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TRAUMATIC INJURY

hazard signs, worker avoiding falling box

Activities: NIOSH Funded Research Grants

NIOSH sponsors research and training through its extramural programs, which complement the Institute's intramural programs. More information is available from the NIOSH Office of Extramural Programs . Our Research Portfolio includes the following NIOSH funded research grants:

Selected Current Extramural Traumatic Injury Research Grants
A Fall Protection System for Residential Construction Considering Usability and Worker Attitudes

Falls from elevation are one of the most prevalent causes of fatalities and injuries on construction sites. Many of these incidents occur on residential construction sites, where fall heights are relatively low (usually 30 feet or less) and the use of personal protective technologies (PPT) related to fall protection is not common. OSHA 1926 Subpart M contains an exemption for the use of PPTs related to falls on residential construction as long as the contractor uses a fall protection plan. The reasoning behind this exemption is to prevent undo financial burdens on small contractors and to not tie-off to points on a wooden structures which may not meet the standards of OSHA 1926 Subpart M. This difference between residential and commercial construction may suggest that falls are not a concern on residential construction sites, but the Bureau of Labor Statistics metastatistics and recent research demonstrate otherwise. Current residential construction methods, especially for a second story floor, do not lend themselves to providing useful anchorage points using typical equipment. Further use of fall arrest systems (FAS) for low-rise or residential construction faces several barriers including the lack of easy to use equipment, and workers attitudes about safety equipment. Both of these obstacles must be overcome to develop effective safety tools for fall prevention and to increase use compliance. We recently observed an innovative FAS that is currently used in the post frame construction industry. Post frame is a construction system relying on embedded posts and trusses covered with sheathing materials. The workers used a relatively simple set of elements to create anchor and tie-off points on the structure. The FAS did not impede the construction process and in some cases was integrated into the truss elements before they were raised from the ground. The workers for these companies have adopted the system and seem to use it willingly. The purpose of this research is to transfer the FAS observed in the post frame construction area to residential construction given its seemingly more usable design. This will necessitate redesign and further testing of some of the fall arrest elements. Also, measurement of worker attitudes and behavioral observation will be used to correlate safety climate with the implementation of the innovative FAS as well as introducing the concepts of usability. The outcome of this project will be a simple and usable fall arrest system for residential construction, which has been verified by mechanical testing and improved by the worker usability study. This fall arrest system will have a direct impact upon the safety of construction workers in residential environments. Procedures and methods used suggest ways to incorporate worker usability and opinions into the design of future protective equipment.

Project contact: Daniel Hindman, PhD
Institution: Virginia Polytechnic Institute and State University
dhindman@vt.edu
Project period:
08/01/2010–07/31/2015

Work Zone Sign Design for Increased Driver Compliance and Worker Safety

Struck-by injuries and fatalities are prevalent in the construction industry, specifically at road construction work zone sites. Although the cause of vehicle-worker fatalities is not reported, one can rationally suggest that they are due to a number of factors including the inattentiveness of the driver and/or worker and the failure of the driver to obey traffic laws. Dynamic message signs (DMS) have been shown to effectively influence driver behavior. However, in order for the signs to effectively influence speed reduction and compliance in work zones, the signs must draw the attention of the driver, the driver must decide to process the message of the sign, and the driver must decide to obey the posted speed limit. The ultimate goal of this research is to develop design standards for dynamic message signs in work zones to reduce the risk of struck-by incidents for construction workers. The specific aim is to determine the impact of sign content, frame refresh rate, and sign placement on driver behavior in work zones. It is expected that signs will be more effective under the following conditions: 1) signs that mention the presence of construction workers, 2) signs with moderate refresh rates, and 3) signs placed farther from the start of the work zone. Each of these factors will be tested in a project using a high-fidelity driving simulator with an integrated eye tracking system. A two (content) three (refresh rate) two (placement) full factorial design will be used to evaluate speed reduction, compliance rate, and eye movements. All independent variables (sign content, refresh rate, placement distance) will be within-subjects variables. Participants' gender, age, driving history, and safety attitude will also be evaluated to account for individual differences. A total of 50 participants will be included in the study. Each participant will complete twelve driving scenarios (one for each of the factorial combination of the experimental factors, counterbalanced across participants) in the driving simulator. During each scenario, participants drive in a four-lane divided highway setting and will encounter highway work zones throughout the scenarios. Driver behavior and attention before entering the work zone and upon entering the work zone will be evaluated to determine impact of the dynamic signs on speed and compliance. The proposed study will assist in lowering the incidence of struck-by incidents in work zones by identifying (and eventually implementing) effective sign designs for reducing driver speed and increasing compliance. Finally, the project will evaluate features of signs that can passively influence driver's visual attention to the dangers experienced by construction workers, supplementing current speed reduction enforcement activities.

Project contact: Lesley Jean Strawderman, PhD, MS
Institution: Mississippi State University
strawderman@ise.msstate.edu
Project period: 09/01/2013–08/31/2016

Machine Guarding: Translation into Practice

This application is a translation research initiative to be conducted by the Park Nicollet Institute, the University of Minnesota, Federated Insurance and the metal-fabrication industry. In-kind and matching support from Federated Insurance will be used to leverage NIOSH funding. We will revise, disseminate, and evaluate wide-scale implementation of the Minnesota Machine Guarding Program, a NIOSH-sponsored R01 intervention. This intervention showed a significant improvement of machine-guarding practices and related safety programs such as lockout/tagout. According to the United States Small Business Association there are an estimated 3.1 million workers in the metal fabrication trades. These workers are at substantial risk of hand injuries including amputations. After accounting for under reporting, the incidence of amputations is estimated at between 11.8 and 19.5 per 100,000 workers. However, the rate in metal fabrication may be as high as 41/100,000 workers. Data from our ongoing work indicate a serious problem with inadequate machine guarding and related safety programs. This indicates the potentially preventable nature of these injuries. The specific aims of this research are to: (1) Revise and expand the Minnesota Machine Guarding Program for dissemination via a community partner. (2) Implement a randomized, controlled study to evaluate effectiveness of a machine guarding intervention with a community partner.(3) Measure the outcome of a randomized, controlled intervention on machine guarding by (a) evaluating a change in the incidence and cost of machine-related injuries; and (b) evaluating improvements in machine guarding and related safety programs. (4) Evaluate factors that will lead to a sustained adoption of this intervention by other sources (e.g., other insurance companies and business associations). Primary study outcomes will include changes in four measures: (1) the cost and rate of injuries; (2) a machine safety score; (3) a business safety audit score; and (4) survey data changes utilizing Social Cognitive Theory. We will evaluate intervention businesses at baseline (t1) and after 12 months (t2). We will utilize a simple randomized trial with two groups: early intervention and delayed intervention. Social Cognitive Theory will serve as our behavioral model for intervention development and design. Public health importance: This study has the potential to provide a model to bring sustainable intervention programs to small manufacturing businesses. Workers in the metal fabrication trades are known to be at high risk of injury. Workers in the metal fabrication trades are known to be at high risk of serious injury. The proposed research program reaches a poorly served segment of the worker community, those in small business enterprises. To our knowledge, this is the first national intervention in small manufacturing facilities. Thus, this study has the potential to provide a new model to bring sustainable intervention programs to small manufacturing businesses.

Project contact: David L Parker, MD
Institution: Park Nicollet Institute
parked@parknicollet.com
Project period: 08/01/2010-7/31/2015

Safety and Health of Latino Immigrant Forestry Services Workers in the Pacific Northwest

This worker engaged project characterizes injury and illness experiences among immigrant Latino forest services workers in relation to workplace risk factors and outcomes in medical treatment, recovery/return-to-work, and safety mitigation. The workforce is largely immigrant, low-literate, and Spanish-speaking with unique vulnerabilities due to a lack of skills and safety training, occupational immobility, remote work locations, and small contractor employment. The complex nature of this work, injury experience and post-injury outcomes will be explored through injury case studies and developed into personal narrative educational modules for worker safety training. Workers in the forestry services industry, or "forest workers", are exposed to inherently high-risk tasks and conditions. These workers, distinct from the logging workforce, do the remote reforestation, rehabilitation and forest thinning/cutting and all the other tasks necessary in tending America's forests. Job-related injury and illness rates among these workers are 2 to 3 times the rates of the average US worker, and fatality rates are 9 times as high. We propose to build on our previous pilot studies, which established a baseline of information on occupational risk factors, injuries, and illnesses among immigrant, Spanish-speaking forest workers in Oregon and Washington. This three year study will use an engaged process based on participatory action research to assure the research is sensitive to worker and employer needs and leads to actionable results. It will investigate the relationships between hazardous working conditions, associated occupational injuries and illnesses, and post-injury health outcomes, including how worker fears of retaliation influence workers' attempts to improve workplace safety and health. Additionally, new print and digital educational resources utilizing narrative storytelling will be developed with Northwest Forest Worker Center's (NFWC) established promotora (community health worker) program and piloted in employer safety training. This proposed research-to-practice project addresses both an underserved workforce in high-risk forestry services and a uniquely vulnerable population. Our research and community partners are positioned to address this complex workforce issue and develop evidence-based safety and health programs. Moreover, this project directly addresses multiple goals delineated by CDC-NIOSH's National Occupational Research Agenda (NORA) for Agriculture, Forestry, and Fishing.

Project contact: Arnold B. De Castro, PhD, MSN/MPH
Institution: University of Washington
bdecastro@uwb.edu
Project period: 09/01/2014–08/31/2017

Development and Evaluation of a Comprehensive Hospital Violence Surveillance System

Violence against workers in the hospital setting has become a growing public health concern in recent years, with 12-month prevalence estimates ranging from 23% to 74% in recent studies. These estimates are considered conservative given that several studies have observed significant underreporting of violent episodes experienced by hospital workers who often accept this as "part of the job." Violence perpetrated by patients and visitors has been reported to be the most common type of violence in this setting. There is a lack of standardized surveillance methodology to capture incident cases of workplace violence, as well as details about the circumstances surrounding these events in the hospital setting. Without these data, policy development is made informally or often based on sentinel events. We propose to design and implement a comprehensive surveillance system that serves to systematically capture episodes of workplace violence inflicted on hospital workers by patients and hospital visitors. This system will involve the design and implementation of enhanced reporting mechanisms through existing systems currently in place in these study hospitals, as well as the development and implementation of violence reporting policies and procedures. This study will take place in two large medical systems located in Texas and North Carolina. We will partner with key stakeholders in each study hospital to develop and implement both the reporting system and reporting policies, as well as promote and educate workers about the new mechanisms for reporting. We will assess the level of integration of the enhanced workplace violence surveillance system in each hospital. This research study addresses NIOSH's strategic goal for promoting effective occupational health surveillance conducted by employers.

Project contact: Lisa A. Pompeii, PhD, COHN-S, FAAOHN
Institution: University of Texas Health Science Center Houston
lisa.pompeii@uth.tmc.edu
Project period:
07/01/2010–06/30/2015

 

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