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H6.1 The Epidemiology of Serious Occupational Burn Injuries in Alabama-Taylor AJ, McGwin G, Smith DR, Birmingham BR, Rue LW

Introduction: Patterns of occupational burn injury vary by geographic region; however, there are no studies in the published literature of patterns of occupational burn injury in the Southeastern United States. The purpose of this study is to describe the epidemiology of serious occupational burn injuries treated at an American College of Surgeons verified Burn Center.

Methods: Patients admitted to University of Alabama at Birmingham (UAB) University Hospital Burn Center between November 17, 1994 and December 31, 1999 for occupational burn injuries treated were included in the study. Demographic factors, type and severity of burns, occupation, and other factors were abstracted from medical records.

Results: Of 345 occupational burns (24.0% of total burns) treated, the majority occurred among males (96.5%, n=333) and those of white race (76.2%, n=263). The mean age was 37.5.

The most common burns resulted from flame, followed by electrical burns, and scalds. The most heavily represented occupations were "manufacturing" (19.1%, n=66), "electrician" (16.2%, n=56), and "laborer" (16.2%, n=56). Occupation was not documented for 13.0% (n=45) of patients. All manufacturing employees, 62.5% (n=35) of electricians, and 76.8% (n=43) of laborers were injured in an industrial setting, as were 68.7% of the total (n=237). Electricians sustained electrical (69.6%) and flame (26.8%) burns. Manufacturing employees and laborers sustained mainly flame and chemical burns, roofers scald burns, cooks scald burns and burns due to explosions, and mechanics flame burns.

Patients sustaining burns due to explosions and flames were more seriously injured than patients sustaining chemical, electrical, scald or contact burns. The mean length of ICU stay and hospital stay were 0.9 days (0 minimum, 60 maximum) and 13.7 days (1 minimum, 134 maximum), respectively. Sixteen patients (4.6%) died.

Conclusions: A significant number of burn injuries occur in the workplace. An understanding of their epidemiology is crucial to prevention efforts.


H6.2 Epidemiology of Work-related Burn Injuries: Experience of a State Managed Workers Compensation System-Islam SS, Nambiar AM, Doyle EJ, Velilla AM, Biswas RS, Ducatman AM

Population-based incidence rates of work-related burn injuries and associated risk factors specific to anatomic sites and degree of burn are not known. Using a state managed Workers Compensation database, we estimated incidence rates of work-related burn injuries and identified high-risk occupations and associated exposures. The annual incidence rate of occupational burn was 26.4 per 10,000 workers with the highest rate observed in the manufacturing sector for males and service sector for females. Welders, cooks, laborers, food service workers, and mechanics had higher incidence rates of burn injury compared to other occupations. Wrist and hand burns accounted for a majority of burn injuries, with females experiencing greater incidence of these distal upper extremity burns (8.9 in females and 6.7 in males per 10,000 workers respectively). Third degree burns (incidence rate 1.3 per 10,000 workers) were also most frequently observed in the upper extremities compared to other anatomic sites. The majority of wrist and hand burns were caused by hot liquids/objects while the majority of eye burns were associated with chemical exposures. Younger cooks and food service workers were at greater risk of burn than older co-workers. Specific occupations are associated with degree of burn, anatomic site, and cause of injury. This information will be useful for targeted intervention among high-risk occupations and work groups.


H6.3 Incidence and Risk of Work-related Fracture Injuries: Experience of a State Managed Workers Compensation System-Islam SS, Biswas RS, Nambiar AM, Syamlal G, Velilla AM, Doyle EJ, Ducatman AM

Population based incidence of work-related fractures and associated risk factors have not been well documented. Using a state managed workers compensation database, we have identified 3,454 work-related fractures that occurred between July 1,1994 and June 30,1995. Incidence rate of fracture was highest in the agricultural sector (194.5 per 10,000 workers), followed by mining (168.8 per 10,000 workers), construction (111.7 per 10,000 workers) and manufacturing (87.5 per 10,000 workers). In each industrial sector, males had significantly higher incidence rate than females except for the educational sector. Fracture of the phalanges was the most common fracture across all industrial sectors (15.8 per 10,000 workers), followed by foot bones (9.5 per 10,000 workers), and carpal bones (7.9 per 10,000 workers). The incidence rates of fractures varied by anatomic sites and occupations with laborers, truck drivers, electricians, carpenters, and nurse aides having higher rates of specific fractures than other occupations. The most common cause of fractures varied by anatomic sites with fall to same level or different level being the most common cause for all anatomic sites except face bones, phalanges, and carpal bones. Similarly, the exposures and surfaces associated with fractures varied by anatomic sites with femur, patella, radius and ulna fractures occurring in association with indoor surfaces. Majority of the ankle fractures occurred in association with outdoor surfaces. This study showed that specific occupations and anatomic sites are associated with specific causes and exposures. This information will be useful in the development of a targeted prevention intervention.


H6.4 Work-Related Traumatic Head and Brain Injuries in Washington State, 1990-1997-Cohen MA, Kalat J, Silverstein B

Traumatic head and brain injuries (THBIs) are severe, life-threatening injuries. Their impact on the worker, the worker's family, the employer, and society can be great. To prevent future injuries from occurring, we must better understand the nature of these incidents, the situations in which they are occurring, trends over time, and their costs.

Accepted Workers' Compensation claims for hospitalized traumatic head and brain injuries in the Washington State Fund system were analyzed. The occurrence of injuries and costs were described by occupation, industry and Washington Industrial Classification (WIC) codes. Various trends were also investigated over time.

Workers with the highest risk of having a traumatic head or brain injury worked in logging, roofing, and road construction. On average, the total workers' compensation claim cost was $135,000/claim, the injured workers took nearly 400 days off work, and spent 67 days in the hospital. The annual workers' compensation cost of these injuries is approximately $14 million. On average, there were 106 THBIs per year in this time period, which amounts to 9 THBIs per 100,000 workers each year in Washington State.

Traumatic head and brain injuries tend to occur in situations where work is being conducted on elevated surfaces, around/in vehicles moving at high speeds and in proximity to large objects elevated above the worker. In most cases, there are known methods to reduce the exposures or the energy involved in the incident. These methods include conducting work at ground level, reducing vehicle speeds, and increasing the distance between the worker and the hazard. Personal protective equipment can also be used (e.g. fall protection systems, seat belts, and hard hats). Like most workplace injuries, traumatic head and brain injuries are preventable. Work sites and conditions should be assessed for their potential to cause injury and hazards eliminated before an injury occurs.



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