This scientific review provides a summary of the evidence regarding the benefits of reducing the illegal blood alcohol concentration (BAC) limit for driving and providing a case for enacting a .05 BAC limit.
Fourteen independent studies in the United States indicate that lowering the illegal BAC limit from .10 to .08 has resulted in 5-16% reductions in alcohol-related crashes, fatalities, or injuries. However, the illegal limit is .05 BAC in numerous countries around the world. Several studies indicate that lowering the illegal per se limit from .08 to .05 BAC also reduces alcohol-related fatalities. Laboratory studies indicate that impairment in critical driving functions begins at low BACs and that most subjects are significantly impaired at .05 BAC. The relative risk of being involved in a fatal crash as a driver is 4 to 10 times greater for drivers with BACs between .05 and .07 compared to drivers with .00 BACs.
There is strong evidence in the literature that lowering the BAC limit from .10 to .08 is effective, that lowering the BAC limit from .08 to .05 is effective, and that lowering the BAC limit for youth to .02 or lower is effective. These law changes serve as a general deterrent to drinking and driving and ultimately save lives.
This critical review supports the adoption of lower illegal BAC limits for driving.
Lowering state blood alcohol concentration (BAC) limits to 0.08, though controversial, has been supported by most evaluation studies to date. The Illinois .08 BAC law implemented in 1997 provided a unique opportunity to evaluate the effect of the law without the simultaneous passage of an administrative license revocation (ALR) law, which has clouded some previous evaluations of the .08 laws. The proportion of all drinking drivers in fatal crashes was compared before versus after implementing the .08 law using time-series analysis to evaluate 12 years of fatal crash data for Illinois and five bordering states. The results showed that the proportion of drinking drivers in fatal crashes decreased by 14% in Illinois and increased by 3% in bordering states. The proportion of drinking drivers in fatal crashes in Illinois, though increasing since 1995, was sharply reduced after passage of the .08 law in 1997, saving more than 100 lives in 1998 and 1999 than it would have without the .08 law.
Falls from heights account for 64% of residential construction worker fatalities and 20% of missed work days. We hypothesized that worker safety would improve with foremen training in fall prevention and safety communication.
Training priorities identified through foreman and apprentice focus groups and surveys were integrated into an 8-hour training. We piloted the training with ten foremen employed by a residential builder. Carpenter trainers contrasted proper methods to protect workers from falls with methods observed at the foremen's worksites. Trainers presented methods to deliver toolbox talks and safety messages. Results from worksite observational audits (n=29) and foremen/crewmember surveys (n=97) administered before and after training were compared.
We found that inexperienced workers are exposed to many fall hazards that they are often not prepared to negotiate. Fall protection is used inconsistently and worksite mentorship is often inadequate. Foremen feel pressured to meet productivity demands and some are unsure of the fall protection requirements. After the training, the frequency of daily mentoring and toolbox talks increased, and these talks became more interactive and focused on hazardous daily work tasks. Foremen observed their worksites for fall hazards more often. We observed increased compliance with fall protection and decreased unsafe behaviors during worksite audits.
Designing the training to meet both foremen's and crewmembers' needs ensured the training was learner-centered and contextually-relevant. This pilot suggests that training residential foremen can increase use of fall protection, improve safety behaviors, and enhance on-the-job training and safety communication at their worksites.
Construction workers' training should target safety communication and mentoring skills with workers who will lead work crews. Interventions at multiple levels are necessary to increase safety compliance in residential construction and decrease falls from heights.
The purpose of this study was to calculate national estimates and examine the extent to which children prematurely use adult seat belts and ride in the front seat of a vehicle during a 30 day period.
Data were obtained from a nationally representative cross-sectional random-digit-dial telephone survey that included child-specific questions on motor vehicle restraint use and seating position.
Among children less than 13 years, parents reported an estimated 618,337 who rode unrestrained and more than one million who rode in the front seat of a vehicle at least some of the time in the past 30 days. During the same time period, close to 11 million children 8 years and younger reportedly used only adult seat belts.
Our results highlight the need for continued outreach to parents regarding optimal restraint use and rear seating position for children every trip, every time.
The goal was to provide a description of fatal crashes involving 13-15-year-old drivers and passengers.
Information was obtained from the Fatality Analysis Reporting System for 2005-2009.
The 1,994 passenger deaths during the 2005-2009 period far exceeded the number of driver deaths (299) or the number of drivers in fatal crashes (744). Passenger deaths occurring with teenage drivers, particularly 16-17-year-olds, increased with passenger age. Most 13-15-year-old drivers in crashes were driving either with no license or permit (63%), or with a permit but without required adult presence (10 percent). Fatal crashes involving illegal driving were most likely to involve high-risk actions such as speeding and nonuse of belts. Supervised learners were few in number (about 12 per year) and had the lowest rates of high-risk actions.
The main issues for 13-15-year-olds' motor vehicle deaths are passenger deaths and driving without a license or adult supervision.
Parents, pediatricians, and others need to recognize the increase in motor vehicle occupant deaths that occurs in the early teen years.
To assess effects of the 1999 Maryland graduated driver licensing (GDL) law on both 16-year-old drivers and other road users.
Calculation and comparison of crash involvement rates and non-fatal injury rates pre-GDL (1996-1998) and post-GDL (2001-2003) by type of road user, per population, and per licensed driver, with adjustment for trends among 30-59-year-old drivers.
Post-GDL, prevalence of licensure decreased 24% among 16-year-olds, and rates of 16-year-old drivers involved in crashes significantly decreased per 16-year-old population (corrected rate ratio (RRc) 0.82; 95% CI (0.71, 0.96)). A significant decrease also was observed for non-fatal injuries per 16-year-old population among 16-year-old drivers involved in crashes (RRc 0.63; 95% CI (0.41, 0.98)). Similarly, decreases, albeit not statistically significant, were observed among their passengers and other vehicle occupants. Per 16-year-old licensed driver, a slight non-significant increase was observed in crash involvement rates; non-fatal injury rates per 16-year-old licensed driver suggest decreased risk (non-significant) among 16-year-old drivers, their passengers, and other vehicle occupants.
Maryland's GDL delayed licensure and reduced crashes and non-fatal injuries among 16-year-old drivers per population. Trends in injuries among other road users involved in crashes with 16-year-old drivers were suggestive of a benefit from GDL, although observed decreases were not significant. Per licensed driver, findings were not significant, but suggested little change in crash involvement and decreased non-fatal injuries. Because one-third fewer 16-year-olds were licensed post-GDL, these results may suggest a selection effect in licensure.
Because Maryland had nighttime restrictions for new drivers before 1999, this study suggests other components of GDL are beneficial for drivers and possibly for other road users. States with weak GDL laws should strongly consider revising them.
We wished to determine the extent to which number of passengers, driver age, and sex were associated with aggressive driving actions (ADAs) in young drivers involved in a fatal crash.
We used U.S. fatal-crash data from Fatality Analysis Reporting System (FARS), 1991 -2008. Proxy measures of aggressive driving included ADA presence and speed differential (posted speed limit minus estimated travel speed). We examined the odds of an ADA and speed differential in young drivers (aged 16 to 25) by passenger status.
Compared to driving alone young drivers (aged 16) had increased odds of an ADA between 14% (OR: 1.14; 95% CI: 1.07; 1.22) and 95% (OR: 1.95; 95% CI: 1.40; 2.74) when accompanied by one and five passengers, respectively. Further, carrying a higher number of passengers was a stronger predictor of speeding in younger drivers.
This study supports the use of graduated licensing approaches. Specifically, developing interventions to reduce aggressive driving appear imperative.
While the results of our study support the use of graduated licensing approaches there is room for improvement. Our study indicates that tackling impaired driving is not sufficient to drastically reduce aggressive driving among the youngest drivers. Further research on young drivers is required to understand the influence of peers and the role of gender on driving behavior. Strategies to reduce aggressive driving behaviors among the youngest drivers may not only prevent crashes during their early driving careers but may also translate into a reduced crash risk over their lifetime.
The Airline Lifesaver (AL) is a 13.3 cm x 9.8 cm card any passenger can deliver to the attendant of a commercial airline in order to prompt the delivery of an important safety message. In particular, the AL requests the following safety--belt reminder be added to the regular announcements given at the end of the flight-"Now that you have worn a seat belt for the safest part of your trip, the flight crew would like to remind you to buckle-up during your ground transportation."
The AL card was handed to 1,258 flight attendants over a 17-year period and compliance with the request for the safety message was systematically tracked. Slightly more than one-third of the AL cards (n=460) included an incentive for making the announcement.
Without the incentive, compliance to give the buckle-up reminder was 35.5% of 798 flights. With the incentive, compliance was significantly higher (i.e., 53.3%).
The validity of the AL intervention is discussed with regard to its: (a) relevance to cognitive dissonance and consistency theory, and (b) broad-based applicability as a component of community-wide efforts to facilitate a safety-focused culture. The 17-year study also demonstrated a practical and cost-effective application of a behavior-based incentive program.
The "choking game" is defined as self-strangulation or strangulation by another person with the hands or a noose to achieve a brief euphoric state caused by cerebral hypoxia. Participants in this activity typically are youths (Andrew & Fallon, 2007). Serious neurologic injury or death can result from engaging in this activity. Recent news media reports have described numerous deaths among youths attributed to the choking game. Because no traditional public health dataset collects data on this practice, CDC used news media reports to estimate the incidence of deaths from the choking game. This report describes the results of that analysis, which identified 82 probable choking-game deaths among youths aged 6-19 years during 1995-2007. Seventy-one (86.6%) of the decedents were male, and the mean age was 13.3 years. Parents, educators, and health-care providers should become familiar with warning signs that youths are playing the choking game (Urkin & Merrick, 2006). Impact of industry: By learning about the risk factors for and warning signs of the choking game, parents, educators, and health-care providers may be able to identify youth at risk for playing the game and prevent future deaths.
This paper deals with the decrease in the rate of accident insurance claims in the German mining industry over the last five decades. It intends to show that this process is above all the result of a prevention policy where companies and the body responsible for the legal accident insurance in the mining industry, the Bergbau-Berufsgenossenschaft (BBG), work hand in hand. A system like the German accident insurance scheme, combining prevention, rehabilitation, and compensation, enables successful and modern safety and health measures.
This paper examines the contribution of the U.S. Consumer Product Safety Commission's (CPSC) 1973 cigarette ignition mattress flammability standard to reduce mattress fires since 1980, when the U.S. Fire Administration's National Fire Incident Reporting System became fully operational.
The paper attempts to separate the effect of the cigarette ignition standard from the declining trend in mattress fires that would have resulted without the standard. We analyze the impact of the 1973 cigarette standard on smoking material ignition fires, deaths, and injuries as well as its effect on fires, deaths, and injuries from all ignition sources (smoking material ignitions, open-flame ignitions, and other ignition sources). Impacts on Industry: The results suggest that the 1973 mattress standard has effectively reduced the mattress fire risk and that further reductions in risk via actions tied specifically to cigarette ignition are likely to be difficult to achieve.
Hundreds of laws have been implemented in the United States over the past few decades designed to reduce alcohol-impaired driving and the crashes that often result. One approach has been to lower the legally allowable alcohol concentration for drivers. We examined the effects of changes in legal BAC limit in 28 U.S. states from January, 1976 to December, 2002.
An interrupted time-series quasi-experimental design was used, incorporating non-alcohol-related crashes as comparisons. Four outcome measures of alcohol-related crash involvement were examined: single-vehicle nighttime, BAC=0.01-0.07, BAC=0.08-0.14, and BAC>/=0.15. Missing BAC test result data were handled by using multiple imputations. Analyses involved estimation of state-specific ARIMA models, controlling for other factors affecting overall crash rates and other major DUI policy changes. Inverse variance weighting methods were used to pool results across states for the most precise underlying estimate of effect of legal BAC limits.
Considerable state by state variability in estimated effects was observed, but results from the pooled analyses were clear and consistent. Changes in legal BAC limits significantly affected alcohol-related fatal crash involvement for both the SVN and BAC test result measures, and the laws affected drivers at all drinking levels.
An estimated 360 deaths are prevented each year in the United States as a result of the move from a 0.10 to 0.08 legal limit in recent years, and an additional 538 lives could be saved each year if the United States reduced the limit to 0.05, consistent with limits in most countries worldwide.
Given the significant effects of lower legal BAC limits on fatal crash involvement, businesses should support implementation of laws that further reduce the legal BAC limit for all drivers. Furthermore, all companies should set higher standards for employees, such as a zero allowable BAC limit for driving during work time.
This study evaluates how the traffic behaviors of young drivers and their attitudes toward traffic regulations have changed over the last 23 years, and particularly, whether the differences in attitudes and behavior between male and female drivers have changed.
The study was conducted in 2001, and it replicated a traffic attitude survey administered in 1978. The same survey was used, enabling comparison between the years. The number of respondents was 3158 in 1978 and 2759 in 2001.
The comparison revealed several differences regarding the background factors, attitudes, and driving style of novice drivers. Most obvious changes in the drivers' background were the changes in education level (higher today), driver training (more private training today), and exposure/experience in terms of kilometers (more today). The summary variable measured that the young drivers showed more negative attitudes toward traffic rules and safe driving in 2001 compared to 1978. Female drivers drove less than males and evaluated their driving skill lower. Female drivers were less involved in accidents and they committed less traffic offenses than males (kilometrage controlled). Female drivers showed a more positive attitude toward traffic safety and rules than males. The difference in traffic attitudes and behavior between males and females in 1978 compared to 2001 remained the same or even increased somewhat.
To examine the validity of police-reported alcohol data for drivers involved in fatal motor carrier crashes.
We determined the availability of blood alcohol concentration (BAC) and police-reported alcohol data on 157,702 drivers involved in fatal motor carrier crashes between 1982 - 2005 using Fatality Analysis and Reporting System (FARS) data. Drivers were categorized as motor carrier drivers if they operated a vehicle with a gross vehicle weight rating of greater than 26,000 pounds. Otherwise, they were classified as non motor carrier drivers. The sensitivity and specificity of police-reported alcohol involvement were estimated for both driver types.
Of the 157,702 drivers, 18% had no alcohol information, 15% had BAC results, 42% had police-reported alcohol data, and 25% had both. Alcohol information varied significantly by driver, crash, and vehicle characteristics. For example, motor carrier drivers were significantly more likely (51%) to have BAC testing results compared to non motor carrier drivers (31%) (p<0.001). The sensitivity of police-reported alcohol involvement for a BAC level>or=0.08 was 83% (95% CI 79%, 86%) for motor carrier drivers and 90% (95% CI 89%, 90%) for non motor carrier drivers. The specificity rates were 96% (95% CI 95%, 96%) and 91% (95% CI 90%, 91%), respectively.
The sensitivity and specificity of police-reported alcohol involvement are reasonably high for drivers involved in fatal motor carrier crashes. Further research is needed to determine the extent to which the accuracy of police-reported alcohol involvement may be overestimated because of verification bias. IMPACT ON THE INDUSTRY: Based on the results of this study, the federal government should continue to work with states to strengthen their strategies to increase chemical testing of all drivers involved in fatal crashes.
The rate for work related accidents in the Spanish mining sector is notably higher than in other countries such as the United States. It produces a very negative impact on the mining industry. This paper is the report of a study on serious and fatal accidents in Spanish mining from 1982-2006. It is based on the reports of 212 accidents (serious or fatal) carried out by the General Management of Energy and Mining of Catalonia (Spain).
The high work-related accident rate in the Spanish mining sector makes it necessary to carry out an analysis and research that can shed light on the causes of this high rate; this is the only way that a solution can be found. The study is based on Feyer and Williamson's analysis of accident causes, as they apply to 212 accidents. The types and causes of the accidents are coded according to the coding system used by the Spanish National Institute for Safety and Hygiene in the Workplace, which allows us to identify a series of direct causes and contributing factors in different accidents. Results If all the causes and factors that are present in the accidents are known, we are able to look for appropriate solutions to reduce them as much as possible. In short, we are able to come up with a series of conclusions that expose the weak links in the management of accident prevention in companies. This is helpful in the struggle to reduce work injuries in the Spanish mining sector.
Falls are a leading cause of mortality and morbidity among adults age 65 and older. Population models predict steep increases in the 65 and older population bands in the next 10-15 years and in turn, public health is bracing for increased fall rates and the strain they place on health care systems and society. To assess progress in fall prevention, the Centers for Disease Control and Prevention conducted a research portfolio review to examine the quality, relevance, outcomes and successes of the CDC fall prevention program and its impact on public health.
A peer review panel was charged with reviewing 20 years of funded research and conducting a SWOT (strengths, weaknesses, opportunities, and threats) analysis for extramural and intramural research activities. Information was collected from grantees (via a survey instrument), staff were interviewed, and progress reports and products were reviewed and analyzed.
CDC has invested over $24,900,000 in fall-related research and programs over 20 years. The portfolio has had positive impacts on research, policies and programs, increasing the public health injury prevention workforce, and delivering effective fall prevention programs.
Public health agencies, practitioners, and policy makers recognize that while there are some evidence-based older adult fall prevention interventions available, many remain unused or are infeasible to implement. Specific recommendations across the public health model, include: additional research in gathering robust epidemiologic data on trends and patterns of fall-related injuries at all levels; researching risk factors by setting or sub-population; developing and testing innovative interventions; and engaging in translation and dissemination research on best practices to increase uptake and adoption of fall prevention strategies. CDC has responded to a number of suggestions from the portfolio review including: funding translation research of a proven Tai Chi fall intervention; beginning to address gaps in gender, ethnic, and racial differences in falls; and collaborating with partner organizations who share in CDC's mission to improve public health by preventing falls and reducing fall-related injuries.
Impact on industry:
Industry has an opportunity to develop more accessible and usable devices to reduce injury from falls (for example, hip protectors and force reducing flooring). By implementing effective, evidence-based interventions to prevent falls and reduce injuries from falls, significant decreases in health care costs can be expected.
This manuscript evaluates the effects of enactment of state laws that required safety belt use in various U.S. states between 1986 and 2000.
Safety belt use was assessed using nationally representative cross-sectional samples of high school seniors; evaluation of the effects of laws used data from over 2,000 high school seniors before and about 3,300 after the laws took effect in 20 states.
Belt use was found to increase significantly between 1986 and 2000, and the laws contributed significantly to that increase. Increases were similar for students differing by gender, race/ethnicity, parent education, grades, truancy, evenings out per week, miles driven per week, and an index of illicit drug use.
The data show that although the laws have increased belt use, use is not universal and continued efforts are needed.
This study shows that many teenagers fail to use belts when there is a secondary use law; an implication is that primary laws would be more efficacious in increasing use among this vulnerable population.
Alaska had the highest work-related fatality rate of any state during 1980-1989. The National Institute for Occupational Safety and Health established the Alaska Field Station (AFS) to address this problem.
AFS established surveillance systems to provide scientific assessments of occupational hazards. Interventions were developed in collaboration with partners and evaluated.
During 2000-2009, Alaska experienced a 42.5% decline in work-related fatalities over the previous decade of 1990-1999. In 2009, the workplace fatality rate for Alaska was 5.6/100,000 workers. Commercial pilot deaths were reduced by 50% and Bering Sea crab fishing death rates were reduced by 60%. Building on this success, AFS established national programs to improve safety in the commercial fishing and oil and gas extraction industries.
A focused, epidemiological approach to reducing fatalities in high-risk occupations is effective. Ongoing commitment to this type of approach will assist in continued success in Alaska and elsewhere.
Subway transit is a relatively safe mode of transportation, yet compared to all other forms of mass transit in the United States (U.S.), subways have the highest fatality rate. The aim of this paper is to characterize subway-related fatalities in order to identify opportunities for risk reduction.
Medical examiner records for all New York City (NYC) subway-related deaths (1990-2003) were reviewed. Data were abstracted on decedents' demographics and autopsy findings, including laboratory findings.
There were 668 subway-related fatalities, of these, 10 (1.5%) were homicides, 343 (51.3%) were determined to be suicides, and 315 (47.2%) were accidental. Although decedent characteristics varied between fatality categories, they were not particularly informative with regard to prevention.
Prevention strategies that focus on structural controls are likely to be most efficacious in improving the overall safety of the NYC subway systems.
These findings suggest that structural rather than individual-level interventions would be most successful in preventing subway fatalities.
This article presents what the authors consider to be among the top 20 practice innovations since the inception of the National Center for Injury Prevention and Control in 1992. The innovations embody various characteristics of successful public health programs and have contributed to declines in violence, motor vehicle, residential fire, and other injury rates over the past 20years. Taken together, these innovations have reduced the burden of violence and injury and have influenced current practice and practitioners in the United States and worldwide.
This study examined deaths of construction workers due to personnel lifts (boom-supported and scissor lifts, suspended scaffolds, and crane platforms).
Deaths of construction workers for 1992-1999 were examined using data from the Census of Fatal Occupational Injuries, a Bureau of Labor Statistics database.
The study identified 339 deaths: 42% from boom-supported lifts; 26% from suspended scaffolds; 19% from scissor lifts; 5% from crane platforms; and 7% from unapproved lifts (e.g., forklift platforms). The main causes of death were falls (36%), collapses/tipovers (29%), and electrocutions (21%).
Recommendations include: following OSHA regulations, wearing personal fall protection equipment, adequate maintenance, inspection before use, and training on the model of lift used. Precautions are also needed to prevent contact with overhead power lines.
The increasing popularity of boom-supported lifts and scissor lifts, both in construction and other industries, make their safety an important issue.
CFOI and SOII data show that 2,287 U.S. workers died and 32,807 workers sustained days away from work due to electrical shock or electrical burn injuries between 1992 and 1998.
The narrative, work activity, job title, source of injury, location, and industry for each fatal electrical accident were examined. A primary causal factor was identified for each fatality.
Electrical fatalities were categorized into five major groups. Overall, 44% of electrical fatalities occurred in the construction industry. Contact with overhead power lines caused 41% of all electrical fatalities.
Electrical shock caused 99% of fatal and 62% of nonfatal electrical accidents. Comprising about 7% of the U.S. workforce, construction workers sustain 44% of electrical fatalities. Power line contact by mobile equipment occurs in many industries and should be the subject of focused research. Other problem areas are identified and opportunities for research are proposed.
Improvements in electrical safety in one industry often have application in other industries.
Between 1992 and 2005, 1412 workers on farms died from tractor overturns. A Rollover Protective Structure (ROPS) is a proven intervention to reduce overturn deaths. However, farm characteristics that are associated with the adoption of ROPS are not well understood.
ROPS prevalence statistics were derived from National Institute for Occupational Safety and Health (NIOSH) surveys that tracked ROPS use on farms. Data were from the years 1993, 2001, and 2004.
In 1993, 38% of tractors were equipped with ROPS. This increased to 51% by 2004. ROPS prevalence rates were higher on farms in the Southern region of the United States, on farms where the operator was 25-34 years old, and on farms with $100,000 or more of farm sales. Low ROPS prevalence rates were associated with farm operators 65 years old or older and with farms with less than $10,000 of farm product sales.
The increase in ROPS prevalence between 1993 and 2004 has not been sufficient to decrease the rate of tractor overturn deaths on farms. Incentive programs targeting older farm operators and low-income farm operations are suggested to increase ROPS use on tractors.
The study provides farm characteristics associated with low ROPS prevalence rates. The results can be used to target farms for future ROPS promotion activities.
Although parking facilities are a common feature of the landscape in the United States, little is known about their safety.
A dataset of parking lot fatalities for 1993-2002, created from the Census of Fatal Occupational Injury (CFOI) research file, was analyzed.
The most common events in parking lots were contact with objects (15%), pedestrian fatalities (13%), homicides (36%), and suicides (11%). The perpetrators of parking lot fatalities, compared to all workplace homicides, were more likely to be known to the victim.
The 206 work-related fatalities per year in parking lots present challenges to the safety community. Although much of the risk results from the usage of motor vehicles, violent acts are even more prominent.
Because homicides are most prevalent in parking lots, both administrative and environmental measures may lower the risk of homicide. Although difficult to assess, various elements of the design of parking facilities may have an influence on the occurrence of injuries.
Although a myriad of research illustrates the safety issues related to farm fatalities in youth populations, very little empirical evidence exists that includes work and non-work related farm fatalities to all youths under 20 years of age at the national level.
This research will use death certificate data for the six years from 1995 to 2000 that were collected by NIOSH from all 50 state vital statistics registries. Demographic data from the 1998 CAIS were used in rate calculations. In addition to providing annual fatality rates and descriptions of the general causes of death, this research will examine the variation between age groups.
Analysis of 695 total farm-related youth fatalities shows an average annual fatality rate of 9.3 fatalities per 100,000 youths. Males account for 80% of these fatalities. The most prevalent causes of death are: machinery (25%), motor vehicle (17%), drowning (16%), suicide (8%) and homicide (6%). Of all youth fatalities occurring while at work, 45% are to youths less than 16 years of age. This same age group accounts for 71% of all non-work related fatalities.
This research will provide farm families and researchers more detailed information on farm hazards that contribute to the deaths of youths. As these youths may encounter hazards while working or playing in their daily environment, identification and elimination of these hazards will increase overall safety on the farm. This research also indicates the need to include youths under 16 years of age in future comprehensive farm safety research.
Traumatic Brain Injury (TBI) is a public health problem in the United States. In 2009, approximately 3.5 million patients with a TBI listed as primary or secondary diagnosis were hospitalized and discharged alive (N=300,667) or were treated and released from emergency departments (EDs; N=2,077,350), outpatient departments (ODs; N=83,857), and office-based physicians (OB-P; N=1,079,338). In addition, 52,695 died with one or more TBI-related diagnoses.
Federal TBI-related laws that have guided CDC since 1996 were reviewed. Trends in TBI were obtained by analyzing data from nationally representative surveys conducted by the National Center for Health Statistics (NCHS).
CDC has developed and is implementing a strategy to reduce the burden of TBI in the United States. Currently, 20 states have TBI surveillance and prevention systems. From 1995-2009, the TBI rates per 100,000 population increased in EDs (434.1 vs. 686.0) and OB-Ps (234.6 vs. 352.3); and decreased in ODs (42.6 vs. 28.1) and in TBI-related deaths (19.9 vs. 16.6). TBI Hospitalizations decreased from 95.5 in 1995 to 77.9 in 2000 and increased to 95.7 in 2009.
The rates of TBI have increased since 1995 for ED and PO visits. To reduce of the burden and mitigate the impact of TBI in the United States, an improved state- and territory-specific TBI surveillance system that accurately measures burden and includes information on the acute and long-term outcomes of TBI is needed.
Empirical studies on the effectiveness of workplace safety regulations are inconclusive. This study hypothesizes that the asynchronous effects of safety regulations occur because regulations need time to become effective. Safety regulations will work initially by reducing the most serious accidents, and later by improving overall safety performance.
The hypothesis is tested by studying a provincial level aggregate panel dataset for China's coal industry using two different models with different sets of dependent variables: a fixed-effects model on mortality rate, which is defined as fatalities per 1,000 employees; and a negative binominal model on the annual number (frequency) of disastrous accidents.
Safety regulations can reduce the frequency of disastrous accidents, but have not reduced mortality rate, which represents overall safety performance. DISCUSSION AND SUMMARY: Policy recommendations are made, including shifting production from small to large mines through industrial consolidation, improving the safety performance of large mines, addressing consequences of decentralization, and facilitating the implementation of regulations through carrying on institutional actions and supporting legislation.
Until recently, about 4,000 coal miners perished annually in China, demonstrating that workplace safety in China's coal industry is an urgent and important issue. This research provides evidence that safety regulations have asynchronous effects and identifies the priorities in improving safety in China's current coal mining. This may assist the Chinese government to design more effective safety improvement policies and improve the effectiveness of safety regulations and safety performance.
This study was designed to explore the temporal aspects of crashes for probationary and non-probationary drivers.
Data from the West Australian Road Injury Database from 1996-2000 were used to calculate age-sex-specific crash rates per 100,000 person-days and to plot proportions of fatal and hospital crashes by time for probationary and non-probationary drivers. The population attributable risk was used to estimate the potential number of lives saved by nighttime driving restriction in the probationary period.
Probationary drivers were seven times more likely to crash than non-probationary drivers. While the highest number of crashes was in the daytime, probationary drivers had a higher proportion of fatal or hospitalization crashes at night than non-probationary drivers.
Restrictions on driving at night could form part of graduated driver training. Even if some probationary drivers disobeyed the restriction, a substantial reduction in car occupant fatalities and hospitalizations could result.
Understanding the reasons for fluctuations in teenage driver crashes over time in the United States is clouded by the lack of information on licensure rates and driving exposure.
We examined results from the Monitoring the Future survey to estimate the proportion of high school seniors who possessed a driver's license and the proportion of seniors who did not drive "during an average week" during the 15-year period of 1996-2010.
During 1996-2010, the proportion of high school seniors in United States who reported having a driver's license declined by 12 percentage points (14%) from 85% to 73%. Two-thirds of the decline (8 percentage points) occurred during 2006-2010. During the same 15-year period, the proportion of high school seniors who did not drive during an average week increased by 7 percentage points (47%) from 15% in 1996 to 22% in 2010, with essentially all of the increase occurring during 2006-2009.
Findings in this report suggest that the economic recession in recent years has reduced rates of licensure and driving among high school seniors.
Little has been published on changes in young driver fatality rates over time. This paper examines differences in Australian young driver fatality rates over the last decade, examining important risk factors including place of residence and socioeconomic status (SES).
Young driver (17-25years) police-recorded passenger vehicle crashes were extracted from New South Wales State records from 1997-2007. Rurality of residence and SES were classified into three levels based on drivers' residential postcode: urban, regional, or rural; and high, moderate, or low SES areas. Geographic and SES disparities in trends of fatality rates were examined by the generalized linear model. Chi-square trend test was used to examine the distributions of posted speed limits, drinking driving, fatigue, seatbelt use, vehicle age, night-time driving, and the time from crash to death across rurality and socioeconomic status.
Young driver fatality rate significantly decreased 5% per year (p<0.05); however, stratified analyses (by rurality and by SES) showed that only the reduction among urban drivers was significant (average 5% decrease per year, p<0.01). The higher relative risk of fatality for rural versus urban drivers, and for drivers of low versus high SES remained unchanged over the last decade. High posted speed limits, fatigue, drink driving and seatbelt non-use were significantly associated with rural fatalities, whereas high posted speed limit, fatigue, and driving an older vehicle were significantly related to low SES fatality.
The constant geographic and SES disparities in young driver fatality rates highlight safety inequities for those living in rural areas and those of low SES. Better targeted interventions are needed, including attention to behavioral risk factors and vehicle age.
In Washington State, 87 workers are killed each year, on average, while in work status. To understand these incidents and to assist in focusing on and development of potential prevention measures, they must be well characterized.
Work-related fatalities between the years 1998 and 2002 are described by the demographics of the victims, types of incidents, the victims' occupations, and industries and location in which they worked.
Motor vehicle- and machinery-related incidents accounted for nearly 33% and 14% of the incidents, respectively. Agriculture, forestry, fishing, hunting, and mining (n=87), and construction (n=83) had the most fatalities. Fatality rates per 100,000 workers for these industries were 25.7 and 8.7, respectively, compared to the state-wide average of 3.1 fatalities/100,000 workers.
These data indicate numerous areas for prevention of work-related traumatic injuries and fatalities.
Eye injury is currently a leading cause of visual impairment and monocular blindness in the United States. Information regarding consumer products associated with eye injuries can have important implications for the prevention of these injuries.
The National Electronic Injury Surveillance System (NEISS) was used to describe the types of consumer products associated with emergency department treated eye injuries in the United States from 1998 through 2002.
The leading product type associated with eye injuries was welding equipment followed by household cleaners, basketball equipment, workshop equipment, and adhesives. Eye injuries attributed to hardware, tools, construction, sports, toys, and lawn equipment were more common among males. In females, eye injuries attributable to chemicals, housewares, storage and organization, and bed and bath items were more common. Differences were also apparent across the age spectrum.
This study identified specific products and categories of products frequently associated with eye injury and prevention initiatives should focus on these items.
This study has identified consumer products associated with eye injuries requiring medical treatment in the United States. Manufacturers of these products could be encouraged to add or strengthen safety messages regarding the potential for eye injury.
The National Occupational Research Agenda (NORA) for the construction industry calls for efforts to identify areas where guidance and regulation are needed to adequately prevent traumatic injuries resulting from a worker coming into contact with objects or equipment.
This descriptive study of work-related contact injuries in the construction industry that were treated in emergency departments (EDs) between 1998 and 2005 utilized records of work injuries captured through a national probability-based sample of U.S. hospitals with 24-hour ED services.
Contact injuries accounted for 54% of all construction ED-treated injuries. Hospitalizations were most common for injuries from contact with discharged nails from pneumatic nail guns, with hand held power saws, and fixed saws. Some injuries were proportionally more serious and sometimes involved multiple workers including trenching injuries and those resulting from collapse of buildings under construction, walls, roofs, and scaffolding. DISCUSSION AND IMPACT: Given that nail gun use is limited primarily to wood frame construction, efforts are needed to control frequent serious injuries associated with these tools. Enforcement of existing trenching regulations is also needed.
Previous work using data from the 1980s showed higher rates of pedestrian mortality in the southern United States.
This study was a descriptive analysis of state-specific mortality information from the National Center for Health Statistics for 1999-2002 and the National Highway Traffic Safety Administration for 2003.
Highest rates were in the southern rim ("Sunbelt") states for the U.S. population and for the non-Hispanic white population. Rural rates in the highest quartile were 2.1 (95% CI 1.8 to 2.6) times those in the lowest quartile. Urban rates in the highest quartile were 2.2 (95% CI 1.9 to 2.5) times those in the lowest quartile. Posted speed limits at crash sites were 2.6 (95% CI 2.0 to 3.4) times more likely to be > or = 35 mph (48.3 km/h) in the highest quartile than in the lowest quartile. Pedestrians killed in the highest quartile were 1.9 (95% CI 1.2 to 3.1) times more likely to have blood alcohol concentrations > or = 0.25 g/dL than pedestrians in the lowest quartile.
The highest pedestrian fatality rates concentrate in Sunbelt states experiencing rapid population growth in the past 50 years. This pattern may result from at least three features of these states: (a) a high percentage of urban vehicle miles traveled; (b) urban sprawl; and (c) a high prevalence of alcohol use - especially heavy use - among Sunbelt pedestrians.
The aims of the study were to evaluate information on motor-vehicle crashes with injuries provided in newspaper reports and to assess the frequency of thematic and episodic reporting of motor-vehicle crashes.
The study used Fatal Analysis Reporting System (FARS) derived variables to code a nationally representative sample of U.S. newspaper reports of motor-vehicle crashes from 1999-2002. A total of 473 newspaper reports of motor-vehicle crashes with injuries were included. Information on the crash event, people involved, and vehicles was extracted. The reports were coded for episodic and thematic news framing.
A majority of newspaper reports used episodic framing. The majority of reports included information on the type of crash, but characteristics about people and vehicles were rarely reported.
Lack of information in newspapers makes them an incomplete source from which to influence public perceptions and attitudes.
This provides an opportunity for news print media to improve public health content.
Newspapers represent an important source of public information; they are, however, an incomplete source [Voight, B., Lapidus, G., Zavoski, R., & Banco, L. (1998). Injury reporting in Connecticut newspapers. Injury Prevention, 4, 292-294.; Baullinger, J., Quan, L., Bennett, E., Cummings, P., & Williams, K. (2001). Use of Washington state newspaper for submersion injury surveillance. Injury Prevention, 7, 339-342]. To increase the accuracy of information provided to the public through media sources, there is a need for increased communication between public health professionals and reporters. The results of this study raise concerns about the contents of motor-vehicle crash information provided in newspapers and suggest that newspapers do not provide information to allow public perception to be in accord with the importance of motor-vehicle crash injuries and health promoting actions to reduce risk of injury. More balanced and detailed information in newspapers would provide an opportunity for news print media to improve public health programs and public perception about the impact of motor-vehicle crashes on safety for all.
This study describes fatal and nonfatal occupational injuries among U.S. correctional officers.
Fatal injuries were obtained from the Census of Fatal Occupational Injuries; nonfatal injuries were identified from the National Electronic Injury Surveillance System- Occupational Supplement.
From 1999-2008, there were 113 fatalities and an estimated 125,200 (CI=±70,100) nonfatal injuries were treated in emergency departments. Assaults and violent acts (n=45, 40%) and transportation related fatalities (n=45, 40%) were the two primary fatal injury events. Assaults and violent acts (n=47,500 (CI=±24,500), 38%) and bodily reaction and exertion (n=25,400 (CI=±16,800), 20%) were the leading events resulting in nonfatal injuries.
While workplace violence is the primary cause of both fatal and nonfatal injuries among correctional officers, transportation events and bodily reactions are also leading causes of occupational injury. Future research is needed to identify risk factors unique to these events and develop appropriate prevention and intervention efforts.
This study adds to the literature on occupational injuries among correctional officers and provides a national level description of fatal and nonfatal injuries across a 10-year period. Given that assaults and violent acts, transportation events, and bodily reaction and exertion were significant injury events, future research should describe detailed injury circumstances and risk factors for correctional officers unique to these events. This would allow appropriate prevention and control efforts to be developed to reduce injuries from these events.
It is likely that youth living on minority operated farms (<3% of U.S. farms) face hazards similar to the general farm population; however, since minority youth are not well represented by general farm surveys, this information hasn't been confirmed.
Nonfatal injury and exposure data were obtained from the 2000 Minority Farm Operator Childhood Agricultural Injury Survey (M-CAIS).
On racial minority farms, there were an estimated 28,600 household youth. Of these, about 41% worked, 26% rode a horse, 23% drove an ATV, and 23% operated a tractor. On Hispanic farms, there were an estimated 17,998 household youth. Of these, 44% worked, 30% rode a horse, 27% drove an ATV, and 25% operated a tractor.
These results show the value of conducting a survey of minorities to identify high risk groups and target issues that may be unique to the minority farm population.
Yard maintenance equipment is potentially dangerous, and some of the more frequency used equipment (e.g., lawn mowers) has been extensively studied. However, the extent of lawn trimmers as a source of injury has not previously been explored.
Data from the Consumer Product Safety Commission's National Electronic Injury Surveillance System were used to estimate the number of patients treated in U.S. emergency departments for lawn trimmer-related injuries. Injury rates were calculated according to age, sex, and race, and characteristics of the injury event were determined.
An estimated 81,907 injuries involving a lawn trimmer occurred from 2000-2009. The incidence generally increased over time. Men, people aged 40-49, and Caucasians were the groups most likely to be injured. The most commonly injured body part was the head, specifically the eye, accounting for 42.5% of the injuries. Contusions and abrasions were the most common type of injury to the head, but lacerations were the most common injury to the extremities, and strains/sprains were the most common injury to the trunk.
Although previous research on lawn trimmers has focused exclusively on injuries to the eyes, the results of the current study show that such injuries are one component of the problem. Because most of the injuries were due to foreign objects, it is important that the use of adequate safety gear be emphasized when operating lawn trimmers.
Results suggest that lawn trimmer design changes and better safety education for trimmer use can reduce the rate of injury and reverse the current trend.
China's rapid motorization has resulted in significant challenges in road safety.
Using official national statistics, this study examines road traffic injuries (RTIs) experienced by foreigners in China. The number of foreigners entering China has increased 2.4 times over the study period, from 10.16 million in 2000 to 24.33 million in 2008.
From 2000- 2008, the number of road traffic fatalities among foreigners similarly increased 2.5 fold, including 49 fatalities reported in 2008. Nonfatal RTIs during this same time frame increased by a magnitude of 1.8 (126 nonfatal injuries in 2000 to 223 in 2008).
This study suggests that the total number of foreigners working or visiting China each year who suffer fatal and nonfatal road traffic injuries is relatively low.
This study provided evidence suggesting that foreigners visiting or working in China face a relatively low risk of road traffic injuries.
Quantifying years of potential life lost (YPLL) highlights childhood causes of mortality and provides a simple method to identify important causes of premature death.
CDC analyzed data from the National Vital Statistics System multiple cause of death files for 2000-2009.
An average of 890YPLL were lost each year due to unintentional injuries for every 100,000 persons aged 0-19 years. YPLL rates differed by sex, age group, race/ethnicity, injury mechanism and state.
This report provides new information which can be used to prioritize interventions and identify subgroups of the population most at risk.
Motor vehicle crashes killed almost 5,000 pedestrians in 2005 in the United States. Pedestrian risk may be higher in areas characterized by urban sprawl. From 2000 to 2004, pedestrian fatality rates declined in the United States, but the Atlanta metropolitan statistical area did not experience the same decline. Pedestrian fatality rates for males, Hispanics, and the 15-34 and 35-54 year age groups were higher in Atlanta than in the United States overall. Pedestrian safety interventions should be targeted to high-risk populations and localized pedestrian settings.
Motor vehicle crashes are the most common cause of death for American adolescents. However, the impact of where teens live on when they begin driving has not been studied.
Data from the 2001 National Household Travel Survey were used to estimate the effect of residential density on the driver status of teens aged 16 to 19 years after matching on demographic characteristics.
Controlling for demographic characteristics, 16 and 17 year old teens in high density neighborhoods had driver rates 15 percentage points below teens living in less dense areas (p<0.001). The effect for 18 and 19 year olds was a 9 percentage point decrease (p<0.001).
These results suggest teens living in less dense and more sprawling communities initiate driving at a younger age than comparable teens in compact areas, placing them at increased risk for crash related injuries. Impact on Industry: The role of environmental factors, such as neighborhood walkability and provision of transit, should be considered in young driver programs.
The main objective of this paper is to highlight travel patterns of older adults living in the United States as depicted in the 2001 National Household Travel Survey (NHTS). The NHTS is a national data collection program sponsored by the Bureau of Transportation Statistics and the Federal Highway Administration. It is the first national comprehensive household survey of both daily and long-distance travel, allowing for analysis of the full continuum of personal travel by Americans. To better understand the transportation needs of older Americans, it is useful to examine how travel patterns differ across age groups. The intent is to present basic travel characteristics of older adults (age 65+) and allow for comparisons with younger adults (ages 19-64). Travel-related characteristics of older adults in the United States: Results of the 2001 survey showed that older Americans travel extensively and rely on personal vehicles as heavily as their younger counterparts. Older Americans conduct 89% of their travel in personal vehicles.
Characteristics of daily trips taken by older adults:
Older adults tend to be less mobile in that they take fewer trips, travel shorter distances, and have shorter travel times. This pattern is even more pronounced among older women. They are also more likely to suffer from self-reported medical conditions that further limit their travel. Characteristics of long-distance travel by older adults: Older men and women take long-distance trips at about the same rates and show a strong preference for using personal vehicles. And, while men and women take an equal percentage of their trips by air, older women show a strong preference for bus travel.
Although older Americans travel extensively, they are less mobile than their younger counterparts. This pattern is more pronounced among older women and among those with self-reported medical conditions that affect their ability to travel outside their home. Older women consistently take the least number of trips per day, have the lowest driving rates, travel the shortest distances, and are more likely to report medical conditions that limit their travel. For men and women who have to give up driving, alternative means of transportation becomes a necessity. Yet, use of alternative transportation is relatively low; excluding personal vehicle and walking, all other means of transportation account for about 2% of daily travel. Further, of those with medical conditions that affect their travel, only about 12% use special transportation services such as dial-a-ride.
Alcohol-related emergency department (ED) that presents an opportunity to intervene to prevent future alcohol-related problems among adolescents and adults has been reported. The single greatest contributor to alcohol related mortality in the United States is unintentional injury, accounting for approximately 26,000 deaths per year and placing a substantial burden on ED. All nonfatal injuries were classified according to the precipitating cause of injury such as fall, struck by or against, motor vehicle crash, principal diagnosis, primary body part injured, disposition upon discharge from the ED location of injury, and intent. Alcohol-related ED visits that did not involve a visible traumatic injury were excluded from the analysis such as acute intoxication, treatment of symptoms caused by chronic alcohol abuse. Alcohol involvement varied according to patient characteristics such as sex or diagnosis, estimates of relation between alcohol involvement and these characteristics may be biased.
The death rate per million tons (DRPMT) is considered as the key index to the quality of coal mine safety management. The index for 2002-2011 revealed a marked improvement in China coal mine safety management during the 10-year period. However, when seasonally adjusted, the 2002-2011 fatality data showed a strong seasonal variation trend. This was reasonably consistent for the 10years, which suggests that it was always the weak link in Chinese coal mine safety management over that time. However, the overall annual decrease in DRPMT was not reflected by any noticeable improvement in the seasonal occurrence of fatal coal mine accidents in China.
This paper focuses on this issue, first by analyzing the seasonal fluctuation of fatal accident statistics, then by investigating whether there was a parallel trend in China production output pressure. Finally an error correction model (ECM) was established to analyze the relationship between seasonal fatality rates and the pressure to increase coal production output, and revealed a close relationship between the two.
Firstly, the finding of this paper can help coal mine companies arrange their production planning more rationally, and decrease the fatalities' seasonal variations. Secondly, this paper is also helpful for the government to improve their regulation policies, to control the frequency of seasonal coal mine disasters.
Motor-vehicle crashes are a leading cause of death in the United States. Seatbelts are highly effective in preventing serious injury and death in the event of a crash. Not all states have primary enforcement of seatbelt laws.
Data from the 2002, 2006, 2008, and 2010 Behavioral Risk Factor Surveillance System were used to calculate prevalence of seatbelt use by state and type of state seatbelt law (primary vs. secondary enforcement).
Self-reported seatbelt use among adults in the United States increased steadily between 2002 and 2010, with the national prevalence reaching 87% in 2010. Overall, seatbelt use in 2010 was 9 percentage points higher in the states with primary enforcement laws than in the states with secondary enforcement laws (89% vs. 80%). Impact on industry: Primary enforcement seatbelt laws and enhanced enforcement of seatbelt laws are proven strategies for increasing seatbelt use and reducing traffic fatalities.
To examine injuries among patients treated in an emergency department (ED) related to the use of a riding lawn mower.
Data were obtained from the National Electronic Injury Surveillance System for the years 2002-2007. National estimates of ED visits for injuries associated with the use of a riding lawn mower were analyzed. Narrative text entries were categorized to provide a detailed record of the circumstances precipitating the injury. Average annual rates were calculated and logistic regression analyses were employed to determine risk estimates for patient disposition and demographic characteristics related to ED visits for injuries associated with riding mowers.
From 2002 through 2007, there were an estimated 66,341 ED visits for injuries related to the use of riding lawnmowers in the U.S., with an average annual rate of 6.0 ED visits per 100,000 males, and 1.6 ED visits per 100,000 females. Older adults had higher rates of ED visits for injuries (7.2/100,000) than younger age groups. The most common injuries involved contusions (24%); sprains/strains (22%) and fractures (17%). The majority of patients (90%) were treated and released the same day. Results of logistic regression analyses revealed that older adults were more likely to be hospitalized when compared to younger age groups; and incidents involving rollovers [OR=5.45 (95% CI=3.22-9.23)] and being run over [6.01 (95% CI 3.23-11.17)] were more likely to result in hospitalization when compared to all other circumstances of injury.
Riding mowers present injury patterns and circumstances that are different than those reported for push mowers. Circumstances related to injuries and age groups affected were varied, making prevention of riding mower injuries challenging. APPLICATION/IMPACT: Findings support the need to increase awareness and/or change the design of riding mowers with respect to risk of rollover injuries.