and Violence against fire-based EMS Responders [SAVER], consisting of 3 metropolitan departments, and Fire service Organizational Culture of Safety [FOCUS], a geographically stratified random sample of 17 departments) were assessed monthly from May to October 2020. Fire department–specific and pooled scores were calculated. Linear regression was used to model trends. Results: We observed concerningly low and decreasing scores on management commitment to safety, leadership communication, supervisor sensegiving, and decision-making. We observed increasing and concerning scores for burnout, intent to leave the profession, and percentage at high risk for anxiety and depression. Conclusions: Our findings suggest that organizational attributes remained generally stable but low during the pandemic and impacted well-being outcomes, job satisfaction, and engagement. Improving safety culture can address the mental health burden of this work. [ABSTRACT FROM AUTHOR]

The mining industry plays a critical role in the U.S. economy, with active mines in every state producing materials such as those used to construct houses and roads, make medicines, and manufacture cars and electronics. Throughout its history, mining has been a male-dominated industry. Recent estimates indicate that between 10% and 17% of miners are women. Previous occupational safety and health (OSH) research has focused primarily on the male experience. In more recent years, the mining industry has engaged in efforts to increase workforce diversity through the recruitment and retention of women miners. To meet the needs of a diverse workforce, it is critically important to identify OSH concerns that are unique to populations that have been understudied and to develop work-related policies and practices that improve their work experiences and health outcomes. The purpose of this article is to describe the specific OSH challenges women as miners face and to discuss how the National Institute for Occupational Safety and Health's (NIOSH) Mining Program is situated to address these challenges through its Mining Program Strategic Plan. [ABSTRACT FROM AUTHOR]

Most meatpacking workers are Black, Latinx, and immigrant workers earning low wages and at high risk for occupational injury. Most meat and poultry plants have on-site workplace clinics (OWCs) where workers are required to obtain care for work-related injuries or illnesses before seeking outside clinical assessment or intervention. Although OWCs can help plant managers identify and mitigate hazards, government and other investigations reveal that OWCs in meatpacking plants not only fail to advocate for safer work conditions, but also nurture conditions that exacerbate injury and illness. This article explores ethical challenges for health care professionals in OWCs, including companies' pressure to keep so-called "recordable" injuries low. This article also suggests changes to support OWCs' roles in safety and injury prevention. [ABSTRACT FROM AUTHOR]

Purpose: Reporting sharps injuries is crucial for healthcare worker occupational safety. However, these incidents are often underreported, thus posing potentially dangerous working environments. Previous small and limited studies have quantified this underreporting in specific groups of healthcare workers. This study aims to expand on these studies by further quantifying sharps injury incidences through a national study, thus better understanding healthcare reporting behaviors and the reasons for underreporting. Patients and Methods: This is a national, multi-center, cross-sectional study conducted via an online anonymous survey distributed through email among United States attending physicians, fellows, residents, medical students, and nurses of all specialties (ie, surgery, medicine, pediatrics). Data analysis used descriptive statistics and regressive modeling with significance defined as p< 0.05. Results: Of over 3000 surveys emailed, 460 (15.3%) healthcare workers responded. The most vulnerable cohort to report sharps injuries were medical students (0.87 injuries per year ± 0.69, n=92) and Postgraduate Year (PGY) 1 (0.67± 0.81, n=71), PGY2 (0.86±-0.82, n=48), and PGY3 (0.92± 0.8, n=45) resident physicians. Healthcare workers in surgical fields reported significantly higher likelihoods (odds ratio=4.61, p< 0.001, 95% confidence interval 2.83– 7.26) of sharps injuries. Medical students reported sharps injuries the least (40%) and nurses reported sharps injuries the most frequently (71%). The three most common reasons for not reporting sharps injuries included (1) healthcare workers perceiving low infection risk based on patient medical history, (2) fear of peer perception, and (3) belief of lack of reporting utility or that reporting is inconsequential. Conclusion: Medical students and physicians early in training, especially those in surgical fields, are more vulnerable to sharps injuries, but are less likely to report, while nurses are the most likely to report. Dedicated sharps training, education to reduce stigma around injury, and implementing a simplified reporting process may help encourage reporting as well as consistency in reporting, leading to improved workplace safety. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Our study demonstrated attenuated cardiovascular reactivity is predictive of future fatigue in truck drivers, who are a safety critical workforce. Attenuated responses to stress may have negative consequences for health and for driving safety, and cardiovascular stress reactivity could identify drivers who may be at heightened risk for developing fatigue. Objectives: This study aimed to investigate the impact of a 6-month health intervention on truck drivers' cardiovascular reactivity to stress and whether cardiovascular reactivity was predictive of depression, anxiety, or fatigue symptoms at 6-month follow-up. Methods: Two hundred thirty-eight truck drivers completed a 6-month cluster randomized controlled trial to increase physical activity and completed a stress protocol (Stroop and mirror-tracing tasks) with measurements of heart rate, systolic blood pressure, and diastolic blood pressure taken, alongside fatigue, anxiety, and depressive symptoms assessment. Measures were taken at 0 and 6 months. Results: Analyses showed a negative relationship between 0-month diastolic blood pressure reactivity and 6-month persistent fatigue. Trends toward negative relationships between systolic blood pressure reactivity and future anxiety and fatigue symptoms at 6 months were evident. Conclusions: Our findings may have serious implications, as fatigue can be a major cause of road traffic collisions in truck drivers. [ABSTRACT FROM AUTHOR]

An early mobility program in a small community hospital resulted in high levels of staff engagement and decreased rates for falls and heel and sacral pressure injuries. [ABSTRACT FROM AUTHOR]

Background Agriculture is one of the most hazardous occupations in the USA. Especially, tractor rollover incidents are the leading cause of farming-related injuries or deaths. This study examines the effect of a VR intervention (Virtual Reality Intervention for Safety Education; VRISE) on behavioral intentions for occupational safety and identifies a psychological mechanism that shows how the immersive technology works. Methods VRISE was developed by a multidisciplinary team of agricultural educators, computer scientists and communication specialists. It was designed to provide a virtual environment where users practice tractor operation and try to avoid several rollover hazards. The participants (291 high school students) were recruited at the 2019 National Future Farmers Association Convention & Expo and randomly assigned to one of three conditions: two different types of control groups (Control1: No treatment group and Control2: 2D Screen group) and the treatment group. Results Findings show that, through the immersive VR experience, the VR intervention enhanced perceived threat of tractor-related accidents which in turn, led to improved behavioral intentions for tractor safety. Conclusions Findings shed light on the effectiveness of a VR intervention to improve public health outcomes, especially in occupational safety education, where unsafe practices often result in injury and fatality. [ABSTRACT FROM AUTHOR]

Purpose: The American College of Radiology (ACR) requires MR personnel not to work alone due to the increased risk of safety issues such as projectiles, aggressive patients, and technologist fatigue. As a result, we intend to assess the current safety of lone-working MRI technologists in MRI departments in Saudi Arabia. Materials and Methods: A cross-sectional study using a self-report questionnaire was conducted in 88 Saudi hospitals. Results: A response rate of 64% (174/270) was obtained among the 270 MRI technologists which were identified. The study discovered that 86% of MRI technologists had prior experience working alone. In terms of MRI safety training, 63% of MRI technologists received such training. A question about lone MRI workers' awareness of the ACR's recommendations revealed that 38% were unaware of such recommendations. Furthermore, 22% were misinformed, believing that working alone in an MRI unit is optional or depends on the individual's desire to work alone. Working alone has the primary consequence of being statistically significantly associated with projectile/object-related accidents/mistakes (p = 0.03). Conclusion: Saudi Arabian MRI technologists have extensive experience working alone without supervision. Most MRI technologists are unaware of lone working regulations, which has raised concerns about accidents/mistakes. There is a need for MRI safety training and adequate practical experience to raise awareness of MRI safety regulations and policies related to lone working among departments and MRI workers. [ABSTRACT FROM AUTHOR]

The future of agricultural work in the United States (U.S.) must account for at least two important trends: 1) the persistence of the industry being riddled with high rates of injury and illness and 2) the growing proportion of hired farmworkers compared to family farmworkers working in these dangerous environments. These workers confront structural disadvantages that impede social justice and prosperity. Social structures like policies, economic systems, institutions, and social hierarchies create health disparities, often along the lines of social categories. The result is an already dangerous industry with vulnerable workers facing unjust risks, especially those that are undocumented. Agricultural health and safety professionals and other stakeholders should engage structural competency curricula in order to increase awareness of impact of structures and be better positioned to improve farmworker health and wellbeing. Similar work has been successful in the training healthcare professionals, e.g. the Structural Competency Working Group (SCWG). New strategies are needed to improve farmworker wellbeing and retain an adequate agricultural workforce. A greater understanding of the social and structural concerns that farmworkers face is an important step towards occupational and social justice. It is also clear that it will require collaboration and community-based efforts creating a larger team of people using similar concepts related to the structural influences on whether health and wellbeing are distributed equitably. This work is being moved forward in healthcare, social work, worker organizations, and community-based initiatives. Agricultural health and safety professionals have a vital contribution to make if they join the ranks. [ABSTRACT FROM AUTHOR]

Trends: Agritourism is increasingly popular, generating the need for additional employees. Given the labor shortages in the U.S., this motivates producers on agritourism operators to develop strategies to address the labor shortages, some of which could impact worker safety. Research and current initiatives: Contributing factors to labor shortages in agriculture include the aging workforce, declining rural populations, the stressful nature of agricultural work, long hours and less labor intensive options. Foreign labor has been impacted by immigration policy changes, H2A program inefficiencies and the recent pandemic. Staffing agritourism operations is further complicated by the need for seasonal employees and staff with varying skill sets, such as hospitality, food service, and retail; industries with critical labor shortages. Some strategies agritourism operators employ to address staff shortages (e.g. employees work longer hours, hiring younger staff) may impact safety. Collaborations between producers and safety professionals could help develop strategies to address labor shortages while ensuring worker safety. Gaps in knowledge, regulation and practice: More information is needed on employees on agritourism operations including the number of employees, hours worked, tasks performed, safety training provided, impact of customers in worksites, injuries incurred, current strategies employed to address the labor shortages, and motivators for staff to participate in safety training. Recommendations for the future: Research is needed to address the gaps in knowledge previously mentioned, and the information gathered used to develop recommendations, safety strategies and resources to help agritourism operators employ effective recruitment and retention strategies that also help establish a safe working environment. [ABSTRACT FROM AUTHOR]

An editorial is presented on characterizing occupational health in the cannabis cultivation industry. Topics include need to identify the health and safety needs of cannabis workers and lay plans for unified and coordinated research and advocacy efforts; and Marijuana Reform pardoning Federal offenses of simple marijuana possession and initiating review of federal scheduling.

Agricultural employers have faced extreme challenges in recruiting and retaining an adequate workforce. Various societal changes have made hiring local workers into agricultural jobs difficult. Therefore, there is a growing reliance on foreign workers and visa programs to meet labor demands. One such program, the TN visa, can be an effective and useful tool for recruiting professional labor for livestock operations, and many agricultural employers have already seen its value. It is likely that the use of the TN program will continue to grow in the future. However, there is opportunity for misuse and abuse of the TN program because there are few administrative rules and limited oversight. We offer recommendations to improve the TN program and the well-being of TN professionals including additional oversight of the program, transparency in recruiting and contracting workers, educating TN workers about U.S. labor rights, ensuring fair pay, and allowing a path to work authorization for TN workers' spouses and children who accompany them in the U.S. Clearly, sustainable solutions to the farm labor shortage are needed. As a field, we need to better understand workforce recruitment and retention concerns as well as mechanisms being used to address such concerns and their impact on workers' health, safety, and well-being. [ABSTRACT FROM AUTHOR]

The number of agricultural fatalities and injuries related to agricultural quad bike use has risen substantially in the last two decades. Safe engineering design features such as crush protection and roll bars have proven potential to lessen the burden of injury but have traditionally not been included in many quad bike safety training programs. The aim of this study was to survey more than 700 young adults working in U.S. and Canadian agriculture to examine self-reported quad bike safety behaviors and awareness of quad bike safety design engineering features. We found that U.S. males continue to be at higher risk for quad bike-rollover incidents when compared to other groups. Even when accounting for other factors such as age and country, we found that participants who reported youth occupational quad bike use (≤14 years old) were up to 200% more likely to allow extra riders and up to 489% more likely to not wear a helmet when compared to participants who reported beginning occupational quad bike use in adulthood. These findings support the Agricultural Youth Work Guideline (AYWG) for occupational quad bike use at age 16. Less than 20% of young adults working in agriculture were aware of safe design features such as wide frames, stability ratings, crush protection devices, and accessories made by the original equipment manufacturer. There is tremendous need to educate the future agricultural workforce about the importance of choosing quad bikes with safer design features. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic spurred some regulators in the USA to require occupational health and safety programs to prevent COVID-19 transmission in workplaces. The objective of this study was to describe such state and federal regulations enacted between January 2020 and January 2022. Regulations, including emergency temporary standards (ETS) and permanent standards, were identified through a search of Nexis Uni and Bloomberg Law and review of US OSHA websites and the Federal Register. Full texts were reviewed for regulatory scope, hazard and exposure definitions, determination of exposure or risk levels, and control strategies. Four state (California, Michigan, Virginia, and Oregon) and two federal regulations were identified. All regulations described respiratory aerosols as the primary source of SARS-CoV-2 and recognized person-to-person transmission by droplet, airborne, and contact routes. Only the US OSHA ETS for healthcare explicitly stated that inhalation of respiratory particles was the most likely method of COVID-19 transmission. The Virginia, Michigan, and Oregon regulations described different categories of risk defined by exposure frequency and duration or specific workplace activities. California described exposure as places and times when employees come into contact or congregate with other people. The US OSHA ETS for healthcare described exposure as involving close contact with suspected or confirmed COVID-19 patients. While all of the state regulations required strategies from across the hierarchy, only the Virginia regulations specifically incorporated the hierarchy of controls. Only the California and Virginia regulations explicitly linked control strategies to the transmission route, while Virginia demarcated control strategies by risk level. Oregon linked risk level to occupancy levels and physical distancing requirements and referred to the use of a layered approach for transmission control. The US OSHA ETS for healthcare defined droplet and airborne precautions but made no mention of the hierarchy of controls or risk levels. Respirators were discussed in most of the regulations. The first Michigan regulation explicitly required respirators appropriate to exposure risk. The California regulations noted that respirators protect the wearer while face coverings protect people around the wearer. These regulations offer insights for a permanent US OSHA infectious disease regulation, such as the need to consider a range of transmission modes including near- and far-range aerosol inhalation, endemic and novel pathogens, workplaces beyond healthcare settings, factors that contribute to exposure and risk, the hierarchy of controls, the role of vaccination, and the importance of written exposure assessment and infection prevention plans. [ABSTRACT FROM AUTHOR]

Background: Research suggests that changes in nurse roles can compromise perceived organizational safety. However, over the past 15 years, many infusion tasks have been reallocated from specialty nurse infusion teams to individual generalist nurses—a process we call infusion task reallocation. These changes purportedly benefit employees by allowing care providers to practice at the "top of their license." However, job demands–resources theory suggests that changing core task arrangements can either enrich or merely enlarge jobs depending on their effects on demands and resources, with corresponding consequences for performance (e.g., safety). There is relatively little research directly exploring these effects and their mechanisms. Purpose: This study examines the relationship between infusion task reallocation and perceptions of organizational safety. We also explore the extent to which this relationship may be mediated by infusion-related resources and psychological safety. Methodology: Data were collected through a survey of 623 nurses from 580 U.S. hospitals. The relationship between infusion task reallocation and perceptions of organizational safety, as well as the potential mediating roles of infusion-related resources and psychological safety, was examined using structural equation modeling. Results: Infusion task reallocation was negatively associated with respondents' perceptions of organizational safety, with nurses working in organizations without an infusion team indicating lower perceptions of organizational safety than nurses working in organizations with an infusion team. This relationship was mediated by nurse perceptions of psychological safety within the organization, but not by infusion-related resources, suggesting that task reallocation is associated with lower perceived organizational safety because nurses feel less psychologically safe rather than because of perceived technical constraints. Practice Implications: The results indicate that, although infusion task reallocation may be a cost-reducing approach to managing clinical responsibilities, it enlarges rather than enriches the job through higher demands and fewer resources for nurses and, in turn, lower perceived organizational safety. [ABSTRACT FROM AUTHOR]

Purpose: The burden of health and safety related issues emanating from the modern workplace is overwhelming. Although the prevailing statistics found in the literature show that victims of workplace fatalities and injuries are higher in developing countries and transition economies, there is a very limited understanding of the causal factors that may correspond to the continuous increase in the occupational exposure of employees to various fatalities and injuries. The purpose of this study was to review the literature on occupational safety of workers with the objective of highlighting the major causal factors of workplace injuries and fatalities from a multi-regional perspective, particularly on job-contexts with highest safety and health related hazards. Methodology: A systematic review of the literature was conducted on 73 empirical studies in the regions of Europe, Africa, the Middle East, Asia, Australia, and the Americas (the US & Canada). Findings: The results showed that the highest number of injuries and fatalities were mostly found in the construction industry. It further emerged that most of the studies were centered in developing countries within Africa and Asia. Other results and recommendations were discussed for each region. Value: The findings from this study have the potential to expose the regional dynamics in relation to safety in the workplace. This study also addresses the main areas of concern for stakeholders to promote organizational development and safety culture. [ABSTRACT FROM AUTHOR]

The US Occupational Safety and Health Administration (OSHA) enforces safety regulations through workplace inspections. The authors estimate the effect of inspections on worker safety by exploiting a feature of OSHA's Site-Specific Targeting plan. The program targeted establishments for inspection if their baseline case rate exceeded a cutoff. This approach generated a discontinuous increase in inspections, which the authors exploit for identification. Using the fuzzy regression discontinuity model, they find that inspections decrease the rate of cases that involve days away from work, job restrictions, and job transfers in the calendar year immediately after the inspection cycle. They find no effect for other case rates or in subsequent years. Effects are most evident in manufacturing and less evident in health services, the largest two-digit industries represented in the data. [ABSTRACT FROM AUTHOR]

With the advent of new sensing technologies and robust field-deployable analyzers, monitoring approaches can now generate valuable hazard information directly in the workplace. This is the case for monitoring respirable dust and respirable crystalline silica concentration levels. Estimating the quartz amount of a respirable dust sample by nondestructive analysis can be carried out using portable Fourier transform infrared spectroscopy (FTIR) units. Real-time respirable dust monitors, combined with small video cameras, allow advanced assessments using the Helmet-CAM methodology. These two field-based monitoring approaches, developed by the National Institute for Occupational Safety and Health (NIOSH), have been trialed in a sandstone quarry. Twenty-six Helmet-CAM sessions were conducted, and forty-one dust samples were collected around the quarry and analyzed on-site during two events. The generated data generated were used to characterize concentration levels for the monitored areas and workers, to identify good practices, and to illustrate activities that could be improved with additional engineered control technologies. Laboratory analysis of the collected samples complemented the field finding and provided an assessment of the performance of the field-based techniques. Only a fraction of the real-time respirable dust monitoring sessions data could be corrected with laboratory analysis. The average correction factor ratio was 5.0. Nevertheless, Helmet-CAM results provided valuable information for each session. The field-based quartz monitoring approach overestimated the concentration by a factor of 1.8, but it successfully assessed the quartz concentration trends in the quarry. The data collected could be used for the determination of a quarry calibration factor for future events. The quartz content in the dust was found to vary from 14% to 100%, and this indicates the need for multiple techniques in the characterization of respirable dust and quartz concentration and exposure. Overall, this study reports the importance of the adoption of field-based monitoring techniques when combined with a proper understanding and knowledge of the capabilities and limitations of each technique. [ABSTRACT FROM AUTHOR]

The article features the ASET Position Statement of the 24/7 Staffing for Neurodiagnostic Long-Term EEG Monitoring Services in 2022. Topics discussed include patients safety supports the need for 24/7 staffing, employee safety considerations support a 24/7 staffing model, and service delivery environments that require 24/7 technologist support. Also noted are American Epilepsy Society (AES) and National Association of Epilepsy Centers (NAEC) guidelines for AE centers on Levels 3 and 4 care.

Latino day laborers (LDL) are a vulnerable population of workers facing considerable risk for occupational injury. Under the guidance of our Community Advisory Board, we developed and tested the feasibility, acceptability and preliminary effects of Vales+Tú (You Are Worth More), a workplace injury risk-reduction program implemented by promotores on street-corners where LDL seek employment. The program was informed by theoretical perspectives emphasizing individual and group agency and self-determination. A pilot three-arm cluster-randomized community trial was conducted among 75 LDL. The intervention arms consisted of an individualized Brief Motivational Interview, a Group Problem Solving activity and a standard of care control (OSHA safety cards). We met our study goal of 25 LDL per intervention arm, and contacted 88% of participants post intervention. Participants evaluated the interventions favorably. At post-test, the Brief Motivational Interview group reported significant reductions in exposure to workplace hazards and increases in risk-reduction practices. The Group Problem Solving participants showed significant reductions in exposure to hazards (t -test −4.16, p < 0.001). Both intervention groups increased their reliance on corner peers, a measure of social support. Standard of care participants increased in self-efficacy to work safely. Overall, the only significant different between the three study conditions was in self-efficacy. These findings provide evidence of the feasibility and acceptability of Vales+Tú and show preliminary program efficacy. A large-scale replication trial will permit a more formal modeling of the study findings. Clinical Trial Registration (ClinicalTrials.gov): NCT04378348. [ABSTRACT FROM AUTHOR]

Background: The accommodations sector is one of the largest employers of immigrant and minority workers in the United States. Hotel housekeepers represent the industry's largest workforce while facing difficult work conditions, health hazards, and psychological stress. This is one of the few empirical studies that address the working conditions of housekeepers in the United States and their perspective of health challenges they face. Methods: A cross-sectional survey study was conducted with hotel housekeepers (N = 140) in Florida and in collaboration with the local labor union as a rapid assessment of occupational health and safety risk exposures, work-related injuries, coping mechanisms, and perceived management responses. Experienced union workers recruited study participants and administered interviewer-administered surveys. The analysis included descriptive statistics and multivariate regression. Findings: Sampled hotel housekeepers were found to work under significant time pressures to complete excessive workloads and to experience chemical and biological exposures and physical and psychosocial strains. Poor work equipment/insufficient supplies had a negative impact on hotel housekeepers' health, these include heavy wet towels vacuum cleaners having a significant effect on (p <.001) sprains and strains. Poor cleaning supplies had a significant effect (p <.001) on chemical burns. Other significant findings are provided in the article. Conclusion/Application to Practice: While housekeeping work conditions include many challenges, relatively simple changes by hotels' management can provide potential relief and improve workers' health and safety outcomes, such as functional equipment, sufficient inventory, management support, and proper rest breaks—subsequently increasing workers' health and reducing accidents, and thus potentially improving productivity at a relatively low cost. [ABSTRACT FROM AUTHOR]

This article explores key nursing liability issues associated with the pandemic, including immunity, documentation, crisis standards of care, delegation and assignment, scope of practice, floating, travel nursing, telehealth, and misinformation and social media. [ABSTRACT FROM AUTHOR]

Social workers are at risk of experiencing burnout, which is associated with numerous negative outcomes for professionals, agencies, and their clients. The purpose of this study is to examine the relationship between professional burnout and workplace conditions, with a particular focus on incidents of client violence. Data were from the 2015–2016 Social Work Safety Survey (SWSS) (N = 141). A multiple linear regression model was created to examine the effect of various workplace conditions on feelings of burnout, including experiencing incidents of client violence, workplace setting, average hours worked, length of time at current job, working primarily with clients who had experienced trauma, satisfaction with supervision, and having participated in a safety training. Feelings of burnout significantly increased as number of incidents of client violence and/or threats of client violence increased (B = 0.14). Additionally, the greater the average hours worked per week (B =.02) and working in private clinical practice (B = 0.63) significantly increased burnout scores. Length of time at current job was inversely predictive of feelings of burnout (B = −0.03). The findings from this study have significant implications for social work education and practice which may omit or overlook the effects of client violence and threats of violence in burnout prevention. [ABSTRACT FROM AUTHOR]

Objectives This study: (i) assessed the relationship between noise exposure and injury risk, comprehensively adjusting for individual factors, psychosocial stressors, and organizational influences; (ii) determined the relative importance of noise on injuries; (iii) estimated the lowest observed adverse effect level (LOAEL) of noise on injury risk to determine the threshold of noise considered hazardous to injuries; and (iv) quantified the fraction of injuries that could be attributed to hazardous noise exposure. Methods In this cross-sectional study at 10 US surface mine sites, traditional mixed effects, Poisson regression, and boosted regression tree (BRT) models were run on the number of reported work-related injuries in the last year. The LOAEL of noise on injuries was identified by estimating the percent increase in work-related injuries at different thresholds of noise exposure using a counterfactual estimator through the BRT model. A population attributable fraction (PAF) was quantified with this counterfactual estimator to predict reductions in injuries at the LOAEL. Results Among 18 predictors of work-related injuries, mine site, perceived job safety, age, and sleepiness were the most important predictors. Occupational noise exposure was the seventh most important predictor. The LOAEL of noise for work-related injuries was a full-shift exposure of 88 dBA. Exposure ≥88 dBA was attributed to 20.3% (95% CI: 11.2%, 29.3%) of reported work-related injuries in the last year among the participants. Conclusions This study further supports hypotheses of a dose–response relationship between occupational noise exposure and work-related injuries, and suggests that exposures ≥88 dBA may increase injury risk in mining. [ABSTRACT FROM AUTHOR]

Social work has been a part of the essential workforce historically and throughout the COVID‐19 pandemic, yet lack recognition. This work explores the experiences and invisibility of social workers within the pandemic response. Data are drawn from a large cross‐sectional survey of US‐based social worker from June to August of 2020. A summative content analysis of responses to the question 'What do you wish people knew about social work during the COVID‐19 pandemic' was undertaken. Participants (n = 515) were majority white (72.1%) and female (90.8%). Seven coding categories were subsequently collapsed into three domains: (1) meeting basic needs, (2) well‐being (emotional distress and dual role) and (3) professional invisibility (workplace equals, physical safety, professional invisibility and organisational invisibility). Meeting social needs requires broad‐based policies that strengthen the health and social safety net. Social workers have and will continue to play a critical role in the response, and recovery from COVID‐19. Organisational and governmental policies must expand to increase the visibility and responsiveness to the needs of social care providers. [ABSTRACT FROM AUTHOR]

Background: Frontline health care workers are particularly vulnerable to burnout and diminished well-being as they endure COVID-19 pandemic-related stressors. While physicians and nurses are the public face of those experiencing burnout in hospitals, these stressors also affect low-wage workers such as food and housekeeping/janitorial service workers whose roles largely remain "invisible" when conceptualizing the essential health workforce and understanding their needs. This study sought to understand the experiences of frontline essential workers to better support them and prevent burnout. Methods: Using a semi-structured interview guide, we conducted 20 in-depth qualitative interviews with workers in three U.S. states. Thematic content analysis was conducted to code and analyze interviews. Results: Workers had an average of 5.8 years in their jobs, which included food services, housekeeping/janitorial, and patient transport roles. Analysis revealed four prominent stressors contributing to worker burnout: changes in duties and staff shortages, fear of contracting or transmitting COVID-19, desire for recognition of their job-related risk, and unclear communication on safety precautions and resources. Protective factors included paid time-off, mental health supports, sense of workplace pride, and self-coping strategies. Conclusion/Application to Practice: As health systems continue to grapple with care delivery in the context of COVID-19, identifying best practices to support all workers and prevent burnout is vital to the functioning and safety of hospitals. Further consideration is warranted to create policies and multipronged interventions to meet workers' tangible needs while shifting the culture, so all members of the health workforce are seen and valued. [ABSTRACT FROM AUTHOR]

This study was conducted to evaluate the prevalence and risk factors for work-related respiratory conditions (asthma, farmer's lung, sinusitis, rhinitis, and environmental allergies, diagnosed by a physician) among farm and ranch operators in the central US. A survey was conducted by the Central States Center for Agricultural Safety and Health (CS-CASH) in 2018, focusing on work-related injuries, illnesses, exposures, and preventive measures in a seven-state region (Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, and South Dakota). Farms and ranches (n = 16,818) with an email address and annual sales exceeding $5,000 were randomly selected for the survey. Agricultural production and weather data were merged with survey responses. The relationship between exposures and respiratory conditions was analyzed using generalized estimating equations. We received responses from 3,268 agricultural operations (19% response rate) containing information on 4,064 individual operators. The life-time prevalence of (any) respiratory conditions among farm/ranch operators was 18%. Risk factors for respiratory conditions included exposures to grain/hay/feed dust (OR 2.41), animal confinement dust (OR 1.57), field/road dust (OR 2.11), manure/silage gasses (OR 1.66), anhydrous ammonia (OR 1.51), fuels/solvents/paints (OR 1.92), older age group >70 vs. <43 (OR 1.40), female gender (OR 1.82), and being primary vs. third operator (OR 1.61). Farmers and ranchers have a high prevalence of respiratory conditions associated with dust and gas exposures at work. More effective protective measures are needed using the hierarchy of controls, including improved use of respiratory protection. [ABSTRACT FROM AUTHOR]

It has been estimated that medical errors are the third highest‐ranking cause of death in the United States. A patient safety culture has been touted for many years as best practice to reduce medical error. While there is a general agreement of its importance, it has remained elusive for many. This study sought to learn how strengthening leadership skills within a health care organization could catalyze patient safety culture improvement. The research asked the following to gain an appreciation for that question: How does a leader ensure consistency in policies, practices, and protocols to create a patient safety culture? What attitudes, beliefs, and collective efficacy are needed to produce a patient safety culture? What leadership characteristics are needed to create a patient safety culture? The research participants were the employees who make up the patient safety department in a large academic health care system. Information was gathered to capture their view of leadership's role in patient safety culture and to gain knowledge relative to their individual experiences following a medical error. [ABSTRACT FROM AUTHOR]

Upon request from tribal nations, and as part of the Centers for Disease Control and Prevention's (CDC's) emergency response, CDC staff provided both remote and on-site assistance to tribes to plan, prepare, and respond to the COVID-19 pandemic. From April 2, 2020, through June 11, 2021, CDC deployed a total of 275 staff to assist 29 tribal nations. CDC staff typically collaborated in multiple work areas including epidemiology and surveillance (86%), contact tracing (76%), infection prevention control (72%), community mitigation (72%), health communication (66%), incident command structure (55%), emergency preparedness (38%), and worker safety (31%). We describe the activities of CDC staff in collaboration with 4 tribal nations, Northern Cheyenne, Hoopa Valley, Shoshone-Bannock, and Oglala Sioux Tribe, to combat COVID-19 and lessons learned from the engagement. [ABSTRACT FROM AUTHOR]

During the COVID‐19 pandemic, teachers in the United States, an already at‐risk occupation group, experienced new work‐related stressors, safety concerns, and work‐life challenges, magnifying on‐going retention concerns. Integrating the crisis management literature with the unfolding model of turnover, we theorize that leader actions trigger initial employee responses but also set the stage for on‐going crisis response that influence changes in teachers' turnover intentions. We apply latent growth curve modelling to test our hypotheses based on a sample of 617 K‐12 teachers using nine waves of data, including a baseline survey at the start of the 2020–2021 school year and eight follow‐up surveys (2‐week lags) through the Fall 2020 semester. In terms of overall adaptation, teachers on average, experienced an increase in work‐life balance and a decrease in turnover intentions over the course of the semester. Results also suggest that district and school leadership provide unique and complementary resources, but leader behaviours that shape initial crisis responses do not similarly affect employee responses during crisis, contrary to theory. Instead, teachers' adaptive crisis response trajectories were triggered by continued resource provision over the semester; increasing provision of valued resources (i.e., continued refinement of safety practices) and improvements in work‐life balance prevented turnover intentions from spiralling throughout the crisis. Crisis management theory and research should continue to incorporate temporal dynamics and identify factors that contribute to crisis response trajectories, using designs and analyses that allow for examination as crises unfold in real time. [ABSTRACT FROM AUTHOR]

For much of 2021, allocating the scarce supply of Covid‐19 vaccines was the world's most pressing bioethical challenge, and similar challenges may recur for novel therapies and future vaccines. In the United States, the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (ACIP) identified three fundamental ethical principles to guide the process: maximize benefits, promote justice, and mitigate health inequities. We argue that critical components of the recommended protocol were internally inconsistent with these principles. Specifically, the ACIP violated its principles by recommending overly broad health care worker priority in phase 1a, using being at least seventy‐five years of age as the only criterion to identify individuals at high risk of death from Covid‐19 during phase 1b, failing to recommend place‐based vaccine distribution, and implicitly endorsing first‐come, first‐served allocation. More rigorous empirical work and the development of a complete ethical framework that recognizes trade‐offs between principles may have prevented these mistakes and saved lives. [ABSTRACT FROM AUTHOR]

The article discusses the efforts to avert heat-related illnesses and injuries in the workplace by citing the study led by environmental engineer Erick Bandala. Other topics include the number of workers who experienced heat-related illnesses or injuries in the U.S. in 2011-2019, the projected economic losses due to heat as per the International Labor Organization (ILO), and the National Emphasis Program (NEP) launched by the U.S. Occupational Safety and Health Administration (OSHA).

Caring for patients with substance use disorder (SUD) can be challenging. Lack of knowledge of SUD treatment may add to nurses' feelings of burnout and intent to leave the workplace. This article describes a novel program for patients with SUD admitted for long-term antibiotic treatment and its impact on the nurses' work environment, particularly burnout. Caring for patients with substance use disorder (SUD) can be challenging. This article describes a novel program for patients with SUD admitted for long-term antibiotic therapy and its impact on the nurses' work environment, particularly burnout. [ABSTRACT FROM AUTHOR]

This commentary on a case discusses oft-overlooked roles of health care organizations' personnel in environmental services and related fields, such as waste management. Such personnel are not protected in the same ways frontline clinicians are, although their risk of exposure to pathogens in the course of their work can be high. This article describes why such personnel should be included in planning personal protective equipment access and in administrative and engineering operations concerning infectious disease emergence, containment, and management. [ABSTRACT FROM AUTHOR]

Approximately 1.7 million infections occur annually in U.S. hospitals, with one in 25 patients acquiring a healthcare-associated infection (HAI) while hospitalized. Ongoing improvements in infection prevention and control protocols and processes reduce the risk of HAIs, but these are inhibited by surface pathogens that persist after routine cleaning and disinfection. It is unknown whether various surfaces and products in the healthcare setting are damaged by disinfectants creating invisible microbial reservoirs and ultimately, increasing the risk of transmitting pathogens. There are a variety of guidelines and recommendations to ensure equipment and surfaces can be cleaned and disinfected for safe use in the clinical setting, but no uniform approach exists for testing and product claims. Additionally, the life cycle of built environment surfaces and assembled clinical equipment may be greatly shortened by surface degradation, impacting cost and organizational sustainability goals. This consensus paper was developed to highlight gaps in evidence and recommend future action to a variety of stakeholders. [ABSTRACT FROM AUTHOR]

A continuing education program was designed to help nurses stay safe while providing nursing care to patients during the COVID-19 pandemic. The program addressed topics aimed at empowering nurses to advocate for their own health and safety as a result of increased knowledge related to caring for patients and communities during a global pandemic. A four-part, on-demand webinar series was offered from January 2021 through January 2022. The program had 1,025 international participants and 995 contact hours were issued. The Frontline Nursing During COVID-19: A New Paradigm continuing education program provided professional development to nurses around the world. It is critical to offer accessible programs that address safety and empowerment for nurses in clinical settings. [J Contin Educ Nurs. 2022;53(9):425–428.] [ABSTRACT FROM AUTHOR]

Background: Nonresidential fires and resultant injuries and deaths have been on the rise the last decade in the United States. Although evacuation is a primary prevention method, people in the workplace still fail to evacuate when they hear a fire alarm. The current formative study applied the Reasoned Action Approach (RAA) to identify belief factors associated with university employees' intention evacuate. Methods: Data were collected from employees at a large public university (N = 490) through an online survey. Multiple linear regression quantified the relative contribution of six RAA constructs that represent belief factors underlying employees' intention to leave the office building immediately the next time they hear a fire alarm. Findings: Nearly 60% of the variation in employees' intention to leave was predicted from the belief factors, adjusted R 2 = 0.598, F (17, 472) = 43.80, p <.001. Controlling for demographic characteristics, five of the six RAA global constructs showed statistically significant independent associations with intention: instrumental attitude (B =.272, SE =.026, p <.001), experiential attitude (B = −.073, SE =.026, p =.024), injunctive norm (B =.210, SE =.075, p <.001), descriptive norm (B =.347, SE =.070, p <.001), and capacity (B =.178, SE =.077, p <.001). Conclusions/Applications to Practice: These findings show the RAA can be successfully applied to provide employees' perspective on safety decisions like evacuation. The belief factors' relative contributions can help safety professionals prioritize interventions to facilitate leaving immediately. Here the high weights for the two normative factors suggest addressing employees' descriptive beliefs that others like them leave and their injunctive beliefs that significant others, like supervisors and safety personnel, approve of their leaving. [ABSTRACT FROM AUTHOR]

The NIOSH WellBQ has direct population and occupational health significance, with indirect significance for clinical practice. The instrument assesses multiple components of well-being spanning the work environment and conditions outside of work that can provide context for health conditions presented by workers. Objective: This article describes development of the National Institute for Occupational Safety and Health (NIOSH) Worker Well-Being Questionnaire (WellBQ). Methods: The NIOSH WellBQ was developed through literature reviews and expert panel recommendations. We drew from a representative sample of the civilian, noninstitutionalized, US working population to pilot the questionnaire. Psychometric analyses were performed on data from 975 respondents to finalize items and optimize the NIOSH WellBQ's psychometric properties. Results: The final questionnaire consists of 16 scales, 5 indices, and 31 single items across 5 domains: (1) work evaluation and experience; (2) workplace policies and culture; (3) workplace physical environment and safety climate; (4) health status; and (5) home, community, and society (experiences and activities outside of work). The instrument demonstrated adequate reliability and validity. Conclusions: The NIOSH WellBQ is a reliable and valid instrument that comprehensively measures worker well-being. [ABSTRACT FROM AUTHOR]

This article discusses how COVID-19 has impacted the American workforce, symptoms of Long COVID syndrome, Multiple Chemical Sensitivity, and ways to avoid triggering its symptoms when sanitizing the workplace and using Universal Design practices to increase accessibility and decrease transmission of COVID-19 among workers. Interface with healthcare providers, rehabilitation professionals, and employers is emphasized. [ABSTRACT FROM AUTHOR]

Occupational safety and health (OSH) related agencies have a plethora of injury data available; however, modern data visualization and user-friendly dissemination tools are lacking in this field. This work has created a geospatial platform using geographic information systems (GIS) combined with big data analytics for the southeastern region of United States. Severe injury reports were collected and visualized through state-of-the-art spatial statistics including spatial clustering, heat maps, and hotspots to identify the most vulnerable regions due to various injury types from a safety vantage point. A special focus was also given to the construction industry, considering the hazardous nature of the industry. Statistically significant spatial clustering was observed within the study region, with Moran's I index of 0.49. Hotspots for severe injuries were also identified with approximately 99% confidence level using Getis Ord Gi* statistics. Results indicated statistically significant high-risk zones particularly around city areas with spatial injury rates (SIR) up to approximately 2.84 per county. Analysis also showed increased number of severe injuries during summer months, with approximately 1,000 injuries during the month of June and July. The construction industry accounted for 20% of all injuries, with "caught-in/between" being the highest amongst the four primary causes of severe injuries, commonly known as the "fatal four." Finally, a web-based application was created to disseminate the results. Big data mining coupled with geospatial technology in OSH management can offer decision makers up-to-date and highly geospatial information for severe injuries that can be integrated in developing a comprehensive occupational safety surveillance plan. [ABSTRACT FROM AUTHOR]