The 7th World Conference on Injury Prevention and Safety Promotion, Vienna, Austria, June 6th-9th 2004. Vienna, Austria: Kuratorium für Schutz und Sicherheit/Institut Sicher Leben, 2004 Jun; :324
Problem under study: Alaska is the largest and northernmost of the United States, comprising 20% of the total landmass of the US. Average seasonal snowfall is 176.5 cm (69.5 inches) for Anchorage and 178 cm (70.1 inches) for Fairbanks, but it can reach as high as 833 cm (328 inches) in Valdez. While comparison non-fatal data is not reliably available for the U.S., as a whole, Comparison of cold-related mortality data in Alaska with the rest of the United States demonstrated that people within Alaska were at higher risk for such deaths. The data for 1991-98 revealed an average cold-related death rate for this nine-year period of .21 per 100,000 US (excluding Alaska) residents. In contrast, the Alaska-specific average cold-related death rate for this period was 1.9 per 100,000 Alaska residents, an average rate that was nine times higher than the rest of the U.S. Objectives: The year-round potential for cold-related injuries has resulted in the formulation of a research question: Are the patterns associated with cold-related injuries to workers in Alaska different than those that occur to people whose injuries occurred outside of work place settings? Methodology: To determine the patterns associated with cold-related injuries in these groups, we analyzed records of all nonfatal injuries requiring hospitalizations of over 24 hours contained within the Alaska Trauma Registry (ATR) for 1991-1999. This database is unique in that it contains longitudinal state-wide, population-based data. Denominator data for worker and other populations was obtained from the State of Alaska Department of Labor and the U.S. Census Bureau. Results: A comparison of work-related and non-work-related nonfatal cold-related injuries in Alaska demonstrated few differences between these two groups. For both populations, the most common mechanism for injury was frostbite of exposed extremities. The factors associated with work-related injuries did not vary significantly from those associated with the non-work-related injuries, with the exception that some of the work-related injury frequencies varied significantly with race/ethnicity. African-American males serving in the U.S. Armed Forces in Alaska had higher injury rates (x2=38.55, p<0.0001) for cold-related injuries when compared to all other workers within the Occupational Group. These injuries often occurred during training and/or field exercises. Within the non-work-related injury population, drug and alcohol involvement was much more likely to occur, vs. the work-related injury population (x2= 41.68, p<0.0001). Conclusion: The reduction of risk factors for non-fatal injuries in both of these populations should target the prevention of frostbite. For at-risk workers, especially for those spending much of their worktime outdoors and/or in the military, such approaches could involve improved training on managing cold exposure, self-assessment of distal and/or exposed body parts for early signs of cold injury, greater attention to warm clothing and footwear, and more stringent supervision while workers are outdoors. Because of the complex social factors surrounding drug and/or alcohol use and the resultant impaired judgment, successful interventions in that milieu should include the use of any available community services to remove at-risk persons from cold weather environments before injuries occur.
The 7th World Conference on Injury Prevention and Safety Promotion, Vienna Austria, June 6th-9th 2004