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Objectives: To describe the incidence rate, severity, burden and aetiology of medical attention and time-loss injuries across five consecutive seasons at a professional ballet company., Methods: Medical attention injuries, time-loss injuries and dance exposure hours of 123 professional ballet dancers (women: n=66, age: 28.0±8.3 years; men: n=57, age: 27.9±8.5 years) were prospectively recorded between the 2015/2016 and 2019/2020 seasons., Results: The incidence rate (per 1000 hours) of medical attention injury was 3.9 (95% CI 3.3 to 4.4) for women and 3.1 (95% CI 2.6 to 3.5) for men. The incidence rate (per 1000 hours) of time-loss injury was 1.2 (95% CI 1.0 to 1.5) for women and 1.1 (95% CI 0.9 to 1.3) for men. First Soloists and Principals experienced between 2.0-2.2 additional medical attention injuries per 1000 hours and 0.9-1.1 additional time-loss injuries per 1000 hours compared with Apprentices (p≤0.025). Further, intraseason differences were observed in medical attention, but not time-loss, injury incidence rates with the highest incidence rates in early (August and September) and late (June) season months. Thirty-five per cent of time-loss injuries resulted in over 28 days of modified dance training. A greater percentage of time-loss injuries were classified as overuse (women: 50%; men: 51%) compared with traumatic (women: 40%; men: 41%)., Conclusion: This is the first study to report the incidence rate of medical attention and time-loss injuries in professional ballet dancers. Incidence rates differed across company ranks and months, which may inform targeted injury prevention strategies., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2021. No commercial re-use. See rights and permissions. Published by BMJ.)

Introduction: This study addressed relative injury risk among Norwegian farmers, who are mostly self-employed and run small farm enterprises. The aim was to explore the relative importance of individual, enterprise, and work environment risks for occupational injury and to discuss the latent conditions for injuries using sociotechnical system theory., Method: Injury report and risk factors were collected through a survey among Norwegian farm owners in November 2012. The response rate was 40% (n = 2,967). Annual work hours were used to calculate injury rates within groups. Poisson regression using the log of hours worked as the offset variable allowed for the modeling of adjusted rate ratios for variables predictive of injury risk. Finally, safety climate measures were introduced to assess potential moderating effects on risk., Results: Results showed that the most important risk factors for injuries were the design of the workplace, type of production, and off-farm work hours. The main results remained unchanged when adding safety climate measures, but the measures moderated the injury risk for categories of predominant production and increased the risk for farmers working with family members and/or employees. An overall finding is how the risk factors were interrelated., Conclusions: The study identified large structural diversities within and between groups of farmers. The study drew attention to operating conditions rather than individual characteristics. The farmer's role (managerial responsibility) versus regulation and safety climate is important for discussions of injury risk. Practical Applications: We need to study sub-groups to understand how regulation and structural changes affect work conditions and management within different work systems, conditioned by production. It is important to encourage actors in the political-economic system to become involved in issues that were found to affect the safety of farmers., (Copyright © 2021 The Author(s). Published by Elsevier Ltd.. All rights reserved.)

Although assessing the cost of workplace injuries and illnesses as part of occupational health and safety management is important in ensuring workplace safety, the issue is generally neglected among informal auto-artisans in Ghana. This paper examines the costs of occupational injuries and illnesses in terms of productivity, financial and social aspects of selected auto-artisans who service or fabricate auto parts in Suame 'Magazine' in Kumasi, Ghana. Employing a descriptive cross-sectional design, data were collected from 957 auto-artisans selected through a multistage cluster sampling method. The study found that the most frequent occupational illnesses and injuries experienced by the auto-artisans are those related to sharp objects (83.9%), inhalation of dust particles (45.8%), objects falling from height (35.6%) and burns (21.8%). These injuries and illnesses have led to loss of productivity and income which affects family members with no variations between the various categories of auto-artisans ( p  = 0.976). It is concluded that occupational injuries and illnesses among informal auto-artisans presents enormous financial and emotional costs to survivors and their families. It is recommended that government should lead a policy dialogue on safety in the country's informal sector, while supporting artisans to establish insurance schemes to support them in times of injuries and illnesses.

High-resolution ultrasound (US) has helped to characterize the "tennis leg injury" (TL). However, no specific classifications with prognostic value exist. This study proposes a medial head of the gastrocnemius injury classification based on sonographic findings and relates this to the time to return to work (RTW) and return to sports (RTS) to evaluate the prognostic value of the classification. 115 subjects (64 athletes and 51 workers) were retrospectively reviewed to asses specific injury location according to medial head of the gastrocnemius anatomy (myoaponeurotic junction; gastrocnemius aponeurosis (GA), free gastrocnemius aponeurosis (FGA)), presence of intermuscular hematoma, and presence of gastrocnemius-soleus asynchronous movement. Return to play (RTP; athletes) and return to work (RTW; occupational) days were recorded by the treating physician. This study proposes 5 injury types with a significant relation to RTP and RTW (P < .001): Type 1 (myoaponeurotic injury), type 2A (gastrocnemius aponeurosis injury with a <50% affected GA width), type 2B (gastrocnemius aponeurosis with >50% affected GA width), type 3 (free gastrocnemius aponeurosis (FGA) tendinous injury), and type 4 (mixed GA and FGA injury). The longest RTP/RTW periods were associated with injuries with FGA involvement. Intermuscular hematoma and Gastrocnemius-soleus asynchronous motion during dorsiflexion and plantarflexion were observed when the injury affected >50% of the GA width, with or without associated FGA involvement, and this correlated with a worse prognosis. The proposed classification can be readily applied in the clinical setting although further studies on treatment options are required., (© 2020 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Objective: To analyze injury frequency, density, location, type, mechanism of injury (MOI), activity phase of injury, and injury risk in professional rodeo., Design: Retrospective epidemiological review., Setting: Professional Rodeo Cowboys Association sanctioned rodeos from 2011 to 2014., Participants: Professional Rodeo Cowboys Association competitors competing in bull riding, bareback riding, saddle bronc riding, team roping, tie-down roping, and steer wrestling., Main Outcome Measures: Injury reports were documented by sports medicine personnel. Variables assessed include event, frequency, density, location, type, MOI, activity phase of injury, and injury density., Results: A total of 2305 injuries from 139,098 competitor exposures (CEs) were reported, demonstrating overall injury density of 16.6 injuries per 1000 CEs (95% confidence interval, 0.016-0.017) and overall risk of injury of 1.69%. Rough stock riders accounted for 88.7% of all injuries. Bull riders, bareback riders, and saddle bronc riders demonstrated injury densities of 48.2, 41.1, and 23.2 injuries per 1000 CEs, respectively. Most injuries (62.9%) were sustained by collisions with the ground or animal, or being stomped on by the animal. Contusions, sprains, and concussions were the most frequent injury types (23.1%, 13.6%, and 11.6%, respectively). Neurological components, knees, and shoulders were the most injured body parts (13.4%, 11.1%, and 11.0%, respectively). Most injuries (36.8%) occurred during or immediately after the dismount., Conclusions: Rough stock events have the greatest risk of injury in professional rodeo, whereas steer wrestling has the greatest risk of injury for timed event athletes. Medical professionals should use these findings to implement prevention programming where possible.

Context: Slips, trips, and falls are leading causes of musculoskeletal injuries in firefighters. Researchers have hypothesized that heat stress is the major contributing factor to these fireground injuries., Objective: To examine the effect of environmental conditions, including hot and ambient temperatures, and exercise on functional and physiological outcome measures, including balance, rectal temperature, and perceived exertion., Design: Randomized controlled clinical trial., Setting: Laboratory environmental chamber., Patients or Other Participants: A total of 13 healthy, active career firefighters (age = 26 ± 6 years [range = 19-35 years], height = 178.61 ± 4.93 cm, mass = 86.56 ± 16.13 kg)., Intervention(s): Independent variables consisted of 3 conditions (exercise in heat [37.41°C], standing in heat [37.56°C], and exercise in ambient temperature [14.24°C]) and 3 data-collection times (preintervention, postintervention, and postrecovery). Each condition was separated from the others by at least 1 week and lasted a maximum of 40 minutes or until the participant reached volitional fatigue or a rectal temperature of 40.0°C., Main Outcome Measure(s): Firefighting-specific functional balance performance index, rectal temperature, and rating of perceived exertion., Results: Exercise in the heat decreased functional balance, increased rectal temperature, and altered the perception of exertion compared with the other intervention conditions., Conclusions: A bout of exercise in a hot, humid environment increased rectal temperature in a similar way to that reported in the physically active population and negatively affected measures of functional balance. Rather than independently affecting balance, the factors of exercise and heat stress appeared to combine, leading to an increased likelihood of slips, trips, and falls.

Children as young as 10 years old are hired to work on farms in the United States (U.S.). These children are largely Latinx. Using interview data collected from 202 North Carolina Latinx child farmworkers in 2017, this analysis documents the heath characteristics and occupational injuries of Latinx child farmworkers and delineates characteristics associated with their health and occupational injuries. Latinx child farmworkers include girls (37.6%) and boys (62.4%), aged 10 to 17 years, with 17.8% being migrant farmworkers. Three-quarters reported receiving medical and dental care in the past year. Respiratory (15.8%) and vision (20.3%) problems were prevalent. Girls more than boys, and younger more than older children had greater health service utilization. Occupational injuries were common, with 26.2% reporting a traumatic injury, 44.1% a dermatological injury, 42.6% a musculoskeletal injury, and 45.5% heat-related illness in the past year. Age increased the odds of reporting work injuries and heat-related illness, and being a non-migrant reduced the odds of reporting work injuries. These results emphasize the need for greater documentation of child farmworker occupational health and safety. They underscore the need to change occupational safety policy to ensure that children working in agriculture have the same protections as those working in all other U.S. industries.

Occupational exposure remains a serious problem for medical staff, especially those working in operation rooms. Hepatitis B virus (HBV) is prevalent in patients undergoing surgery, and anesthesiologists are at risk of occupational acquisition of blood-borne HBV infection. To the best of our knowledge, there are no data about HBV prevalence and vaccinations, as well as attitudes toward sharp injuries and gloving among anesthesiologists in China, where the HBV prevalence is high. To clarify these, the present study was conducted.An electronic questionnaire including HBV markers, gloving during practice, and reporting patterns of sharp injuries was created and sent to anesthesiologists.After excluding 10 uncompleted questionnaires, 1739 questionnaires were included in the final analysis. Of all analyzed anesthesiologists, 1599 (91.9%) had experienced sharp injuries, and 1313 (75.5%) had experienced >1 sharp injury. Considering HBV vaccination histories, 1381 anesthesiologists (79.4%) received 3 vaccination doses, and only half of the immunized anesthesiologists received reminder HBV vaccination doses after work before exposure. There were 696 anesthesiologists (40.0% of all participants) who were ever exposed to HBV, and nearly two-thirds of them (440) were exposed to HBV more than once. There was a more positive attitude toward gloving and double-gloving to reduce HBV exposure.The incidence of occupational HBV exposure among anesthesiologists is high, and its threat should be considered. HBV vaccinations and adherence to postexposure guidelines are recommended. The high prevalence of sharp injuries during anesthesia practice highlights the importance of safe anesthesia practices, such as gloving or double-gloving, especially when in contact with high-risk body fluids.

Purpose To determine whether healthcare use and return-to-work (RTW) outcomes differ with GPs' injured-worker caseload. Methods Retrospective analyses of the Compensation Research Database, which captures approximately 85% of all injured worker claims in Victoria, Australia was conducted. Four injured-worker caseload groups were examined that represented the 25th, 50th, 75th, and 100th percentiles of claimants seen per GP over the 8-year study period (2003-2010): (i) 1-13 claimants; (ii) 14-26 claimants; (iii) 27-48 claimants; and (iv) 49+ claimants (total claims, n = 124,342; total GPs, n = 9748).The characteristics of claimants in each caseload group, as well as the influence of caseload on three outcomes relevant to RTW (weekly compensation paid, work incapacity days, medical-and-like costs), were examined. Results Distinct profiles for high versus low caseload groups emerged. High caseload GPs treated significantly more men in blue collar occupations and issued significantly more 'alternate duties' certificates. Conversely, low caseload GPs treated significantly more women in white collar occupations, predominantly for mental health injuries, and issued significantly more 'unfit-for-work' certificates. Few significant differences were found between the two intermediate GP caseload groups. High caseload was associated with significantly greater medical-and-like costs, however, no caseload group differences were detected for weekly compensation paid or duration of time-off-work. Conclusions Training GPs who have a low injured-worker caseload in workers' compensation processes, utilising high caseload GPs in initiatives involving peer-to-peer support, or system changes where employers are encouraged to provide preventive or rehabilitative support in the workplace may improve RTW outcomes for injured workers.

Background: Agricultural safety and health researchers have used a variety of classification and coding schemes to identify and categorize injury, illness, and disease associated with agricultural hazards. This paper demonstrates how the Farm and Agricultural Injury Classification (FAIC) and Occupational Injury and Illness Classification System (OIICS) coding schemes can be used in tandem for all agricultural injuries., Methods: Specific cases from the AgInjuryNews.org database were selected to illustrate how the FAIC and OIICS codes can be applied to agricultural injury, and to illustrate limitations that still exist with each coding scheme., Results: Using the FAIC and OIICS together provided a clearer picture of an injury incident by combining more explicit occupational and non-occupational exposures with incident type details in a single table., Conclusions: Both FAIC and OIICS coding schemes depend on sufficient information being available from injury reports. This paper concluded with suggestions for improving coding of agricultural injury., (© 2018 Wiley Periodicals, Inc.)

Introduction: Healthcare workers (HCWs) are exposed to various risk factors and risky behaviours that may seriously affect their health and ability to work. The aim of this protocol is to detail the steps to follow in order to carry out a scoping review to assess the prevalence/incidence of injuries among HCWs., Methods and Analysis: The study will be carried out in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses-Protocols guidelines. Studies will be selected according to the following criteria: P (HCWs), E (exposure to injuries), C (different types of exposure and different categories of HCWs) and O (prevalence/incidence and determinants of injuries). A time filter has been set (literature between 2000 and 2018) to enable updated, direct comparison between the findings and the epidemiological data available at national and local 'Istituto Nazionale per l'Assicurazione contro gli Infortuni sul Lavoro' (National Institute for Insurance Against Accidents at Work) centres in Italy. No language restriction will be applied., Ethics and Dissemination: Formal ethical approval is not required; primary data will not be collected, as they have already been published. The results will be disseminated through peer-reviewed publication(s), conference presentation(s) and the press., Competing Interests: Competing interests: None declared., (© Author(s) (or their employer(s)) 2019. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)

As part of ongoing surveillance of fatalities and injuries involving agricultural confined spaces by Purdue University's Agricultural Safety and Health Program, nearly 300 cases involving manure storage, handling, and transport equipment and facilities have been documented over the past 30 years. With the exception of a summary of 77 fatalities published by Beaver and Field 1 , these cases have not been previously analysed or published due to a lack of resources and the limitations of the Purdue Agricultural Confined Spaces Incident Database (PACSID) which was designed primarily for analysis of grain-related cases. These limitations included differences in terminology used to code case information in the PACSID and dissimilar causative and contributing factors. To develop a consistent and more useful approach to process and analyze data, 28 U.S. manure-related incidents involving 39 victims documented as having occurred in 2017 were examined for type of incident, victim characteristics, primary contributing factors, and nature of injuries. A review of literature was conducted to identify previously reported contributing factors, and a coding rubric was developed and reviewed by a panel of experts. It was determined that the rubric provided a consistent way to code and analyze descriptive information available on each case. A pilot analysis was completed of the 39 cases using the new tool, and results were summarized. The final methodology will be used to analyze all historically documented incidents, as well as future incidents. Findings presented include a review of relevant literature, discussion of the methods used in case documentation, classifications developed from sample data, and a summary of incidents in 2017. Anticipated outcomes include: 1) consistent strategy to document, code, and summarize manure-related incidents; 2) means of classification of key contributing factors; 3) identification of new or emerging trends; and 4) completion of previously documented incidents.

Introduction: Healthcare workers account for 10% of the EU's total workforce, with a significant proportion of those employed in hospitals. Musculoskeletal injuries are the predominant group of injuries in healthcare professionals due to the physical demands of their work, such as the mobilization and positioning of the dependent patients. The management of this type of problem should take into account direct and indirect costs, such as periods of incapacity for work due to illness, hiring and training of new employees during periods of absence, reduced levels of productivity and the effects on production and quality of work., Objectives: 1-Characterization of injuries resulting from occupational accidents in hospital workers according to the International Classification of Diseases ICD-10; 2-Identification of the predictive factors of absenteeism duration due to temporary work incapacity in workplace accidents., Methods: A retrospective observational study was conducted based on the analysis of 1621 cases of work-related accidents of employees of Centro Hospitalar São João from January 2011 to December 2014. An ICD-10 classification code was associated with each of the accident cases, based on pre-established criteria for classification of the specific diagnoses of musculoskeletal injuries. The duration of temporary work incapacity was compared between the categories of sociodemographic variables, among six categories of ICD-10 primary diagnosis (reclassification), and between the two major chapters of ICD-10 classification-chapter XIX (direct trauma) and chapter XIII (indirect trauma-strain injuries). The sociodemographic predictors of the occurrence of strain injuries were determined by logistic regression. A multinomial logistic regression analysis was conducted with selection of duration of work incapacity as the dependent variable., Results: A total of 824 cases of musculoskeletal injuries occurred on hospital premises during the study period, which corresponded to a total of 22159 lost workdays in the context of temporary work incapacity due to work injury. According to the ICD-10 reclassification, the three most frequent diagnostic groups were direct lower limb trauma (n = 230, 27.9%), spinal strain injuries (n = 194, 23.5%) and direct upper limb trauma (n = 174, 21.1%). Significant differences were observed in temporary work incapacity duration among the ICD-10 diagnostic categories: spinal strain injuries were the diagnostic group associated with longer duration of temporary work incapacity, with a median = 14.0 (25-75th percentile: 6.0-35.0). The only variable that demonstrated to be significantly predictive of temporary work incapacity less than or greater than 20 days was the ICD-10 diagnostic group. The regression results revealed a 5-fold increase in risk in the case of spinal strain injuries for temporary work incapacity durations of less than or greater than 20 days (OR = 5.58 and OR = 5.89 respectively)., Conclusions: The study findings support the benefits of the characterization of workplace injuries by medical diagnostic groups, namely in the interpretation of the sequelae of the accidents and the medical contextualization of the accidents. Association of ICD-10characterization can improve the analysis of workplace accidents at an institutional level, and promote the implementation of preventive measures and control of absenteeism., Competing Interests: The authors have declared that no competing interests exist.

Background: Work-related injuries are commonly seen in the emergency department (ED). This study sought to analyze characteristics of ED patient visits that were billed under workers' compensation., Methods: This was a retrospective chart review of visits during 2015 that were billed under workers' compensation at an academic ED. The following variables were collected: age, gender, mechanism of injury/exposure, diagnoses, imaging performed, specialty consultation, operative requirement, follow-up specialty, and ED disposition., Results: In 2015, 377 patients presented to the ED for work-related injuries. The most common mechanism of injury was fall. Frequent diagnoses included lower extremity injuries and hand/finger injuries. The most common consulting service was orthopedics. Only five patients were referred to occupational medicine for follow up., Conclusion: Knowledge of the types of occupational injuries and subsequent care required may help guide both workers and employers how to best triage patients within the healthcare system. Alternative settings such as occupational medicine or primary care services may be appropriate for some patients., (Copyright © 2018 Elsevier Inc. All rights reserved.)

In industrial societies, work-related musculoskeletal disorders are common among workers, frequently resulting in recurrent injuries, work disability, and multiple compensation claims. The risk of idiopathic musculoskeletal injuries is thought to be more than twice the risk of any other health problem among workers in the health care sector. This risk is highly prevalent particularly among workers whose job involves frequent physical tasks, such as patient lifting and transfer. Workers with recurrent occupational injuries are likely to submit multiple work disability claims and progress to long-term disability. The objective of this study was to explore the influence of injury type and worker characteristics on multiple compensation claims, using workers' compensation claims data. This retrospective study analyzed 11 years of secondary claims data for health care workers. Workers' occupational groups were classified based on the nature of physical tasks associated with their jobs, and the nature of work injuries was categorized into non-musculoskeletal, and traumatic and idiopathic musculoskeletal injuries. The result shows that risk of multiple injury claims increased with age, and the odds were highest for older workers aged 55 to 64 (odds ratio [OR] = 3.5). A large proportion of those who made an injury claim made multiple claims that resulted in more lost time than single injury claims. The study conclusion is that the nature of injury and work tasks are probably more significant risk factors for multiple claims than worker characteristics.

Introduction: We analyzed workers' compensation (WC) data to identify characteristics related to workers' compensation claim outcomes among janitorial service workers in Washington State., Method: We analyzed WC data from the Washington State Department of Labor & Industries (L&I) State Fund (SF) from January 1, 2003 through December 31, 2013, for janitorial service workers employed in the National Occupational Research Agenda (NORA) Services Sector. We constructed multivariable models to identify factors associated with higher medical costs and increased time lost from work., Results: There were 2,390 janitorial service compensable claims available for analysis. There were significant differences in injury type and other factors by gender, age, and language preference. Linguistic minority status was associated with longer time loss and higher median medical costs. Women were estimated to account for 35% of janitorial service workers but made up 55% of the compensable claims in this study., Conclusions: Janitorial service workers comprise a large vulnerable occupational group in the U.S. workforce. Identifying differences by injury type and potential inequitable outcomes by gender and language is important to ensuring equal treatment in the workers' compensation process., Practical Applications: There were significant differences in injury and individual characteristics between men and women in this study. Women had twice the estimated rate of injury to men, and were more likely to require Spanish language materials. Improving communication for training and knowledge about the workers' compensation system appear to be high priorities in this population of injured janitorial service workers., (Copyright © 2017 Elsevier Ltd and National Safety Council. All rights reserved.)

Background: This preliminary study evaluates a real-time syndromic surveillance system to track occupationally-related emergency room visits throughout New Jersey., Methods: Emergency Department (ED) chief complaint fields were evaluated from 79 of 80 hospitals in NJ in 2014, using work-related keywords and ICD-9 E-codes, to determine its ability to capture non-fatal work-related injuries. Sensitivity analysis and descriptive statistics, were used to evaluate and summarize the occupational injuries identified., Results: Overall, 11 919 (0.3%) possible work-related ED visits were identified from all ED visits. Events with the greatest number of ED visits were slips, trips, and falls (1679, 14%). Nature of injury included cuts, lacerations (1041, 9%). The part of the body most affected was the back (1414, 12%). This work-related classifier achieved a sensitivity of 5.4%, a specificity of 99.8%, and a PPV of 2.8%., Conclusions: This evaluation demonstrated that the syndromic surveillance reporting system can yield real-time knowledge of work-related injuries., (© 2017 Wiley Periodicals, Inc.)

Introduction: A 2009 Government Accounting Office (GAO) report, along with numerous published studies, documented that many workplace injuries are not recorded on employers' recordkeeping logs required by the Occupational Safety and Health Administration (OSHA) and consequently are under-reported to the Bureau of Labor Statistics (BLS), resulting in a substantial undercount of occupational injuries in the United States., Methods: OSHA conducted a Recordkeeping National Emphasis Program (NEP) from 2009 to 2012 to identify the extent and causes of unrecorded and incorrectly recorded occupational injuries and illnesses., Results: OSHA found recordkeeping violations in close to half of all facilities inspected. Employee interviews identified workers' fear of reprisal and employer disciplinary programs as the most important causes of under-reporting. Subsequent inspections in the poultry industry identified employer medical management policies that fostered both under-reporting and under-recording of workplace injuries and illnesses., Conclusions: OSHA corroborated previous research findings and identified onsite medical units as a potential new cause of both under-reporting and under-recording. Research is needed to better characterize and eliminate obstacles to the compilation of accurate occupational injury and illness data., Practical Applications: Occupational health professionals who work with high hazard industries where low injury rates are being recorded may wish to scrutinize recordkeeping practices carefully. This work suggests that, although many high-risk establishments manage recordkeeping with integrity, the lower the reported injury rate, the greater the likelihood of under-recording and under-reporting of work-related injuries and illnesses., (Published by Elsevier Ltd.)

Parallel reimbursement regimes, under which providers have some discretion over which payer gets billed for patient treatment, are a common feature of health care markets. In the U.S., the largest such system is under Workers' Compensation (WC), where the treatment workers with injuries that are not definitively tied to a work accident may be billed either under group health insurance plans or under WC. We document that there is significant reclassification of injuries from group health plans into WC, or "claims shifting", when the financial incentives to do so are strongest. In particular, we find that injuries to workers enrolled in capitated group health plans (such as HMOs) see a higher incidence of their claims for soft-tissue injuries (which are hard to classify specifically as work related) under WC than under group health, relative to those in non-capitated plans. Such a pattern is not evident for workers with traumatic injuries. Moreover, we find that such reclassification is more common in states with higher WC fees, once again for soft tissue but not traumatic injuries. Our results imply that a significant shift towards capitated reimbursement, or reimbursement reductions, under GH could lead to a large rise in the cost of WC plans., (Copyright © 2016 Elsevier B.V. All rights reserved.)

Background: Men comprise nearly two-thirds of trafficked and forced labourers in common low-skilled labour sectors including fishing, agriculture and factory work. Yet, most evidence on human trafficking has focused on women and girls trafficked for sex work, with scant research on trafficked men and boys., Methods: We analyse survey data from the largest systematic consecutive sample of trafficked people collected to date to describe the prevalence of violence, occupational health risks and injuries and associated factors. Participants were labour-trafficked men and boys using post-trafficking support services in Thailand, Cambodia and Vietnam., Findings: Data are presented on 446 males aged 10-58. Men and boys were mainly trafficked for fishing (61.7%), manufacturing (19.1%) and begging (5.2%). Fishermen worked extensive hours (mean 18.8 hours/day, SD 5.9) and factory workers worked on average 11.9 hours/day (SD 2.9). 35.5% of male survivors had been injured while trafficked; 29.4% received no personal protective equipment (e.g. gloves). The most commonly reported injuries among all males were deep cuts (61.8%) and skin injuries (36.7%), injuries for which fewer than one-quarter reported receiving medical care. Six fishermen lost body parts, none of whom received medical care. Most males (80.5%) had no or very few rest breaks. One-third (37.8%) experienced severe violence. Work-related injuries were associated with severe violence (AOR 3.44, CI:1.63-7.26), being in the fishing sector, (AOR 4.12, CI:2.39-7.09) and threats (AOR 2.77, CI:1.62-4.75). Experiencing any violence was associated with threats (AOR 26.86, CI:14.0-51.23), being in the fishing sector (AOR 18.53, CI:8.74-39.28) and fluency in language of destination country (AOR 0.39, CI:0.20-0.75)., Conclusion: This study highlights the abuse and extreme occupational hazards suffered by trafficked men and boys. Occupational health and safety interventions are urgently needed to protect male migrant labourers working in high-risk sectors, particularly fishing., Competing Interests: The authors have declared that no competing interests exist.

Background: There is limited data available regarding the cost of firefighter injuries. This information is necessary to develop targeted injury prevention strategies., Objective: To categorize the cost of injuries filed in 2012 by firefighters from a from a large department by job duty, injury type, body part affected, and the general motion pattern employed at the time of injury., Methods: Data were taken from reports filed by CFD personnel and claims filed with the Workers' Compensation Board (WCB) of Alberta between January 1, 2012 and December 31, 2012., Results: Of the 244 injuries reported, 65% were categorized as sprains and strains, the most frequent of which affected the back (32%). The total cost of all claims was $555,955; 77% were sprain/strain-related. Knee and back injuries were most costly ($157,383 and $100,459). Categorized by job duty, most sprains/strains (31%) were sustained while attending to fire station responsibilities, although physical training was associated with the highest costs (34%). Fireground operations were attributed to 18% of sprains/strains and 16% of costs. Lifting injuries were more frequent (23%) and costly (20%) than all injuries., Conclusions: The most common and costly injuries occurred while attending to fire station-related responsibilities and during physical training.

Aim: To examine the quality of manual job coding carried out by occupational health teams with access to a software application that provides assistance in job and business sector coding (CAPS). Methods: Data from a study conducted in an Occupational Health Service were used to examine the first-level coding of 1,495 jobs by occupational health teams according to the French job classification entitled “PSC- Professions and socio-professional categories” (INSEE, 2003 version). A second level of coding was also performed by an experienced coder and the first and second level codes were compared. Agreement between the two coding systems was studied using the kappa coefficient (κ) and frequencies were compared by Chi2 tests. Results: Missing data or incorrect codes were observed for 14.5% of social groups (1 digit) and 25.7% of job codes (4 digits). While agreement between the first two levels of PCS 2003 appeared to be satisfactory (κ=0.73 and κ=0.75), imbalances in reassignment flows were effectively noted. The divergent job code rate was 48.2%. Variation in the frequency of socio-occupational variables was as high as 8.6% after correcting for missing data and divergent codes. Conclusions: Compared with other studies, the use of the CAPS tool appeared to provide effective coding assistance. However, our results indicate that job coding based on PSC 2003 should be conducted using ancillary data by personnel trained in the use of this tool.

Objectives: Emergency medical technicians (EMTs) and paramedics are at serious risk for work-related injuries (WRIs) during work hours. Both EMTs and paramedics have higher WRI rates, according to the literature data. This study was designed to investigate causes and characteristics of WRIs involving EMTs and paramedics staffed in Western Turkey., Methods: All health care personnel staffed in Emergency Medical Services (EMS) in the city were interviewed face-to-face in their off-duty hours to inform them about the study. Excluded from the study were those who declined to participate in the study, those who were not on duty during the two-month study period, and those who had been working in the EMS for less than one year. The subjects were asked to answer multiple-choice questions., Results: A total of 163 personnel (117 EMTs and 46 paramedics) comprised the study sample. Eighty-three personnel (50.9%) were female and mean age was 29.7 years (SD=8.4 years). The most common mechanisms of WRI, as reported by the personnel, were motor vehicle accidents (MVAs; 31.9%), needlestick injuries (16.0%), ocular exposure to bodily fluids (15.4%), and sharp injuries (9.8%), respectively. Needlestick injuries commonly occurred during intravenous line procedures (59.4%) and inside the cruising ambulance (n=20; 62.5%). Working inside the cruising ambulance was the most commonly accused cause of the WRI (41.3%)., Conclusion: Paramedic personnel and EMTs are under high risk of WRI. Motor vehicle accidents and needlestick injuries were the most common causes of WRI. Strict measures need to be taken to restructure the interior design to protect personnel from all kinds of WRIs. Yilmaz A , Serinken M , Dal O , Yaylacı S , Karcioglu O . Work-related injuries among emergency medical technicians in Western Turkey. Prehosp Disaster Med. 2016;31(5):505-508.

Methodological considerations of football injury epidemiology have only scarcely been described. The aim of this study was to evaluate the inter-rater agreement in injury capture rate and injury categorization for data registered in two different prospective injury surveillance audits studying the same two Norwegian male professional football clubs for two consecutive seasons, 2008-2009. One audit used team-based exposure (TBE) recording and the other individual-based exposure (IBE). The number of injuries recorded and corresponding injury rates (injuries/1000 h exposure) were compared between audits. Cohen's kappa and prevalence-adjusted bias-adjusted kappa (PABAK) coefficients were calculated for injury variables. Of 323 injuries included, the IBE audit captured 318 (overall capture rate 98.5%, training 98.9%, match 97.8%) and the TBE audit 303 injuries (overall capture rate 93.8%, training 91.4%, match 97.1%). Agreement analysis showed kappa and PABAK coefficients regarded as almost perfect (> 0.81) for 8 of 9 injury variables, and substantial (ƙ 0.75) for the variable injury severity. In conclusion, the capture rate for training injuries was slightly higher with IBE recording, and inter-agreement in injury categorization was very high., (© 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Introduction: Agriculture is known to be a dangerous industry in Korea, as well as in other countries. According to earlier studies, the root cause of occupational injury can be identified with errors in the various systems of safety, and such identification is helpful for the prevention of occupational injury., Objective: The aims of this study were to examine the root causes of cases of agricultural injury in Korea, based on insurance claims and identification of errors in systems of safety., Materials and Method: Using the Korean Mutual Aid Insurance's injury claim database, 277 injury cases were identified, of which 68 were contacted. Root causes were categorized, using the logic tree diagramming method and the systems of safety described in the literature., Results: Seventy-five percent of all injuries were attributable to falls, strangulation, amputation and collision from flying and falling objects. 194 root causes were found for all injuries. The percentages of errors in all the systems of safety for each root cause were 24.7% - training/procedure, 20.3% - design, 11.9% - mitigation, 9.3% - human factor, 6.2% - maintenance/inspection, and 1.0% - warning/notification. The percentage of root causes which could not be categorized due to a shortage of information was 18.6%., Conclusions: It was found that most agricultural injuries were caused by a complex layer of root causes which were classified as errors in the systems of safety. This result indicates that not only training and personal protective equipment, but also regulation of safety design, mitigation devices, inspection/maintenance of workplaces, and other factors play an important role in preventing agricultural injuries. The identification of errors will help farmers to implement easily an effective prevention programme.

Introduction: Studies on autocoding injury data have found that machine learning algorithms perform well for categories that occur frequently but often struggle with rare categories. Therefore, manual coding, although resource-intensive, cannot be eliminated. We propose a Bayesian decision support system to autocode a large portion of the data, filter cases for manual review, and assist human coders by presenting them top k prediction choices and a confusion matrix of predictions from Bayesian models., Method: We studied the prediction performance of Single-Word (SW) and Two-Word-Sequence (TW) Naïve Bayes models on a sample of data from the 2011 Survey of Occupational Injury and Illness (SOII). We used the agreement in prediction results of SW and TW models, and various prediction strength thresholds for autocoding and filtering cases for manual review. We also studied the sensitivity of the top k predictions of the SW model, TW model, and SW-TW combination, and then compared the accuracy of the manually assigned codes to SOII data with that of the proposed system., Results: The accuracy of the proposed system, assuming well-trained coders reviewing a subset of only 26% of cases flagged for review, was estimated to be comparable (86.5%) to the accuracy of the original coding of the data set (range: 73%-86.8%). Overall, the TW model had higher sensitivity than the SW model, and the accuracy of the prediction results increased when the two models agreed, and for higher prediction strength thresholds. The sensitivity of the top five predictions was 93%., Conclusions: The proposed system seems promising for coding injury data as it offers comparable accuracy and less manual coding., Practical Applications: Accurate and timely coded occupational injury data is useful for surveillance as well as prevention activities that aim to make workplaces safer., (Copyright © 2016 Elsevier Ltd and National Safety Council. All rights reserved.)

Objective: Vast amounts of injury narratives are collected daily and are available electronically in real time and have great potential for use in injury surveillance and evaluation. Machine learning algorithms have been developed to assist in identifying cases and classifying mechanisms leading to injury in a much timelier manner than is possible when relying on manual coding of narratives. The aim of this paper is to describe the background, growth, value, challenges and future directions of machine learning as applied to injury surveillance., Methods: This paper reviews key aspects of machine learning using injury narratives, providing a case study to demonstrate an application to an established human-machine learning approach., Results: The range of applications and utility of narrative text has increased greatly with advancements in computing techniques over time. Practical and feasible methods exist for semiautomatic classification of injury narratives which are accurate, efficient and meaningful. The human-machine learning approach described in the case study achieved high sensitivity and PPV and reduced the need for human coding to less than a third of cases in one large occupational injury database., Conclusions: The last 20 years have seen a dramatic change in the potential for technological advancements in injury surveillance. Machine learning of 'big injury narrative data' opens up many possibilities for expanded sources of data which can provide more comprehensive, ongoing and timely surveillance to inform future injury prevention policy and practice., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/)

Background: The US commercial fishing industry is hazardous, as measured by mortality data. However, research on non-fatal injuries is limited. Non-fatal injuries constitute the majority of occupational injuries and can result in workers' lowered productivity and wages, lost quality of life, and disability. In the United States, a Work Process Classification System (WPCS) has previously been applied in Alaskan freezer-trawl and freezer-longline fleets to identify causes of injuries and specific hazards, but not to other fishing fleets., Objectives: This descriptive epidemiologic study aimed to explore the application and modification of the WPCS in multiple Alaskan fleets, characterize non-fatal occupational injuries in these fleets, and identify work processes that could be targeted for further investigation and future injury prevention efforts., Design: Traumatic, non-fatal injuries on-board Alaskan commercial fishing vessels were identified through United States Coast Guard investigative reports. Characteristics of injuries, as well as worker characteristics, were analysed. Injuries were coded using the WPCS., Results: We successfully utilized the WPCS to code non-fatal injury cases (n = 136). The most frequent main work processes associated with non-fatal injuries included: on-board trawlers, handling frozen fish and processing the catch; on-board vessels using pot/trap gear, handling the gear and shooting/setting the gear; on-board longliners, traffic on board and hauling the gear; and on-board processor vessels, processing the catch, other work with the catch, and handling frozen fish., Conclusions: The study confirmed that a WPCS can be applied to multiple Alaskan fleets to identify hazardous tasks. Hazards were unique for each vessel gear type. Future injury prevention efforts should target work processes associated with the most frequent and most severe injuries. Future studies should establish time estimates for work processes in order to determine risk estimates. Efforts to improve non-fatal injury reporting, especially on smaller commercial fishing vessels, should be undertaken.

Purpose: Acute work-related trauma is a leading cause of death and disability among U.S. workers. Existing methods to estimate injury severity have important limitations. This study assessed a severe injury indicator constructed from a list of severe traumatic injury diagnosis codes previously developed for surveillance purposes. Study objectives were to: (1) describe the degree to which the severe injury indicator predicts work disability and medical cost outcomes; (2) assess whether this indicator adequately substitutes for estimating Abbreviated Injury Scale (AIS)-based injury severity from workers' compensation (WC) billing data; and (3) assess concordance between indicators constructed from Washington State Trauma Registry (WTR) and WC data., Methods: WC claims for workers injured in Washington State from 1998 to 2008 were linked to WTR records. Competing risks survival analysis was used to model work disability outcomes. Adjusted total medical costs were modeled using linear regression. Information content of the severe injury indicator and AIS-based injury severity measures were compared using Akaike Information Criterion and R(2)., Results: Of 208,522 eligible WC claims, 5 % were classified as severe. Among WC claims linked to the WTR, there was substantial agreement between WC-based and WTR-based indicators (kappa = 0.75). Information content of the severe injury indicator was similar to some AIS-based measures. The severe injury indicator was a significant predictor of WTR inclusion, early hospitalization, compensated time loss, total permanent disability, and total medical costs., Conclusions: Severe traumatic injuries can be directly identified when diagnosis codes are available. This method provides a simple and transparent alternative to AIS-based injury severity estimation.

Cattle have been identified as leading sources of injuries to agricultural workers. The present study focused on worker injuries that involved the interaction of cattle, cattle handlers, and farm structures or equipment. The goal of the study was to identify opportunities for injury prevention. We examined 221 reports of injury to cattle handlers from the Consumer Product Safety Commission's National Electronic Injury Surveillance System (NEISS). Expected interactions led to many of the cattle-handling injuries reported in the NEISS database. In almost 30% of cases, cattle pushed workers into structures such as fences, gates, posts, and walls. In another 16% to 19% of injuries, cattle struck gates and other objects, propelling them at the victims. The present research makes several important contributions to the study of cattle-handling injuries. First, the research supports an increased emphasis on the development of safer gate designs (e.g., gates that are remotely operated or that absorb energy to limit the speed at which they may be propelled by animals). Second, the research suggests a need for additional study of energy-absorbing fence and wall structures. We view these two points to be of significance because gates and associated structures (e.g., posts, fences, and walls) accounted for 45% of the injuries in the dataset, based on the associated injury narrative. Finally, the research identifies a previously unexplored source of agricultural injury data, namely the NEISS database.

Background: A capture-recapture analysis was performed to estimate the total number of work-related amputations. We examined the impact of misclassification due to differential injury reporting on the estimate of total number of work-related amputations., Methods: Bureau of Labor Statistics' Survey of Occupational Injuries and Illnesses (SOII) samples and workers' compensation records (WC) were used to estimate the total number of work-related amputations. Some of the amputation cases in one data source matched with injuries other than amputations in the other data source. We performed sensitivity analyses reassigning such cases as matched amputations., Results: Depending on how we treated the cases matched with other injuries, the total number of work-related amputations ranged from 276 to 442 cases, yielding dramatically different capture rates (35-87%)., Conclusion: Due to differential classification, estimates of work-related amputations would be biased. Our findings highlight the importance of accurately reporting and classifying work-related injuries and illnesses., (© 2014 Wiley Periodicals, Inc.)

Background: Estimates of select occupational injuries and illnesses often differ across data sources. We explored agreement in injury classifications and the impact of differences on case estimates among records reported to multiple data sources., Methods: We linked cases reported in the Bureau of Labor Statistics (BLS) annual Survey of Occupational Injuries and Illnesses (SOII) to Washington State workers' compensation (WC) claims and evaluated agreement in injury characteristics coded in each data source according to the same occupational injury and illness classification system., Results: Agreement between data sources was greatest for body part and lowest for event or exposure. Agreement on nature of injury varied by condition. WC-assigned injury codes estimated 94% more amputations than SOII-assigned codes while SOII-assigned codes estimated 34% more work-related MSD cases., Conclusions: Accounting for classification differences may improve case ascertainment within individual data sources and help align injury and illness estimates derived from different data sources., (© 2013 The Authors. American Journal of Industrial Medicine Published by Wiley Periodicals, Inc.)

Problem: Occupational injuries and diseases are costly for companies and for society as a whole. This study estimates the overall costs of occupational injuries and diseases in Québec, both human and financial, during the period from 2005 to 2007., Method: The human capital method is used to estimate lost productivity. A health indicator (DALY) is used in combination with a value of statistical life (VSL) to estimate, in monetary terms, the pain and suffering costs resulting from occupational injuries., Results: The costs of occupational injuries and diseases occurring in a single year in Québec are estimated at $4.62 billion, on average, for the 2005-2007 period. Of this amount, approximately $1.78 billion is allocated to financial costs and $2.84 billion to human costs. The average cost per case is $38,355. In view of the limitations identified in the study, it can be argued that this is an underestimation of the costs. Result analysis allows the injury/disease descriptors and industries for which the costs are highest to be identified., Practical Applications: The results of these estimates are a relevant source of information for helping to determine research directions in OHS and prevention. The methodology used can be replicated for the purposes of estimating the costs of injuries and diseases in other populations., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Some types of workers such as farmers and soldiers are at a higher risk of work-related injury and illness than workers from other occupations. Despite this fact, they are not covered under the Industrial Safety Health (ISH) Act or the Industrial Accident Compensation Insurance (IACI) Act. The Safety Aid System for Farmers (SASF) is a voluntary insurance scheme, and it is the only public compensation plan for self-employed farmers. Fifty percent of SASF premiums are subsidized by the Korean government. Soldiers are compensated by the Veterans' Pension (VP) Act. The approval standard of and procedure for the VP Act are provided in the Decree of VP Act, and the Council for VP Benefits determines work-relatedness in the claimed cases. Meanwhile, SASF applies the insurance clause automatically without any expert advice or additional procedures. Furthermore, compared with IACI, these programs pay fewer benefits to workers. Thus, a stronger institutional strategy is needed to maintain a safe work environment, to protect workers' health in unavoidably hazardous environments, and to compensate for work-related injuries and diseases.

Background: The term "professional dance" comprises various dance styles. There are no studies which investigated work related traumatic injuries with regard to five different dance styles., Objective: To define dance-style related differences of traumatic injuries., Methods: The basis for the evaluation were the occupational injuries of professional dancers of six theaters (n=1339; f: n=658, m: n=681) and one State Ballet School (n=612; f:n=421, m: n=191)., Results: Independent of the dance style, the lower extremity (leg and hip) is the most frequently injured anatomical region (p< 0.001). The more dancers move away from the classical dance technique, the more traumatic head/neck injuries increase (p<0.001). Injury patterns and injured structures also show differences subject to dance styles (p< 0.001). In classical dance the most commonly sustained injuries are due to intrinsic factors with the significance of extrinsic factors increasing the more dancers diverge from defined classical dance techniques., Conclusion: The results shown in the study clarify the enormous dance-style related differences in traumatic injuries sustained by dancers. These differences support the development of dance-style related injury prevention measures and suggest further investigations with the focus being placed on the influence of organizational structures (e.g. number of performances) as well as on the working environments.

Introduction: Acute work-related trauma is a leading cause of death and disability among U.S. workers. Occupational health services researchers have described the pressing need to identify valid injury severity measures for purposes such as case-mix adjustment and the construction of appropriate comparison groups in programme evaluation, intervention, quality improvement, and outcome studies. The objective of this study was to compare the performance of several injury severity scores and scoring methods in the context of predicting work-related disability and medical cost outcomes., Methods: Washington State Trauma Registry (WTR) records for injuries treated from 1998 to 2008 were linked with workers' compensation claims. Several Abbreviated Injury Scale (AIS)-based injury severity measures (ISS, New ISS, maximum AIS) were estimated directly from ICD-9-CM codes using two software packages: (1) ICDMAP-90, and (2) Stata's user-written ICDPIC programme (ICDPIC). ICDMAP-90 and ICDPIC scores were compared with existing WTR scores using the Akaike Information Criterion, amount of variance explained, and estimated effects on outcomes. Competing risks survival analysis was used to evaluate work disability outcomes. Adjusted total medical costs were modelled using linear regression., Results: The linked sample contained 6052 work-related injury events. There was substantial agreement between WTR scores and those estimated by ICDMAP-90 (kappa=0.73), and between WTR scores and those estimated by ICDPIC (kappa=0.68). Work disability and medical costs increased monotonically with injury severity, and injury severity was a significant predictor of work disability and medical cost outcomes in all models. WTR and ICDMAP-90 scores performed better with regard to predicting outcomes than did ICDPIC scores, but effect estimates were similar. Of the three severity measures, maxAIS was usually weakest, except when predicting total permanent disability., Conclusions: Injury severity was significantly associated with work disability and medical cost outcomes for work-related injuries. Injury severity can be estimated using either ICDMAP-90 or ICDPIC when ICD-9-CM codes are available. We observed little practical difference between severity measures or scoring methods. This study demonstrated that using existing software to estimate injury severity may be useful to enhance occupational injury surveillance and research., (Copyright © 2013 Elsevier Ltd. All rights reserved.)

The factors driving the rapid increase in US medical spending are a concern for both policymakers and payers. This article analyzes variation in spending growth rates for a large sample of persons with workplace injuries. We analyze trends by type and age of injury, and by type of provider. Medical spending growth ranged from 2 percent to 12 percent for different injuries, and 3 percent to 16 percent across different types of providers. We decomposed spending growth into price, volume, and service intensity growth rates. Service intensity accounts for 20 percent of overall expenditure growth, but is a particularly large and variable contributor to spending growth in inpatient services, ranging from 35 percent to 73 percent of total spending growth among the four most prevalent injuries we studied. Efforts to forecast spending, and to design policies that manage spending growth, should account for heterogeneous trends across patients and providers.

Purpose: To develop a classification algorithm and accompanying computer-based clinical decision support tool to help categorize injured workers toward optimal rehabilitation interventions based on unique worker characteristics., Methods: Population-based historical cohort design. Data were extracted from a Canadian provincial workers' compensation database on all claimants undergoing work assessment between December 2009 and January 2011. Data were available on: (1) numerous personal, clinical, occupational, and social variables; (2) type of rehabilitation undertaken; and (3) outcomes following rehabilitation (receiving time loss benefits or undergoing repeat programs). Machine learning, concerned with the design of algorithms to discriminate between classes based on empirical data, was the foundation of our approach to build a classification system with multiple independent and dependent variables., Results: The population included 8,611 unique claimants. Subjects were predominantly employed (85 %) males (64 %) with diagnoses of sprain/strain (44 %). Baseline clinician classification accuracy was high (ROC = 0.86) for selecting programs that lead to successful return-to-work. Classification performance for machine learning techniques outperformed the clinician baseline classification (ROC = 0.94). The final classifiers were multifactorial and included the variables: injury duration, occupation, job attachment status, work status, modified work availability, pain intensity rating, self-rated occupational disability, and 9 items from the SF-36 Health Survey., Conclusions: The use of machine learning classification techniques appears to have resulted in classification performance better than clinician decision-making. The final algorithm has been integrated into a computer-based clinical decision support tool that requires additional validation in a clinical sample.

In the past century, the United States farming industry has changed dramatically. Farming and food production have grown tremendously, and large industrial farms are now commonplace. Despite this, small farms located in rural communities continue to make up a majority of this country's agriculture. Farmers work with large machinery, large animals, and agricultural chemicals and fertilizers. These potential hazards, combined with rigorous work, long hours, and the natural environment cause higher rates of work-related injury, trauma, and illnesses than in most professions. This article discusses common injuries sustained in the farming industry as well as the challenges radiologic technologists face when diagnostic imaging is needed.

Objectives: The aim of this study was to examine utility of appending International Classification of Diseases (ICD) codes from Vital Statistics Mortality (VSM) data to Bureau of Labor Statistics (BLS) Census of Fatal Occupational Injuries (CFOI), and compare occupational event characteristics based on ICD external cause and BLS Occupational Injury and Illness Classification System (OIICS) event codes., Methods: We linked VSM records with CFOI records for 2003 and 2004., Results: Ninety-five percent of approximately 11,000 CFOI cases were linked to VSM cases. Linked data suggest that CFOI OIICS event and VSM ICD codes identified similar leading events. However, VSM data were generally less specific., Conclusion: Lack of detail inherent in ICD codes and death narratives limits specificity of injury characteristics in VSM data. Appending ICD codes to CFOI appears to offer little value. Research comparing work- and non-work-related events may be better served by having a defined framework to crosswalk both coding schemes to facilitate comparisons., Impact on Industry: Over the last two decades, both ICD and OIICS have been used to characterize occupational injury circumstances; however, this is the first study to use linked case comparisons of the OIICS and ICD codes at a detailed level. This study confirmed that multiple source data systems provide more detail surrounding an incident than a single source data system does. Our results suggest that OIICS-coded CFOI data are a better source for occupational injury research and prevention purposes. For future comparison studies requiring ICD, it would be advantageous to have a defined framework that could easily be used to map both coding schemes (OIICS and ICD)., (Published by Elsevier Ltd.)

Purpose: The Multidimensional Pain Inventory (MPI) was designed to help capture unique characteristics of chronic pain patients. The present study examined the proportion of subgroups classified by the MPI in a chronic disabling occupational musculoskeletal disorder (CDOMD) patient cohort, and described characteristics of MPI profile groups in terms of other psychosocial variables., Methods: A cohort of 1,270 CDOMD patients undergoing an interdisciplinary functional restoration program was studied. Before the start of the program, all patients received a standard psychosocial assessment battery. A MPI computer program scored and identified pre-defined MPI subgroups: Adaptive Coper (AC); Interpersonally Distressed (ID); and Dysfunctional (DYS)., Results: The distribution of MPI profiles for CDOMD patients was similar with those of highly disabled patients, with the largest proportion of patients having the DYS profile (44 %), followed by AC (33 %) and ID (23 %). The DYS profile group showed the highest level of pain severity, and psychosocial distress; the ID group had a moderate level; and the AC profile group had the lowest level. Higher rates of psychiatric disorders were also found in the DYS and ID groups. The DYS profile group was less likely to complete the treatment program., Conclusion: The present study further demonstrated the clinical utility of the MPI classification in a large cohort of CDOMD patients, indicating that the MPI profiles successfully distinguish among patients who may require extra psychosocial attention to achieve successful treatment gains and program completion.

Objectives: Traumatic brain injury (TBI) is one of the most common, costly, and disabling occupational injuries. Objectives included determining whether work-related TBI could be reliably identified using the Occupational Injury and Illness Classification System (OIICS) and describing challenges in developing an OIICS-based TBI case definition., Methods: Washington State trauma registry reports and workers' compensation claims were linked (1998 to 2008). Trauma registry diagnoses were used as the gold standard for six OIICS-based TBI case definitions., Results: The OIICS-based case definitions were highly specific but had low sensitivity, capturing less than a third of fatal and nonfatal TBI., Conclusion: The use of OIICS versus International Classification of Diseases-Ninth Revision-Clinical Modification codes underestimated TBI and changed the attributable cause distribution, with potential implications for prevention efforts. Surveillance methods that can more fully and accurately capture the impact of work-related TBI across the United States are needed.

Background: Individuals who work in the construction industry are at high risk of occupational injury. Robust surveillance systems are needed to monitor the experiences of these workers over time., Methods: We updated important surveillance data for a unique occupational cohort of union construction workers to provide information on long-term trends in their reported work-related injuries and conditions. Combining administrative data sources, we identified a dynamic cohort of union carpenters who worked in Washington State from 1989 through 2008, their hours worked by month, and their workers' compensation claims. Incidence rates of reported work-related injuries and illnesses were examined. Poisson regression was used to assess risk by categories of age, gender, time in the union, and calendar time contrasting medical only and paid lost time claims., Results: Over the 20-year study period, 24,830 carpenters worked 192.4 million work hours. Work-related injuries resulting in medical care or paid lost time (PLT) from work occurred at a rate of 24.3 per 200,000 hr worked (95% CI: 23.5-25.0). Medical only claims declined 62% and PLT claims declined 77%; more substantive declines were seen for injuries resulting from being struck and falls to a lower level than from overexertion with lifting. Differences in risk based on union tenure and age diminished over time as well., Conclusions: Significant declines in rates of reported work-related injuries and illnesses were observed over the 20-year period among these union carpenters. Greater declines were observed among workers with less union tenure and for claims resulting in PLT., (Copyright © 2012 Wiley Periodicals, Inc.)

Purpose: To describe the demographics and clinical characteristics of work-related open-globe injuries (OGIs) at a level I trauma center over a 10-year period., Methods: Retrospective series., Results: A total of 183 eyes with work-related OGIs were identified. The majority of injuries occurred in men (96.7%). The anatomic site of the wound was zone 1 in 107 eyes (72.3%). The most common cause was nail gun use (47.0%). The types of OGI included 32 ruptures (17.5%), 112 penetrating injuries (61.2%), 38 intraocular foreign bodies (IOFB) (20.8%), and 1 mixed rupture/IOFB injury (0.5%). Presenting visual acuity (VA) was worse than 20/200 in 112 eyes (65.9%) and no light perception (NLP) in 10 eyes (5.8%). Final VA worse than 20/200 occurred in 64 eyes (37.2%); 11 eyes underwent enucleation. In comparison to non-work-related OGIs (420 eyes), we found significant differences in types and zones of injury, initial and final mean VA, enucleation rate, incidence of cataracts, hyphema, retinal detachment, hemorrhagic choroidals, and afferent pupillary defect (APD). Using multivariate analysis, significant prognostic factors for a final VA of NLP were zone 3 injury, rupture injury, and initial VA of NLP. Risk factors for enucleation included zone 3 injury, APD, and endophthalmitis., Conclusions: Work-related injuries were noted to have a much higher incidence of IOFBs and cataracts compared to non-work-related OGIs. Zone 3 injuries, rupture injuries, and a presenting VA of NLP were found to be significant predictors for a final VA of NLP. Zone 3 injury, APD, and endophthalmitis were found to be significant predictors for enucleation.

Objective: The aim of this study was to examine the relationship between age and the lost-time workers' compensation claims in British Columbia, Canada, over three time periods (1997-98, 2001-02 and 2005-06). We examined if the relationship between age and risk of lost-time claims is consistent over time and for different nature of injury categories., Methods: Secondary analyses of lost-time workers' compensation claims combined with estimates of person-years of exposure generated from the Canadian Labour Force Survey were performed. Analyses examined the relationship between age and claim risk using sex-stratified regression models, adjusting for time period, occupational characteristics and whether the claimant was employed in the goods or service industry. Multiplicative interaction terms were used to examine if the relationship between age and lost-time claim risk changed over time. Seven separate regression models were generated to explore the variation in the effect of age across nature of injury groups., Results: We observed important differences in the relationship between age and risk of injury depending on the nature of injury examined. A negative relationship was observed between age and lost-time claims for open wounds, while a positive relationship was observed for traumatic injuries to bones, nerves and the spinal cord. We found no evidence that the relationship between age and risk of lost-time claims changed over time periods., Conclusions: The association between age and risk of lost-time claims depends on the nature of injury under investigation. We found no evidence that the relationship between age and overall lost-time claim risk has changed over time in British Columbia.

Background: In Malaysia, surveillance of fatal occupational injuries is fragmented. We therefore analyzed an alternative data source from Malaysia's Social Security organization, the Pertubuhan Keselamatan Sosial (PERKESO)., Methods: We conducted a secondary data analysis of the PERKESO database comprised of 7 million employees from 2002 to 2006., Results: Overall, the average annual incidence was 9.2 fatal occupational injuries per 100,000 workers. During the 5-year period, there was a decrease in the absolute number of fatal injuries by 16% and the incidence by 34%. The transportation sector reported the highest incidence of fatal injuries (35.1/100,000), followed by agriculture (30.5/100,000) and construction (19.3/100,000) sectors. Persons of Indian ethnicity were more likely to sustain fatal injuries compared to other ethnic groups., Conclusions: Government and industry should develop rigorous strategies to detect hazards in the workplace, especially in sectors that continuously record high injury rates. Targeted interventions emphasizing worker empowerment coupled with systematic monitoring and evaluation is critical to ensure success in prevention and control measures., (Copyright © 2012 Wiley Periodicals, Inc.)

Background: The American Academy of Underwater Science (AAUS) constitutes the single largest pool of organizations with scientific diving programmes in North America. Members submit annual summaries of diving activity and any related incidents., Methods: All diving records for a 10-year period between January 1998 and December 2007 were reviewed. Incidents were independently classified or reclassified by a four-person panel with expertise in scientific diving and diving safety using a previously published protocol. Subsequent panel discussion produced a single consensus classification of each case., Results: A total of 95 confirmed incidents were reported in conjunction with 1,019,159 scientific dives, yielding an overall incidence of 0.93/10,000 person-dives. A total of 33 cases were determined to involve decompression illness (DCI), encompassing both decompression sickness and air embolism. The incidence of DCI was 0.324/10,000 person-dives, substantially lower than the rates of 0.9-35.3/10,000 published for recreational, instructional/guided, commercial and/or military diving., Conclusions: Scientific diving safety may be facilitated by a combination of relatively high levels of training and oversight, the predominance of shallow, no-decompression diving and, possibly, low pressure to complete dives under less than optimal circumstances.

The objective of the present study was to estimate the magnitude and the structure of ENT losses in modern local armed conflicts. We have considered characteristics of battle injuries inflicted in modern wars based on the materials collected during the armed conflicts in the Caucasus during 1999-2002 and stored in the Military Medical Museum (MMM) of the Russian Defense Ministry. A total of 5608 case records of the surgical treatment of mechanical injuries were analysed including 4002 gunshot wounds and 1606 closed injuries (contusions). ENT and neck wounds were the main and concomitant injuries in 102 and 107 subjects respectively who accounted for 2.5% and 2.7% of all the wounded servicemen. Fifty five (3.93%) and 21 (1.3%) of the 1606 subjects had a closed ENT and neck wound as the leading and concomitant injury, respectively. According to the materials collected in MMM, ENT contusion was the main injury in 111 (25%) of the 410 servicemen who had received contused wounds in the armed conflict of 1999-2002.

Background: Health care workers (HCWs) are prone to occupational accidents and injuries such as needle pricks in the course of their day to day activities in the health care setting., Objective: To determine the prevalence of needle sticks and other occupational exposures among HCWs in a Nigerian tertiary hospital., Methods: This was a descriptive cross sectional design involving all the doctors, and all laboratory workers and a selection of nurses. A structured, pre-tested, selfadministered questionnaire was the tool for data collection., Results: A total of 167 HCWs made up of 47 (28.1%) doctors, 100 (59.9%) nurses and 20 (12.0%) laboratory workers were interviewed. Twenty-five (53.2%) doctors, 53 (53.0%) nurses and 10 (50.0%) laboratory workers making a total of 88 (52.7%) HCWs had had needle pricks, while 28 (59.6%) doctors, 53 (53.0%) nurses and 8 (40.0%) laboratory workers making a total of 89 (53.3%) have had blood splashes. A higher proportion of nurses 54 (54.0%) had cuts from drug ampoules than doctors (34.0%) while 16 (36.2%) doctors had glove perforation during surgery compared to nine (9.0%) nurses. Only 43 (25.7%) HCWs reported to the staff clinic after sustaining accidents/injuries., Conclusion: The prevalence of needle sticks and other occupational accidents/injuries among HCWs in the Federal Medical Centre, Asaba, Nigeria is high. There is also a high rate of non-reporting of these injuries to relevant authorities. All health facilities should have a written injection safety policy and a post-exposure protocol and HCWs should be continually educated on them.