Analysis of working conditions focusing on biological risk: firefighters in Campo Grande, MS, Brazil

Firefighters are exposed to a wide range of risks, among them, biological risk. The objective was to analyze working conditions of firefighters in the city of Campo Grande, MS, Brazil, focusing on risk conditions of exposure to biological material. Three hundred and seven (307) firefighters were interviewed for data collection and observed for ergonomic job analysis (AET). Results: 63.5% of the firefighters suffered some kind of job related accident with blood or body fluids. Statistically significant association was found between having suffered accidents at work and incomplete use of personal protective equipment (PPE). About AET regarding the biological risks, 57.1% of all patients had blood or secretions, which corresponds in average to 16.0% of the total work time, based on a working day of 24 h. Besides biological risks, other stressing factors were identified: emergency and complexity of decision, high responsibility regarding patients and environment, and conflicts. Health promotion and accident prevention actions must be emphasized as measures to minimize these risks.     

A controlled case study of supervisor training to optimize response to injury in the food processing industry

The role of supervisors to aid injured workers, access health care, and provide reasonable accommodation may prevent prolonged disability among workers reporting musculoskeletal pain. Although supervisor training has been a common element of broad-based ergonomic interventions to prevent injuries, the impact of supervisor training alone to improve injury response has not been studied. In a controlled design, 11 supervisors in an intervention group and 12 supervisors in a delayed intervention control group from the same plant were provided a 4-hour training workshop. The workshop emphasized communication skills and ergonomic accommodation for workers reporting injuries or health concerns. Workers' compensation claims data in the 7 months before and after the workshop showed a 47% reduction in new claims and an 18% reduction in active lost-time claims versus 27% and 7%, respectively, in the control group. Improving the response of frontline supervisors to employees' work-related health and safety concerns may produce sustainable reductions in injury claims and disability costs.     

Factors affecting the organizational responses of employers to workers with injuries

The organizational responses of employers to work-related injuries is one of several significant influences on return-to-work outcomes. Thus, understanding the factors that lead to better or worse organizational responses to work injuries may ultimately help to improve success in this area. The purpose of this study was to systematically explore factors that might influence the organizational responses of employers to injured workers, based on employee perceptions. Cross-sectional survey data were collected from 2,943 subjects with work-related injuries which had occurred less than eight weeks prior to survey completion. Measured variables included pre-injury demographic and job factors, injury circumstances, and a measure of post-injury events that comprised the organizational response. Multivariate linear regression results show that age, gender, job dissatisfaction before injury, prior difficulty performing job tasks, injury severity, back injury and lost time were all associated with negative organizational responses, suggesting potential opportunities for intervention.     

Effectiveness of a screening tool to detect injuries during Army Health Care Specialist training

The purpose of this project was to evaluate the effectiveness of an initial screening and referral process in reducing the impact of musculosketetal injuries among soldiers attending Health Care Specialist training. Musculoskeletal injury among Army Health Care Specialist students have been reported to be approximately 24% for men and 24-30% for women. The highest student visit rate to the troop medical clinic for musculoskeletal injuries, for men and women, occurs during the first week of training. Anecdotal reports indicate that many students arrive for training with existing injuries or symptoms. This project was designed to assess whether formalized early screening, referral, and intervention could 1) identify arriving students who need musculoskeletal injury-related medical attention, 2) reduce the number of students receiving limited duty status during their 10-week training, 3) decrease the total number of limited duty days for students, and 4) decrease the number of students who cannot graduate due to musculoskeletal injury. Students (N=291) from one company were divided into three groups of 97 students. Three methods were used to screen and refer students for medical intervention: 1) traditional (T), 2) by health care providers (HCP), or 3) by Drill Sergeants (DS). Screening by HCP and DSs involved using a new screening tool to identify and consequently refer students with symptoms to a troop medical clinic (TMC) for early evaluation and intervention. Using the screening tool, HCPs identified 92% of students with injuries, while DSs accurately identified 80%. The screening did not reduce the number of students receiving limited duty status, total limited duty days, or the number of students that could not graduate due to musculoskeletal injury ("holdovers") (p>0.05). The screening tool demonstrated good sensitivity and specificity whether conducted by HCPs or DSs. It failed to demonstrate efficacy in reducing the impact of musculoskeletal injuries among Combat Medic soldiers, as measured by limited duty days and holdovers.     

Injury prevention in physiotherapists--a scientific review

This review targeted all research previously conducted on the topic of musculoskeletal disorders and injury among physiotherapists, with a particular focus on studies that had examined individual, physical and psychosocial risk factors and provided suggestions or recommendations to prevent such injuries. Scientific literature published in English languages was searched using electronic way. A total of 17 appropriate studies were located and examined, most of which had focused on the prevalence of musculoskeletal disorders/pan or any other injury. From the review, it was shown that major risk factors among the physiotherapist were manual therapy, repetitive movement, awkward and static posture, physical load, lifting and transferring, treating large number of patients treating in a single day, working while injured, years of experience. The preventive measures that described in these literatures were awareness of reporting of injury, use of less manual therapy, proper exercise, formulation of new devices, intervention at the level of workplace, work schedule allocation, proper training, ongoing risk assessment and control.     

Emergency department use for injuries by adolescents in foster care

Youth in foster care are overrepresented with respect to their utilization of emergency department (ED) services. This study examines the ED utilization patterns of adolescents in foster care and evaluates the characteristics of injury related versus non-injury related visits. We found that adolescents in foster care have high rates of ED use (1.84 visits per year (95% CI 1.59, 2.12)), with 31.2% of ED visits being injury-related. Male gender was found to be the only independent predictor of having an injury related vs. non-injury related ED visit (odds ratio 2.22 (95% CI 1.27–3.87)). Regarding the mechanisms of injury, adolescent youth in group homes were significantly more likely to present with injuries inflicted by themselves or by others in their residence (p < 0.05 for both) but less likely to present with accidental injuries or injuries sustained during recreation (p < 0.05 for both). Resources and interventions targeted at both youth and group home staff related to behavioral health assessment, post-traumatic coping skills and conflict management may have beneficial effects.     

Planning + practice = preparedness: a case study in injury prevention

At 5:30 p.m. on May 8, 2003, 1,200 employees were at work at the Oklahoma City, Oklahoma, General Motors Production Plant when it was hit by an F4 tornado. Although the plant sustained extensive structural damage none of the employees were injured. The plant's commitment to emergency response planning, the routine practice of those plans through drills, tests, and education, and the smooth implementation of the plan at the appropriate time helped prevent injury and potential loss of life. This case study provides an example of effective injury prevention.     

Cost-effectiveness of a prework screening program for the University of Illinois at Chicago physical plant

A post-offer screening program jointly developed by the Occupational and Physical Therapy Departments (University of Illinois at Chicago) was first implemented in March 1998. A total of 712 screens were completed from 3-01-98 through 2-28-01. A quasi-experimental design was utilized to analyze changes in Workers' Compensation costs between the three-year period prior to, and the three-year period following program inception. Additionally, injury rates and mean cost per injury were compared between injuries sustained between 3-98 and 3-01 which were incurred by workers who had passed screening and those that had not been screened. Finally, the tabulated cost per screen and reduction in Workers' Compensation costs allowed derivation of a dollar spent/ dollar saved ratio. Dramatic declines in number of injuries, total costs and mean cost per case occurred in the three-year period following program inception. Mean cost per case also dramatically declined comparing injured workers who had passed screening versus those who had never been screened. Cost savings were over US dollars 18 per dollar spent on the program. While a number of mitigating variables may have accounted for some of the profound effects noted, decrease in average cost per case (indicating possible reduction in severity of injury) was consistent with existing literature.     

A return to the worker role after injury: firefighters seriously injured on the job and the decision to return to high-risk work

This paper presents information on occupational choices and behaviors as described by the model of human occupation and the profession of occupational therapy. This project was designed to answer the research question, "Why do people choose to return to the same high-risk careers after sustaining a serious work-related injury?" Two firefighters from a New York metropolitan area were interviewed individually to explore their roles, especially the worker role, their injuries, and their decisions to return to the same high-risk type of work. The results indicate that a strong social support system from co-workers, and the motivation and enjoyment of the job were the common factors that influenced the two participants to return to their jobs.     

Domestic violence among male and female patients seeking emergency medical services

Gender differences among a cohort of injured patients seeking emergency medical services were examined with respect to their experiences as perpetrators and/or victims of domestic violence. Contextual issues, including violence initiation, emotional and behavioral responses to partner-initiated violence, and injury frequency and severity were analyzed. Women reported male partner-initiated violence more frequently than men reported female partner-initiated violence. Behavioral responses to partner initiated violence varied. Women were more likely to report using force back and to involve law enforcement. Women were more likely to be injured in a domestic assault over their lifetime, within the last year, and at the time of recruitment. Comparison of injury severity revealed that women reported higher rates of injuries than men in all possible severity categories. Women also reported experiencing more fear than men during partner-initiated violence, as well as being subjected to larger numbers of dominating and controlling behaviors, and greater intimidation secondary to their partner's size. Understanding contextual differences in partner violence for women and men has significant implications for policy development, identification, treatment, and referral of patients identified as living in violent relationships.     

Cold-related injuries in a cohort of homeless adults

People experiencing homelessness have an increased risk of cold-related injuries. This study determined the rate of emergency department (ED) visits for cold-related injuries among homeless adults and low-income controls in Toronto, Canada. Homeless individuals were recruited at shelters and meal programs. Age- and sex-matched controls living in low-income neighborhoods were selected. ED utilization was ascertained over 4-years of follow-up (2005–9) using administrative databases. A total of 16 ED visits for cold-related injuries were observed among 587 homeless men and 296 homeless women. The rate of ED visits was 6.7 (95% CI, 4.2–12.4) per 1000 person-years of observation among homeless men and 0.9 (95% CI, 0.03–5.6) among homeless women. ED visit rates were significantly higher among homeless men compared to low-income men (P?<?0.001) and significantly higher among homeless men compared to homeless women (P?=?0.03). Targeted public health interventions are needed to reduce the risk of cold-related injuries among people experiencing homelessness.     

The acquisition of tacts,mands, and intraverbals by individuals with traumatic brain injury

Two individuals who sustained traumatic brain injuries from motorcycle accidents were taught several verbal responses by using tact, mand, and intraverbal training procedures. The rate of acquisition for each operant and the transfer to untrained verbal operants involving the same response topography were measured. The results showed that tacts and intraverbals were acquired quickest, and training on the tact produced the greatest amount of transfer to the untrained verbal operants. Intraverbal training also resulted in transfer for both subjects, but to varying degrees. Direct mand training proved to be the least efficient way to generate a mand repertoire, and when acquired showed least amount of transfer to the untrained operants. These results seem to be in contrast with the findings of similar research with developmentally disabled individuals, and may have implications for methods of language instruction for the brain injured population.

     

Moving targets: bicycle-related injuries and helmet use among university students.

We conducted a cross-sectional study to evaluate bicycling habits and helmet use in a sample of university students in a southwestern state university. Thirty-one of 100 students in our sample owned bicycle helmets; of these, 17 (54.8%) wore helmets during most (more than three fourths) of their bicycle trips. Almost half of the students reported that more than 25% of their bicycling was done in heavy traffic but they rarely used bicycle trails. Sixty-five students in the sample had sustained at least one minor injury during the previous 5 years, and 18 had been hospitalized as a result of bicycle-related injuries. We found no substantial differences between male and female subjects in bicycle-related hospitalizations, although male subjects were more likely to sustain minor injuries than were females. Helmet ownership was most strongly associated with previous injury experience, especially hospitalization resulting from bicycling injuries (OR = 3.6; 95% CI = 1.3, 10.1). We also observed an association between helmet ownership and possession of insurance coverage for bicycling injuries (OR = 3.0; 95% CI = 1.2, 7.6). Ethnicity was a factor in helmet ownership--helmets were owned by 26 of 69 (37.7%) of non-Hispanic whites, in contrast to 1 of 24 (4.2%) of all other ethnic groups combined. Our survey data suggest that perceived risk is an important factor in bicyclists' use of safety helmets.     

Visits to the college health service for alcohol-related injuries

A study of alcohol-related injuries presenting to the local emergency room and the campus health service indicated an annualized rate of 25.16 injuries per thousand students. Twenty-four percent of injuries presenting to the emergency room were assessed as alcohol-related; another 6% were listed as being "suspected." Less than 4% of the injuries presenting to the campus health service were assessed as alcohol-related, and a similar number were listed as "suspected." Males had a significantly higher rate of alcohol-related injuries than females, and undergraduates had a higher rate than graduate students. Differences among the undergraduate classes were not significant. An investigation of the time of presentation indicated that most alcohol-related injuries occurred after hours and on weekends.     

Average cost per person victimized by an intimate partner of the opposite gender: a comparison of men and women

Differences in prevalence, injury, and utilization of services between female and male victims of intimate partner violence (IPV) have been noted. However, there are no studies indicating approximate costs of men's IPV victimization. This study explored gender differences in service utilization for physical IPV injuries and average cost per person victimized by an intimate partner of the opposite gender. Significantly more women than men reported physical IPV victimization and related injuries. A greater proportion of women than men reported seeking mental health services and reported more visits on average in response to physical IPV victimization. Women were more likely than men to report using emergency department, inpatient hospital, and physician services, and were more likely than men to take time off from work and from childcare or household duties because of their injuries. The total average per person cost for women experiencing at least one physical IPV victimization was more than twice the average per person cost for men.     

Worker perceptions of organizational support and return-to-work policy: associations with post-injury job satisfaction

This study evaluates the psychometric properties of an industry-based employee measure of employer responses to injuries (i.e., organizational support and return-to-work policies) and explores the relationship of these variables to post-injury job satisfaction. Survey data were collected from 1438 employees with work-related injuries in 13 construction companies and 13 transportation companies. Factor analyses supported the two-factor structure of the scale, and both organizational support and return-to-work policies were independently associated with post-injury job satisfaction. The results suggest a need for understanding organizational responses to injuries, employee perceptions of injury response, and the impact of both on organizational outcomes.     

Employment Breaks,Pay, and Career Development among Australian Women

Career breaks may be associated with women’s relatively poorer pay and promotion prospects. To test this and other hypotheses, a sample of Australian women was asked to review their lives as paid and unpaid workers. About half of the women reported that they were currently working at the same skill level as in their first job, a quarter had improved, while about 20% were currently in lower-skilled work than in their first job. Tertiary education and further education after first entering the labour force is associated with continuing to work at the same skill level after a break. Breaks from working were found to last typically for up to one year and were thus unlikely to account for a sustained skill loss. Women’s responsibilities for household tasks rose during breaks, and persisted at a higher level after the return to work. Different models are appropriate for the analysis of earnings of continuous workers and those with breaks. There appear to be no relative pay penalties for broken work experience for the highly educated or those in highly skilled jobs. Continuous workers in ‘women’s’ occupations receive a higher return than others to their human capital.     

Posttraumatic stress disorder (PTSD) symptoms among firefighters: Roles of resilience and locus of control

Firefighting is a an extremely stressful occupation that risks exposure to traumatic events as part of the job. Despite this, the literature on stress and trauma pays little attention to this occupation and its generalization to other, high risk occupations. This study examined resilience and work locus of control as predictors of posttraumatic stress disorder (PTSD) symptoms among Nigerian firefighters. Participants were 116 paid, professional firefighters (98 males and 18 females) who completed the Post-Traumatic Stress Disorder Checklist-Civilian Version (PCL-C), Resilience Scale (RS-14), and Work Locus of Control Scale (WLCS) and provided vital demographic information. Multiple regression analysis was used to analyze the data. Results showed that resilience negatively predicted PTSD symptoms such that higher resilience was associated with fewer symptoms of PTSD. Work locus of control was a positive predictor of PTSD symptoms, indicating that externality of control beliefs in the workplace was associated with more PTSD symptoms. Relevant demographic factors especially higher years of service, being a senior firefighter, and higher educational status were associated with lower PTSD symptoms. Findings underscore the potential value of resilience training and implementing behavioral health programs to modify firefighters’ external locus of control beliefs. Interventions should consider resilience and locus of control focused interventions as protective factors for PTSD.     

Participatory ergonomics: determining injury control "buy-in" of US Army cadre

Overuse injuries account for the majority of lost duty time profiles for soldiers attending Advanced Individual Training (AIT) to become a Combat Medic at Ft. Sam Houston (63% for men and 74% for women). An intervention program was initiated with two AIT Battalions (BN) in an effort to reduce overuse injuries. The purpose of this paper is to describe methods of tracking the participation of supervisors during the intervention program. Methods used to monitor participation included recording the number of coordinating meetings, keeping minutes of advisory committee meetings, and conducting perception surveys. Over an 18-month period, the number of coordinating meetings decreased. Surveys identified the opinions, values, and self-identified roles of supervisors (drill sergeants and cadre) in regard to injury prevention with their assigned student-soldiers before and after an intervention program. At the initiation of the injury control program, 103 individuals completed a 27 question, anonymous survey to assist planners with developing a strategy that would encourage participation of cadre and drill sergeants in preventing injuries. One year later, 191 individuals from the same battalion completed the same survey. Results revealed a slight, statistically insignificant, decrease in supervisors' perception of the presence of overuse injuries in their BN (31.4% vs. 27.4%, p>0.05), and the level of acceptable injuries moved from the 16-30% range to the 1-10% range (chi2=4.65, p<0.05). Post-intervention, more supervisors believed their physical training programs could impact overuse injuries (pre 20.4% vs. post 31.6%, Chi2=6.7, p<0.01). The results reveal several methods to track the involvement of participants, to develop intervention strategies, and to monitor cultural shifts necessary to the injury control process.     

The impact of involuntary job loss on those disabled by society: a pilot study to encourage effective participation

Over half of the people who become disabled whilst employed are thought to be pressured into leaving their job. This study investigates the experience of involuntary retirement/redundancy due to disability. Three researchers who had all experienced such involuntary job loss were trained to conduct the research. Semi-structured interviews were designed and conducted by disabled researchers. The training of the researchers enabled them to successfully conduct a research project. The results of the project show the impact of involuntary job loss due to disability to be considerable. This study would suggest that government reforms to create new opportunities for disabled people of a working age are well overdue. Although there were some problems experienced with the amount of training required and the lack of objectivity, training disabled researchers to conduct research proved to be a valuable experience for both the researchers and the facilitators.