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PS.01 The Economic Impact of Occupational Fatalities, A Retrospective Study (1995-1998)-Beaulieu AM, Leighton RW, Lim KC, Richards RF

Background: Since 1991 the Maine Department of Labor (MDOL) in collaboration with the Federal Bureau of Labor Statistics began documenting occupational fatalities under the Census of Fatal Occupational Injuries (CFOI) program. The CFOI program record occupational fatalities under guidelines that identify the nature, part, source and event that led to that fatality.

Purpose of Study: The primary objective of the study is to determine the magnitude of the economic impact of fatal workplace injuries from 1995 through 1998 in Maine and how many of these fatalities were preventable.

Methodology: Using data from the CFOI and the Maine Workers' Compensation Board (WCB), the economic impact of 86 fatalities was assessed using indicators such as years of potential life lost, loss of future earnings, Workers' Compensation payments and OSHA penalties.

Results: The 86 fatalities accounted for 1,919 years of potential life lost study. The total sum of lost wages based on the retirement age of 65 not adjusting for inflation is estimated to be over $1.3 million. Of the 86 cases, 29 (33.7%) cases had WCB death benefit payment, which totaled $1.49 million and incurred $170,857.00 in medical cost. Funeral cost accounted for $198,071.00.

OSHA investigated 23 cases and levied fines totaling $554,625.00. An analysis of 50 case reports by BLS Safety consultants indicated that 90.0% of these fatalities were preventable.

Discussion: Work-related fatalities present a significant economic impact to employers. Direct cost includes death benefit payments and medical expenses. Indirect cost includes lost of productivity due to disruptions at work, poor morale and OSHA fines. Long term impact includes the years of potential life lost and potential earnings. In addition, work-related fatalities have a significant impact on the quality of life of the families of the deceased workers.


PS.02 Measuring the Economic Burden of Occupational Fatal Injuries in the United States, 1990-1995- Biddle EA

Traumatic occupational injuries claimed the lives of over 30,000 American workers from 1990-1995 as reported through the National Traumatic Occupational Fatalities (NTOF) surveillance system. Fatalities represent the worst possible outcome for a worker and the highest burden to society. According to the National Safety Council, the median value of life lost to occupational fatality in 1997 was $890,000. As with nearly all other studies, these losses are an aggregate value and shed no light on the variations in costs for differing worker characteristics or circumstances of the event. The ability to make these distinctions can aid in prioritizing efforts to prevent these devastating events.

Numerous theoretical models to measure the cost of occupational fatalities to society have been developed. The cost of illness method is the most commonly adopted approach for legal proceedings and formal policy analyses. This method is divided into two components, direct and indirect costs. Direct costs are actual dollar expenditures associated with the fatality while indirect cost is the value of lost output due to decreased productivity. The value of productivity losses can be calculated using a Human Capital approach by determining the present value of a future stream of output valued at market earnings.

This project developed a user-friendly computer program to calculate the Human Capital cost of fatal injuries reported through NTOF. The model provides comprehensive national estimates for the economic burden of all occupational fatal injuries and specific estimates for the burden on selected groups (e.g., specific industries, occupation groups, and teenage workers). Finally, this model provides an additional reliable basis, economic risk, for targeting and evaluating the effectiveness of investments in prevention of occupational fatalities.


PS.03 The Practicality of Using Fault Tree Analysis to Improve Mine Safety-Kerkering JC, Coleman P, Beus M, Iverson S, Stewart W

Many mining safety research projects are multi-faceted. It is therefore difficult for management and researchers to determine where to focus their research efforts. Fault tree analysis may provide an effective tool.

Fault tree analysis is a systematic safety analysis tool that proceeds deductively from the occurrence of an undesired event (accident, injury, equipment malfunction) to the identification of the causes of that undesired event. Bell Telephone Laboratories first used this tool in the 1960s. The aerospace and nuclear industry then successfully adopted it to enhance the safety of their operations. These early applications, however, required large computers and expensive software and were on predominantly deterministic, static, closed systems quite unlike the open-ended and ever-changing work environment encountered in mining. Our research explored the feasibility of extending fault tree analysis to the dynamic mine environment. One recurring mine safety problem, the blockage of an ore pass, was analyzed using a currently available and inexpensive fault tree program on a personal computer. The analysis identified basic and intermediate events that led to the failure of the ore pass; it graphically depicted the interrelationship between these various subordinate events as well as the various cut sets and the minimal cut set (all members are necessary for the occurrence of the top event). Focus groups were used to estimate relative probabilities of occurrence for each of the basic events. A sensitivity analysis on these probabilities showed the basic events (wrong ore-size to grizzly-opening ratio, excessive moisture or finer content) having the greatest influence on ore chute blockage. This suggests these events should be first addressed in a program of safety research designed for most efficiently preventing the ore chute blockage. This research shows that it is feasible with personal computers and inexpensive software to use fault tree analysis to improve mine safety.


PS.04 The Economic and Social Impact of Work-Related Carbon Monoxide Poisoning-Chenoweth BA, Lim KC, Nadeau MR, Roy JC, Surette RI

Background: The Maine Workers' Compensation Board (WCB) reported an average of eight cases of carbon monoxide (CO) poisoning per year (1994-1998). In 1999, the Maine Department of Labor (MDOL) received reports from the Maine Agricultural Safety and Health Program (ASHP) of two incidents where twenty-two workers required medical treatment. One incident occurred at a plant where workers were exposed to CO from propane-powered forklifts. The other involved workers using propane-powered floor buffers.

Purpose of Study: The objective of this study is twofold: 1. Demonstrate to employers the benefits of the MDOL "SafetyWorks" program, which offers training to employees to recognize and prevent CO poisoning, at no cost to employers. 2. Develop a generic research protocol to assess the economic and social impact of work-related injuries.

Methodology: The sample (n=39) consisted of 1998-1999 cases of CO poisoning from the databases of the WCB and the ASHP. Medical cost indicators such as the use of a hyperbaric chamber measured the economic impact of these cases. Other cost indicators included loss of income and OSHA fines. The injured workers were interviewed by telephone to assess any social impact of these injuries.

Results: Of the 39 cases investigated, medical costs for 33.3% of these cases were not available because no Workers' Compensation claims were filed. The total medical cost for twenty-four cases was $35,230.00. Other economic indicators were indemnity payments from the WCB and OSHA fines. Seventy-one percent of those interviewed reported no prevention training was provided following their CO exposure.

Discussion: The data demonstrated that the benefits of the MDOL "SafetyWorks" outweigh training costs (time away from work) incurred by employers who send their employees to CO poisoning prevention training. The study also showed that research on the economic impact of work-related injuries could not be systematically collected under the current system.


PS.05 Integrating Injury Research With Industry Experience to Develop Measures for Preventing Worker Injuries From Vehicles and Equipment in Highway Work Zones-Fosbroke DE, Pratt SG, Burkhart JE, Marsh SM, Casini VJ, Moore PH, Smith GJ

Highway workers are exposed to injury from moving construction vehicles and equipment within the work zone and from motor vehicle traffic passing through the work zone. Census of Fatal Occupational Injuries (CFOI) data indicate that of the 600 work-related fatalities in the U.S. highway construction industry between 1992 and 1996, 328 (55%) were vehicle or equipment-related incidents that occurred in a work zone. Historically, prevention has been based on the premise that worker injuries are minimized when work zone traffic collisions are minimized. However, only half of the vehicle-related fatalities among highway workers involve a motorist.

To better understand highway worker injury risks, NIOSH reviewed current highway safety literature, analyzed worker fatality data, investigated selected fatalities, and held a workshop with government, labor, industry, academia, and State transportation departments. Workshop participants were asked to discuss measures that would reduce or eliminate hazards to highway workers. By bringing together people with diverse interests in work zone safety, NIOSH hoped to improve our understanding of the hazards faced by highway workers, raise the industry's awareness of these hazards, and initiate discussion about hazard reduction measures. The resulting NIOSH document outlines specific measures that contractors, contracting agencies, policy makers, manufacturers, law enforcers, and researchers can take to reduce occupational injuries in highway work zones. Though the efficacy of this intervention has yet to be evaluated, the development process is a model of how to develop pragmatic recommendations by combining injury research with industry experience.


PS.06 Pilot Study of Transient Risk Factors for Sharps-Related Injuries in Health Care Workers-Fisman DN, Harris AD, Sorock GS, Gordon K, Brandt G, Mittleman MA

Healthcare workers in the USA sustain approximately 400,000 injuries annually, due to needles and other sharp devices. Such injuries are associated with the transmission of HIV and hepatitis C. Although some factors, such as the use of gloves, modify the risk of sharps-related injuries, little is known about the potentially modifiable circumstances leading to such injuries. This is largely due to the methodological limitations of traditional case-control and cohort studies in the assessment of risk associated with repeated, transient exposures. We therefore designed a case-crossover study to evaluate the risk of sharps-related injuries associated with brief, transient exposures, including rushing, fatigue, and the provision of emergency care. Case-crossover methodology, which uses each subject as his or her own control, was developed specifically to evaluate the effects of transient exposures on the immediate risk of injury or disease occurrence. The study involves two large teaching hospitals:

University of Maryland Medical Systems, in Baltimore, and Beth Israel Deaconess Medical Center, in Boston. Recruitment of subjects has been facilitated through multi-disciplinary collaboration of injury epidemiologists with the hospital employee health services and infectious diseases services that oversee management of sharps-related injuries. Informed consent for interview is obtained at the time of management of the injury.

Consenting subjects participate in a telephone interview. Twenty subjects were recruited in the preliminary phase of the pilot study. Employees, trainees, and students have been enrolled, and it has been possible to contact 18 of twenty subjects within 3 days of injury reporting. The questionnaire used has permitted assessment of injuries sustained in surgical and non-surgical work environments. Participant response to the questionnaire has been favorable. Our preliminary experience with this multi-center pilot case-crossover study suggests that this methodology provides a feasible means of assessing brief, transient exposures as risk factors for sharps-related injuries in healthcare workers.


PS.07 Impact of a Changing U.S. Workforce on the Occupational Injury Experience, 1980-1994-Hartley DL, Biddle EA

The civilian labor force has increased considerably over the past quarter century-due in part to rapid population growth and an increasing retirement age. According to the Bureau of Labor Statistics projections, the number of older workers will increase by 48% between 1998 and 2008, from 17 million to 25 million workers.

Between 1980 and 1994, workers aged 65 years and older had the very highest workplace injury death rates-3 times the rate for other workers. The National Traumatic Occupational Fatalities Surveillance system reported 6,471 fatalities of civilian workers aged 65 years and older. The number of all fatalities has decreased over time, but the proportion of older worker fatalities has increased-ranging from a low of 6% of all work-related fatalities in the early 1980's to 8% in 1994.

Characteristics of older worker fatalities during 1980-1994, suggests that interventions need to focus on those who work in agricultural settings, who work around or operate machines, and who are exposed to fall hazards and risk factors for violence. Past fatality experience and projected employment patterns can be analyzed together to better understand the impact of an aging workforce on occupational safety and health.


PS.08 Five Workers Engulfed & Suffocated in Corn in Nebraska, 1999-Hetzler WE

Background: In Nebraska, where corn production is the second highest in the nation, the land is dotted with grain bins, gravity feed bins and gravity feed wagons. When workers enter these bins and wagons they can become engulfed in corn and suffocate. In the United States, between 1980 and 1994, over 120 people (NTOF reported 88 deaths from 1980 to 1992 and CFOI reported 33 deaths from 1993 to 1994) were killed by grain engulfment.

Purpose: To identify and describe trends in grain engulfment fatalities and disseminate preventive strategies to those who can intervene in the workplace.

Methods: Nebraska entered into a cooperative agreement with NIOSH in 1994. Using protocols developed by the NIOSH FACE program, corn engulfment cases were identified and on-site investigations were conducted. Using the Haddon model, investigators were able to identify multiple causes and develop multiple prevention strategies to help prevent similar types of deaths.

Results: Five cases were identified. Three cases involved entry into corn bins; one case dealt with a bin that burst, burying the victim, and another case involved a semi grain hopper engulfment.

Conclusions: Recommendations to prevent future similar fatalities include complying with national safety standards, installing locks on access doors to bins and silos, and equipping workers with two-way communications equipment. To disseminate the recommendations, the NE FACE program developed a FACE FACTS sheet that summarized these cases and detailed the prevention recommendations and collaborated with the Omaha and Nebraska Safety Councils who distributed 2,500 FACE FACTS to businesses throughout Nebraska and Western Iowa. This poster will also be presented to the regional meeting (Iowa, Nebraska, Colorado and Kansas) of Farm Safety 4 Just Kids, in June, 2000. The FACE FACTS sheet was placed on the NE FACE website and numerous presentations were given to the Nebraska agricultural community.


PS.09 Fatality Assessment and Control Evaluation (FACE) Program: Recommendations for Preventing Injuries and Deaths of Workers Who Operate or Work Near Forklifts-Higgins DN, Braddee RW

Background: Forklifts, also known as powered industrial trucks, are used in numerous work settings, primarily to move materials. Each year in the United States, nearly 100 workers are killed and another 20,000 are seriously injured in fork-lift related incidents [BLS 1997,1998].

Purpose: To identify and describe trends in forklift-related fatal incidents and to use data collected in fatality investigations to formulate and then disseminate preventive strategies to those who can intervene in the workplace.

Methods: Data from the National Traumatic Occupational Fatalities (NTOF) data base are used to describe trends and rates of fatalities over a 15 year period. It is estimated that NTOF, which is based solely on death certificates, identifies about 80% of work-related deaths. Through investigations done in the Fatality Assessment and Control Evaluation (FACE) program, additional characteristics such as safety practices, standards, and equipment are detailed. Through surveillance and investigations, potential risk factors are identified and prevention strategies are developed.

Results: From 1980 to 1994, 1,021 workers died from traumatic injuries suffered in work-related incidents that involved forklifts. The majority of these deaths were due to forklift overturns (22%), workers struck by forklifts while working nearby (20%), victims crushed by forklifts (16%), and falls from forklifts (9%). Between 1983 and 1999, the NIOSH FACE program investigated 13 fatalities that involved workers who died as a result of forklift injuries.

Conclusions: Recommendations include working in compliance with national safety standards, establishing and implementing written safe work procedures, retrofitting roll-over protective structures and seat belts (where applicable), and providing appropriate worker training.


PS.10 Eye Injury Prevention Among Mechanical Contractors-Hsu L, Hunting KL, Welch LS

A survey on eye injury prevention was distributed to approximately 2000 mechanical contractors; 171 completed surveys were received. Each contractor reported the number of eye injuries during 1998 which required first aid or medical care. The aggregate eye injury rate (total) was 4.6/100 workers. Rates varied by size of contractor and the type of work done by the contractors.

A substantial number of contractors had high quality eye injury prevention programs. Almost all contractors required workers to use eye protection either all the time or for specific tasks. Some companies reported strict enforcement mechanisms for these requirements, while other companies relied primarily on frequent reminders to workers. Many contractors mentioned that motivating employees to wear eye protection was their biggest challenge, but others reported successes from supplying comfortable, high quality, stylish safety glasses, including such features as anti-fog coatings, shaded lenses, and lanyards.

Almost all contractors provided eye protection training. Training generally covered eye injury hazards and prevention, but a minority of training programs focused on selecting and fitting appropriate eyewear. For about two-thirds of the contractors, the "standard" eye protection was safety glasses with side shields; the remainder relied on unshielded safety glasses. For instance, many eye injuries occur during overhead work; top and side shields are needed to prevent these injuries. Thus, a key issue for prevention is whether the type of eye protection worn is sufficiently protective for the task being performed.

It was somewhat surprising to find that contractors with a more comprehensive eye injury prevention program did not have a lower rate of eye injury. However, high quality eye injury programs and higher injury rates may identify companies which work under high-risk conditions. To see if prevention programs work, company specific rates must be evaluated before and after implementation of eye injury prevention programs.


PS.11 Work-related Acute Eye Injuries Presenting to the West Virginia University Hospital Emergency Department-Inman CJ, Jackson LL, Helmkamp JC, Islam SS, Furbee PM

Background: Over 600,000 work-related eye injuries occur annually. This number may be low because clinical recognition and surveillance mechanisms to accurately characterize occupational injuries are lacking.

Methods: To develop a better understanding of occupational eye injury circumstances and under-reporting of work-related injuries, we examined all emergency department (ED) visits for an eye injury presenting at West Virginia University Hospital Emergency Department during 1996. Through the emergency department-based injury surveillance system (EDBISS), we identified 556 eye injury visits. Medical charts were reviewed for injury circumstances and work-relatedness-defined as any injury or illness incurred while doing work for compensation, all agricultural production activities, and while doing work as a volunteer for an organized group.

Results: On the basis of chart review, we identified 326 first visits for patients 18 years and older with an eye injury: 98 were work-related, 184 were non-work related, and 44 were possibly work-related. Based on admissions information, EDBISS indicated that 90 visits were work-related of the 98 cases identified from chart review (Kappa=90%). Since there were other misclassifications regarding work-relatedness and possible work-relatedness this kappa value may be an over estimate. From chart review, 69 cases filed West Virginia Workers Compensation claims. Of these, 54 (78%) were matched with the West Virginia Workers Compensation database which captures all work-related injuries in the state except voluntary organizations and churches. We are exploring reasons for the low match rate by comparing the matched and unmatched cases with regards to severity of injury and occupation.

Conclusions: Injury surveillance that relies on compensation or insurance providers may under-report occupational injuries as seen in this example. Injury prevention would benefit from improved recording of work-related details by ED staff


PS.12 Occupational Homicide and Non-facility Based Workers-Johnson RM, Loomis D, Wolf S, Gregory E

About 12% of all fatal occupational injuries are homicides (1,2), homicide is recognized as a problem in occupational safety (3-7). Non-facility based [NFB] workers, specifically taxi-cab drivers, have high rates of homicide relative to other workers (3,5,8). The risk of homicide for other NFB workers is less clearly understood than the risk for taxi-cab drivers. However, because such workers are often exposed to a number of risk factors for occupational homicide (e.g., exchange of money with the public, working late-night or early-morning hours, working in community settings, working alone), it is important to examine their risk for homicide.

The data for this poster come from Dana Loomis's occupational homicide in North Carolina case-control study (n=152). The goals of these analyses are to (1) evaluate the risk of workplace homicide for NFB workplaces compared to other workplaces, and to (2) evaluate factors potentially associated with NFB workplace homicide (e.g., such as typical duties, hours worked, training, protocol for robbery situations). To address the first goal, we will compare the homicide rates among the two categories of workplaces. For the second goal, we will examine exposure to risk and protective factors for occupational homicide restricting analyses to the 69 workplaces with NFB workers. Case workplaces (n for NFB workplaces=23) include those in which a worker was killed while on duty, and were identified through the North Carolina medical examiner system. Control workplaces (n for NFB workplaces=46) were sampled randomly from state businesses and agencies contained in "American Business Lists". We administered a questionnaire to collect detailed information on workplaces, the demographic characteristics of their employees, and an array of factors potentially related to the risk of workplace homicide. Descriptive statistics will be presented in detail. Odds ratios and 95% confidence intervals will be generated using conditional logistic regression.


PS.14 Perceived Postural Sway and Discomfort During Simulated Drywall Lifting and Hanging Tasks-Long DJ, Pan CS, Chiou SS, Skidmore PO, Zwiener JY

This study identified the perceived postural sway and discomfort experienced by construction workers performing simulated drywall lifting and hanging tasks under laboratory conditions. Sixty construction workers (mean age = 34.4 8.5 years) with at least 6 months of installation experience (mean experience = 8.7 6.1 years) participated in this study. From a previous field study, four methods each for the tasks of lifting and hanging drywall were identified. Participants were assigned in random order to one lifting and one hanging method. Subjects then performed four replications of the assigned lifting and hanging methods. To determine subject perception of postural instability and whole body discomfort, participants were verbally asked a questionnaire at the completion of each replication. An ANOVA with repeated measures was performed to determine which, if any, of the lifting or hanging methods were perceived by subjects as causing significantly more postural sway or discomfort.

For the hanging tasks, the horizontal hanging of drywall onto a wall was perceived as causing significantly more postural sway and discomfort than the horizontal hanging of drywall onto a ceiling (p<.05). Horizontal hanging of drywall onto a wall was also perceived as causing more discomfort than the vertical hanging of drywall onto a ceiling (p<.05). Among the four lifting tasks, there were no significant differences perceived by subjects for either postural sway or discomfort.

This study provides subjective balance measures for drywall lifting and hanging tasks. These results, when combined with parallel studies on kinetics and kinematics as well as the field studies, will allow recommendations for the safest lifting and hanging methods for reducing fall injuries.


PS.15 Causes of Electrocutions Among Construction Workers-McCann MF, Chowdhury RT

This paper analyzes the causes of electrocutions among construction workers, based on Census of Fatal Occupational Injuries (CFOI) data for the years 1992 through 1997. The 836 resulting fatalities were divided by occupation into two categories: 268 electrical workers (electricians and apprentices, electrical power installers and repairers, and their supervisors); and 568 non-electrical workers, comprising all other construction occupations.

Contact with overhead power lines caused the electrocution of 34% of the 268 electrical workers, and 53% of the 568 non-electrical workers. For purposes of this paper, electrocutions due to overhead power lines, buried, underground power lines and lightning were excluded, since there have been previous studies on these topics. The remaining electrocutions were then divided into several categories.

Contact with electrical equipment (wiring, light fixtures, and other electrical parts such as circuit breakers, transformers, control panels and junction boxes) comprised 50% of all electrical worker electrocutions, but only 19% of non-electrical worker electrocutions. Contact with metal objects that became energized by contact with live electrical circuits and parts caused 9% of electrocutions of electrical workers and 8% of non-electrical workers. Analysis of the CFOI narratives indicated that working "live" or near live electrical circuits and parts was the major cause of these fatalities.

Contact with appliances or machinery caused 4% of the electrocutions of electrical workers and 6% of non-electrical workers. Power tools and portable lights caused 4% of the electrocutions of non-electrical workers. Defective power cords and extension cords were major contributing factors in many of these electrocutions.

Other contributing factors to these electrocutions included working in cramped spaces (such as attics, above drop ceilings, basements and under houses), and worker or equipment (such as portable lights or extension cords) contact with water. Contact with household voltage (120/240 volts) was involved in at least 13% of all electrocutions.


PS.16 An Analysis of Falls by Construction Type Among Construction Workers-McCann MF, Chowdhury RT

This paper analyzes 364 fatal falls to a lower level among construction workers, based on Census of Fatal Occupational Injuries (CFOI) data for 1997. Nine records were excluded from the study because they involved falls prior to 1997 with the deaths occurring in 1997. The most frequent trades involved were construction laborers (27%), roofers (11%), carpenters (10%), and structural metal workers (9%).

The fatal falls were classified into several categories of construction type based on the industry field, location field, and narrative of the CFOI records. The percentage of total falls by the various construction types selected were: residential (one-family home or townhouse) - 17%, non-residential building - 59%, unspecified building - 10%, other than building - 9%, and unknown - 4%.

Several differences were apparent in the types of falls for residential and non-residential buildings. Falls from or through roofs were similar (35% of all residential falls vs. 39% of all non-residential building falls), as were falls from scaffolds (16% each). The percentage of falls through floor openings was higher for residential compared to non-residential buildings (10% vs. 3%), as was the percentage for falls from ladders (32% vs. 14%). Residential construction had no fatal falls from aerial lifts, while 6% of fatal falls from non-residential buildings were due to aerial lifts. These differences probably are due to differences in construction methods.

Fatal falls involving self-employed workers also differed by construction type. Overall, 17% of total fatal falls involved self-employed workers, comparable to the percentage of self-employed workers in the construction workforce. Residential construction was responsible for 43% of the fatal falls of self-employed workers, while non-residential building construction was responsible for 11% of self-employed fatal falls.. These figures might reflect the greater number of self-employed workers involved in residential construction.


PS.17 Work-related Injury Among California Migrant Hispanic Farm Workers-McCurdy SA, Beaumont JJ, Wilson BW, Henderson J, Samuels SJ, Schenker MB, Morrin L, Carroll D

Objectives: To evaluate injury experience through a harvest season among migrant Hispanic farm workers. Study hypotheses include piece-work vs. hourly pay, and the role of multiple employment.

Methods: We conducted a prospective cohort study of injury across the 1997 harvest season among migrant Hispanic farm worker living in local migrant family housing centers. Participants completed an initial interviewer-administered work-and-health questionnaire with periodic followup during the season.

Results: One-thousand two hundred and six adult farm workers completed the initial survey. Participation rates in participating housing centers ranged from 82%-95%. Eight hundred thirty-nine persons (69.6%) completed the fourth and final periodic questionnaire. There were 96 occupational and 44 nonoccupational injuries observed over the harvest season or reported for the preceding year , yielding a one-year reported occupational injury rate of 10.4/100 FTE. Increased risk was noted for men (11.0 vs. 9.2/100 FTE for women) and current smokers (14.1 vs. 9.0/100 FTE for neversmokers). Sprains and strains were predominant, comprising 29 (30%) occupational injuries, followed by lacerations, comprising 14 (15%) occupational injuries. The most commonly involved body parts were the head (28%) and trunk (26%). Overexertion and strenuous movements were the most common external cause, comprising 26 (27%) occupational injuries.

Conclusions: Quantitative injury risk for this cohort appears comparable to that of agricultural workers in other U.S. settings. Results addressing a priori study hypotheses will be discussed at the conference.


PS.18 Do Complaints Take OSHA to Less Risky Workplaces?-Mendeloff JM

In many years, more than half of OSHA's inspections in general industry are triggered by complaints from workers or their representatives. There has been considerable controversy about whether responding to these complaints represents a good use of OSHA's resources. Critics have argued that complaints to OSHA are often tools used as part of unrelated labor-management conflicts.

The research reported here examines whether the work places that receive "complaint inspections" are less hazardous (as measured by injury rates from the OSHA logs) than workplaces that are not inspected or that are subjected to "planned inspections."

We used the 1995 OSHA Data Initiative, which collected OSHA logs from 80,000 establishments in manufacturing and a few other industries. All establishments had at least 60 employees. These data were merged with OSHA's data file on inspections.

We examined the results for the 9 4-digit SICs with the largest number of establishments. Overall, we found that the average injury rate was higher at workplaces with complaints (7.39 per 100 workers) than at those with planned inspections (6.80) or with no inspections (5.98). The same pattern was found when we looked within each of the 4-digit industries and within size groups within them. In addition, we found that, for complaint inspections, the number of serious violations cited was significantly and positively correlated with the injury rate, relative to the industry and size group average.

These data do not support the view that complaint inspections tend to take OSHA to workplaces with minor injury problems.


PS.19 Occupational Fatalities Associated With Harvesting and Handling Large Bales-United States, 1980-1998, Minnesota FACE, 1993-1999, Oklahoma FACE, 1995-1999-Parker DL, Wahl GL, Douglas MR, Mallonee S, Archer PJ

The agriculture industry has one of the highest occupational fatality rates of all U.S. industries. Nationally, the Census of Fatal Occupational Injuries (CFOI) identified 65 work-related fatalities associated with harvesting and handling bales in the United States during 1992-1998.

Since the mid-1970's traditional small forage balers have gradually been replaced by large balers in the agricultural industry. While the harvest and handling of small bales exposed workers to hazards, harvesting and handling large bales weighing between 1,000 and 1,500 pounds exposes workers to new hazards.

The National Institute for Occupational Safety and Health (NIOSH) State-based Fatality Assessment and Control Evaluation (FACE) program conducts research designed to identify and study factors that increase the risk of fatal occupational injuries. The goal of the FACE program is to prevent occupational fatalities across the nation by identifying and investigating work situations at high risk for injury and then formulating and disseminating prevention strategies to those who can intervene in the workplace.

This poster summarizes large bale case investigations conducted by the Minnesota FACE (MN FACE) program during 1993-1999 and the Oklahoma FACE (OK FACE) program during 1995 1999. During 1993-1999, MN FACE investigated 11 incidents (4 tractor rollovers, 3 entanglements, 2 struck by and 2 caught between) and OK FACE investigated 2 entanglement incidents associated with harvesting and handling large bales. In three of the five entanglement cases, fires developed within the balers.

The MN FACE and OK FACE program investigations resulted in the development of specific safety recommendations to reduce the risk of fatal injury associated with harvesting and handling bales. These recommendations focus on the use of appropriate machinery, proper machine operation and maintenance, availability of fire fighting and communication equipment, and using tractors equipped with a rollover protective structure and a seat belt.


PS.20 Injury Surveillance Using Existing Workers' Compensation Medical Claims Data-Peele PB, Stockman CK, Tollerud DJ

The routine processing of workers' compensation medical claims for injured workers creates a rich database of information about workplace safety. Few, if any, employers currently take advantage of the existence of these data to monitor workplace injuries. The goal of this research is to improve the welfare of employees by providing employers with explicit guidelines for using their medical claims data to monitor workplace safety and to evaluate safety programs.

Workers' compensation medical claims data for the 29,000 FTE employees of the City of Philadelphia for the years 1994-1997 supply the basic dataset for developing monitoring techniques. Using only these data, we construct weighted variables capable of rapidly capturing the number and severity of injuries. These are benchmarked to injuries in previous years and mapped over time to offer employers an ongoing surveillance window to observe changes in workplace safety. Additionally, we estimate the under-reporting of injuries that necessarily occurs when only medical claims data are used to count injuries. This is done by tracking the gap between all reported injuries and injuries receiving formal medical treatment.

Because most workplace injuries result in very short courses of medical treatment, we find this system to be both feasible and reliable for monitoring workplace safety. Importantly, this novel injury surveillance system does not require any additional data collection by employers. Hence it is a low-cost, easily implemented surveillance/monitoring system that would alert employers to changes in workplace safety, allowing them to intervene early when signs of safety degradation appear. The study population for developing this system is a large municipality, but given the similarity of labor mix across municipalities, these results are immediately and directly applicable to other municipalities. In addition to other municipalities, we expect our guidelines to have direct application for many other large employers as well.


PS.21 ICD-9-CM vs. ICD-10 for Coding Occupational Fatalities: Is ICD-10 Better, Worse, or Just Different?-Pope MJ, Reed DK

The International Classification of Diseases (ICD) is used extensively for coding occupational injury and fatalities. The widely used ninth revision, clinical modification, commonly referred to as ICD-9-CM, is gradually being replaced with the tenth revision, or ICD-10, which was released in 1992. Although an ICD-10-CM has also been developed, its implementation isn't expected to be until after 2001. Mortality data from death certificates has been recorded using ICD-10 since January 1, 1999. This study addresses how the new coding will affect those who rely on ICD codes to track and evaluate workplace fatalities.

The Fatality Assessment and Control Evaluation (FACE) project (funded by NIOSH) at the Kentucky Injury Prevention and Research Center (KIPRC) has tracked occupational fatalities in the state since its inception in 1994. Currently more than 800 fatalities are included in a database of general information that contains ICD-9-CM codes for the cause of death. In preparation for the change to ICD-10, cases were re-coded and the resulting code definitions were compared to the previously coded ICD-9-CM code definitions to determine the effects of the change. This presentation will show the perceived benefits and deficits of the "new" coding system as it relates to actual occupational fatality cases.


PS.22 Fatal Incidents Involving Farm Equipment on Public Roadways-Reed DK, Struttmann TW

Data linkage of the Fatality Analysis Reporting System (FARS) and the Fatality Assessment Control Evaluation (FACE) for occupational fatalities in Kentucky revealed agriculture as the second highest Industry and Occupation for work-related roadway fatalities in Kentucky from 1994-97.

Farm equipment on public roadways pose a hazard to not only the operator but also the rural driving population. Between 1994-97, there were 430 fatal motor vehicle crashes (MVC) involving farm equipment on US roadways. California, Wisconsin, Kentucky, Texas, Indiana, and Minnesota lead the nation in number of fatal MVCs involving farm equipment.

Based on the number of farms in each of these states, the leading states were California, Indiana, and Wisconsin. Rates per 10,000 rural roadway miles were 30.7 for California, 21.32 for Wisconsin, and 20.91 for Indiana. Based on the number of wheeled tractors per farm, the leading states were California, Texas, and Kentucky. Kentucky had the most incidents per 1,000,000 licensed drivers with 7.95; Minnesota had 6.97/1,000,000; and Indiana 5.03/1,000,000.

From the 430 fatal MVCs, 281 cases involved farm equipment vs a motor vehicle in transport. In 51.6% of these cases, the farm equipment driver was not injured. 30.6% of the farm equipment drivers were killed. This suggests the driver and passengers of a motor vehicle in such an incident are in danger of losing their lives. Over half of these incidents involved a motor vehicle rear-ending the farm equipment. Interventions must focus on all rural drivers as well as farmers.


PS.23 A Cost Model for Traumatic Injuries in Mining-Sacks HK, Pana-Cryan R

A cost model for traumatic injuries in mining has been developed as a tool to assist in focusing injury prevention research. Assigning a relative cost to an injury event provides a useful method for ranking research projects. It also provides compelling evidence for employers and employees to invest in preventative measures. The starting point for the model is the Mine Health and Safety Administration's (MSHA) injury and illness database. The database provides information on the victim's age, occupation, injury severity and time lost from work. The model, based on a societal perspective, calculates lost earnings and non-market loss (also known as home production) as a proxy for lost production. It also calculates medical costs. Earnings are derived from union contract data and commercial wage surveys. Future earnings estimates are adjusted for the employment cost index, discount rate, and life cycle salary growth. Medical costs are based on the days lost from work and the degree of injury. Aggregated data from the National Council on Compensation Insurance (NCCI) detailed claims information reports were analyzed. The analysis showed that medical costs are linearly related to days lost and benefit class. The model assigns a cost to each lost time injury in the MSHA database.


PS.24 Experiences of Widows Following a Farm-related Fatality-Scheerer A, Brandt V

Farming families have been identified traditionally with a strong family bond resulting from both living and working together. When a farming fatality occurs, surviving family members are left to deal with not only the tragedy of losing a loved one, but also the loss of a coworker. The stress confronting farming families may contribute to serious consequences for their business, their relationships with each other, and the mental health of the individual members. These issues were explored through in-depth personal interviews with farming widows in Kentucky.

Families who experienced a farming fatality were identified through the Kentucky Fatality Assessment and Control Evaluation (FACE) Project, a statewide surveillance system for occupational fatalities. Eligible candidates for interviews were families in which the death had occurred between one and five years prior to the interview (1994-1998). Interviews with seven widows were selected for analysis. NUDIST software was used to organize and code the data into meaningful themes and groups.

Similar themes were found among the respondents as they described the consequences of the fatality on their family and business. Economic issues were an underlying consideration in many aspects of their experience. Even though none of the widows lost their farm or home because of financial difficulties, they did make changes in the amount or type of commodities so that it was manageable without hiring outside help. To maintain income, it was necessary to continue with chores such as caring for livestock and tending to crops which left little time for personal bereavement. Respondents discussed the changes in their farm and family, their coping mechanisms and support systems. In developing resources for families in similar circumstances, it is important to understand how intertwined their lives are with the farm environment and economics of the business.


PS.25 Injuries Relating to Tobacco Farming in Kentucky-Struttmann TW, Caudill D, Reed DK

Agriculture is one of the most hazardous occupations in the United States. Although the investigation of agricultural injuries by segmenting a particular commodity is not new, none have concentrated on tobacco production. In 1997, tobacco production in the U.S. was reported at 1,747,702,321 lbs. Kentucky produced 30.4% of this on over half its 82,273 farms.

Tobacco farming is labor intensive, involving several phases of production, each exposing the farmer and farm family to different modes of injury. In two agricultural regions, 2,911 agricultural injury cases were identified through emergency departments between 1992 and 1999. Of these cases, 703 were related to tobacco production.

Analysis of the tobacco injuries shows the median age was 31 years. More than half of the injuries occurred in August and September. Falls were the leading cause of injury, comprising 27.1% of the total. Injuries from edged/piercing instruments were next with 24.3%. Seventeen percent of the injuries were to children under 18 years. There was an increase in the number of Hispanic workers, from 3% in 1992 to 14% in 1999. There were five fatalities, three of which were from tractor overturns. The mean hospital charge was $489, with a median of $213 and a range of $8 - $25,778.

This descriptive study can be used in the development of appropriate prevention strategies for tobacco production. Many of the injuries sustained to the upper and lower limbs were due to the tobacco spears used during the harvest. These injuries could be avoided by using leather chaps on lower legs and leather gloves with gauntlets for the hands. Falls from height could be reduced by using single-story barns or curing structures such as post-row frameworks. Prevention measures must also focus on migrant workers that are affected by language and cultural barriers.


PS.26 California Fatality Assessment and Control Evaluation (FACE): Summary of Occupational Fatalities in Los Angeles County 1992-1998-Styles LE, Tibben R, Harrison R, Gillen M, Fowler J, Guerriero J

The California Department of Health Services, in collaboration with the National Institute for Occupational Safety and Health (NIOSH), has established the California Fatality Assessment and Control Evaluation program (FACE) for the surveillance and investigation of workplace fatalities. The FACE program seeks to link multisource reporting of fatal occupational injuries with timely investigations to identify work-related risk factors, make recommendations for preventing fatalities, and facilitate workplace prevention programs. Preliminary results from 1992-1998 show that the leading cause of occupational fatalities in Los Angeles County was homicide (42%), followed by transportation-related (15%), crushed/compressed/struck by/caught in (12%), falls (12%), electrocution (5%), fire/explosion (3%), other (10%). This presentation will summarize the demographics and the industry and occupation of those who died at work. Investigated deaths will be highlighted and specific recommendations to prevent similar deaths will be discussed.


PS.27 Epidemiology of Occupational Injury Among Cooks-Velilla AM, Islam SS, Syamlal G, Ducatman AM

Several studies have shown cooks to have a greater risk of burn injury compared to other occupations. However, epidemiological characteristics of other work-related injuries among cooks are not well documented. Using a state-wide workers compensation database, the epidemiological characteristics of work-related injuries among cooks were described. During a four-year study period (1995-1998) there were 213,111 compensable injuries, 6130 (2.9%) of which were among cooks. The most common injuries among cooks were laceration (30%), sprain (28%), and heat burn (15%). However, when compared to other workers, cooks were found to be at higher risk of heat burns, lacerations, and chemical burns (RR 7.7, 1.9, and 1.6 respectively). Of the injuries among cooks, 58% occurred in females and 42% in males. Female cooks were significantly older than male cooks (mean age 41.7 vs. 26.8 years). A greater proportion of cooks (52%) earned lower weekly wages at the time of injury ($200 or less) compared to other workers (19%). In contrast to other occupations where women are the lower wage earners, among cooks lower wage earners are predominantly male. The risk of injury to cooks also varied by age category. Adolescent cooks (age 14-19 years) had a higher risk of compensable injury (RR 2.6) compared to other adolescent workers. This study shows that work-related injuries among cooks are significantly different from other occupations and as such, require targeted intervention strategies to reduce injuries.



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