Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U60-OH-008483, 2010 Dec; :1-32
The Kentucky Occupational Safety and Health Surveillance (KOSHS) program is an expanded program that includes a fundamental occupational injury and illness surveillance program and a Fatality Assessment and Control Evaluation program. This final progress report for the Kentucky expanded KOSHS program covers only a two-year grant funded period from July 1, 2008 - June 30, 2010, in contrast to other states with expanded Occupational Safety and Health Surveillance programs who were funded for five years. Kentucky ranked as the 14th -worst state for fatal occupational injury rates in 2008, down from the 8th worst in 2004 (John Sestito, NIOSH, personal communication), but was still 59% above the national rate (5.9 KY deaths/ 100,000 workers compared to 3.7 US deaths/ 100,000 workers in 2008), and is among the states with the highest nonfatal occupational injury and illness incidence rates (8th worst) (BLS, 2009). These elevated rates are attributable in part to the concentration of KY workers in higher-risk industry sectors, but nevertheless are clear indications of the need for further work to lower the state's burden of occupational injuries and illnesses. The specific aims of the KOSHS and FACE programs from July 1, 2008- June 30, 2010, were to: 1) maintain comprehensive multi-source population-based surveillance of occupational injuries and illnesses occurring in Kentucky using 20 indicators; 2) establish a state-specific indicator for the population-based surveillance of occupational falls; 3) sustain the -Kentucky- Working to Save Lives- consortium; 4) apply nonparametric statistical analysis methods to the CRASH data set; 5) provide targeted worker and employer groups with a sound evidence basis for improved worker safety; 6) conduct comprehensive and timely multisource surveillance of all occupational fatalities occurring in Kentucky; 7) perform on-site investigations of selected fatality cases involving motor vehicle collisions; 8) perform a case-control study to determine the association between the number of passengers and injury severity in older male driver motor vehicle collisions; 9) develop and disseminate fatality narratives of interpersonal violence-related occupational homicides utilizing multiple sources of data; and 10) perform a process, impact, and outcome evaluation of the major activities conducted. Epidemiological analyses of transportation industry injuries (the effect of passengers on older semi truck driver at-fault collisions), and unintentional poisonings were performed (methadone-related poisonings, and dermal exposure to organic solvents among farmers). Alternative surveillance data sources were explored (admission intake data) and alternate methods for analysis of data were developed (kth nearest neighbor (kNN) approach) and utilized (narrative text analysis) to identify new and existing risk factors for an occupational injury. Partnerships were formed and expanded that resulted in the development of interventions (bucket truck video, fuel shutoff valve prototype, and worker safety presentation) to be used as educational and engineering controls. Implemented process changes by companies included the mandated use of chains on dump trucks hauling asphalt, the prohibition of vehicle repair by truck drivers, and the mandated use of safety belts within the sleeper berth of semi trucks. Epidemiological analyses, and worker fatality reports, were used to inform public policy. A fatality report on a trucker who died when exiting an interstate off-ramp with a 0.6% blood level of cocaine was produced and distributed by the FACE program. The release of this report was brought to the attention of Kentucky state senators who proposed legislation to require an employer of any driver with a CDL who tests positive for drugs/alcohol to notify the Transportation Cabinet within five business days. FACE personnel testified before the Kentucky General Assembly's Interim Joint Committee on Transportation in 2008 and provided copies of the fatality report, three similar fatality reports, and trucking hazard alerts to members of the committee. The bill will be resubmitted in 2011. Also, KOSHS personnel contributed to the 2010 KY Strategic Highway Safety Plan through participation in the commercial vehicle emphasis area and the KY Traffic Records Advisory committee. In addition, The KY Transportation Cabinet has now mandated that concrete median barriers being constructed include emergency access points. A process, impact and outcome evaluation of major activities was performed and results showed that the KOSHS program has been effective in the population-based surveillance of traumatic injuries among workers. The system was useful, met its objectives, and had an impact on targeted industries and sectors. The epidemiological results and interventions can be utilized in the workplace for worker safety training programs. The formation of partnerships and policy development can be shared between states to reduce the burden of occupational injuries.
Injuries; Surveillance-programs; Traumatic-injuries; Mortality-rates; Morbidity-rates; Fall-protection; Workers; Safety-measures; Safety-practices; Safety-programs; Motor-vehicles; Drivers; Humans; Men; Women; Epidemiology; Farmers; Agricultural-industry; Poisons; Solvents; Exposure-levels; Skin-exposure; Risk-factors; Drugs; Training
Terry L. Bunn, Kentucky Injury Prevention and Research Center, College of Public Health, University of Kentucky, 333 Waller Ave., suite 242, Lexington, KY 40504